Decades of scientific work in Uganda

The 1990s: Combating Sleeping Sickness

The history of the Mbarara center began in the mid-1990s, when Epicentre teams joined forces with MSF in the fight against African human trypanosomiasis, better known as sleeping sickness.

Establishing a permanent presence in Uganda in 1995, Epicentre contributed to several studies aimed at improving the diagnosis and management of this neglected tropical disease. This work was part of the international scientific effort that led to the development of treatments that are simpler, safer, and better suited to resource-limited settings. In particular, it contributed to the adoption of the nifurtimox-eflornithine combination (NECT), which is now recommended for the treatment of sleeping sickness caused by Trypanosoma brucei gambiense.

The 2000s: Advancing malaria care

Starting in the 2000s, the Mbarara center became a major player in malaria research. In 2006–2007, Epicentre sponsored a clinical trial comparing artemether-lumefantrine (Coartem®) with quinine for the treatment of uncomplicated malaria in pregnant women. This study helped to strengthen knowledge about the use of artemisinin-based combination therapies during pregnancy.

The center also participated in the multicenter AQUAMAT trial, one of the largest studies ever conducted on severe malaria in children in Africa. Conducted in nine African countries, this trial demonstrated that injectable artesunate significantly reduces mortality compared to quinine. Its results led to an update in the World Health Organization’s recommendations and established artesunate as the standard of care for severe malaria.

The 2010s: Tuberculosis at the center of research

In response to the growing prevalence of tuberculosis in East Africa, the Mbarara center developed new clinical and laboratory research capabilities.

In 2007, Epicentre inaugurated a Biosafety Level 3 (BSL-3) laboratory, which has become an essential tool for tuberculosis research. This facility enables the cultivation of Mycobacterium tuberculosis, the evaluation of new diagnostic tools, and participation in international clinical trials.

In particular, the teams are contributing to several studies that contribute evidence for advancing TB diagnostic and therapeutic strategies. Among these was research which demonstrated that a single positive microscopic examination is sufficient to diagnose pulmonary tuberculosis, contributing to the evolution of international guidelines. The center also participates in several international trials aimed at shortening the duration of treatment for drug-sensitive tuberculosis. This research addresses a major challenge: developing treatments that are simpler and easier to follow, while maintaining their effectiveness.

A recognized platform for vaccine research

Thanks to its expertise in clinical trials and its infrastructure that meets international standards, the Mbarara center is gradually establishing itself as a leading platform for the evaluation of new vaccines.

Over the years, the teams have participated in trials of vaccines against outbreak-prone diseases including Ebola and yellow fever. In particular, the center has helped demonstrate that a fractional-dose regimen of the yellow fever vaccine provides long-lasting protection in adults, children, and people living with HIV. These findings played an important role in expanding the WHO’s recommendations regarding the use of lower doses during vaccination campaigns.

Today: Addressing new health challenges

Building on its strong foundation in infectious disease research, the Mbarara center is now expanding its scope to address new health issues, including sickle cell disease, pediatric cancers, and other emerging chronic diseases.

The center is also strengthening its capabilities in epidemiology, operational research, and the social sciences to better understand health behaviors, barriers to accessing care, and the acceptability of medical interventions. These approaches enable the development of strategies tailored to the realities of local populations and the constraints of health systems.

Community engagement as a core pillar is embedded from the outset of research development and carried through every stage of the research process. By working closely with patients, communities, and local stakeholders, the Centre promotes participatory research, strengthens trust, and supports informed and voluntary participation in research.Thirty years after its establishment in Uganda, the Mbarara center continues to generate evidence that helps improve prevention, diagnosis, and treatment strategies for the benefit of the most vulnerable populations.

Key Milestones

1996

Epicentre established a permanent presence in Mbarara to support programs combating sleeping sickness.

1997

Participation in the evaluation of new cholera vaccines in Uganda.

1999

First randomized trial in Mbarara demonstrating the efficacy and good tolerability of the artesunate-sulfadoxine-pyrimethamine combination in the treatment of malaria.

2001

Evaluation of new rapid diagnostic tests for malaria.

2003–2008

Participation in research demonstrating the efficacy and better tolerability of the nifurtimox-eflornithine combination (NECT) for the treatment of sleeping sickness, leading to its inclusion on the WHO Model List of Essential Medicines in 2009.

2006–2007

Clinical trial comparing artemether-lumefantrine with quinine for the treatment of uncomplicated malaria in pregnant women.

2007

Demonstration that a single positive microscopic examination is sufficient to diagnose pulmonary tuberculosis, contributing to the evolution of WHO recommendations.

2007

Establishment of a Biosafety Level 3 (BSL-3) laboratory dedicated to tuberculosis research.

2007-2010

AQUAMAT: Evidence of significant reduction in mortality with artesunate in African children with severe malaria

2012–2022

Participation in the RIFATOX, RIFAVIRENZ, and RIFASHORT trials evaluating shortened treatment regimens for drug-sensitive tuberculosis.

2018–2023

Participation in the TB-Speed, STATIS, and CONTACT studies, which contributed to improving the diagnosis, prevention, and management of tuberculosis in children and people living with HIV.

2019

Study site for the evaluation of an innovative “4-in-1” pediatric formulation for the treatment of HIV in children.

2019–2022

Participation in the Zebovac trial, which is evaluating a “prime-boost” vaccination regimen using Ad26.ZEBOV as the first dose, followed by MVA-BN-Filo 56 days later, against Ebola

2018–2023

Participation in the EDCTP-funded DNDi trial that evaluates efficacy and safety of fexinidazole in patients with Trypanosoma brucei rhodesiense (r-THA).

2021

Demonstration of the efficacy of fractional dose yellow fever vaccination in adults, children, and people living with HIV.

2022

Obtained GCLP (Good Clinical Laboratory Practice) accreditation for the laboratory at the Mbarara research center.

2023-2025

Tb-Algo-PED : Evaluation of the effectiveness and acceptability of two treatment decision algorithms for TB in children and assess the feasibility and acceptability of the new 4-month regimen for non-severe TB.

2023-2025

deTACT, a roadmap for deployment of a fixed dose triple combination of Artemether-Lumefantrine-Amodiaquine to treat malaria

2025 

Launch of a study to develop a decision-making algorithm to improve the detection of pediatric cancers and enable earlier treatment

2026 

Launch of a study assessing the feasibility of decentralizing care for patients with sickle cell disease in Kasese, Uganda