EDCTP Anniversary Presentation: EDCTP 20 years and beyond – from strategy and numbers to sustainable impact

In a keynote address at the EDCTP 2023 Forum, EDCTP2 Executive Director Dr Michael Makanga gave a whistle-stop tour of the first 20 years of EDCTP – summarising not just trends in funding but also, most importantly, what that funding has achieved.

Dr Michael Makanga suggested that EDCTP had been on a journey over the past 20 years, growing and evolving over time. This journey began with the opening of a European Office in February 2004, followed by an African office in July 2004. The focus of the first EDCTP programme was on HIV/AIDS, TB and malaria, and it introduced the integrated approach that has been sustained through subsequent programmes, with a central focus on clinical research but also a strong commitment to capacity building, including support for fellows in Africa.

Dr Makanga flagged just a few of the many achievements of the first EDCTP programme. These have included new fixed-dose combinations of antiretrovirals for children with HIV infections, influential studies of prevention of mother-to-child transmission of HIV, and landmark antimalarial drug trials. The programme also supported an innovative ‘multi-arm multi-stage’ (MAMS) study of TB treatments, through the PanACEA Consortium.

EDCTP2: bigger and bolder

In 2014, the EDCTP2 programme was launched as part of the Horizon 2020 programme. The legal basis of EDCTP changed, with the formation of the EDCTP Association – a partnership between countries in Europe and sub-Saharan Africa, with 11 countries as full members and African representation on its governing board.

The scope of EDCTP2 expanded to include neglected infectious diseases, diarrhoeal diseases, lower respiratory tract infections, and diseases of epidemic potential. The scale of activities also grew significantly, including a much-expanded fellowship programme.

Funding increased substantially, as did geographic reach: institutions in 72 countries, 44 in Africa and 20 in Europe, have been involved in EDCTP2 projects.

Although many projects are still ongoing, the impact of EDCTP2 has already been significant. Highlights have included a trial demonstrating the efficacy of a simplified treatment for cryptococcal meningitis in HIV patients and a phase IIb trial of the R21/Matrix-M vaccine for malaria, both of which fed into new WHO recommendations.

EDCTP-funded studies have also made major contributions to monitoring of human African trypanosomiasis (HAT) elimination, development of a new version of praziquantel suitable for schistosomiasis treatment in young children, and the demonstration of the additional health benefits deriving from a combination of RTS,S vaccine use and seasonal malaria chemoprevention.

EDCTP3: into the future

Dr Makanga will also be leading EDCTP into a new era, as newly appointed Executive Director of the recently launched Global Health EDCTP3 programme.

This will have a new legal basis, as a Joint Undertaking, meaning that the European Union, through the European Commission, will be a partner with the EDCTP Association, representing European and Africa Member States. Funding has again been increased, the programme’s scope has been expanded to include antimicrobial resistance and the impacts of climate change, and there will be potential to involve a greater number of third parties.

EDCTP has now grown to encompass 15 countries from Europe and 27 from Africa, with two aspirant members. The aim now is to build on the major impact achieved through the first two programmes, to deliver more public health benefits to populations in sub-Saharan Africa and to strengthen institutional and human capacity in the region so that it is better able to address its own health challenges.

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