NYU_ABUDHABI_Research agenda Rwanda.pptx

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1. Health Research agenda in Rwanda Dr. Muhammed Semakula, Head of Department of Planning, Strategic Information, and Health Financing, Ministry of Health Rwanda Butaro HD2SS – NYU Abu Dhabi Workshop Abu Dhabi , May 2024

2. The health status of the population Life Expectancy at Birth (LE): Trends and comparison with SSA of life expectancy at birth between 1978 and 2022 by sex Rwanda at 69.6 years (2022 data) ranks 8th/48 countries in Sub Saharan Africa (SSA). Ahead of Rwanda is: Cape Verde (74.1), Mauritius (73.7), Seychelles (73.4), etc.

3. The health status of the population Gains in LE due to: Rising standard of living, Improved lifestyles and education, Access to quality health care The 2022 RPHC indicates: overall death declined by 63% from the previous census Life Expectancy at a specific age as of 2022

4. Major Causes of Death Reported by NISR in 2022 Global Burden of Disease (GBD, 2019) Cause 2009 Rank 2019 Rank Change in deaths per 100k, 2009-2019 Lower respiratory infection -23.7 Neonatal disorders -24.2 Stroke +4.4 Tuberculosis -14.9 Ischemic heart disease +5.8 Diarrheal diseases -24.2 Malaria -11.3 HIV/AIDS -40.6 Cirrhosis liver +1.1 Road injuries -2.7 2 1 7 5 8 4 6 3 9 11 1 2 6 4 5 3 7 8 9 10 Communicable, maternal, neonatal, and nutritional diseases Non-communicable diseases Injuries

5. Risk Factors Source: IHME Global Burden of Disease (GBD, 2019) Risk 2009 Rank 2019 Rank Change in DALYs per 100k, 2009-2019 Malnutrition -6324.6 Air pollution -1582.9 WaSH -2492.6 Alcohol use -200.1 Unsafe sex -1825.7 High blood pressure 167.7 Tobacco -6.2 High fasting plasma glucose 155.8 Occupational risks -5.3 High body-mass index 300.1 Metabolic Risks Environmental/Occupational Risks Behavioral Risks 1 2 3 4 5 6 7 8 9 10 1 2 3 5 4 7 6 9 8 11

6. 6 Shift of burden of disease and Life expectancy in Rwanda 24.5 per 1000 32.4 per 1000 7.3 per 1000

7. Why establishing the Disease surveillance system Cause of death in Rwanda, 2022 Causes of morbidity , 2023

8. Maternal and Neonatal Mortality “ No mother should die while giving birth!! Indeed, we need to explore and understand the situation! ”

9. Trends in Maternal Mortality ratio

10. Trends in Neonatal Mortality rate

11. Disease Programs

12. 12 Era of Disease control

13. Reduction in Malaria Incidence

14. Health Sector Strategic Plan (HSSP V) 2024-2030 Strategic Framework

15. Health Sector Strategi Plan V Health security and emergency management Objectives Quality of Care based on Primary Health Care Health workforce Biomanufacturing, Research, innovation, Regulation and digitalization Health infrastructure modernization P1.1.1. Health Professional Career Guidance & Recruitment P1.1.2. Health training capacity development of the country including Private Public Partnership P1.1.3. Partnerships promotion with medical training institutions (regional and global) P1.1.4. Resource mobilization for training and upskilling P1.2.1. Health workforce retention P1.2.2. Health workforce deployment optimization P1.2.3. Health workforce empowerment HSSP V Pillars HSSP V Priorities Quadruple skilled health workforce Health workers’ fulfilment and satisfaction Build, upgrade and maintain healthcare facilities up to standard Establish Kigali Health City (KHC) Aptly equip health facilities Maximize the readiness and operationalization of health facilities P3.1.1./2.1./3.1. Maternal, neonatal and child health P3.2.2./3.2. Nutrition P3.1.2/2.3./3.3. Non-communicable disease prevention and control P3.1.3./2.4./3.4. Infectious disease prevention and control P3.3.4. Emergency medical services and trauma P3.3.5. Community based health services P3.1.3/2.4./3.6. Metal health P3.1.4/2.5./3.7. Adolescent and youth health services P3.1.5/2.6./3.8. Sexual and reproductive health P3.3.9. Specialised medicine P3.3.10. Availability of medicine and medical consumables P4.1.1./2.1./3.1. AI driven disease surveillance and outbreak prediction P4.1.2./2.2./3.2. Smart integrated one health system P4.1.3./2.3./3.3. Health intelligence centre P4.1.4./2.4./3.4. Pioneering next generation point of entry surveillance P4.1.5./2.35/3.5. Multi-pathogen genome sequencing to identify public health threats P5.1.1./2.1./3.1. Build research capacity P5.1.1/2.2./3.2. Foster collaboration between industry and academia P5.1.3./2.3./3.3. Genomics and precision medicine research P5.1.4./2.4./3.4. Data for decision making and policy P5.2.5./3.5. Investment in drug manufacturing and technology transfer P5.4.1. Health research cloud infrastructure P5.4.2. Digitalization of the health sector Attain universal health care coverage Improve the level of population health literacy Enhanced health service availability Protect the public from public health threats Strengthen local and internation partnerships in heath security Enhance capacity for early detection, notification and response Advance scientific knowledge Promote research into drug and discovery Promote health related innovations Enhance digital health P2.1.1. Health facility expansion, renovation and rehabilitation P2.1.2./2.1./4.1. Health facility accreditation and standardization P2.2. Strategic acquisition of medical equipment P2.3.1Invest and attract investment for operationalization of Kigali Health City P2.3.2. Medical tourism P2.4.2. Optimal health facility use Mission: To provide and continually improve promotive, preventive, curative, rehabilitative, and palliative healthcare services of the highest quality equitably to enhance the well-being of the population in Rwanda Crosscutting enablers Health Financing Leadership and Governance Vision: To have a healthy and productive population that contributes to the realization of Rwanda’s development goals Vision Mission Enhance Education Quality of Health Workforce

16. Health Sector Strategi Plan V Continued Crosscutting Enablers Health Financing Leadership and Governance Objectives 1.1.1 Resource mobilization, focusing on domestic funding 1.2.1 CBHI Sustainability 1.1.2, 1.2.2 Effective pooling and purchasing mechanism 1.1.3 Economic evaluation HSSP V Priorities Improved Efficiency Financial risk protection 2.1.1; 2.2.1; 2.3.1 Enhance good governance 1.1.2; 2.1.2 Well-functioning coordination mechanisms at all levels 2.3.1 Conducive environment for private sector engagement Increased private investment in health Improved accountability and transparency Improved community satisfaction and ownership

17. Health Research Agenda 2024-2029

18. 18 5 Pillars for Health Research and Development Clinical research ecosystem Resource mobilization for R&D Research Coordination Scientific Communication Research Capacity Building Health Research

19. Gaps and proposed interventions Gap Intervention Difference from existing interventions Research framework Policies, Guidelines, Research Agenda Research Ecosystem: Infrastructure, regulatory framework, human workforce dvp Develop the Health Sector Research Policy National Health Research Agenda Research Strategic Plan with Roadmaps Regulations Each institution had it’s own research policy and guideline. The Previous research agenda was outdates in 2018. No Existing Roadmap Biobanking System, Bioinformatics tools Clinical trial Building clinical trial capabilities development Certified at least 30 clinical trials sites, including regional offices and provincial hospitals Translating Clinical Trial Execution into Job Creation Increased CT sites from 10 to 30. Certification from recognised institutions.( IQVIA, …) Include clinical trials, into the curricula of learning institutions. Conduct research Clinical Trial Observational studies based on program surveillance (Cohort studies) Basic research and discovery Pandemic surveillance ( Genomic surveillance, AMR, climate change…) Digital health, big data and Artificial intelligence Impact evaluation studies for programs strategic plans interventions. Many studies conducted were cross sectional . We plan to upgrade to more observational studies. Expansion of genomic surveillance from COVID-19 to other pathogens. Improve the diagnosis tools using technology, data science and bioinformatics Capacity Building for research 1 . Diploma in research for junior researchers 2. Clinical trial trainings 3. Fellowship programs in research and data science 4. Academic trainings ( Msc , PhD, and Post Docs) => Currently ~ 12 PhD students Recognised diploma for research Fellowship program is new. Increase the collaboration with Int’l universities aiming at least 40 PhDs in 5 years.

20. Gaps and proposed interventions Gap Intervention Difference from existing interventions Get Research into Policy and Practice (GRIPP) Enhance the action research capacity and resources. and translation into policy Provide grants to researcher from decentralised level for action research Involve fellows in clinical research Data use for diagnosis and clinical decision Use of Artificial intelligence and data science methods to facilitate the disease predictions, diagnosis and clinical management Low use of AI solutions Resource mobilization for research and Development Increase resources mobilization for Research and Development through donors and competitive grants application. Data commercialization for sustainability Advocate for increased domestic funding for Research and Development Establishment of the Grant Office to map research grants and coordinate the applications. Data are share freely Currently most of the funding is external

21. 21 Research Output Rwanda Region

22. 22 IRCAD- Africa

23. 23 The GOR is building and Strengthening a conducive ecosystem to become a bio-manufacturing hub for Africa continent Bio-manufacturing hub for Africa continent

24. H.E. President Paul Kagame Republic of Rwanda Ursula von der Leyen EU Commission President Dr. Ugur Sahin Co-Founder & CEO BioNTech Official Launch of BioNTech in Rwanda 18 December 2023

25. 26 Thank you for your attention!