MMV on the ground: stories from the field and the lab

2019
Stephan Duparc, André-Marie Tchouatieu, Jaya Banerji, James Duffy

Along the road to health impact in the fight against malaria MMV encounters new people, places and ideas. Over the past 20 years these experiences have shaped the way we work to design, create and ultimately deliver new medicines to vulnerable populations. We draw our inspiration for the future from these experiences. Here are four interviews with MMV staff on some of their most memorable encounters:

Stephan Duparc, Chief Medical Officer

1. Describe one of your earliest field experiences at MMV.

When I first came to MMV in 2007 our staff was comprised of 25 people, about a quarter of what it is today, and our pipeline was just starting to expand. With it there was the need for expansion of the sites we used for clinical testing. Four studies in parallel were to be conducted on Pyramax® (pyronaridine-artesunate), a medicine that became the only ACT indicated for both of the two main strains of malaria. At that time, the only sites being used for clinical testing were located in East and Central Africa. I had contacts with francophone partners from West Africa and initiated discussions with sites that I knew of. We visited Burkina Faso, Mali, Senegal and Ivory coast. It was an exciting time and a key moment in the development of MMV’s growing network.

2. Describe an encounter with an interesting person you met.

When we conducted clinical studies, they were usually outside of the cities, in villages. Each time we’d have to go to the village head and ask for permission to set up our testing centre in the local health facilities. This was important because we would be sending doctors from outside the region, and even outside the country, to the village and the support of the local population was needed. I remember going to visit the village head at one of our potential sites in southern Mali. We told him that we’d help to improve the capacities of their health centre and bring doctors to the village during the period we planned to conduct the study. If people fell ill they could receive treatment directly at the centre, free of charge. This was very well received, as in rural areas the nearest properly equipped and managed health centres are often miles away and patients have to pay to be treated. The staff at the sites were enthusiastic to collaborate with us and happy to see our growing pipeline of medicines. To this day we still use that site in southern Mali and remain in contact with our partners there, as well as others visited during that period.

André-Marie Tchouatieu, Associate Director, Access & Product Management

1. Describe one of your most recent field experiences at MMV.

One of my most recent experiences was in Guinea in October of 2018, where I participated in the door-to-door distribution of a preventive malaria medicine (Seasonal Malaria Chemoprevention, or SMC). It was the first year of SMC implementation in the Dabola District and the enthusiasm of the population and the community health workers was contagious. The director of the Dabola area hospital explained that there had been a 25% reduction in malaria-related hospital admissions compared to 2017 since the implementation of SMC. As a practical illustration, he also noted that there had been an important decrease in the demand for blood bags for transfusion, which he attributed to a decrease in the number of children with severe anaemia caused by malaria. On this trip I was lucky to also meet mothers and their young children who were directly benefitting from this intervention. It was a huge source of inspiration to continue to expand the reach of this important tool to protect young children from malaria.

2. Describe an interesting person you met.

I met a community health worker who is a mother of nine and committed to seeing children in her area free from malaria. She walks miles each day during the distribution season to ensure that all eligible children in her village receive their dose of SMC. Her husband is the village head and helps to mobilize local health workers to distribute the medicines. He is just as motivated as his wife. The couple is entirely dedicated to the fight against malaria in their village and their passion is truly inspiring to see.

Jaya Banerji, Senior Director, Communications

1. Describe one of your earliest field experiences at MMV.

Between 2007 and 2010, MMV collaborated with the Ministry of Health Uganda and other partners on a 2-year pilot to test whether providing highly subsidized ACTs via private drug sellers could improve access to effective malaria treatment in the country’s rural communities.

In 2008, we had organized the grand launch of CAPSS (Consortium for ACT Private Sector Subsidy) in one of the rural pilot districts. I used use the opportunity to talk to some people in the district for a film we produced -The affordability gap.

2. Describe an encounter with an interesting person you met.

I interviewed several people and found the plight of poor patients and the sight of empty shelves in rural pharmacies hard to accept. I asked myself: how could we at MMV help to change that?

One afternoon I had the privilege of meeting the amazing, big-hearted, Gladys Sugeri. She said she was a ‘digger’ – a subsistence farmer, who single-handedly cared for 20 children, 12 were her own, six were her grandchildren, and two were the village orphans.

When she told me she had lost three children to malaria in the past two years, it was clear that her inability to pay for treatment was one of the reasons her children had died. What she needed was access to a fully stocked public pharmacy or, at the least, to effective ACTs that her meagre income could afford at her local drug seller. We believed CAPSS could make that a reality.

And it did…to a point. The CAPSS project went on to demonstrate that subsidized, quality ACTs combined with effective social marketing campaigns and proper training and education, could shift patients to buying more effective medicines. The results of the Uganda pilot joined the stream of international evidence to support the launch of the financing mechanism AMFm (Affordable Medicines Facility, malaria) in 2009. 

James Duffy, Director, Drug Discovery

1. Describe one of your most memorable experiences working with an MMV partner.

During 2018 and 2019, I was fortunate to travel to South Africa and work at the University of Cape Town with our long-standing collaborator Prof. Kelly Chibale and his team. Over the last 10 years, with MMVs help, Prof. Chibale has built a team of over 60 scientists working on drug discovery projects focused on diseases that disproportionately affect Africa. Prof. Chibale leads his team by example and has helped to debunk the myth that Africa is not, and cannot be, a source of innovation.

My role during my secondment was to help the team develop their strategic and scientific thinking across their portfolio and to provide training and mentorship to the scientists. 

2. How has this experience influenced your work at MMV?

Spending time embedded in a project team MMV works with gave me a greater understanding of the challenges of working at the “coalface” of malaria drug research. It is important to take time to listen to the voices of the researchers in the laboratories, clinics and health centres. Without their input and expertise, we will never reach our goals. As Prof. Chibale often reminds his team “if you want to go fast, go alone, if you want to go far, go together”.