THE National Institute for Medical Research (NIMR) is celebrating its 40th anniversary this year since it became operational in 1980. Its establishment came about due to the government’s need for generating scientific information in the development of better methods and techniques of enhancing disease management, prevention and control in the country.
Over the last 40 years of its existence, NIMR has recorded remarkable achievements which have immensely contributed to the development of the health sector in the country.
Some of the major achievements include studies on antimalarials (antimalarial medication), improvement in HIV/Aids diagnosis and treatment, improving quality of the Central Tuberculosis Reference Laboratory (CTRL), developing different herbal and alternative therapies as well as conducting scientific research on non-communicable diseases (NCDs), among others.
NIMR Director-General, Prof Yunus Mgaya, said recently at the launch of NIMR's 40th anniversary that some major achievements in research had implications for public policy and practice.
He said studies on antimalarials conducted at NIMR Amani and Tanga had contributed to a change of treatment of malaria from chloroquine to suphadoxine - pyrimethamine (SP) and from SP to an artemether-based combination therapy (ACT).
"This has resulted in improving malaria case management and ultimately reducing morbidity and mortality in Tanzania," Prof Mgaya said.
He added that NIMR had also conducted trial on injectable artesunate (AS), which proved to be superior to quinine in preventing mortality among children, noting that such evidence had been utilised by the World Health Organisation (WHO) in updating malaria treatment guidelines.
Prof Mgaya further noted that in the late 1980s and early 1990s NIMR's Amani Research Centre researched on insecticide impregnated bed-nets, which had led to the adoption of use of the nets as part of universal malaria control strategies.
"Researches on mosquitoes responsible for transmitting malaria, the use of larvicides, social science and behavioural studies on the prevention and management of malaria have continuously been carried out in the country in different intervals and have yielded positive results in the change of public policy guidelines," he said.
He further said that NIMR had contributed to improvements in HIV/Aids diagnosis and treatment through a study on a reduction of early mortality among HIV/Aids-infected subjects starting antitetroviral therapy (Remstart) trail, which revealed a new approach to manage patients with advanced HIV/Aids in Tanzania and Zambia.
"Through a combination of a short period of home support, combined with screening for cryptococcal meningitis and pre-emptive treatment with fluconazole, reduced deaths by 28 per cent in HIV/Aids patients with CD4 count less that 200 cells/ul," Prof Mgaya noted.
According to experts, cryptococcal meningitis is a type of disease caused by a fungus called Cryptococcus. He further observed that the Remstart trial had contributed to the revision of WHO guidelines (2017) for managing advanced HIV/Aids and a rapid initiation of the antiretroviral therapy.
"NIMR also conducted another trial for the treatment of HIV/Aids associated cryptococcal meningitis using different drug combinations... the results of this study have led to WHO to issue new cryptococcal meningitis diseases guidelines," he said. Prof Mgaya further said that NIMR Muhimbili Centre in collaboration with National Tuberculosis and Leprosy Control Programme had contributed to the improved quality of CTRL and other TB laboratories in the country.
"NIMR Muhimbili has also contributed to the surveillance and monitoring of TB drug resistance in the country...further innovative strategies on the use of stool to diagnose TB using GeneXpert testing has revealed great success with policy implications for clients who cannot produce sputum," he said.
On traditional medicines, Prof Mgaya said NIMR had developed different herbal and alternative therapies that were currently undergoing research to ascertain their effectiveness.
"They include Nimrcaf, a remedy for cough and flue, Nimrvit, a healthy drink with multiple vitamins, Persivin, herbal treatment for benign prostate, hypertrophy and Nimregenin, a herbal remedy for the management of cancer," Prof Mgaya said. He noted that herbal remedies for malaria and other diseases through the use of resisted traditional healers were also being explored.
Prof Mgaya explained that NIMR had also contributed to government response to NDCs, which had become a growing health threat globally. He said that a national survey conducted by NIMR on NCDs had helped to highlight the burden of diseases, including diabetes, hypertension and cardiovascular diseases risk factors.
"The results of the study helped to inform the NCD strategic plan 2016/20 and other government efforts to respond to NCD burden," he said. He noted that other ongoing NCD studies included a H3A diabetes study which documented the prevalence and environmental and genetic determinant of type 2 diabetes in sub-Saharan Africa. "This study will fill the knowledge gap of causes or reasons for acquiring diabetes, especially in sub-Saharan Africa...this will guarantee much needed evidence on the types and subtypes of diabetes and generate evidence of specific drivers of diabetes," Prof Mgaya said.
NIMR’s study conducted on schistosomiasis and lymphatic filariasis had contributed to the policy and practice change. It has greatly contributed to health system studies and is implementing some trails to improve service delivery to patients with co/multiborbidities especially for chronic disease conditions.
NIMR has also contributed substantially in disease surveillance and response for outbreak diseases and has been a pioneer of the East Africa Disease Surveillance Network (Eaidsnet). He said due to better results the Ministry of Health, Community Development, Gender, Elderly and Children scaled up interventions to cover the whole country.
Chief Medical Officer, Prof Abel Makubi, said there was no doubt that NIMR had substantially contributed to the health sector in the country.
"This has been possible due to increased human personnel with professional skills in research and additional research centres and improved research environment, including the availability of laboratories with international standards."
Prof Makubi said although NIMR had identified its priority areas for research in the next five years, the government would like to see more emphasis put on traditional medicines and NCDs. Prof Makubi commended NIMR for coming up with various herbal and alternative therapy products used by members of the public while others were still being researched on.
"Although we have recorded some notable achievements we should ensure members of the public are provided with study findings."
He also said that more efforts should also be made in NCDs to reduce the burden on government and individual citizens.
Prof Makubi, however, said NIMR had contributed greatly to the health sector, noting that it was conducting research on a health system aimed at improving the sector.
"NIMR is conducting studies on better ways of providing integrated services on chronic diseases such as HIV/Aids, TB and non-communicable diseases," he said.
He noted that a study on integrated health services aimed at improving service delivery by enabling a patient to access services in one area instead of visiting different clinics to access health services. "Preliminary results show positive responses from patients on the acceptance of the system," he said.
In commemorating 40th anniversary NIMR planned a series of activities in November to December this year to be held at all NIMR centres and headquarters in the country. The activities include the dissemination of its achievements through various media platforms, facilitate blood donation and provide services such as screening for diabetes and hypertension.