Meet the CIPHER fellows

Edith B Milanzi

Year awarded: 2021
Institution: MRC Clinical Trials Unit at UCL
Research site: Uganda
Primary mentor: Jeannie Collins, University College London

Edith B Milanzi is a medical statistician, originally from Malawi, and now based in the UK as a Research Fellow at the Medical Research Council (MRC) Clinical Trials Unit at University College London. Dr Milanzi specializes in complex analyses of longitudinal data in paediatric and adolescent populations. Her work is focused on the development of the Global Paediatric Data Platform, which aims to pool real-world data on paediatric and adolescent HIV from high-burden countries to strengthen capacity for timely monitoring of uptake, safety and effectiveness of new paediatric formulations.

More information on Edith B Milanzi | Email

“This project aims to strengthen capacity of high HIV-burden countries, particularly in sub-Saharan Africa, to utilize real-world data to monitor the uptake and impact of new paediatric formulations, including safety and effectiveness outcomes, which will be critical in informing future clinical care and research.”

Research project: Real-world data on the uptake, safety and effectiveness of paediatric antiretroviral therapy in children and adolescents living with HIV

The issue

Children continue to lag behind adults in access to antiretroviral therapy (ART): an estimated 53% of children living with HIV will receive ART by the end of 2020 compared with 74% of adults. Among children on ART, a lower proportion are virally suppressed than adults. The introduction of new optimized ART, such as dolutegravir in paediatric formulations, is hoped to reduce the gaps in each step of the cascade of care in children and adolescents. As these new regimens are rolled out globally, data from the highest-burden countries with the largest numbers of children and adolescents living with HIV are often lacking. This has been identified as a critical information gap, especially in low- and middle-income countries. Real-world data from these settings on the uptake, safety and effectiveness outcomes are needed, particularly in settings with high prevalence of co-morbidities, such as tuberculosis; this will be critical in informing future care and policies.

The CIPHER project

The overarching goal is to establish a global data platform that pools data from multiple countries, firstly to assess the uptake and short-, medium- and long-term outcomes of dolutegravir in children and adolescents, including the newly approved 10mg formulation for young children. The longer-term aim is to establish a platform with the capacity to rapidly monitor new formulations as they emerge. Dr Milanzi is working closely with partners, such as the Uganda Ministry of Health, on the establishment of an observational cohort that utilizes routine electronic medical records to address these important public health questions. With CIPHER’s support, the aim is to expand the platform to multiple countries.

The impact

The Global Paediatric Data Platform is directly positioned as the monitoring component of the World Health Organization’s Global Accelerator for Paediatric Formulations (GAP-f). The platform will inform national and international stakeholders, including ministries of health, programme managers, policy makers and the global research community, on the evolving epidemiological trends of children receiving HIV care, the impact of the roll out of newly approved paediatric formulations, and forecasting of future paediatric drug needs.

IPHASA 2021
1st International Paediatric HIV Symposium in Africa - Virtual Symposium 17-18 November 2021

Contact

Resources

Events

Annual international workshop on “Children and Adolescents HIV-Exposed and Uninfected”

CIPHER Grant Programme
Awards up to $150,000 to early-stage investigators to address critical research gaps in paediatric and adolescent HIV in resource-limited settings.

CIPHER Growing the Leaders of Tomorrow Fellowship
Provides support to young investigators in sub-Saharan Africa on priority research topics in paediatric and adolescent HIV clinical science.

CIPHER Global Cohort Collaboration
Brings together the largest collaboration of paediatric and adolescent HIV observational cohort networks to answer key questions of global public health.

Research agendas for paediatric and adolescent HIV