Research across the world is changing due to large investments in science and innovation in developing economies. The emergence of new health research centres in West Africa and new funding bodies such as the Global Health Fund and the Gates Foundation means that MRC UK needs to ensure that its funding provides a unique contribution, utilising its reputation for delivering excellent science.

The strategy of MRC (UK) The Gambia is being developed within the broader context of MRC’s global health strategy. This review, commenced in August 2008, is resulting in a number of changes not just to our research portfolio, but also to how and where we spread our investments and activities across the sub-region in the coming years.
Building on MRC (UK) The Gambia’s unique resources, working groups of Unit scientists have convened to develop three new research themes:

Child survival: Early childhood deaths in The Gambia and the rest of the developing world remain unacceptably high. MRC has recently re-affirmed its strong commitment to the Government of The Gambia to make this a key theme of its research going forward. Working closely with the Ministry of Health we envisage the improvement of diagnosis and the introduction of treatment trials that will focus on the severe infections affecting this age group.

Elimination & Disease Control: In common with other countries in the sub-region, The Gambia has experienced a sharp decline in malaria prevalence over the past ten years. The National Malaria Control Programme, MRC and other partners in The Gambia and West Africa are now investigating the feasibility of eliminating malaria using a combination of approaches. Utilising its considerable expertise in these areas, The Unit also plans to address research questions relating to the elimination and control of trachoma, Hib, TB and Hepatitis B infections in The Gambia and the West African sub-region.

Vaccination: Over 20 years, the partnership between the MRC and the Government of The Gambia has resulted in The Gambia having one of the best Extended Programme of Immunization (EPI) schedules in Africa. Hib and Hepatitis B vaccines, both trialled in The Gambia are now a standard part of the Government’s vaccination campaigns and are being rolled out in other countries. The pneumococcal conjugate vaccine – trialled in the Upper River Region of The Gambia and until recently unavailable in Africa - will be included in the country’s Extended Programme on Immunisation in the near future. The safe testing and adoption of vaccines against the tropical infectious diseases that blight The Gambia, the sub-region and the developing world will remain an integral part of The Unit’s strategy.

The Unit’s plan for change was endorsed at a meeting of the MRC Global Health Group and received a favourable response at the meeting of MRC Council in July. Further work is now in progress, including the planned recruitment of three theme leaders to shape and implement new science; The Unit’s leadership team is moving ahead to identify and attract potential candidates of international calibre with a proven track record of winning substantial external funding.

The Unit’s leadership is also working on the financial viability of the plan. The MRC will sustain the current level of investment in global health research, but expenditure in The Gambia itself will reduce significantly. The future organisation of The Unit will be along the lines of an MRC Centre, with a core “platform” of strategic resources, capabilities and infrastructure, and a set of independently-led, largely externally funded science programmes.

At the end of the year, The Unit’s plan for change will be reviewed again in detail by the MRC UK’s governing bodies including the Council. Details of the outcome of these meetings will be communicated to all key stakeholders without delay.