Breaking the Vicious Cycle of Disease and Poverty: 25 Years of CISM and Successful Cooperation Between Spain and Mozambique

[This blog post is a one of a series of articles to commemorate the 25th anniversary of CISM. Author: Cristina Gutiérrez Hernández, head of the Humanitarian Action Office at the Spanish Agency for International Development Cooperation (AECID). She served as General Coordinator of Spanish Cooperation in Mozambique from 2014 to 2018.]

When I think about the 25^th anniversary of the Manhiça Health Research Centre (CISM), it stirs up feelings both personal and professional.

I nostalgically remember my passionate interest, as a medical student, in everything having to do with research on infectious diseases, especially tropical diseases. In order to even exist, these diseases relied on sophisticated biology-based behaviour, involving other species in their life cycle. They were also influenced by the changing weather conditions⁠—altitude, humidity, temperature, etc.⁠—of whatever part of the world they found themselves in.

When I think about the 25th anniversary of the Manhiça Health Research Centre (CISM), it stirs up feelings both personal and professional

Each disease was a story unto itself. Malaria was a perfect example of a parasite’s ability to survive and cause one of the diseases with the highest rates of morbidity and mortality in certain parts of the planet. Around that time⁠—the late 1980s and early 1990s⁠—people first started talking about something that had once been inconceivable: a vaccine that could stop this dreaded disease.

Many years later, after my career had taken a turn towards development cooperation, I had the opportunity to see CISM in person for the first time in 2014, in my capacity as General Coordinator of Spanish Cooperation in Mozambique, a position I had only recently taken up. The visit to CISM was a must, given the key role of the centre in Spain’s cooperation efforts in the country.

Cristina Gutiérrez in Mozambique. Photo: Miguel Lizana / AECID. 

That first visit took me back to those years when my life was more directly devoted to medicine. It was a dream come true to be there, listening as a group of researchers discussed the early findings of studies on the RTS,S vaccine against malaria.

It was a dream come true to be there, listening as a group of researchers discussed the early findings of studies on the RTS,S vaccine against malaria

But I also discovered that CISM was so much more. Its work was focused on a noble mission: finding solutions to the main communicable diseases that specifically affect Mozambique and many of the world’s poorest countries. Biomedical research was, and is, the centre’s tool for helping to break the vicious cycle of disease and poverty: more disease leads to more poverty, and more poverty leads to even more disease. CISM’s work, therefore, was supporting the economic and social development of vulnerable populations.

Since its creation in 1996, CISM has developed as a bilateral cooperation programme between the governments of Mozambique and Spain, whose activity, comprising three closely interrelated pillars, provides a powerful raison d’être for the centre and represents the courageous commitment of the Spanish Agency for International Development Cooperation (AECID) to overcoming a seemingly insurmountable barrier to ending poverty: disease.

1. Biomedical research is CISM’s main tool. The most emblematic studies are the RTS,S malaria vaccine trials, but the centre has also been involved in research on other highly prevalent infectious diseases in the region, such as pneumonia and diarrhoeal diseases. CISM produced scientific evidence that made it possible for the Mozambican Ministry of Health to include vaccines against pneumococcus and rotavirus⁠—microorganisms responsible for high rates of morbidity and mortality in the country’s infant population⁠—in its Expanded Programme on Immunisation. CISM has also been involved in other areas that pose major challenges for Mozambique, such as HIV/AIDS and tuberculosis, in a context where properly collected data on the causes of disease and death are sparse.

2. Training lays the groundwork for CISM’s sustainability over time. In conjunction with internationally renowned academic institutions, CISM has collaborated on various master’s and doctoral programmes, providing thesis tutoring for graduate students in the health sciences. These young people give us hope that this important research work can continue into the future.

3. Clinical care⁠—mainly at Manhiça Hospital, but also at many health centres across the country⁠—allows CISM to combine its biomedical research with epidemiological and social studies and interaction with public health policy, thereby raising the profile of the centre’s research.

The AECID has played a crucial role in CISM’s development since its creation in 1996

The AECID has played a crucial role in CISM’s development since its creation in 1996. In fact, the AECID is the main funder of the centre’s general operations. This is the solid base of support that any research centre needs in order to keep the lights on and cultivate successes and advances through various studies funded by multiple sources. I trust that these research efforts will continue for many years and that we can move forward together to break the vicious cycle of disease and poverty.