The European Union (EU) in February kicked off the operational phase of an ambitious clinical research partnership with Africa. But experts warn that the initiative's prioritization could set back the treatment of other, less noteworthy, diseases.

The European and Developing Countries Clinical Trials Partnership (EDCTP) aims to establish centers across Africa for clinical trials of new interventions against HIV, malaria and tuberculosis. The initiative is funded until 2008 by equal contributions of around €200 million from both the European Commission and EU member states. “This is one of the biggest international research and development efforts against these three diseases,” says European Research Commissioner Philippe Busquin.

There is broad support on both continents for the program, which is expected to result in larger, more powerful trials. “The EDCTP is an organization which has massive promise,” says Tim Tucker, director of the South African AIDS Vaccine Initiative. The partnership with Europe gives African nations a real opportunity to build local infrastructure and strengthen their contribution to research, Tucker says. Still, it will be a big challenge to empower the African states to go beyond carrying out the instructions of their European partners, he notes.

When funding bodies like the EDCTP focus solely on diseases that cause the greatest mortality, there is a risk that research into other diseases will suffer, warns David Warrell, founding director of the Centre for Tropical Medicine at the University of Oxford. “A number of these bodies are now refusing to even consider applications on diseases outside their shortlist,” Warrell says.

The EDCTP program could inadvertently have a long-term impact on the development of new treatments for nonprioritized conditions, such as acute respiratory tract infections and diarrheal diseases, or local problems that require therapeutic intervention, Warrell adds. “It ignores the diversity of human suffering,” he says.

Piero Olliaro, the EDCTP's new executive director, agrees that more funds must be made available for lesser-known diseases. But focusing on HIV, malaria and tuberculosis will have the greatest impact, Olliaro says. In the long term, he adds, the EDCTP's investment in African facilities can only benefit research into other diseases.