Story Source: FDA Voices
US Food and Drug Administration
Department of Health & Human Services
By: Beverly Corey, DVM
FDA and its partners in Sub-Saharan Africa have made great strides in
improving the oversight of the clinical trials of medical products in
development—an important advance in protecting public health in both the
U.S. and Africa. This is important not only to protect the Africans who
are participating in these tests of medical products, but also because
the FDA and other regulatory authorities must rely on the results of
these studies when reviewing marketing applications for the products.
FDA’s Office of International Programs (OIP) established its
Sub-Saharan Africa Post in Pretoria, South Africa, in June 2011. We have
been building regional relationships that allow us to share information
about FDA policies and procedures, and to better understand the
regulatory landscape there. The latter is no small feat in this vast
region of 54 countries with varying degrees of regulatory strengths and
capabilities.
However, our collaboration with the Southern Africa Development
Community (SADC), which represents 15 African nations, has allowed FDA
to strategically engage in strengthening regulatory capacity in the area
of Good Clinical Practices (GCPs) and clinical trial inspections. These
practices, and the inspections to ensure that they are followed, are
designed to protect the integrity of data produced by the trial and the
safety of its participants.
This activity has given expertise to regulators who did not think
their knowledge base was extensive enough to audit (monitor) and inspect
clinical trials. Regulators in countries that once did not audit
clinical trials are now doing so. With more than 2,000 clinical trials
being conducted in Africa—over half of them in South Africa—this is a
momentous public health achievement. The Sub-Saharan Africa Post
conducted a successful FDA/SADC Good Clinical Practice Inspection
training from August 24-28, 2012, in Lusaka, Zambia. Thirty six drug
regulators from 13 SADC countries participated, including Angola,
Botswana, Lesotho, Malawi, Mauritius, Mozambique, Namibia, Seychelles,
South Africa, Swaziland, Tanzania, Zambia and Zimbabwe.
This was the third in an FDA training series—typically offered in
three to four phases—to develop trainers who have expertise in clinical
practices and inspection. These individuals will also be prepared to
train others within their agencies and the regulated community.
This particular workshop was designed to reinforce lessons learned
and provide additional inspectional experience for those who completed
workshops in the first two training phases in Botswana in 2010 and in
Pretoria in 2011. The goals of Phase 3 include reviewing core knowledge
and skills, preparing inspection reports and inspectional observations;
acquiring additional mock inspection experience at clinical investigator
sites; gaining experience with new types of study protocols; and
promoting regional networking.
These countries continue to make substantial progress in the
oversight of clinical trials. For example, at the onset of our first
training, only three of 13 participating countries were involved in how
clinical trials are conducted. We now have an additional two countries
conducting oversight, with others poised to start soon. Other milestones
from our training include important advances towards systematic
oversight in Botswana, Mauritius, Swaziland, Tanzania, Zambia and
Zimbabwe.
The definitive winner here is public health, both the health of the
African people who participate in the trials and the health of the
patients who may one day be taking these drugs being studied.
Beverly Corey, DVM, is the Senior Regional Advisor for Sub-Saharan
Africa, FDA Office of International Programs, US Embassy, Pretoria,
South Africa
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