Mohamed Said: PROF. CHARLES MGONE: A GLIMPSE AT A GENIUS SCIENTIST

Dr Charles Mgone (left) and The Citizen senior

The Citizen Senior Journalist Damas Kanyabwoya interviewing Prof. Charles Mgone

Raising medical research capacity should start from medical school, renowned medical research says. Dr Charles Mgone has spent two decades leading world renowned research programs on tropical diseases, helping, in the process, to makebreakthroughs in vaccine discoveries for the big killer diseases—malaria and HIV/Aids. In this interview with The Citizen Reporter Damas Kanyabwoya, he sheds more light on trials for HIV and malaria vaccines, on the public health system and on what Tanzania should do to build medical research capacity. Excerpts:

How close are we to the HIV vaccine? Media reports to that effect have been the subject of much debate with some disputing the credibility of the reports.

Reports about breakthroughs in HIV are credible. But first of all we have to agree that the vaccine against HIV is very elusive. It is not an easy thing. Not as simple as that. This is because the organism [the HIV virus] is very complicated. It keeps on changing itself, we call it mutations.

Having said that, there have been some promising vaccine trials. One of them is RV 144 which has been tried in Thailand. In Tanzania, the organisation that I was leading - the European & Developing Countries Clinical Trials Partnership (EDCTP) - sponsored the vaccine trials that have also been very promising. It’s coming, but if you ask me to tell you when it will be ready, I would not be able to do that. But it is promising. It might not be ready by next week or next month not even next year.

What about the malaria vaccine?

The vaccine has been tried here in Tanzania but also in Ghana, Burkina Faso and some other African countries. It has shown to reduce mortality in severe malaria that has been the main cause of deaths for children. It is not the magic bullet yet but it is helpful. It was registered last year. Other malaria vaccines are being developed. But I think eventually it may require a combination of vaccines so as to get something that may be much more effective.

There have been allegations that foreign research organisations use Africans as guinea pigs. How good do you think is the oversight capacity in clinical trials in Tanzania in particular and in Africa in general?

In fact at the EDCTP it was part of our responsibilities to increase African regulatory oversight capacity for clinical trials. Tanzania is one of those countries that are doing well in that area. We have institutional ethics review committees; the national ethics review committee and the Tanzania Food and Drugs Authority. All these bodies function as overseers. Before international research is conducted, researchers have to apply for permits from these bodies. They look at the research proposals; they check research protocols to make sure everything is shipshape. I mean even in advanced countries, there could be some people violating the ethics principles but it is very rare here. I do not think that is a problem in Tanzania.

What should be done to strengthen the link between medical researchinstitutions and medical schools?

Actually that is one of the things I have been always advocating for. We, researchers, tend to work in isolation. And in Tanzania, we have very strong medical research centers. There is Ifakara, NIMR, to name just a few. There are also very capable scientists in all fields. But these talents are not fully utilized. In other countries, you will find that these experts also spend some of their good time in universities, teaching. But here usually when a student finishes school you hear them saying they want to go into research.

But research should be in calculated in students training programs from the beginning. They should be sent to research centres during their school years to get advantage of the better research facilities and learn directly from experiences of researchers themselves the same way they are sent to hospitals.

I believe there is a lot of room for interactions between research institutions and higher learning institutions. Higher learning institutions conduct some research but they should collaborate more with research institutions.

I say this because developing the culture of research takes a long time. Therefore we need to build the culture right from school through imparting the values of imagination, innovation and entrepreneurship, which are critical to a good researcher. But medical schools should use researchers to serve as mentors to students right from the beginning. Students need to have somebody they can emulate, look at as an example. And mentors take students and guide them through all those difficulties.

The only problem is that the money spent in research is very meagre-and this is not only in Tanzania it is all over the world- people expect someone else will discover something. And because of market failure-lack of interest of big pharmas on tropical diseases- even when HIV/Aids medicine is discovered, still how we use it under our circumstance, how best to apply it requires research.

What can Tanzania learn from Papua New Guinea?

I left Papua New Guinea fifteen years ago. The country is classified as a middle income country mainly because of its mineral wealth. But it is underdeveloped in terms of capacity of researchers. But they were open. They put up attractive salaries, they built the infrastructure to support research. And they were attracting talents from worldwide. So one of the things, if I have to say, is we have to build the infrastructure. We have to invest. If you look at countries that invest in research capacity as well as the infrastructure, many developing countries are doing badly. And Africa is doing worse. And in Africa there are some countries that are worse than others. In Tanzania since we started advocating for the allocation of one per cent of GDP in terms of revenue things have started improving. But we are not yet in the clear. About 99 per cent of research funding still comes from outside, which is dangerous because the one who pays the piper calls the tune. And investments should be holistic. You also invest in regulatory structures. You have to invest on training of researchers and you have to fund research.

What is your comment on public health system in Tanzania?
From a helicopter view, since I have been away for too long. The Tanzania health system was based on a very sound basis. The way we had prepared our structure there are dispensaries which serve health centres, these serve district hospitals which serve regional hospitals then referral hospitals.On paper it sounds good yet you will see that the doctor-to-patient ratio is very poor, even by East African standards. Facilities have also been eroded. There is shortage of medicine, inadequate diagnostic aid. This is an open secret, I am not saying something that people do not know. You always write about these things in your newspapers.The issue is to improve the facilities and retain doctors. I now hearthat there is internal drainage, in addition to the external one. Doctors are being trained but they do not practice. They do other things even if they remain in the country.

Brief Profile

Born in Dar es Salaam in May 1949 in Dar es Salaam Prof. Charles Mgone attended the Mnazi Mmoja Primary School and Kitchwele Middle School. After secondary schools at the St Joseph’s Convent he joined University of Dar es Salaam Medical School at Muhimbili where he graduated in 1975 as a pediatrician. He did his initial post-graduate studies at Muhimbili Hospital and then went to Newcastle University in England in 1986 to continue with his studies. Part of his training at New Castle was in the Royal Victoria Infirmary. It is here that he developed interest in genetics. He then enrolled at the University of Glasgow for a PhD in in medical genetics specialising in molecular genetics. It is at Glasgow where his career in research took off. He got involved in research on a disease called Porphyria and became a leading expert in detecting causes of porphyria. After a brief stint teaching at Glasgow he moved on to Papua New Guinea (PNG) where he joined the research team of the PNG Institute of Medical Research. He became Deputy Director and later Acting Director of the Institute. He stayed in Papua New Guinea for nine years and then came back to Tanzania where he served as Network Director of the African Malaria Network Trust a position he held for three years. In 2006 he joined the European and Developing Countries Clinical Trials Partnership (EDCTP) as Executive Director. The programme involved getting African involvement and African leadership in trying to solve problems that were endemic mainly Malaria, HIV and TB - the big three. He retired in December 2015. In January 2016 he was appointed chairperson of the World Health Organisation’s Scientific and Technical Advisory Committee (STAC) of the Special Programme for Research and Training in Tropical Diseases. He also chairs the board of the Africa Research Excellence Fund.

Prof.. Mgone at his residence in Bunju behind is his swimming pool which
he loves as a young boy he used to swim across Ferry to Kigamboni and back
competing with his child hood friend Salim Hariz
(All Photos and Text Courtesy of The Citizen)