Raph Hamers: Infectious diseases research in Indonesia

My name is Raph Hamers, I'm a senior clinical scientist at OUCRU Indonesia where I lead the clinical infectious disease research programme. My work focuses on the prevention, diagnosis and management of infectious diseases that are relevant to Indonesia, mainly tuberculosis, HIV, COVID-19 and antimicrobial resistance. I work very closely with our local partners at Universitas Indonesia and other institutions.

OUCRU Indonesia has been involved in the RECOVERY trial, which is an international effort to find new treatments for COVID-19. Indonesia was one of the first countries outside of the UK to enrol participants into this trial. RECOVERY has to date been able to identify four effective treatments to save lives of patients with severe COVID-19. The main advancement of RECOVERY is that it offers a very simple and flexible model that is applicable to low- and middle-income countries to rapidly recruit patients, and that model will be taken forward in Indonesia to study not only COVID-19 but also influenza and bacterial pneumonias.

One of the main challenges of doing research in Indonesia is that we need more expertise. We need to make more investments in finding people who want to dedicate their career to research. We're working with young research talents in Indonesia by offering research degree training and mentorship, and we do that by drawing expertise from the wider Oxford Tropical Network.

Another challenge of doing research in Indonesia is to make sure that our research findings and any innovations that we discover are indeed translated into policy. To achieve that, we increasingly work with policy makers to ensure that we do achieve tangible impacts that make a difference to the lives and well-beings of Indonesians.

The World Health Organization recently launched a global research agenda for antimicrobial resistance in human health. That agenda aims to accelerate and streamline efforts that are going on to tackle the emerging threat of antimicrobial resistance. Working with the WHO, I've led the process of accumulating existing evidence gaps in areas relevant to antimicrobial resistance. That ranges from vaccines, antibiotic stewardship, health policy, and then we invited global experts, hundreds of them, to advise us on prioritising those topics that we identified. We brought down that number of 3,000 to 40 of the most pressing issues. That agenda also includes topics that are most relevant for low- and middle-income countries. For OUCRU Indonesia this means that this agenda is extremely useful to guide our priorities in the work we do. For example, we are increasingly focusing on the rational use of antibiotics and how we can achieve that in hospitals and communities.

In my research program we focus on infectious diseases that are most relevant for Indonesia, mainly tuberculosis, HIV, COVID-19 and other emerging infections. We'd like to take system approaches to tackle those challenges. Which means that we are not only looking at technical innovations, trying to explore new vaccines, new drugs, new diagnostics, but combine this with rigorous implementation research which means that we investigate how these innovations can indeed be implemented in the best possible manner, so that they are feasible, that they are acceptable, and that they are indeed used by people.

In the future, we hope to be able to contribute to really decrease the burden of the huge diseases that are currently a big problem in Indonesia, and I'm mainly thinking of tuberculosis and HIV in certain vulnerable groups. If in our research we can make both technical innovations, and also make sure that we do implementation research that ensures that these innovations are effectively implemented, that would be really a great achievement.

This interview was recorded in January 2024.