PAC-CI programme, 30 years of scientific excellence and Franco-Ivorian partnership

An exemplary Franco-Ivorian scientific adventure. From research programme to the International research platform in global heath

Born in 1996 out of a visionary Franco-Ivorian collaboration, the PAC-CI programme quickly positioned itself at the forefront of clinical research in Africa. From its inception, the programme has conducted innovative clinical trials, trained generations of researchers and healthcare professionals, and helped shape public health policies globally.

Over the years, the PAC-CI programme has seen its field of research expand to include all infectious diseases and the number of partners increase. At the crossroads of clinical research, epidemiology, and the human and social sciences, the programme has been built on a model of close collaboration between Ivorian and French teams.

The creation in 2023 of the Côte d’Ivoire International Research Platform in Global Health (PRISME) marked a new phase in the strengthening of the Franco-Ivorian partnership, broadening PAC-CI’s historical scope of actions to all global health issues and bringing together a larger number of Ivorian and French partners, including the Ministry of Higher Education and Research, the University of Bordeaux, Inserm and IRD.

The PRISME Côte d’Ivoire partnership, hosted by PAC-CI, aims to accelerate research, training and innovation by responding to Côte d’Ivoire’s needs and by drawing on a network of excellence and cutting-edge infrastructure.

Scientific advances that have changed the course of the HIV epidemic

The Franco-Ivorian teams working with PAC-CI have made a decisive contribution in three key areas of HIV care:

• Prevention of mother-to-child transmission: in the 1990s, PAC-CI demonstrated, through the Ditrame trial, the effectiveness of antiretroviral prophylaxis in reducing HIV transmission from mother to child during pregnancy and breastfeeding. This was a major breakthrough that influenced global recommendations and saved thousands of lives.

• Prevention of opportunistic infections in adults: the Cotrimo-CI trial, conducted in 1999, demonstrated the efficacy of cotrimoxazole in preventing early opportunistic infections in people living with HIV, significantly improving their quality of life.
• Universal treatment: in the 2010s, the TEMPRANO trial showed that early administration of antiretrovirals improves health outcomes, having a lasting impact on HIV management strategies around the world.

These high level results were quickly incorporated into national and international guidelines, illustrating the direct impact of PAC-CI on public health policies.

A commitment beyond HIV

Together with its partners, PAC-CI has also been able to mobilise in response to other health crises. During the Ebola epidemic in West Africa, the programme managed to continue HIV trials while fully mobilising to fight the virus, in collaboration with Guinea and other partners.

The JIKI clinical trial, conducted in Guinea, enabled potential treatments to be tested. In order to improve responses to viral epidemics beyond Ebola, research is continuing on the transmission and management of other emerging infectious diseases in the region.

The Franco-Ivorian MEREVA CMG: Methodological expertise for conducting international research projects

For nearly 20 years, PAC-CI and the GHiGS team at the Centre U1219 Bordeaux Population Health (France) have jointly coordinated the MEREVA methodology and management centre (CMG). This engineering facility supports the set-up, coordination and monitoring of international research projects, while actively contributing to the training of researchers in the field of infectious diseases. MEREVA plays a central role in the implementation of the vast majority of studies conducted by Franco-Ivorian research teams. It draws on a vast network of international partners, enabling the completion of more than 30 research projects per year in over 30 countries in Africa, Asia, Latin America and Europe.

And tomorrow: PRISME and new challenges

With the creation of PRISME, organised mainly around PAC-CI, Franco-Ivorian collaboration is entering a new era. This platform, which relies on 30 years of experience, aims to broaden the scope of actions to other infectious diseases, non-communicable diseases and emerging public health issues, in response to locally identified priorities. It is part of its ongoing commitment to training and strengthening research capacities in Africa, and to regional collaborations for more equitable and inclusive research.

For three decades, in particular through the quality of its clinical trials – their influence on Ivorian and international recommendations, and its ability to respond to major health crises, PAC-CI has profoundly shaped the fight against HIV in Africa and around the world.