title: Clinical Research and the Training of Host Country Investigators: Essential Health Priorities for Disease-Endemic Regions.
abstract: The health-care needs and resources of disease-endemic regions such as west Africa have been a major focus during the recent Ebola outbreak. On the basis of that experience, we call attention to two priorities that have unfortunately been ignored thus far: 1) the development of clinical research facilities and 2) the training of host country investigators to ensure that the facilities and expertise necessary to evaluate candidate interventions are available on-site in endemic regions when and where they are needed. In their absence, as illustrated by the recent uncertainty about the use of antivirals and other interventions for Ebola virus disease, the only treatment available may be supportive care, case fatality rates may be unacceptably high and there may be long delays between the time potential interventions become available and it becomes clear whether those interventions are safe or effective. On the basis of our experience in Mali, we urge that the development of clinical research facilities and the training of host country investigators be prioritized in disease-endemic regions such as west Africa.
authors.forename: Ousmane A
authors.initials: OA
authors.lastname: Koita
authors.forename: Robert L
authors.initials: RL
authors.lastname: Murphy
authors.forename: Saharé
authors.initials: S
authors.lastname: Fongoro
authors.forename: Boubakar
authors.initials: B
authors.lastname: Diallo
authors.forename: Seydou O
authors.initials: SO
authors.lastname: Doumbia
authors.forename: Moussa
authors.initials: M
authors.lastname: Traoré
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Krogstad
mesh_terms: D000962:Antimalarials / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D003695:Delivery of Health Care; D019353:Endemic Diseases / Q000517:prevention & control*; D006268:Health Facilities; D006282:Health Personnel / Q000193:education*; D019142:Hemorrhagic Fever, Ebola / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D016778:Malaria, Falciparum / Q000453:epidemiology / Q000517:prevention & control; D008302:Mali / Q000453:epidemiology
chemical_list: D000962:Antimalarials; D000998:Antiviral Agents