1. Building Research Team for Disaster and Funding in Resource Poor Settings
Dr. Augustine Onyeaghala
Global Health Trial Workshop, Abuja January, 2017.

2. Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017
Highlights
Background
Statement of problem and Justification
Disaster Management concept and Clinical Research
Competencies for Clinical Research Team
Responsibility of the research team.
Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017

3. Presentation Objectives
Understand the meaning of disaster research
Justification for building the right team
Basic concepts of disaster management
Application of disaster management to disaster research
Basic competences required for clinical research team
Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017

4. Background : Basic Definitions
Disaster:
A disaster is a sudden, serious disruption of the functioning of a community or a society involving widespread human, material, economic or environmental loss and impacts, which exceeds the ability of the affected community or society to cope using its own resources (Wikipaedia)
Economic effects of disaster
Mortality /morbidity
Loss of capital
Mobilization and diversification of resources to curtail primary disaster
Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017

5. Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017
Research:
An investigative process employed to address gaps, provide solution, facts and generate new information.
Team Building :
A process of getting diverse people to work together and effectively in order to achieve the desired result.
Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017

6. Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017
In summary
We need a team of professional, who will work effectively and efficiently using evidence based approach (research) to mitigate, prevent, manage and monitor health disasters.
Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017

7. Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017
Background Cont’d
In the words of the President of the World bank Jim Young Kim:
“The world was woefully unprepared for the outbreak of Ebola. There is need for emphasis on building robust health systems, as it is a multiple-win approach. Nations cannot simply focus on disease surveillance., but effective health care has to follow. Fight against epidemics such as Ebola can improve health systems, economic prospects, and multilateral cooperation in mobilizing public and private funds.” [1]
1. Jim Yong Kim [2016]. Conference on Ebola with World Bank Group and Parliamentarians Jointly organized by the Parliamentary Network and the World Bank. Available at: . Accessed on 11th January, 2017.
Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017

8. Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017
Implication
Adequate preparation is required for effective management of disasters
Building robust health systems of which clinical research is a component becomes inevitable
Focus on epidemiological data is not sufficient
Using research methods and technologies to provide solutions is crucial
Good health systems provide a win-win situation.
Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017

9. Some Health Disasters in Nigeria
Ebola Outbreak of 2014 –Patrick Sawyer Syndrome.
Meningitis outbreak in Nigeria and other African countries
Nigeria recorded 9086 cases and 562 deaths. The highest in Africa.
Lassa Fever-Almost becoming endemic.
Zika Virus – expecting to outburst.
Antimicrobial Resistance – a big challenge to global health
Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017

10. Brain Storming /Critical Thinking
Question
Do you think that currently, Nigeria has an effective clinical research team who will help manage, mitigate and reduce economic and social burdens of sudden outbreak of medical disaster (s)?
How do we move forward ??
Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017

11. Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017
Statement of Problem
Most disasters emerge unannounced
Currently no core clinical research disaster response team is available [ Compare Field Epidemiologist]
Most solutions are sought for after the disaster has emerged
Lack of best available evidence worsens treatment, management and prognosis.
Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017

12. Justification for Building Clinical Research Team for Disaster
Predictive and Preventive approaches are better than curative
Great generals are assembled earlier before any major national wars.
Economic gains and man power development.
Enhances local building of capacity
Prevent loss of resources through capital flight.
Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017

13. Who constitutes the Team ?
Research Team
PIs
CoPIs
Nurses
CRAs
CRCs
Data Managers
Safety Monitoring Committee
Pharmacists
Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017

14. Disaster Management : Basic Concepts
Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017

15. Mitigating Disaster
Mitigate
Determine Risk Vs Exposure
Systematic Review of available evidence
Evaluate Interventions
Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017

16. Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017
Team Preparation
Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017

17. Research Team Response
Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017

18. Competencies for Clinical Research Team
GHTN competency concept designed for CRPs,[2] advocated the following skills for clinical research team :
Good knowledge of scientific thinking
Adequate knowledge of Design & Planning of Research
Knowledge of protocol development
Ability to analyze and interpret research data
2. GHTN [2016]. Global Competency Framework for Clinical Research available at Accessed on 10th January, 2016.
Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017

19. Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017
Research Ethics, Quality and Risk Management
Adequate knowledge of ethics and conduct of ethical research
GCP / QMS
ICP/ICD
Risk and safety management
Regulatory issues
Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017

20. Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017
Competences cont’d.
Research Operations
Good knowledge of data collection (Precise, and accurate)
Safe guarding of data through maintenance of database
GCLP for Clinical laboratories
Site Management
Initiation, selection, monitoring and close outs
Scientific report writing/communication
Management of resources.
Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017

21. Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017
Responsibility
Assemble the right clinical research team for disaster management
Impact the required skills and certification
Liaise with academic institutions to develop and implement novel programs in disaster research
Conduct Research
Play advocacy roles.
Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017

22. Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017
Funding Research
What is our national budget for Research ?
Basic truths about funding of research
Research is business
Most sponsors fund studies which address their interest.
Competence and track record are essential for attracting funds
Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017

23. Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017
Organizations that fund research :
CDC.
Bill and Melinda Gates
Royal Society for Tropical Medicine [RSTM]
GSK
Pfizer
Local Sponsors
US National Institute of Health [NIH]
Global Health
Governments of : Germany, Japan, China
Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017

24. Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017
Questions ???
Dr Onyeaghala, GHTN Workshop Abuja 28 January, 2017