Diabetes Academy Africa: training the next generation of researchers in sub-Saharan Africa
Authors: Simeon-Pierre Choukem, Jean Claude Mbanya
Journal: The Lancet Global Health (2018)

The greatest increase (156%) in the number of people with diabetes worldwide between 2017 and 2045 will occur in sub-Saharan Africa,1International Diabetes FederationIDF diabetes atlas—eighth edition.http://www.diabetesatlas.org/resources/2017-atlas.htmlDate: 2017Google Scholar where more than two-thirds of diabetes cases are undiagnosed and where atypical diabetes phenotypes are common.2Sobngwi E Choukem SP Agbalika F et al.Ketosis-prone type 2 diabetes mellitus and human herpesvirus 8 infection in sub-Saharan Africans.JAMA. 2008; 299: 2770-2776Crossref PubMed Scopus (73) Google Scholar, 3Choukem SP Sobngwi E Fetita LS et al.Multitissue insulin resistance despite near-normoglycemic remission in Africans with ketosis-prone diabetes.Diabetes Care. 2008; 31: 2332-2337Crossref PubMed Scopus (25) Google Scholar, 4Choukem SP Sobngwi E Boudou P et al.β- and α-cell dysfunctions in Africans with ketosis-prone atypical diabetes during near-normoglycemic remission.Diabetes Care. 2013; 36: 118-123Crossref PubMed Scopus (30) Google Scholar This situation confirms the urgent need for efficient prevention, care, and research programmes. In 2017, The Lancet Diabetes and Endocrinology Commission on diabetes in sub-Saharan Africa highlighted the importance of capacity building and quality research in effectively tackling diabetes in the region.5Atun R Davies JI Gale EAM et al.Diabetes in sub-Saharan Africa: from clinical care to health policy.Lancet Diabetes Endocrinol. 2017; 5: 622-667Summary Full Text Full Text PDF PubMed Scopus (228) Google Scholar Such a strategy should include mentorship of young leaders. Sub-Saharan Africa has by far the lowest output of diabetes research compared with other regions,6ScimagoSJR—compare countries.http://www.scimagojr.com/countryrank.php?area=2700&category=2712Date: 2015Google Scholar the main causes probably being the limited opportunities for career development and brain drain.7Kigotho W Migration and brain drain from Africa acute.http://www.universityworldnews.com/article.php?story=20131011121316706Date: Oct 11, 2013Google Scholar However, this general picture of sub-Saharan Africa hides serious inequalities between countries: some lack qualified physicians to provide minimal care for diabetes, whereas others have high-calibre researchers who have provided data for estimates of diabetes burden.8Mbanya JC Motala AA Sobngwi E Assah FK Enoru ST Diabetes in sub-Saharan Africa.Lancet. 2010; 375: 2254-2266Summary Full Text Full Text PDF PubMed Scopus (438) Google Scholar Harnessing the experience of these advanced academics could be a cheap, sustainable solution to the problem of poor mentorship for young researchers. The idea for the creation of an independent group of recognised academics to locally train and mentor the next generation of African leaders in diabetes emerged in September, 2014, when some academics from sub-Saharan Africa met during an international diabetes congress. Most of them had been either attendees or faculties of renowned international diabetes seminars, such as the French intensive course on diabetes, the Cambridge Diabetes Seminar, or the European Association for the Study of Diabetes–Robert Turner course on diabetes research in Oxford, UK. These academics gathered in Abidjan, Côte d'Ivoire, in January, 2015, to brainstorm about the reasons for and logistics of such an initiative. From this, Diabetes Academy Africa (D2A) was formed. The aim of D2A is to provide high-quality training and mentorship for young physicians and scientists who work in diabetes prevention, care, or research, and who are committed to excellence.9Diabete Academie Afriquehttps://diabete-academie-afrique.org/presentation-d2a/qui-sommes-nous/Google Scholar Each batch of mentees are selected through an application process and complete two complementary and interactive sessions over 2 consecutive years. The first session focuses on epidemiology and pathophysiology, and the second session covers clinical complications and management. Mentees also work on their personal development and their science-specific writing and communication skills. 27 trainees from eight countries in sub-Saharan Africa (Benin, Burkina Faso, Cameroon, Côte d'Ivoire, Guinea, Mali, Senegal, and Togo) were selected for the initial programme (table). The first training session took place on Jan 28–31, 2016, in Abidjan. Before the session, mentees received landmark articles to read for preparation. The faculty were nine African experts from four countries and two French experts. The second session was held as pre-congress activities in Conakry, Guinea (Nov 20–22, 2016) and was completed in Yaoundé, Cameroon (April 18, 2017). The faculty were ten African experts, one French, one Swiss, and two British. In brief, sessions were organised into pathophysiology, genetics, epidemiology, clinical and therapeutics, scientific writing, and personal development and leadership. Each lecture included a 45–60 min presentation and 30–45 min of guided group discussion—mainly focused on local implementation and perspectives. Each day started with a report on the activities of the previous day, presented by a mentee who was chosen by the group.TableTraining timetable for the first batch of Diabetes Academy AfricaSession 1Session 2Day 1 Introduction to Diabetes Academy AfricaOpening lecture: the academic career How to communicate orally in scienceOral presentation of research project summariesDay 2 Report of day 1Diabetes: major challenges in Africa and the worldGroup discussion: challenges in diabetes in AfricaOmics in diabetesEpidemiological methods in diabetes research. Part 1: overviewEpidemiological methods in diabetes research. Part 1: major clinical trialsIntroduction to critical reading of a scientific paper Selection of and awards for the four best communicationsMicrovascular complications: diabetes and the eye; diabetes and the kidneysMacrovascular complications: diabetes and the heartHypertension and diabetesDiabetic foot: lecture and practical workshopOral antidiabetic drugs and glucagon-like peptide-1 receptor agonistsInsulinsDay 3 Report of day 2Pathophysiology of diabetesMethods to explore glucose metabolism in vivoManaging one's e-reputationPathophysiology of diabetes complicationsScientific bases of management guidelines for type 2 diabetesPersonal development and leadership 1 Macrovascular complications: diabetes and stroke; peripheral artery diseaseNutritional therapyTherapeutic educationTherapeutic strategy in type 1 diabetesTherapeutic strategy in type 2 diabetesOrganisation of diabetes careAdvocacyDay 4 Report of day 3Publication process: from literature search to publication of an articlePractice: how to use ZoteroPractice: critical reading of a scientific paper (the EMPA-REG trial)Personal development and leadership 2Practical recommendations for the period between sessions: schedule, research projects, papers writing, and networking Why research diabetes?Group discussionsStudy designLiterature searchData analysisGrant application Open table in a new tab Between sessions, faculty members regularly interacted with trainees by posting homework on the D2A website. Trainees have been encouraged to network and design and submit research projects, and they will benefit from the expertise of D2A faculty. D2A will also provide funding for selected small research projects. The academy also encourages multicountry projects and plans to track and monitor the career of each D2A alumnus. We believe that the D2A initiative has paved the way for equipping sub-Saharan Africa for the multifaceted battle against diabetes, while contributing to the prevention of brain drain. We hope that D2A will be a model for other disciplines, especially those related to non-communicable diseases. We declare no competing interests. Diabetes Academy Africa is registered as a not-for-profit association in Côte d'Ivoire (Ref N° 0418/PA/SG/D1). The training of the first intake of Diabetes Academy Africa was supported by an unrestricted educational grant from Servier Laboratories. Server Laboratories did not have any role in the writing or submission of this work.