Ifakara Health Institute (IHI)

Experience

A non-profit medical research institute, based in Tanzania, East Africa. Ifakara Health Institute (IHI) started back in the 1950s - initially as a "field research station" of the Swiss Tropical and Public Health Institute. We became an independent non-profit organisation in 1996. IHI is now one of the leading health research centres in Africa.

We attract funding for research through competitive grant applications from organisations such as the Bill and Mellinda Gates Foundation, the European Clinical Trials Development Partnership and many others. Much of our research centres on Malaria (ways to control the mosquito vector, better drugs, new diagnostics etc.). IHI was one of 11 centres around the world that took part in the recent clinical trial of the world's most clinically-advanced malaria vaccine candidate the RTS,S. IHI is also the first centre in Africa where clinical trials for the sporozoite malaria vaccine (PfSPZ) will be conducted.

The organisation is led and managed by Tanzanians, and is are proud to have nearly 30 PhD scientists working with it. IHI has collaborative projects with many global centres of excellence in health research, such as SwissTPH, the London School of Hygiene and Tropical Medicine, Colombia University, Harvard, Johns Hopkins and many others.

One of the things that IHI does is to continuously monitor births and deaths in a "surveillance" population of about half a million people. For every death, we track the age, sex, place. We also determine the probable cause of death by interviewing the bereaved about the symptoms of the deceased - a process called "verbal autopsy". This surveillance system allows us to monitor mortality trends in different age groups and from different diseases. The system has been operating now for more than 10 years.

The information is used by the Government of Tanzania to monitor progress in improving health outcomes. For the researchers, the surveillance system provides a way of measuring whether a novel health intervention has had a measurable impact on mortality.

Research interests

o IHI conducts a wide range of health-related research, including biomedical and environmental studies, trials of drugs, vaccines and diagnostics, health-systems research, Impact Evaluation, and Policy Delivery.

o With its registered office in Ifakara town, Morogoro Region, IHI also has six other offices in Dar es Salaam; Bagamoyo and Rufiji in Pwani Region, Kigoma, Mtwara and Dodoma. The Dar es Salaam office serves as the coordination centre. In addition to these offices, IHI has established sentinel panel of 24 districts spread across the country.

Research and training
o In 2012, IHI staff authored over 79 articles which were published in international peer-reviewed journals, an increase of 43.6% from the previous year's record.

o IHI employs 227 world-class Tanzanian scientists, including PhD 30, MSc 117, BSc/BA 81.

o The organisation produces about 10 new PhDs annually and supports a similar number to pursue graduate studies. As of December 2012, a total of 96 students at various levels were on full/partial IHI funding with 32 PhDs, 24 Msc and 40 at other levels.

Research infrastructure
o 2 Biosafety level II labs
o Biosafety level III lab Bacteriology and Virology
o Clinical Trial Hospital
o Entomology screen houses
o Entomological labs Category 3
o Demographic Surveillance System covering a population of 350,000 in 4 districts
o Population and facility based surveillance (SPD) covering 1,500 health facilities in 24 districts and a population of 800,000 across the country
o Validated data management and storage facilities
o Training facilities for clinical and research studies
o Office and support centers in 7 locations in Tanzania

Impact of IHI work
o Collaboration with GSK on the development and testing of a sweetened pediatric formulation of Coartem®– in dispersible tablet form.

o Demonstrated a 27% improvement in child survival from the use of insecticide-treated bed nets, leading to the adoption of ITNs in national and international malaria control policy.

o Proved the “community effect” of ITNs, encouraging policy for universal coverage.

o Found the intermittent preventive treatment for malaria in infants (IPTi) reduced clinical malaria episodes by 59% and halved severe anaemia. This trial led to the foundation of the IPTi Consortium, generating evidence for international policy.

o Conducted Phase 2 trials of the malaria vaccine RTS,S in infants, finding a promising safety profile and 65% protection against first malaria infection over a 6-month follow up. IHI was the first of several centres to launch Phase 3 trials of the Phase III trial of RTS,S reported that it provided modest protection against both clinical and severe malaria in young infants.

o Confirmed the impact of Integrated Management of Childhood illnesses, achieving a 13% reduction in under-five deaths. IMCI is recommended globally by WHO.

o Established that patient-centred strategies for TB treatment improve compliance and treatment completion.

o Verified the effectiveness of biological control of Anopheles mosquitoes in Dar es Salaam.

o Developed a tool to identify groups at high risk for urinary schistosomiasis. The tool has been validated in seven countries and has been adopted by WHO.

o Monitors and evaluated the Tanzania National Voucher scheme for ITNs.

o IHI is renowned for work in development and evaluation of complementary tools for malaria prevention and monitoring:
1. Spatial mosquito repellents
2. Mosquito-killing fungi
3. Odour-baited mosquito control devices
4 . Juvenile insect hormone analogues (Filial infanticides)
5. Zooprophylaxis using insecticide-treated cattle and
6. Mosquito larval control using soil bacteria granules (Bacillus thuringiensis var israelensis)
7. Autodissemination of juvenile hormone analogues (JHAs)

o The Severe Disease in Children (SDC) studies resulted in:
1. Revision of National Guidelines for Malaria Diagnosis and Treatment (2012)
2. Development of National Clinical Manual, Job-aids & Facilitators’ training Manuals
3. Development of a Monitoring and Evaluation Tool for the Management of SDC
4. National Roadmap for maternal and newborn care
6. Change UNICEF country strategy (2007-2011).

Recognition
o IHI was the proud recipient of the Prince of Asturias Award in 2008. The Prince of Asturias Awards are a series of annual prizes awarded in Spain by the Prince of Asturias Foundation to individuals, entities or organizations from around the world who make notable achievements in the fields of sciences, humanities and public affairs. The aim is to encourage and promote scientific, cultural and humanistic values that form part of mankind's universal heritage.

o In 2010, IHI received the (Tanzania) National Award for Science and Technology.

Some of IHI Collaborators:
Local
• Tanzania Training Centre for International Health (TTCIH)
• Nelson Mandela-African Institute of Science and Technology (NM-AIST)
• Muhimbili University of Health and Allied Sciences (MUHAS)
• National Institute for Medical Research (NIMR)
• The Commission for Science and Technology (COSTECH)
• Reseach for Poverty Aleviation (REPOA)
• The African Malaria Network Trust (AMANET)
• National Sentinel Surveillance
• Sokoine University of Agriculture (SUA)
• Tanzania Social Trust Fund (SATF)
• Economic and Social Research Foundation (ESRF)
• Tumaini University
• University of Dar Es Salaam (UDSM)
• Tanzania Medical Stores Department (MSD)

International
• Bill and Melinda Gates Foundation
• CDC Atlanta
• Danish Bilharziasis Laboratory
• Hospital Clinic Barcelona
• London School of Hygiene & Tropical Medicine
• University of Glasgow
• Durham University
• Plan International
• Swiss Tropical and Public Health Institute (Swiss TPH) formerly known as Swiss Tropical Institute (STI)
• University of Maryland at Baltimore
• CNRFP, Burkina Fasso
• INDEPTH sites
• Manhica Research Centre, Mozambique
• Med Biotech Laboratory, Uganda
• MRTC, Mali
• Navrongo Health Research Centre, Ghana
• University of Cape Town, South Africa
• University of Ibadan, Nigeria
• The Global Fund to Fight AIDS, Tuberculosis and Malaria

Disease areas

Other information

Malaria, TB, HIV, Sexually-transmitted infections, staphylococcal disease, viral circulation and non-malarial fevers. Also water and sanitation related diseases and zoonotic disease. studies of health system performance including service delivery; quality, effectiveness and equity; health financing, human resources, governance and accountability and social determinants of health.

Also focus on maternal, neonatal and child health services; national programs and changes in population health and demographics. Custodian of of Health and Demographic Surveillance, Facility Based Information System and SAVVY.

For more information visit website: http://www.ihi.or.tz/ Facebook: https://www.facebook.com/IfakaraHealthInstitute