TDR Ten Year Strategy endorsed by JCB

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					             Special Programme for Research & Training
             in Tropical Diseases (TDR) sponsored by
             U N I C E F / U N D P / W o r l d B a n k / W H O

30th anniversary
of the Joint
Coordinating Board

TDR Ten Year Strategy
     endorsed by JCB
                                  PAGE 6
    No78      S U PPLEMENT • Special JCB

           Anniversary message from
           the Director of TDR
                                                                       dan Mahler. I have had the privilege of meeting with,
                                                                       and hearing, Dr Mahler on several occasions and have
                                                                       observed how, when he relates to WHO’s mission and
                                                                       goals in the world today, he often refers back to early,
                                                                       basic documents and decisions — such as the WHO

                                                                       We in TDR have a chance in a historical moment like
                                                                       this one to reflect on our own foundations, upon the
                                                                       essential principles that drive us, that make us unique,
                                                                       and can also propel us forward.

                                                                       Many of these principles are underlined in TDR’s gover-

                                                                       nance structures. From the beginning TDR was unique,
           It was a great honour for me, as TDR’s present director,    almost revolutionary (to use 1970s language), in the
           to participate in convening the 30th anniversary cel-       equal mix of so-called ‘donor’ and ‘recipient’ govern-
           ebrations of the JCB — including such a broad range         ments that it brought to the table. The programme also
           of former directors and staff, partners and collabora-      brought together diverse UN and development agen-
           tors. Many of the meeting participants have led the         cies — UNDP, the World Bank and WHO — joined more
           management and governance of the programme over             recently by UNICEF. Through the structure of TDR’s Joint
           its critical years of infancy and maturity. But they will   Coordinating Board as well as the Scientific and Tech-
           be the first to admit that it is through the efforts of     nical Advisory Committee (STAC), scientific working
           thousands of others, contributing as investigators,         groups and steering committees, TDR set a precedent
           committee members and advisers, that TDR’s impact           by seeking equality between developed and develop-
           on research and disease control history over 30 years       ing countries in the determination of research priorities,
           has been, and continues to be, so significant.              definition of tasks and their implementation.

           A summary of TDR’s history has been prepared in cel-        The success of these formulas is evident not only in
           ebration of TDR’s 30 years. Some brief excerpts of your     TDR’s work, but in the fact that elements of this gov-
           comments and remarks, thoughts and reflections about        ernance have been copied by other organizations such
           TDR’s history past and present are gathered together        as UNAIDS. The collaborative model epitomized by TDR
           here in these supplement pages, while full texts are        is of enduring value today in an era when coordination
           available on the special anniversary pages of the TDR       between UN agencies and between the UN and other
           website:                                    public and private organisations is so important.

           I have been associated with TDR myself, in one way or       But what about the future of TDR? Our new TDR Ten Year
           another, since 1988, when I first began serving on ex-      Strategy, endorsed at the JCB 30th session, while reflect-
                                                                       ing today’s needs and realities, builds on TDR’s historic
           pert committees related to malaria vaccine develop-
                                                                       principles. The new strategy reinforces essential gover-
           ment. The programme then was just completing its
                                                                       nance principles, grounded in the need to transparently
           first decade; but the thing that impressed me from the
                                                                       and equitably improve international public health, and
           start was the fact that research in TDR had a clear focus
                                                                       builds upon them further. Through our new strategic
           and purpose — to reduce disease burden, to make a dif-
                                                                       emphasis on stewardship, we lay the foundation for even
                                                                       closer consultations and coordination with our four co-
                                                                       sponsoring agencies, which all made statements at JCB
           One of our most noted guest speakers at the JCB 30th        30, and spoke about their continuing commitment to
           anniversary was former WHO Director-General Half-           TDR.
S U P P L E M E NT • Special JCB                                                                              No78

Our new strategic emphasis on ‘empowerment’ en-              NEW STRATEGY
gages developing countries even more profoundly as
stakeholders, owners and leaders of TDR’s operations.        Expanded TDR role in stewardship
This involves two aspects: the fostering of disease en-      and empowerment of research
demic country leadership in research and even deeper         on diseases of poverty
involvement of developing countries in TDR’s gover-          JCB approves new
nance structures.                                            TDR Ten Year Strategy                       6

Within TDR, we can see the shift already taking place.
More developing countries are opting to become re-
source contributors to the Special Programme and sev-
                                                             Excerpts from presentations
eral generations of highly trained and internationally
renowned researchers are emerging in the South, as
                                                             at the 30th Session of the JCB
well as the North. This is generating a new and emerg-
ing equality in terms of policy, practice and know-how                                                        3
about engagement in health research.
                                                                           Dr Margaret Chan,
                                                                           WHO Director-General          4
Of course, there is still a tremendous way to go to fully
realize the promise of this international activity, capac-
ity and knowledge. We need to address the new and
re-emerging diseases that have become a threat over
the past decades, and sustain the control and elimi-
nation of TDR’s originally targeted diseases, for which
there have been numerous research-led disease control
                                                             UNICEF, UNDP, World Bank Co-sponsors        9
advances over the years. There are new opportunities
that can be further enhanced through the increased
commitment and funding of research by countries and
                                                                           Opening addresses             10
In the wake of the JCB 30th anniversary, and looking
forward to the next 10 years, TDR is poised to build on
its past and make a major difference to global research,
to global health, and through that, to global develop-
ment.                                                                      Closing addresses             11

                                                                                        Former WHO and
                                                                                        TDR leadership   13

Dr Robert G Ridley,
TDR Director
                                                                           Brazil offers to host
                                                                           JCB 31 in June 2008           16
    No78      S U PPLEMENT • Special JCB

           Celebrating 30 years
           Excerpts from presentations at the 30th Session
           of the Joint Coordinating Board, 19-21 June 2007

           Dr Margaret Chan                                             system. … Unless we make some radical changes in the
                                                                        way we deliver services to the poor, we will not achieve
           Director-General of WHO                                      our international commitments.
           Full text version available at:                              We know the lessons from decades of experience: build

                                                                        national capacity, and promote local ownership and
           en/index.html                                                community engagement. We need to make local priori-

                                                                        ties, local conditions, and the local expertise of scientists
                                                                        our point of departure. We know that demand-led initia-
                  We are about to launch a new vision and strategy      tives have the greatest chance of sustainable success.
           for TDR. I believe the ambitions TDR have set ad-
                                                                        And so firmly acknowledged in the new (TDR) strategy,
           dress some of the most pressing needs in public health
                                                                        health leaders in endemic countries know best what
                                                                        they need most. And they know what works in their
           Since its inception, TDR has always been concerned           countries.
           with the neglected needs of neglected populations. It has
                                                                        It is good to see that TDR will continue to engage in
           always brought the power of rigorous scientific investi-
                                                                        product development for the most neglected diseases,
           gation to bear on the infectious diseases of the poor.
                                                                        like the helminths, that are not being addressed by oth-
           In my address to the Health Assembly last month, I de-       ers.
           scribed the complexities of the public health landscape
           and the challenges they present for WHO and its many         Countries also want support for implementation. The
           partners. Unprecedented commitment has been accom-           new directions for TDR will increase our ability to at-
           panied by a surge of new initiatives and innovative fund-    tack, on multiple fronts, some very long-standing and
           ing mechanisms and a rapid growth of public-private          seemingly intractable problems. I mean here our abil-
           partnerships. These partnerships include new models          ity to… scale up show-case pilot projects to reach large
           for conducting R&D for product development. As we            populations; to improve access to existing interventions
           know, some of these models were nurtured by TDR.             or reach the poor on an adequate scale.

           While these are certainly welcome trends, they have also     I also mean our ability to address multiple health needs
           introduced some problems. The field is crowded. There        in a cost-effective, integrated way. All of you will know
           are more actors in health than in any other sector. Roles    that the points I am stressing pertain to elements in the
           and responsibilities are blurred, as are lines of account-   new vision and strategy. The new ambitions fixed for this
           ability. Who is in charge — countries or donors?             Programme greatly expand the portfolio of strategies be-
                                                                        ing pursued in our collected efforts to improve health
           We have seen a burst of interest, and a burst of activity.   and alleviate poverty. They help round out the picture.
           But what is the impact on health outcomes? Are we clos-      We are closing in.
           ing the gaps, especially among the poor?
                                                                        The new vision and strategy give TDR a more strategic
           Here is the catch: if we want better health to work as a     role, and allow a more holistic approach. These are very
           poverty-reduction strategy, we must reach the poor. This     welcome attributes in the complex landscape of public
           is the acid test, and this is where we are failing.          health. We greatly need coordination, cohesion and co-
           The poor are traditionally the hardest group to reach.       herence. We need stewardship for an effective global ef-
           They tend to live in remote rural areas or urban shanty      fort. And we need to enable endemic countries to take
           towns that are beyond the reach of the formal health         the leadership role in this effort.
S U P P L E M E NT • Special JCB                                                                                                      No78


In line with the strategy, I believe we must      Dr Margaret Chan, WHO Director-        sis being given to implementation re-
build on what exists, but not by doing the        General, at the opening JCB            search, especially for large-scale disease
                                                  session, flanked by TDR Director,
same old things in the same old ways. I am                                               control. TDR will be looking for inno-
                                                  Dr Robert Ridley, on left, Dr Anarfi
personally very glad to see TDR move into         Asamoa-Baah, Deputy
                                                                                         vative ways of getting new and existing
new territory. These are the hard tasks, but it   Director-General WHO behind            interventions to populations who have
is absolutely vital that they be addressed.       her, and on right, former WHO          poor geographical or economic access
                                                  Director-General, Halfdan Mahler       to services.
We must be smart in the way we respond to         and outgoing JCB Chairman Dr
increased commitment and resources. I wel-        Bijan Sadrizadeh.                 TDR will also be strengthening its tra-
come the initial focus on community-based                                           ditional work on training and capacity
interventions and strategies. Since inadequate delivery            building. One unfortunate consequence of the surge of
systems are a key bottleneck, it is smart to deliver pack-         international interest in health is this: scientists in dis-
ages of interventions, and to use established systems to           ease endemic countries are being left behind in global
do so. It is smart to build on what works well in difficult        research planning and priority setting. We must not
situations. TDR is doing this with APOC (the African               allow this to happen … actually engaging scientists in
Programme on Onchocerciasis Control), which is reach-              endemic countries in product development is likely to
ing 60 million people. Integrated delivery of multiple             bring the most rewarding results for all concerned.
interventions is a value-added approach that brings
                                                                   Ladies and gentlemen, the strategy calls on TDR to
multiple benefits for health.
                                                                   strengthen its strategic links with co-sponsoring agen-
But we need an evidence-based understanding of which               cies, and most especially with WHO. I warmly welcome
combination of tasks can be effectively integrated, and            this move. TDR’s experience and expertise make a vital
of how community empowerment can be sustained. If                  contribution as WHO develops its health research strat-
we want initiatives to be demand-led, we must pick the             egy and supports the Intergovernmental Working Group
right entry point. TDR is doing this with malaria. It is           on Public Health, Innovation and Intellectual Property.
smart to integrate the clinical management of people co-
                                                                   The tasks mapped out for TDR over the coming years are
infected with diseases long addressed by single initia-
                                                                   not easy, but they are absolutely vital to our goals and
tives. TDR is gathering evidence for treatment policy for
                                                                   our prospects for long-term success. These new func-
TB and HIV co-infection, focusing on national control
                                                                   tions, if performed well, will greatly increase our chanc-
programmes at the primary care level.

                                                                   es of making life better for the world’s huge population
These are just some of the «hot topics» set out in the             of neglected people with neglected health needs. I wish
new strategy. I warmly welcome the major new empha-                you every success.
    No78      S U PPLEMENT • Special JCB

           Expanded role in stewardship and empowerment of
           research on neglected diseases of poverty

           JCB approves new TDR
           Ten Year Strategy
           In a 30-year anniversary session, TDR’s Joint Coordinating Board (JCB) endorsed a new strategy that
           strengthens and expands TDR’s focus on prevention and control of ‘infectious diseases of poverty.’ The
           strategy builds upon TDR’s substantial record in developing drugs, delivery strategies and research ca-
           pacity in countries where parasitic tropical diseases are endemic. The new plan, however, also addresses
           some of the new and emerging infectious disease challenges facing developing countries, such as TB-HIV
           co-infection, sexually transmitted infections, and dengue virus.

           Over the coming decade, TDR will focus on address-          dedicated to health research in the developing world,
           ing key bottlenecks or gaps in getting health care treat-   “to foster an effective research effort on infectious dis-
           ments to poor and remote populations, and fostering         eases of poverty in which disease-endemic countries
           research and policy leadership in disease endemic           play a pivotal role.”
           countries, as part of its new Ten Year Strategy, unani-
                                                                       “If we want better health to work as a poverty reduc-
           mously approved by the JCB following 3 days of meet-
                                                                       tion strategy, we must reach the poor. This is the acid
           ings (June 19-21).
                                                                       test,” said WHO Director General Dr Margaret Chan,
           The strategy and vision, developed over the past year,      speaking at the JCB’s opening session. “I am very glad
           calls on TDR, one of the major UN-based programmes          to see TDR move into this new territory.”
S U P P L E M E NT • Special JCB                                                                                             No78

JCB pays tribute to TDR’s successful
past                                                            “To foster an effective global research
                                                                effort on infectious diseases of poverty
Over the past three decades, TDR research paved the             in which disease endemic countries play

way for the control of leprosy, onchocerciasis (river
blindness), Chagas disease, lymphatic filariasis and vis-
                                                                a pivotal role is TDR’s new vision.
ceral leishmaniasis, the Director-General noted. These
five neglected tropical diseases, which previously killed
or disabled millions of people every year, are now target-
ed for global or regional elimination, “largely as a result
                                                                ers and experts in disease control globally, particularly
of tools and strategies developed through TDR-coordi-
                                                                those from disease-endemic countries, we identify key
nated activities.”
                                                                disease control problems or gaps that research needs to
TDR also sponsored the first large-scale field trials of in-    address. We sponsor that research in partnerships, lead-
secticide-impregnated bednets in the mid-1990s, dem-            ing to evidence-based solutions that can be taken up by
onstrating their life-saving value in malaria control.          health ministries, global health agencies and disease-con-
                                                                trol officials.”
Implementation research expanding                               Research on how to implement is critical to WHO’s
Under the new strategy, TDR’s field research experience         broader goal of improving access to critical health-saving
and networks will be harnessed to address one of the            medications and tools. “TDR’s experience offers some of
biggest challenges faced by the global health commu-            the best models for doing that — and in the long term,
nity: access to primary health treatments for poor peo-         investment in that kind of research saves time and mon-
ple. Implementation research — research to investigate          ey,” said new JCB chairman Dr Rolf Korte, a senior health
how best to use health tools and drugs more effectively         policy advisor at the German-based GTZ, and a represen-

in communities and health systems — has traditionally           tative of the Government of Germany. Korte was elected
been a cornerstone of TDR’s work.                               at the meeting to replace outgoing JCB chairman, Dr Bijan
                                                                Sadrizadeh, Senior Adviser to the Minister of Health and
Chan cited TDR’s model for community-directed treat-
                                                                Medical Education, in the Islamic Republic of Iran.
ment with ivermectin for onchocerciasis as one of the
models for how research can improve health access.
Community-directed treatment has become the back-               ‘Stewardship’ and ‘Empowerment’
bone for control strategies in remote, rural African
                                                                central to the strategy
communities facing a shortage of formal health care
services. Community-directed treatment systems now              The JCB endorsement followed endorsement of the pro-
cover 60 million Africans, and by 2010 will cover some          posed strategy by TDR’s Scientific and Technical Adviso-
100 million people, nearly one-sixth of the sub-Saharan         ry Committee (STAC) at its annual meeting in February.
population. The onchocerciasis control effort has been          STAC and JCB also reviewed details of the 11 new “busi-
described as “one of the most triumphant public health          ness lines” being developed to make the new strategy
campaigns ever waged in the developing world” (UNES-            operational. These include business lines designed to
CO, 2005).                                                      reinforce TDR’s role in ‘stewardship’ for global research
Now, TDR is supporting African scientists to explore            activities and promote ‘empowerment’ of developing
how community-directed systems could be used to de-             country research leadership on neglected priorities.
liver other essential primary health care interventions         The stewardship business line will engage broad-based
that are still underutilized — such as insecticide-treated      groupings of stakeholders to evaluate and propose new
bednets, home-based malaria treatment, TB diagnosis             research directions for diseases and thematic areas —
and treatment, and Vitamin A supplements.                       moving dialogue beyond expert-only arenas. However,
“TDR-supported research has made a difference because           experts also will be engaged continuously in virtual web-
of a long-term commitment from countries and donors             based discussions as part of “disease reference groups”
to research as a critical factor in disease control,” said Dr   and “thematic reference groups” so that the most up-to-
Robert Ridley, Director of TDR. “Together with research-        date research issues are continually being assessed.
    No78       S U PPLEMENT • Special JCB

           A web-based knowledge management platform, Trop-                             official JCB observer governments and agencies partici-
 , also is being developed with several partners,                      pated.
           along with a new publications series on trends and de-
                                                                                        A range of dignitaries attended and gave addresses com-
           velopments in tropical diseases.
                                                                                        memorating the 30th anniversary. These included the
           The ‘Empowerment’ business line aims to build leader-                        Health Minister of Ghana, Major Courage Quashigah
           ship at individual, institutional and national levels so                     (Rtd), and the Minister of Health and Medical Education
           that countries can better initiate research activities, de-                  of the Islamic Republic of Iran, Dr Kamran Lankarani,
           velop a stronger international health research presence                      guests of honor at the opening and closing ceremonies
           and effectively use research to inform policy.                               respectively. Also attending were the ambassadors of
                                                                                        Thailand and Luxembourg to the United Nations Office
           Neglected priority needs                                                     in Geneva, and senior officials or diplomatic envoys of
                                                                                        the Governments of Brazil, India, Mali, and Nigeria. Two
           Research on neglected priority needs is the focus of a                       former TDR directors, Dr Adetokunbo Lucas and Dr
           series of business lines that cover topics such as: treat-                   Carlos Morel, made remarks, along with former WHO
           ment for TB/HIV co-infections; development/evaluation                        Director-General, Dr Halfdan Mahler, and former WHO
           of quality-assured diagnostics, particularly for remote                      Assistant Directors General, Mr Warren Furth and Dr
           locales; and expansion of drug discovery networks with                       Stanislas Flache. Also present was a representative of the
           public and industry partners to accelerate the identifica-                   Mectizan (ivermectin) Donation Program.
           tion of potential new drug leads for diseases receiving
                                                                                        Mahler, who helped lead the creation of TDR in the
           insufficient focus from private sector R&D.
                                                                                        1970s while WHO Director-General, told the JCB: “As
           Business lines also address: innovation for product                          WHO prepares to write the history of its first 60 years,
           development in disease-endemic countries; innova-                            any chapter on tropical diseases would highlight the im-
           tive vector control; new drugs for helminth infections                       mense contribution of TDR. It is my conviction that new
           (e.g. lymphatic filariasis, onchocerciasis and schistoso-                    WHO Director-General Dr Margaret Chan can benefit
          miasis); evidence for antimalarial policy and scale-up                       enormously from TDR’s input into her commitment to
           of management tools; and research to support visceral                        improving health in Africa in the coming decades.”
           leishmaniasis elimination. A business line on integrat-
           ed community-based health interventions will take the                        * Excerpts of JCB anniversary speeches and
           community-directed treatment model for onchocerciasis                        remarks on following pages.
           forward and examine other applications.
                                                                                            Link to WHO Press release on new TDR Strategy and Strategy full
           Gathered for the JCB anniversary session and strategy
           endorsement were JCB members representing TDR’s
           four cosponsors — UNDP, UNICEF the World Bank and
                                                                                          Contact: Jamie Guth
           WHO — as well as 30 governments of developed and                   
           developing countries. In addition, 21 representatives of

           Outgoing JCB Chairman Dr Bijan Sadrizadeh hands over the chairmanship to Professor Rolf Korte, elected at the JCB 30 meeting.
S U P P L E M E NT • Special JCB                                                                                    No78

Co-sponsors addresses
Mr Kul Gautam                                                                 Mrs Joy Phumaphi
Assistant Secretary-General                                                   Vice President and Head,
of the United Nations and                                                     Human Development
Deputy Executive Director of                                                  Network, the World Bank
the United Nations Children’s                                                 (in videotaped presentation)
(in videotaped presentation)

“       UNICEF’s work has ben-
efited greatly from TDR’s research.
TDR sponsored the largest field
trials ever on insecticide-treated
bednets. TDR also contributed to
                                        ACT therapy as their official
                                        policy. We commend TDR for
                                        its new strategy… This strategy
the development of ACTs (artemis-       with detailed deliverables, time-
inin-combination therapies).            lines and partnerships, provides a

UNICEF is today the largest             solid roadmap for TDR as it enters


purchaser of bednets in the             its fourth decade of operations.
world, 25 million in 2006. And          You can count on UNICEF’s sup-                I would like to assure you
68 countries today have adopted         port.                                 of the World Bank’s commit-
                                                                              ment to TDR and to the excellent
                                                                              work you have been doing with
                                                                              partners in developing countries.
                                                                              We have been a cosponsor of TDR
                                                                              since its inception in 1977. From
                                                                              1981 until the present we have
Mr Julian Fleet                         low- and middle-income countries      contributed US$ 82 million to
Chief, HIV/AIDS Liaison Unit,           and in contributing to numerous       its programmes. We see TDR as
UNDP Office in Geneva, on               scientific, technical and educa-      critical to responding to the needs
behalf of Mr Kermal Dervis,             tional partnerships. We in UNDP       of the global development agenda,
Administrator of the United             are particularly pleased that TDR     not only to attain the Millennium
Nations Development                     and our Southern African Capacity     Development Goals, but to assure
Programme                               Initiative (SACI) have teamed up      sustainable development. We see
                                        to help build and strengthen op-      research and development as being
                                        erational research capacity within    critical to building the capacity
                                        national programmes in sub-           of developing countries to inform
                                        Saharan Africa, with the aim of       not only the health agenda, but
                                        improving the delivery and uptake     also the development agenda and
                                        of treatment for HIV and oppor-       the agenda of the social determi-
                                        tunistic infections including TB,     nants of health... We have a global
                                        as well as promoting a “research      network that has been created
                                        ethos” within the public health       by TDR which has proven to be
                                        systems. As a founder and long        absolutely critical to informing
                                        standing co-sponsor, UNDP re-         evidence-based integration of
                                        mains engaged in TDR. TDR is an

                                                                              research findings into the agen-
                                        early example of the kind of global   das of developing countries. …
                                        partnership for development           We are extremely delighted and
        UNDP wishes to join the         envisaged in Millennium Develop-      hopeful that the agenda of TDR
other co-sponsors in commending         ment Goal 8, helping to develop       will continue to support these
TDR for its important accomplish-       the research capacity and research

                                                                              principles, and contribute to focus
ments over the last 30 years to         leadership which help make avail-     on capacity building and imple-
combat major neglected diseases         able new technologies to control      mentation.

of the poor. We would like to draw      disease, improve health and, in
particular attention to TDR’s key       turn, advance overall economic
role in nurturing local scientists in   and social development.
     No78      S U PPLEMENT • Special JCB

            Dr David Heymann                                                               past while recognizing the need
                                                                                           to adapt to the future. WHO pro-
            Assistant Director-General
                                                                                           vides a bridge and a link for TDR
            for Communicable
                                                                                           to work effectively within coun-
            Diseases; Representative
                                                                                           tries and with national institu-
            of the Director-General for
                                                                                           tions, and an incredible source of
            Pandemic Influenza and Polio
                                                                                           knowledge and outreach on what
            Eradication, and TDR Special
                                                                                           problems need to be addressed
            Programme coordinator
                                                                                           from a disease control perspec-

                                                                                           tive as well as on debates around
                                                                                           policy development. By enabling
                   I am looking forward to          port researchers and governments       TDR to operate as a broad-based
            working closely with TDR to             in disease-endemic countries so        co-sponsored research programme
            develop and implement the new           that they can play a pivotal role      within WHO, closely aligned to
            strategy, building on its strong his-   in setting research priorities and     disease control and development
            tory of discovery research, product     agendas and conducting research.       needs, we seek to build on WHO’s
            development and clinical studies,       We believe this is what is needed      and TDR’s strengths to assist the
            and strengthening of research           to make a long-term health impact

                                                                                           development of innovation and
            capabilities in disease endemic         that is sustainable from within        evidence-based policy and ac-
            countries. This new strategy is a       and contributes to improved            tion.
            bold approach to be a convener on       health, poverty alleviation and real
            health research issues, and to more     economic growth. TDR’s future is
            strongly and strategically sup-         building on the successes of the


            Opening addresses
            Governments that have hosted JCB sessions

                                                                                           the TDR for their contribution
                                                                                           to the current vibrant leadership
                                                                                           in health research that is emerg-
                                                                                           ing in countries such as Ghana
                                                                                           and other African countries. For
                                                                                           me this is clear evidence of the
                                                                                           focus on capacity building that
                                                                                           has characterized the partnership
                                                                                           between the TDR and developing
                                                                                           countries. I believe that the new
                                                                                           vision and strategy will further
                                                                                           seek to deepen this partnership
                                                                                           for the benefit of our people,
                                                                                           especially the poor and disadvan-
                                                                                           taged. The link between health
                                                                                           research and the development of
            Major Courage Quashigah (Rtd)                                                  health policy, planning and service
                                                                                           delivery will remain critical to our
            Minister of Health of Ghana                                                    developmental efforts, and so we

                                                                                           have also committed to increasing
                                                    control of some of these diseases      investments in health research,
                   We in the developing             can be traced to the support of-       with emphasis on health systems
            world have over the last 30 years       fered to our scientists and research   improvement, policy formulation,
            benefited from the constructive         institutions in the development of     human resource development
            partnership with the TDR in our         realistic interventions and innova-    and enhancement of indigenous

            fight against endemic diseases.         tions, some of which have helped       initiatives in health industry with
            Indeed many of the advances we          us shape our health policies over      increasing south-south coopera-
            have made in the management and         the years. I am also grateful to       tion and networking.
S U P P L E M E NT • Special JCB                                                                                                      No78

                                      Dr Sihasak                              Mr Vijay Trivedi
                                      Phuangketkeow                           Counsellor, Permanent
                                      Ambassador and Permanent                Mission of India to the United
                                      Representative of Thailand to           Nations Office and other
                                      the United Nations Office and           international organizations in
                                      the Specialized Agencies in             Switzerland on behalf of the
                                      Switzerland                             Ambassador and Permanent

Mr Jean Feyder
Ambassador and Permanent
Representative of the
Grand-Duchy of Luxembourg
                                      “       By strategically promoting
                                      structured capacity-building in
                                      health decision-making, TDR can
                                      provide a platform for advancing
                                      scientific and ethical conduct as
                                                                                                “       India has
                                                                                                 been a proud
                                                                                                 member of the
                                                                                                 TDR partnership
                                                                                                 and has benefited
to the United Nations Office          core elements of health policy and
                                      development. This is the highest        from, and contributed toward,
at Geneva                                                                     scientific and technical progress

                                      level of empowerment. In view of
                                      this, TDR is uniquely positioned        under TDR. TDR, at present, is go-
                                                                              ing through a stage of transforma-

                                      to facilitate the growing global dis-
       I want to underline that       cussion on health research policy       tion in view of the increasing mul-
Luxembourg is extremely pleased       and development.                        tiplicity of stakeholders, on the one
with the achievements of TDR                                                  hand, and decline in the resource
over the past 30 years and their                                              base for research, on the other,
impact on health in disease                                                   and therefore, faces challenges that
endemic countries... Luxembourg
supports the new strategic vision
                                                                              need to be overcome for effective
                                                                              implementation of TDR’s mandate
of TDR. It is eager for its imple-                                            and the opportunities that need
mentation in the context of a                                                 to be further exploited to enhance
strengthened effort by the WHO                                                product delivery and improve the

and by other intergovernmental

                                                                              R&D base of the Programme. India
and private organizations to pro-                                             will continue to constructively
mote health research.                                                         engage with TDR.

Closing addresses
Governments supporting in research dialogue leading up to
the 2008 Global Ministerial Forum on Research for Health

Dr Kamran Lankarani                                                                                                   Dr Kamran Lankarani
                                                                                                                      (on the right)
Minister of Health and Medical                                                                                        presents a gift
Education of the Islamic                                                                                              from the Islamic
Republic of Iran                                                                                                      Republic of Iran
                                                                                                                      to Dr Margaret

                                                                                                                      Chan, Director-
                                                                                                                      General of WHO, to
       The Islamic Republic of Iran                                                                                   the 30th anniversary
welcomes the new strategy for the                                                                                     of TDR’s JCB.
TDR Programme, and the vision
that the disease endemic countries
will play a pivotal role. We sup-
port the new strategic functions of
stewardship, empowerment and
research on neglected priorities.
     No78      S U PPLEMENT • Special JCB

            With regard to stewardship, we        With regard to empowerment,             it to implement the activities in
            believe TDR has an important new      we fully support this concept           the new strategy. My Government
            role to fulfill and we welcome the    which builds on the three de-           will do its best to maintain and
            Programme providing a neutral         cades of TDR capacity building.         increase its financial support to the
            platform for partners to discuss      In the Islamic Republic of Iran,        Programme and we call on other
            and harmonize activities. We look     we promote strong health re-            nations like ourselves to make
            forward to the sharing of knowl-      search leadership but this can be       financial contributions, however
            edge through the global informa-      strengthened, especially through        small, as an indication of their
            tion platform on health research      regional networks and assistance        commitment. We also invite the
            needs, opportunities and activities   to low income countries, and we         richer nations to increase their
            on infectious diseases of poverty.    look forward to collaborating with      support for the important activities
                                                  TDR in this domain also. I am           of this Programme. TDR is one of
                                                  very pleased to learn that the JCB      the few programmes which truly
                                                  has endorsed the Business Plan          involve disease endemic countries.

                                                  for the new strategy which can          We encourage our brother coun-
            Major Courage                         now move ahead. Of course, TDR          tries to indeed play their pivotal
            Quashigah (Rtd)                       needs financial resources to enable     role.
            Minister of Health of Ghana
            (present at both opening and
            closing sessions)

1          “       Ghana is particularly
            delighted that its representative
            Dr Frank Nyonator has been
            elected as the Vice Chairman of
            the JCB. This shows the confidence
            you have in us and recognition of
            our long standing relation with
            TDR. Mr Chairman, next year
            we will be meeting in Bamako,

                                                  Mallam Ibrahim                          Dr Mamadou
            Mali as a follow up to the high
            level Ministerial meetings held in
            (2006) in Abuja and Accra. Before     Talba                                   Souncalo Traoré
            this, ministers from Africa will      Permanent Secretary of the              Head, Department of
            be meeting in Algeria to further      Ministry of Health of Nigeria           Education and Research in

            consolidate the African position                                              Public Health, Faculty of
            on the health research agenda.                                                Medicine and Pharmacy and
            I am glad that TDR has taken a                Among many other achieve-       Odonto-stomatology, on behalf
            keen interest. On behalf of my        ments, TDR has played a pivotal         of the Minister of Health, Mali

            government and also, I believe,       role in initiating and catalysing the
            my colleague health ministers, I      generation of key knowledge in-
            once again congratulate you all       cluding the development of drugs                In Mali, we are very
            for a successful meeting and for      to treat tropical disease; provided     aware of how TDR helped a
            adoption of the Ten Year Vision       evidence for advances in health         “first generation” of researchers
            and Strategy. We pledge our full      policy, strategy and practice related   to gain access to the highest
            support to the goals and objectives   to several important diseases; sup-     levels of professional training,
                                                  ported more than ten thousand           and subsequently, facilitated

            and we hope that together we will
            work towards the realization of the   projects and trained thousands of       the training of a critical mass
            ideas captured by the vision.         developing country scientists. In       of researchers over several
                                                  collaboration with the Govern-          generations, constituting a corps
                                                  ment of Ghana, we enthusiastically      of research excellence of which our
                                                  organized the High Level Ministe-       country can today be proud. Mali
                                                  rial Meeting on Health Research         will support TDR’s efforts in the
                                                  in Africa in Abuja, in March 2006,      implementation of the new strategy
                                                  which was followed by the joint         and will do its utmost to ensure
                                                                                          that the Global Forum on Health

                                                  hosting of the JCB Session in Accra
                                                  in June 2006, which was the first       Research planned for November
                                                  Session to be held in Africa.           2008 in Bamako offers an

                                                                                          opportunity for all partners present
                                                                                          to join Mali in supporting the TDR
                                                                                          Programme in this process.
S U P P L E M E NT • Special JCB                                                                                       No78

Former WHO and TDR

                                                                                          From the left: Mr Warren
                                                                                          Furth, Dr Stanislas Flache
                                                                                          and Dr Halfdan Mahler

Dr Halfdan Mahler                      Mr Warren Furth                       Dr Stanislas Flache
Former WHO Director-General            Former Assistant Director-            Former Assistant Director-
(1973-1988)                            General and Special                   General and Special
                                       Programme Coordinator                 Programme Coordinator

                                       (1980-1989)                           (1977-1980)

                                       “                                     “
        It is my conviction that
the Director-General of WHO,
Dr Margaret Chan, could hugely                 By 1989, when I retired               As former WHO Assis-
benefit from TDR’s input to her        from WHO, some 65 TDR prod-           tant Director-General, I recall
very special WHO commitment            ucts were in actual use or being      with pleasure this period, when
to improving African health in the     tested in TDR trials. I have always   overseeing the integration of TDR’s
coming decade. If that commit-         felt that the continuous review       undertakings with other WHO
ment is to be realized, it would,      of TDR’s activities by STAC, JCB      activities was among the most
in my opinion, require immense         and the Standing Committee held       satisfying of my responsibilities.
efforts in political, epidemiologi-    TDR accountable in a way that is      On the other hand, ensuring con-
cal, sociological, economic and        unparalleled, in comparison to        tinued financial support of TDR by
systems research, in order to test-    other UN programmes. TDR has          its co-sponsors and other donors
run throughout Africa sustainable      been and continues to be a power-     was a challenge and presented

and cumulatively growing health        ful force for good in this troubled   occasionally some difficulties. I am
systems in order to realize health     world. I am glad to have played a     happy to express deep apprecia-
gains through primary health           small part in its history.            tion to my former colleague, past
care. I am sure that such a role for                                         TDR Director Dr Adetokunbo
TDR would be welcomed, both                                                  Lucas, as well as other past and
by WHO’s Member States at large                                              present TDR leadership and staff,

and the global donor community                                               for their excellent performance
in particular. So dear TDR, happy                                            and wish them continued success
                                                                             in the future.

birthday and happy landings in
the challenges and the problems of
the next 30 years!
     No78      S U PPLEMENT • Special JCB

                                                   TDR’s success formula includes:       On the occasion
                                                   clearly defined goals, global
                                                   networks, multidisciplinary input,    of the 20th anniver-
                                                   flexible and innovative strate-
                                                   gies, objective decision-making,
                                                                                         sary of the Mectizan
                                                                                         Donation Program

                                                   partnerships including the drug
                                                   industry and long-term commit-
                                                   ment by all stakeholders.
                                                                                         Dr Yao Sodahlon
                                                                                         Associate Director, Lymphatic
                                                                                         Filariasis, Mectizan Donation

            Dr Adetokunbo
                                                                                         “       The Mectizan Donation
                                                                                         Program is a symbol of the fruit of
                                                                                         all of the collaborations between
                                                                                         all of the TDR directors, WHO and
                                                                                         the pharmaceutical industry since
                                                                                         TDR’s inception. There are three
            Nigeria, former TDR Director                                                 great events. The pharmaceutical
            (1976-1986)                                                                  industry tested, and TDR helped

                                                                                         field test a drug (ivermectin) to
                                                                                         treat onchocerciasis in 1982-1987,
1                  The work of TDR led to
            the invention, development and
                                                                                         contributing to the its registration
                                                                                         as Mectizan®. The second great
            deployment of multiple-drug                                                  event was the donation by the
            therapy for leprosy. In 1985, when                                           pharmaceutical industry (Merck)
            MDT was accepted as a global                                                 of a product that it had innovated.
            strategy, 122 countries had sig-       Dr Carlos Morel                       In 1989, Merck expanded its
            nificant prevalence of leprosy. In     Brazil, former TDR Director           Mectizan donation programme to
            2004, only six countries still had a   (1998-2004)                           countries where lymphatic fila-

            significant level, and even in those                                         riasis is endemic. The third great
            countries, the expectation is that                                           event was the distribution; TDR
            within the foreseeable future, lep-                                          innovated an approach, which is
                                                           Something that I think is
            rosy will be eliminated (as a public                                         community-directed treatment,
                                                   very important in TDR is the JCB.
            health problem). Same thing has                                              which triggered a revolution in the
                                                   I am on many boards… But here
            happened with onchocerciasis, the                                            health services of countries where
                                                   you see something unique. First
            cause of river blindness. Under the                                          onchocerciasis was endemic.
                                                   you have the UN umbrella. Sec-
            leadership of Roy Vagelos, Merck                                             We have distributed nearly 500
                                                   ondly, you have this partnership…
            decided to develop a compound                                                million tablets and the results are
                                                   we have eliminated the divide
            for human use. Then, Vagelos                                                 eloquent. I hope for more success
                                                   between donor and recipients. We

            made the further decision to do-                                             for TDR in the future and for
                                                   are partners today. And as partners
            nate the drug for use in develop-                                            many more intersectoral collabora-
                                                   we see the emergence of more
            ing countries. Last year some                                                tions.
                                                   and more ‘innovative developing
            69.3 million treatments were
                                                   countries’, such as China, India,
            facilitated. And they are keeping to
                                                   Brazil, Cuba and Thailand. These
            their word ‘as much as is required
                                                   countries are in a very different
            for as long as it takes.’ I thank
                                                   position than 30 years ago, and
            Merck for making the donation
                                                   can serve as good platforms for
            of ivermectin but I thank them
                                                   action along with TDR. Some
            even more for this slogan which, I
                                                   say the field is crowded. I would
            hope, will soon be adopted by all
                                                   say it is not crowded enough.
            the donors to TDR.
                                                   No one tells us that too many
            The five pillars of support for TDR    people work on cancer or obesity.
            were the strong leadership within      But when you have a few people
            WHO, secondly the talented and         working on neglected diseases,
            committed colleagues in WHO,           we say it’s crowded! I don’t think

            then the global networks of scien-     it’s crowded. I would like to have
            tists, the generous donors, and fi-    many more people working on
            nally the pharmaceutical industry.     neglected diseases.
S U P P L E M E NT • Special JCB                                                                                                                                           No78

                                                                   Above: Dr Anarfi Asamoa-Baah, Deputy              JCB Representatives, Dr Jacques Laruelle of
                                                                   Director-General WHO and outgoing JCB             Belgium and Prof Gustavo Kouri of Cuba.
                                                                   Chairman, Dr Bijan Sadrizadeh. To left: Prof
                                                                   Herbert Gilles, JCB Representative of Malta and
                                                                   former TDR Director, Dr Adetokunbo Lucas.
                                                                                                                                      Far left:
                                                                                                                                      Dr David Heymann,
                                                                                                                                      Assistant Director-
                                                                                                                                      General WHO/CDS and
                                                                                                                                      TDR Special Programme
                                                                                                                                      Coordinator with Dr
                                                                                                                                      Bijan Sadrizadeh.

                                                                                                                                      Left: Dr Ok Pannenborg,
                                                                                                                                      World Bank Representative
                                                                                                                                      to the JCB and WHO
                                                                                                                                      Director-General Dr
                                                                                                                                      Margaret Chan.

                                                                                                                                                Above (far left): Prof Peter
                                                                                                                                              Ndumbe, Chairman of TDR’s
                                                                                                                                                STAC, Dr Gill Samuels STAC
                                                                                                                                                   Co-Rapporteur, Dr Bijan
                                                                                                                                                 Sadrizadeh and Dr Viveka
                                                                                                                                               Persson, JCB Representative
                                                                                                                                                                of Sweden.
                                                                        Ms Susan Block Tyrrell           Dr Frank Nyonator,
                                                                        and Ms Christine Elliott-        Vice Chairman of JCB                Above: JCB Representatives of
                                                                        Coze, JCB staff.                 and Director of Policy,               TDR cosponsoring agencies:
                                                                                                         Planning, Monitoring                 Dr Pannenborg, World Bank;
                                                                                                         and Evaluation, Ghana                      Mr Julian Fleet, UNDP;
                                                                                                         Health Service.                         and Mr Pascal Villeneuve,
                                                                                                                                                                of UNICEF.

From left: TDR Director Dr Robert Ridley, Ghana Health Minister Major
Courage Quashigah (Rtd), former TDR Directors Dr Carlos Morel and Dr
Adetokunbo Lucas, and Dr Bijan Sadrizadeh.
     No78         S U PPLEMENT • Special JCB

     Brazil offers to host
                                                                                                is published three
                                                                                  times a year by the Special
                                                                                  Programme for Research and
                                                                                  Training in Tropical Diseases (TDR),
                                                                                  sponsored by UNICEF/UNDP/World

     JCB 31 in June 2008
                                                                                  Bank and WHO.

                                                                                  Both html and PDF versions of the
                                                                                  newsletter are available on the TDR
                                                                                  website. All material submitted
                                                                                  to TDRnews undergoes editorial

     Professor Reinaldo Guimarães
                                                                                  review. Articles and illustrations
                                                                                  published in TDRnews which are
     Secretary of Science, Technology and Strategic Health Products,              not copyrighted may be reproduced,
                                                                                  provided credit is given to TDR and
     Ministry of Health of Brazil, on behalf of Minister of Health Dr José        provided such reproduction is not
     Gomes Temporão                                                               used for commercial purposes.
                                                                                  Articles do not necessarily reflect

                                                                                  the views of WHO.

                                                                                  Communications Manager
             Brazil has profited immense-                                         Jamie Guth
     ly from TDR. When we were trying
                                                                                  Managing Editor
     to convince our decision-makers
                                                                                  Elaine Fletcher
     that Chagas disease transmission
     could be brought to a halt, TDR                                              Design and Layout
                                                                                  Lisa Schwarb
     was our most reliable ally. When
     in the 1980s, institutions that now                                          Production team
     have worldwide recognition such                                              Jocelyne Bruyère and
                                                                                  Laurie Ingels
     as FIOCRUZ were weak and fragile
     and needed capacity strengthen-                                              Pictures:

                                                                                  All the pictures are WHO/TDR/
     ing, TDR played a critical and                                               Williams with the exception of the
     fundamental role. Now, on behalf                                             picture at the bottom of page 11
     of President Lula and Minister José                                          which is WHO/TDR/Ingels.
     Gomes Temporão, I am honoured
     to have witnessed the acceptance       what we call the “Health Industrial
     of the Joint Coordinating Board to     Complex”; Brazil is reshaping its
     have its 31st session in Brazil. Our   macro-policies in innovation and         To our readers:
                                                                                     We are always interested in shar-
     Government sees this as a unique       biotechnology; the Oswaldo Cruz          ing information about tropical
     opportunity to discuss collabora-      Foundation (FIOCRUZ) is collabo-         disease research. Please send us
     tions and partnerships. Currently      rating with the Governments of           announcements for meetings,
     the Ministry of Health is investing    Angola and Mozambique towards            new programmes, institutions,
     over US$ 10 million in R&D in          the establishment of National            publications, etc. and we will
                                                                                     try to get them into either this
     six neglected diseases which are of    Schools of Public Health. TDR’s          newsletter or into our website.
     direct interest to TDR — Chagas        Ten Year Vision and Strategy,
     disease, dengue, leishmaniasis,        emphasizing the pivotal role that
     leprosy, malaria and tuberculosis.     disease endemic countries should
     The Ministry of Health is teaming      play, can provide a sound platform

     up with Brazil’s National Bank of      for sharing experiences, foster-
     Social and Economic Development        ing collaborations and nurturing
     to rescue, reshape and develop         partnerships.

                                                                                  TDR/World Health
                                                                                  20, Avenue Appia
                                                                                  1211 Geneva 27

                                                                                  Fax: (+41) 22 791-4854

                                                                                  To our readers:
                                                                                  We are always interested in
                                                                                  sharing information about
                                                                                  tropical disease research.
                                                                                  Please send us announce-
                                                                                  ments for meetings, new pro-
                                                                                  grammes, institutions, publica-
                                                                                  tions, etc, and we will try to get
                                                                                  them into either this newslet-
                                                                                  ter or onto our website.

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