RESEARCH, INNOVATION AND COLLABORATION MARK THE 2ND MTBI ANNUAL FORUM IN MAPUTO

The meeting brought together researchers, healthcare professionals, representatives of national and international institutions, partners and students to discuss scientific advances and research priorities in tuberculosis in Mozambique.

How can scientific research findings be translated into practical solutions to address the challenges posed by tuberculosis (TB) in Mozambique? This was one of the key questions guiding the discussions at the 2nd Annual Forum of the Manhiça TB Initiative (MTBI), held last Thursday, 1 October, in Maputo.

Under the theme “Advancing Research to Improve Tuberculosis Control in Mozambique,” the forum provided a platform for sharing scientific evidence, reflecting on current challenges and identifying opportunities to strengthen research and its contribution to public health policies and practices.

The meeting was part of the celebrations marking the 30th anniversary of the Manhiça Health Research Centre (CISM), commemorating three decades of contributions to scientific knowledge generation and health improvement in Mozambique.

Research Aligned with National Health Priorities

Representing the Ministry of Health (MISAU), José Manuel, National Director of Planning and Cooperation at MISAU, highlighted the importance of the Forum as a platform for dialogue, knowledge sharing and closer engagement between the scientific community and those responsible for defining and implementing national health policies.

Acknowledging that TB remains a major challenge for Mozambique despite the progress achieved, the MISAU representative stressed the need to generate scientific evidence that addresses the country’s specific challenges and contributes to improving the prevention, diagnosis, treatment and follow-up of people affected by the disease.

He also called for stronger collaboration among national programmes, research institutions, universities, healthcare professionals, communities and cooperation partners to ensure that the knowledge generated translates into interventions that have a meaningful impact on population health. “We therefore recognise the contribution of MTBI and CISM to strengthening tuberculosis research in the country, as well as the Centre’s three-decade track record in advancing health research in Mozambique,” the MISAU representative emphasised at the event.

For Dr Alberto García-Basteiro, a researcher and Head of Tuberculosis Research at CISM, forums such as this are essential for fostering joint reflection on responses to the disease, from diagnosis and treatment to prevention and the consequences of TB for people’s health and quality of life.

The researcher highlighted the importance of closer coordination among national programmes, research institutions, technical partners, healthcare facilities and funders to ensure that research is increasingly aligned with public health priorities. He also emphasised the participation of students, describing it as a positive sign of growing interest in scientific research among younger generations. 

New Approaches to Tuberculosis Diagnosis and Prevention

One of the highlights of the scientific programme was the keynote lecture delivered by Professor Molebogeng Rangaka, a researcher affiliated with University College London in the United Kingdom and the University of Cape Town in South Africa.

Her presentation explored advances and challenges in diagnosing tuberculosis (TB) infection, with a particular focus on the limitations of currently used methods, such as the Tuberculin Skin Test (TST or PPD) and the Interferon-Gamma Release Assay (IGRA). Although these tests can identify an immune response associated with exposure to Mycobacterium tuberculosis, they cannot reliably distinguish active TB disease from latent TB infection, nor can they identify those at greatest risk of developing the disease.

In this context, the need to develop more accurate diagnostic tools was highlighted. Such tools should go beyond simply identifying exposure to the bacterium and help answer a fundamental question: “Who is at the highest risk of developing tuberculosis and would benefit most from preventive treatment at this point in time?”

The presentation highlighted three key dimensions for assessing progress in diagnostic tests: accuracy, in identifying people at greater risk of developing tuberculosis; clinical impact, by demonstrating tangible benefits in preventing the disease and reducing the number of cases; and people’s preferences, by considering factors such as accessibility, cost, speed and ease of use.

Rangaka concluded with a call to action for Mozambique: “The next generation of TB diagnostics must go beyond identifying exposure to the disease and focus on identifying those at greatest risk of developing TB and those who would benefit most from preventive treatment.”

The Voice of Someone Who Has Experienced Tuberculosis

One of the highlights of the event was the testimony of Carla Cândida, who shared her experience as a survivor of multidrug-resistant tuberculosis (MDR-TB), bringing the perspective of someone who has experienced the challenges associated with the disease firsthand into the discussion.

In her personal account, Carla described her difficult journey of approximately five years, during which she attended several healthcare facilities before being cured. She expressed her gratitude for the care and support provided by healthcare professionals and stated that she had not experienced any form of discrimination throughout the process.

Her testimony drew researchers’ attention to the lengthy and demanding nature of TB treatment, which can pose barriers to completion. She noted that “people often discontinue treatment because of the long period they have to take medication.”

Her account reinforced the importance of placing people affected by tuberculosis at the centre of research and the development of strategies to address the disease, taking into consideration not only clinical outcomes but also patients’ experiences, needs and quality of life.

National Research Presents Findings and New Perspectives

The scientific programme included presentations of several studies conducted by national researchers, covering different aspects of tuberculosis, from diagnosis and prevention to treatment and the consequences of the disease.

Patrícia Manjate, from CISM, presented a study on immune biomarkers capable of distinguishing bacteriologically confirmed TB cases from clinically diagnosed cases, as well as predicting treatment outcomes in people living with HIV.

Amuly Chilopola, also from CISM, presented the TB QUEST study, which aims to deepen understanding of the epidemiology of asymptomatic tuberculosis, contributing to a better understanding of how the disease presents and the challenges involved in identifying it.

Meanwhile, Agostinho Lima, from CISM, discussed lessons learned and key considerations for the future introduction of a new tuberculosis vaccine in Mozambique, in the context of ongoing efforts to develop new prevention tools.

The consequences of TB after completion of treatment were also highlighted in a presentation by Pedroso Nhassengo, from the National Institute of Health (INS), who examined the implications of post-tuberculosis lung disease for the health and quality of life of affected individuals.

Collaboration and Setting Priorities for Tuberculosis Research

The roundtable discussion, entitled “How can we develop a tuberculosis research agenda that addresses the country’s priorities?”, was another key moment of the Forum. The discussion brought together representatives from the National Tuberculosis Control Programme (PNCT), the US Centers for Disease Control and Prevention (CDC), CISM, INS and the Aurum Foundation, providing an opportunity to bring together different perspectives on the challenges, priorities and research opportunities in Mozambique.

Among the main points discussed was the need to establish permanent dialogue mechanisms between national programmes and research institutions, enabling challenges identified during programme implementation to be translated into research questions and studies with practical applications.

Participants also reflected on the importance of aligning national research agendas with international research priorities and funding opportunities, while keeping the country’s specific needs in focus.

The need to strengthen the capacity of Mozambican institutions to define and lead their own research agendas, foster partnerships and mobilise resources for studies relevant to the national response to tuberculosis was also emphasised.

In this context, the Aurum Foundation highlighted the potential of operational research to address questions arising during the implementation of TB control programmes, generating evidence to support decision-making and the development of recommendations by the PNCT.

From Knowledge Generation to Action

In conclusion, the Forum reinforced a key message: scientific research can only fully realise its potential when the findings generated contribute to improving health policies, programmes and practices.

The 2nd MTBI Annual Forum thus highlighted the importance of consolidating a tuberculosis research agenda guided by national priorities, underpinned by partnerships and responsive to the needs of affected individuals and communities. More than a platform for presenting scientific findings, the meeting provided an opportunity to strengthen dialogue among researchers, policymakers, healthcare professionals and partners, reaffirming their collective commitment to translating knowledge into practical solutions to improve tuberculosis prevention, diagnosis, treatment and control in Mozambique.