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13 October 2015

13 October 2015. SAMRC ANNUAL REPORT 2014/15 –SUMMATIVE REPORT. 1. Scope of Presentation. Introduction: Prof Zodwa Dlamini DC Performance against SAMRC strategic objectives: Prof Glenda Gray , President Research Highlights: Prof Glenda Gray & Dr Richard Gordon (SHIP & GIPD)

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13 October 2015

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  1. 13 October 2015 SAMRC ANNUAL REPORT 2014/15 –SUMMATIVE REPORT 1

  2. Scope of Presentation • Introduction: Prof ZodwaDlamini DC • Performance against SAMRC strategic objectives: Prof Glenda Gray, President • Research Highlights: Prof Glenda Gray & Dr Richard Gordon (SHIP & GIPD) • HR: Prof Glenda Gray • Financial Report: Mr Philip du Plessis 2

  3. STRATEGIC GOALS OF THE SAMRC • Administer Health Research effectively & efficiently • Lead the generation of new knowledge • Support innovation and technology development to improve health • Build capacity for the long term sustainability of the country’s health research 3

  4. INTRODUCTION • SAMRC - funds &conducts medical research with the focus on the top 10 causes of death in SA • provides top tier funding opportunities to develop new knowledge in medical research that is innovative and technology driven • Is spearheading the NHSP & the training of medical and allied health professionals wrt medical research • Addressing transformation of external funding by introducing a number of new initiatives & re-evaluating its grant funding mechanism 4

  5. FINANCIAL YEAR IN REVIEW • Third consecutive clean audit! • 2 Vice Presidents appointed – stable executive team • 8 new extramural research units based at universities • 3 Cancer centres based at UKZN, Wits and UCT • The President & CEO of the SAMRC and her team has, through her collaborations with Gates Foundation, UKMRC-Newton Fund and PATH has secured R100 million funding into the organisation for the next three years. • During the reporting period the SAMRC board approved the redesigning of the SAMRC Corporate Identity to improve the organisations’ communication and marketing ability. 5

  6. TRANSFORMATION • R30 Million awarded to five historically under resourced universities in South Africa to fund research projects that will contribute to the prevention, reduction and control of disease in the country. • Actively supporting WSU & SMU to augment research capacity • Self-initiated Research grants re-aligned to increase ESI grantees • In improving clinical research, the SAMRC collaborates with DOH and the private sector to facilitate National Health Scholarship with the aim of producing 1000 PHD graduates over the next 10 years. • 41 Employees were promoted to higher job levels across all categories, levels, race and gender. This includes employment of the first African female Unit Director. 6

  7. RESEARCH HIGHLIGHTS & MEASURED DELIVERABLES • 481 Peer reviewed articles with an SAMRC affiliated author were published in the ISI journal • An additional 20 articles were published in peer reviewed articles with an SAMRC affiliated author in the top four journals – NEJM, Lancet, Science and Nature • 86 Bursaries, scholarships and fellowships were provided to post-graduate participants at different universities. • 101 Research grants were awarded by SAMRC during the reporting period • In promoting innovation and technology 31 invention projects were funded during the reporting period. 7

  8. FINANCIAL HIGHLIGHTS • Third clean audit • Medium Term Expenditure Framework (MTEF), has confirmed an increase from 39.8% to R623 892 in funding allocations for the year 2014/15. • SAMRC remains financially strong with accumulated reserves of R24 million. • During the reporting period an increase of 7.1% to R391 million was evident. 8

  9. 2014/15 Organizational Performance 9

  10. STRATEGIC GOALS OF THE SAMRC • Administer Health Research effectively & efficiently • Lead the generation of new knowledge • Support innovation and technology development to improve health • Build capacity for the long term sustainability of the country’s health research 10

  11. Objectives and Indicators 11

  12. Budget Programme 1 - Administration 12

  13. Budget Programme 2 – Core Research Note: * signifies that data will be contributed by both intramural and extramural units. Where the symbol does not appear, the data is only from intramural units. 13

  14. Budget Programme 3 – Innovation & Technology 14

  15. Budget Programme 4 – Capacity Development 15

  16. Achieved 9 out of 10 targets • 90% achievement for 2014/15 Financial Year • - The SAMRC will be in a strong position to achieve the remaining annual target following on the implementation of an additional requirement whereby recipients of SAMRC funds are obligated to acknowledge the SAMRC in all publications or publicity materials emanating from, related to or based on SAMRC funded project work. Summary of Annual Performance 16

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  18. ORGANISATIONAL HIGHLIGHTS 18

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  21. Leading causes of death, 2nd NBD Study for SA 1997 2012 21

  22. Children under 5 years, South Africa 2012N=47,760 Source: 2nd National Burden of Disease Study 22

  23. Age standardised death rates for cancers by sex, SA 1997 – 2010 Source: 2nd National Burden of Disease Study 23

  24. Research Highlights from 2014/2015 24

  25. Strengthening the Eastern Cape Cancer Register • Enlarging office staff • Updating to CANREG 5 • Engaging part-time data collectors in study area • Enhancing the use of the data 25

  26. GENDER BASED VIOLENCE BIG SCIENCE: STRATEGIC GOALS: Building global evidence base on What Works to prevent GBV Deepening understanding of the health impact of GBV Building stronger responses to GBV in South Africa 26

  27. MRC Centre for TB research. Aims to have a continuum of research from basic to applied Diagnostics Biomarkers Bioinformatics “Omics” Drug discovery & trials Vaccine trials Drug resistance Disease dynamics Transmission Field sites Pharmacology Genetics TBTrials Immunology Bacteriology Molecular Epidemiology Community 27

  28. SAMRC TB Research Host Pathogen Infection prevention Bioinformatics Biomarkers Drug development 28

  29. A sample of SA MRC NCDRU projects 29

  30. The South African Diabetes Prevention project Step 1- Invite eligible participants (115/ED) • Shaded cells represent group based intervention periods; • Blank cells represent control periods. • Each cell represent of group of 14 clusters • O indicates measurements of the outcomes variables; and X indicates implementation of the intervention • The group-based lifestyle intervention will be delivered in 6 sessions (2 hours each). The first five sessions will extend over the first eight weeks, and the last session delivered at 8 months Step 2- Home screening via risk score (92/ED) Random selection of potential participants (200/ ED) Random sample of 56 electoral district (ED) Step 3- Baseline evaluation (45/ED) 4 O O O X 3 O O O X Participants/ Clusters Inclusion based on OGTT (20/ED) 2 O X O O 1 O X O O 1-12 13-24 25-36 37-48 Randomisation: 28 ED (clusters) per arm Months of intervention Figure: SA-DPP study schema Pilot phase to start soon, baseline funding 30

  31. Maternal & Child Health The ESMOE-EOST scale-up programme has demonstrated an improvement in knowledge and skills of health care professionals and has been shown to reduce deaths of mothers and babies. 31

  32. RR 0.78, 95% CI 0.67-0.90 RR 0.80, 95% CI 0.65-0.992 32

  33. 33

  34. Maternal & Child Immunisation • First placebo-randomized, controlled trial globally which demonstrated protection of pregnant women and their infants against influenza-confirmed illness (NEJM 2014). • Prolific research portfolio on Group B Streptococcus disease, including undertaking the first clinical trial of an investigational trivalent GBS conjugate vaccine in pregnant women, aimed at protection of their young infants. 34

  35. B3Africa • Bridging Biobanking and Biomedical Research across Europe and Africa • Create a harmonised ethical and legal framework between European and African partner institutions • Trustable informatics platform to allow sharing bio-resources and data • Provide an “out-of-the-box” informatics solution that facilitates data management, processing and sharing • context of limited resources 35

  36. Representation of Sequenced Whole Genomes of Rotavirus 36

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  39. Impact of Rotavirus Vaccine at Oukasi Primary Health centre, Brits, NW province Post-marketing surveillance & vaccine impact studies on the burden of RV infection • Delayed rotavirus season (Red peaks) • Less cases of rotavirus-associated diarrhoea 39

  40. High impact reseachBirth to twenty cohort • Colloquially called “Mandela’s Children” • Prospective birth cohort (Johannesburg-Soweto) • 1988-9 • Recruited 3273 mothers and babies (households) in 1990 • Approx 68% still in contact with the study • 21 data collection surveys completed • Recent survey in 2012-2013 • 3 generations • 1G = Mothers • 2G = Bt20 participants • 3G = Babies of the Bt20 participants (n=800+) 40

  41. High impact reseachFirst 1000 days • Maternal pre-pregnancy weight (urban SA: 67% overweight or obese) • Gestational weight gain (urban SA: 9kg) • Gestational diabetes (urban SA: 14%) • Pre-eclampsia (urban SA: 6%) • Anaemia (urban SA: 31%) • HIV (urban SA: 30%) • Maternal stress and depression risk (urban SA: high >30%) • Co-morbidities • Fetal growth; gestational age; • birth weight & length (programming) • Infant growth 41

  42. Lundeen et al. 2015 Paed Obesity FUTURE DEVELOPMENTS 42

  43. Norris et al. Unpublished FUTURE DEVELOPMENTS Prevalence of overweight/obesity (%) Age (years) 43

  44. Achievements 2013 - 2015 44

  45. Flagship Program • Sample projects • Evaluating a new drug regimen for patients with multi-drug resistant TB – a randomised controlled trial • Effectiveness of an alcohol-focused intervention in improving adherence to antiretroviral therapy (ART) and HIV treatment outcomes • A multi-disciplinary approach to understand the causes and consequences of HIV transmission and drug resistance in hyper-epidemic setting in rural South Africa • The impact of rape in women on HIV acquisition and retention linkages to care: a longitudinal study 45

  46. Early detection of T2D To improve the health of diabetics through prevention, early detection and treatment • T2D diagnosis is made by measuring the person’s fasting blood glucose following an overnight fast • A diagnosis of T2D occurs mostly due to the other associated conditions such as hypertension, hypercholesterolemia, atherosclerosis, myocardial infarction or stroke • Early detection requires development of a way to diagnose diabetes at a very early stage before irreversible tissue damage occurs

  47. HumanStudy: Protein expression in plasma To improve the health of diabetics through early detection, prevention and treatment

  48. Impact of early markers identified • Earlier detection and screening of patients could prevent people of developing diabetes • Financial burden of diabetes Direct cost • 20% health budget related to the treatment and hospitalisation of diabetics • the treatment of long-term complications, such as heart disease and stroke, kidney failure, blindness and debilitating foot problems Indirect cost • Sickness, absence, disability, premature retirement or premature mortality causes loss of productivity • Costs of lost production may be as much as 5 times the direct health care cost

  49. Rapid diagnosis of tuberculosis in resource poor settings • Advantages: • Unlike GeneXpert, this technology detects three unique M.tb genes in sputum • Pooled sensitivity of 73% and specificity of 95% - better than sputum microscopy • Differentiates between live and dead bacteria (prevents false positives) • Developed for point-of-care • Disadvantages • Uses sputum • Next Steps: • Develop an assay for drug resistance testing • Look for funding and commercial partner to develop working prototype (closed & automated system) • Lysis: • Release of DNA • Capturing of DNA • Amplification & Analysis: • Real-time PCR 49

  50. Rapid diagnosis of tuberculosis in resource poor settings (cont.) TB PROTEC (Part 1) SERS DEVICE (Part 2) 50

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