New Vision (Kampala) - December 5, 2006
Fred Ouma

The Joint Clinical Research Centre (JCRC), together with partners at Mulago Hospital, Uganda Virus Research Institute, Entebbe as well as other partners in Africa, was the first centre to carry out a research that describes the best HIV treatment in resource-constrained countries.

The centre has since expanded from one site serving AIDS patients to 42 sites - many of them in remote rural areas providing antiretroviral therapy (ART) to over 35,000 Ugandans. JCRC in Mengo, Kampala, last week marked 15 years since it started medical research, care and treatment in HIV/AIDS.

Destined to be a vibrant self-sustaining centre of excellence in medical research, training and health care services, the centre has expanded and attracted partners worldwide over time. It has formed an extensive network of research with other organisations in Uganda, US, Europe and the Far East including Japan.

This is no mean feat as many countries around the world are already emulating the centre's best HIV treatment outcome.

As a joint venture of the Ministry of Health, Makerere University and Ministry of Defence, the centre started at the height of the AIDS crisis in the country in the 1990s.

The epidemic was raging with vengeance as people were dying in numbers. There was absolutely no treatment for all AIDS patients. And to worsen the matter, there were lots of false claims and rumours especially by herbalists and quacks that surrounded the unknown plague, popularly referred to as 'Slim' because people in the advanced stage of the disease become extremely emaciated.

Prof. Peter Mugyenyi, the JCRC director recalls: "The early 1990s was a very difficult time. Any employer will tell you many of their employees went missing to attend funerals in the villages.

"Many organisations lost the cream of their people. It was indeed a crisis period and JCRC was specifically formed and charged to find a scientific solution to this catastrophe. It led the effort to find treatment and also carried out research in an attempt to help alleviate the scourge," he says. The centre's most important achievements include introduction of treatment in Uganda, participating in the preventive programme and increasing access to quality treatment.

"When the cost (of ARVs) decreased, access increased. We're in the leadership of increasing access to treatment in the country," Mugyenyi adds.

Together, JCRC and partners have carried out a lot of research on AIDS that has formed the way forward in managing the epidemic that inflicts nearly 40 million people worldwide. Mugyenyi reveals that some of the research carried out by the centre has been pioneer work.

Besides, as the first centre in Africa to import antiretroviral (ARVs) drugs and one of the first to test these drugs and make them accessible to the population in 1992, JCRC is the largest provider of ARVs in Sub-Saharan Africa. Equipped with the biggest reference laboratory, providing services to other centres giving ARVs in the country and the Great Lakes region, it boasts as the coordinating centre for research grants for many young scientists in many parts of Africa.

Mugyenyi says, "We've many grantees in Western Africa, Southern Africa, East and Central Africa. We receive grants from donors and competitively award and monitor them from JCRC."

The centre also provides training assistance and research grants to Masters degree and Ph.D students at Makerere and Mbarara universities and other institutions abroad. The aim is to build capacity for indigenous scientists to develop best practices in clinical and scientific arenas.

Prof. Epelu Opio, the JCRC Board chairman would simply attribute the JCRC's success story to basically three factors: good management coupled with good governance prevailing in the country and personal involvement of President Yoweri Museveni to fight AIDS.

"With good management characterised by hand work, commitment and resilience, the centre has built a good reputation locally and internally," says Opio.

Museveni was the first JCRC chairman and Dr. Ben Mbonye was the first director in 1991. Both were among several people who were recently awarded for outstanding contribution to the HIV/AIDS fight.

In a bid to fulfil its dream of becoming a regional centre of excellence, JCRC has established six centres of excellence in all regions of Uganda to provide critical laboratory tests including CD4s and Viral Load.

For the first time, advanced tests will be accessible to all rural areas of the country through patient and specimen referral strategy.

Dr. Samson Kibende, the JCRC deputy director says a programme for robust adherence through the Timetable for Regional Expansion of Antiretroviral Therapy (TREAT) has been created.

He says although there is still a funding gap and establishing a network to reach rural people, greatest of all is covering as much number as possible.

"We aim at making sure that everybody who needs services get them. Until that is achieved, we feel there is a lot to do," Kibende adds.

To date, JCRC offers treatment to vulnerable groups such as orphans, children, caretakers of orphans, pregnant women and their spouses, poor men and women especially widows.

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