African research teams and the development of scientific evidence to inform public health strategies ; the example of malaria and the Médecins de Campagne program

Abstract

Socio-sanitary development is a dynamic adaptive process to macro-economic, micro-economic, socio-cultural, technological and climate change conditions. Public health and healthcare strategies are increasingly based on scientific evidence. The ability of African research teams to make a significant contribution to this evidence base and "think differently" about their development is one of the major challenges of the ^21st century. The training of national skills and their harmonious professional integration, with a career plan in their countries of origin, are essential for the creation of a critical mass capable of making a significant impact. Mali and its partners have made this choice in the field of medical training and the development of health research capacity at the Ecole Nationale de Médecine et de Pharmacie and the University of Bamako. The creation of the Malaria Research and Training Center, within the Department of Epidemiology of Parasitic Affections at the Faculty of Medicine, is part of this dynamic. A team of talented young Malians has been trained in Mali, Africa, France, Italy, the UK and the USA. They are working on malaria to help African countries in the process of eliminating it. With the structural adjustment of 1988 and the non-recruitment of doctors/pharmacists into the civil service, the teaching staff of the Faculty of Medicine and the French NGO Santé Sud (based in Marseille) developed, with the government of the Republic of Mali and its development partners, an innovative medicalization of rural areas with young, motivated and entrepreneurial doctors: the "Médecins de Campagne". MRTC works with the network of MCs on epidemiological surveillance of antimalarial drug resistance and case management, to inform the National Malaria Control Program. With an international scientific output, the results of the MRTC and its partners, published in high impact journals, contribute significantly to the implementation of malaria control/elimination strategies in Sahelian countries. These WHO-recommended strategies are helping our countries to scale up malaria control/elimination programs in Africa's Sahelian-Saharan countries, and are having a significant impact on health status.

Ogobara Doumbo

Professor of Parasitology-Mycology and Director of the MRTC and holder of the Drs Mérieux Chair of the Academies 2013. Son and grandson of a Dogon traditional practitioner, Professor Ogobara K. Doumbo studied medicine in Mali. He then served as a rural doctor with surgical skills, before completing his specialist training in France and the USA. On his return to Mali, he and his Malian and NIAID/NIH colleagues set up the MRTC, with the support of the Malian government, NIAID/NIH, TDR/WHO, the Rockefeller Foundation, French and Italian cooperation and USAID. It has trained 5 successive generations of young Malians in France, the UK and the USA to PhD level, with a 95% return on investment. Today, these young people form the backbone of the MRTC team at the University of Bamako. The MRTC is a Pôle d'Excellence of the AUF, FMérieux and NIAID/NIH, and with over 300 Impact Factor publications contributes to strategies for combating malaria. It is regarded as one of Africa's "success stories" in developing research capacity and maintaining researchers in their own countries.