Interview with Mudarshiru Bbuye on infectious diseases research and equity in clinical research

Mudarshiru Bbuye is a Research Fellow at the Makerere University Lung Institute, Uganda, and the coordinator of the Coalition’s Virology, Immunology & Diagnostics Working Group. He is an experienced public research scientist with a demonstrated history of working in public health and basic science research institutions and in the COVID-19 response in Uganda. His main interests include research in lung health, especially tuberculosis and its interaction with HIV, and recently COVID-19 pathophysiology.

Tell us about some key events in your life that led you to choose a career in infectious diseases research.  

As a child, I always wanted to be a pharmacist as I was fascinated by the pharmacies and how they provided essential medicines to those in need in my home village. As I grew older, this interest in science and public health led me to pursue a Bachelor of Science degree in biological sciences from Kyambogo University and later, a master’s in public health from Makerere University.  

My first and second internships at the Rakai Health Sciences Program and Makerere University School of Biomedical Sciences were pivotal moments that significantly influenced my research career as I witnessed from up-close the impact of the HIV and TB epidemics through research studies and programs undertaken at these institutions. As a budding biomedical scientist, I gained invaluable firsthand experience in implementation research which reinforced my interest in infectious disease research. Additionally, the mentorship I received during the early stages of my career played a key role in shaping my research career development. 

You are a member of the Virology, Immunology, Diagnostics working group in the Coalition. What motivated you to join it and what is your proudest achievement from this collaboration?

I first heard about the Coalition from my colleague Dr Winters Muttamba at Makerere University, and from my mentor Dr Wilber Sabiti, who is the co-chair of the Working Group on Virology, Immunology and Diagnostics. The Coalition was set up during the early days of the COVID-19 pandemic when many low- and middle-income countries were struggling to implement research amid a pandemic. Our objective was to fill some of the knowledge gaps and provide guidance as well as a platform to learn and exchange during the pandemic. Whether it was advice on COVID-19 diagnostics or resource mobilization, we tried to support each other, and shared lessons learnt. 

We are also looking at creating a biorepository to support researchers in low-resource settings, who do not necessarily have the capacity to collect biological samples.

One of the highlights from this collaboration is the fact that as part of the Coalition, we were able to review COVID-19 testing guidelines across the world, from high-resource to low-resource settings. We are also looking at creating a biorepository to support researchers in low-resource settings, who do not necessarily have the capacity to collect biological samples.  

Why is it important to invest in biobanking and genome sequencing capacity in low-and middle-income countries?

One of the limitations that researchers in low-resource settings face is the challenge of collecting biological samples. It takes a lot of money and infrastructure to collect biological samples. So, biobanks could provide solutions to some of these challenges. You can collect samples of defined phylogenetic populations and store them as duplicates, allowing other researchers interested in collecting similar phylogenetic data from the same population to study different health issues, to work with the bank of biological samples. This will help us undertake much more research with little additional costs.  

The other issue is genome sequencing capacity. As researchers in low-resource settings, we often have to send our samples to laboratories in the US or the UK, which takes both time and money.  Biobanking samples would facilitate sharing genomic data of interest from other laboratories for both upper and low-income countries to answer important research questions. 

As someone who has worked extensively in clinical research for diseases like HIV, tuberculosis and COVID-19 in Uganda, what kind of support should be extended to researchers conducting clinical research in low resource settings?

We need resources to conduct research, and this includes a broad range of support to set up laboratories to conduct sophisticated analyses, be able to compensate participants in trials, and cover the logistical expenses of doing science. Most importantly, there is a skill gap that needs to be bridged so that researchers in low-resource settings can get access to technology that is usually only available in high-resource settings.  

We are producing important knowledge and data that contributes to global studies and the development of new tools for several diseases and yet, once in the market, these products become unaffordable to most people in low-income countries.

We need to also recognize the crucial role of those conducting research in low-resource settings, despite all the limitations. We are producing important knowledge and data that contributes to global studies and the development of new tools for several diseases and yet, once in the market, these products become unaffordable to most people in low-income countries. So, we need improved capacity to design and develop tools like diagnostic products and vaccines, using locally sourced materials, so that our local populations can benefit from our research. 

What is your vision for equity in clinical research? 

Africa and low-income countries around the world should be given the benefit of doubt to develop interventions. My vision for equity in clinical research is when researchers in low-resource settings have the capacity and mandate to develop locally led interventions to solve their problems even during epidemic response periods 

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