Central Africa Regional Network on Clinical Research (CANTAM): Strengthening Clinical Infectious Diseases Research in Central Africa

The clinical research network of excellence for Central Africa (CANTAM) was established in 2008 with the aim of strengthening the individual, institutional and infrastructural capacities in three Central African countries (Cameroon, Gabon and Republic of Congo) along with Germany to conduct clinical trials on tuberculosis (TB), HIV/AIDS and malaria. The basis was to conduct epidemiological studies, and train staff in good clinical and laboratory practices, whilst strengthening the clinical trials infrastructure. Over the years, it appeared necessary to increase partners as specific skills were lacking. With the addition of the Democratic Republic of Congo, Zambia, United Kingdom and the Netherlands, the CANTAM2 network was formed in 2016. In CANTAM2, clinical research capacities on TB were strengthened, and the first multicenter clinical trial on malaria was successfully conducted (ClinicalTrials.gov ID: NCT03201770). Notwithstanding these successes, clinical research in Central Africa is still facing significant gaps, exemplified by the limited number of clinical trials conducted to date. It is for this reason that for the years 2021-2023, the objectives of the CANTAM are to: 1) Set-up and conduct epidemiological studies on HIV/AIDS, tuberculosis (TB), malaria, neglegted tropical diseases (NTDs) and COVID-19 to collate baseline data for future clinical trials; 2) Design and implement training activities necessary to conduct clinical studies on traditional medicines for parasite and viral infections; 3) Prepare the sites for future Phase I to IV clinical studies, by specifically strengthening pharmacovigilance including regulatory authorities and national or institutional ethics committees; 4) Developing adapted training platform and mentorship programmes. Five indicators of success have been identified for CANTAM3: 8 new female scientists established, accreditation of new laboratories, increase in the number of clinical trials, mapping of disease incidences in all CANTAM countries and established pharmacovigilance activities in the region. Given the fragile health systems in Central Africa, new and re-emerging infectious disease outbreaks, such as the COVID-19 pandemic can paralyse health systems and existing structures. CANTAM3 envisage to synergize our existing efforts at local and regional level, while considering our strengths and weaknesses of the network identified by our own evaluation. In CANTAM3 we propose an innovative governance structure that will leverage added responsibilities and ownership to each partner country within the CANTAM network, implementing internal incentives for the best contributors. As a result, CANTAM3 will be able to make a significant contribution in the field of malaria, HIV/AIDS, TB, NTDs as well as other viral diseases, such as COVID-19.