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Advancing Together Towards Global Health

[This text has been written by Francisco Saúte, Director General of CISM and, Antoni Plasència, Director General of ISGlobal. This blog post is a one of a series of articles to commemorate the 25th anniversary of CISM].

Mopeia inquirers team

With the dawn of the new year, our celebration of the 25th anniversary of the Manhiça Health Research Centre (CISM) has drawn to a close. After rereading all the articles published in this series, we are proud to see that the relationship of cooperation, exchange and friendship that began a quarter of a century ago has continued to grow and gain strength ever since.

The governments of Spain and Mozambique joined forces in 1996 to lay the groundwork for what would become CISM; in turn, CISM was instrumental in the evolution of the Barcelona Institute for Global Health (ISGlobal). Since then, we have advanced together along the path of global health with a single objective: finding solutions to the health inequalities that affect the planet’s most vulnerable populations. With a model of equitable partnership and mutual exchange, a shared scientific agenda, and a two-way academic programme involving the University of Barcelona and Eduardo Mondlane University, we have put into practice the African proverb that has guided and inspired us from the outset: If you want to go fast, go alone. If you want to go far, go together. And indeed, we have come a long way.

The fruits of this long-standing strategic partnership are many. The scientific evidence generated by our research teams has contributed to the development of health policies that have saved thousands of lives in Mozambique

To give just a couple of examples, CISM produced the necessary evidence for the inclusion of meningitis, pneumonia and diarrhoea vaccines in Mozambique’s Expanded Programme on Immunisation —which has had a huge impact on the number of lives saved—and data generated by our teams have shed light on the importance of tuberculosis as a cause of death in the country.

The human papillomavirus (HPV) vaccine is yet another very significant case. The Government of Mozambique recently announced a nationwide rollout of this vaccine, which will help to improve the health and lives of thousands of women in the coming years. The role of CISM and ISGlobal in this process has been fundamental: in 2001, researchers from the two centres generated basic information that explained the reality of HPV in the country.

We subsequently collaborated on Mozambique’s first HPV vaccination pilot project, and CISM was tapped to oversee the evaluation of the programme. In short, knowledge generated by our teams over the past two decades made this fantastic news possible.

However, our scientific contributions over the course of more than two decades have also had an impact beyond Mozambique’s borders. Malaria research—the field that initially jump-started the collaboration between the two centres—is certainly one of the greatest examples. CISM and ISGlobal were involved in the clinical development of RTS,S, the first malaria vaccine, which the World Health Organisation (WHO) has recommended for widespread use in sub-Saharan Africa.

This vaccine constitutes a historic breakthrough not only for the field of malaria but for global health generally, as it was the first vaccine ever developed against a parasite. Although imperfect, this new tool will be used alongside existing strategies for controlling and preventing a disease that disproportionately affects children under five years of age and pregnant women in sub-Saharan Africa. In addition, work carried out at CISM also influenced the WHO’s decision to recommend intermittent preventive treatment to prevent malaria in the first year of life.

Another area of cutting-edge research currently being spearheaded by CISM and ISGlobal is the determination of causes of death. In collaboration with Maputo Central Hospital and Hospital Clínic, our two centres have developed and validated the minimally invasive autopsy technique, a promising method with the potential to radically change our understanding of causes of death and, therefore, shape global health priorities.

Despite the undeniable influence of our contributions thus far—those mentioned above are just a small sample; see CISM’s 25th anniversary website for more information—we mustn’t rest on our laurels. In the 21st century, it is intolerable that millions of children continue to die from preventable and treatable diseases. We believe we have an ethical duty to keep investigating the control and prevention of infectious diseases affecting the poorest and most vulnerable populations, and we will continue to do precisely that.

At the same time, we mustn’t overlook the new health threats posed to these populations by non-communicable diseases and climate change. This is an area in which our strategic collaboration can continue to grow and gain strength, so that we may contribute, through the knowledge we generate, to improving health and promoting equity across the globe.

Now more than ever, we must look to the future, aware of the enormous responsibility conferred by the legacy of these 25 years of work in Manhiça and Barcelona. Thanks to ongoing support from the Spanish Agency for International Development Cooperation (AECID), the Mozambican Ministry of Health, the Bill & Melinda Gates Foundation and the ”la Caixa” Foundation, among many other institutions that have funded our joint projects, we have achieved a great deal.

We must continue along the same lines, fortifying the collaborative model based on research and cooperation that has proved so successful, fostering the development of scientific and technical capabilities in young people on both continents, and transferring all the knowledge we have generated to influence health policies, thereby making a real impact in the fight against health inequalities.
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