//Fellow profile: Dr Joseph Fokam

Fellow profile: Dr Joseph Fokam

 

EDCTP Career Development Fellow Dr Joseph Fokam has generated important data on the evolution of HIV infections and the emergence of drug resistance in adolescents living with HIV. In March 2024, Dr Fokam was appointed as the Lead-Person (Permanent Secretary) of the National AIDS Control program in Cameroon. In this interview, Dr Fokam tells us how his fellowship helped him becoming a leader in his field, coordinate large collaborative research studies, and grow in his professional career.

What inspired you to pursue a career in science?
I got inspired to pursue a career in science because of the high burden of infectious diseases in our communities, especially HIV/AIDS, a poverty-related disease with a substantial rate of mortality and new cases in sub-Saharan Africa in general and Cameroon in particular. Thus, after completing my secondary school, I pursued my higher education with the study of infectious diseases as a specialty at the School of Medicine. This was a unique opportunity for me to design my MSc and PhD topic on HIV/AIDS, with a special focus on combating HIV drug resistance as a threat to achieve the elimination of AIDS as a public health threat.

Where were you in your career before your fellowship and what made you decide to apply for the EDCTP Career Development Fellowship?
Before my CDF, I was undertaking my two-year postdoctoral fellowship at the Faculty of Medicine of the University of Rome Tor Vergata in Italy. During this fellowship, I attended the EDCTP Forum at Lusaka-Zambia, under the mentorship of Prof Carlo-Federico Perno. I then learned about the opportunity of the EDCTP Career Development Fellowship, I applied and was successful.

Your EDCTP Fellowship focused on treatment failure and drug resistance mutations in adolescents living with HIV. Why is it important to focus on this special population?
With the advent of HIV treatment, reduction in mortality has been remarkable in all infected age groups, except for adolescents (especially those vertically infected) among whom the mortality rate was still at 50%. We therefore implemented this study to understand barriers to successful treatment response in this vulnerable population and proposed evidence-based recommendations to policy-makers. The project’s preliminary findings triggered the creation of a virology platform for Cameroon called VIROFORUM (with an official decision from the Ministry of Public Health); the project raised awareness of patient and programme factors favoring poor treatment response and HIV drug resistance emergence among adolescents, and consequently, we were able to reduce treatment failure from 40% to 28% and HIV drug resistance emergence from 96% to 85%. Thus, our project helped in closing gaps in treatment response and survival rates between adolescents and other target populations in Cameroon.

How has this Career Development Fellowship allowed you to establish yourself as an independent researcher who is leading your own research studies and able to attract funding?
I was completing the last months of my postdoctoral fellowship in Italy when the CDF result was released. While preparing still to relocate to Cameroon, I was appointed as the Head of the newly created Virology laboratory at my home institution (CIRCB) in Cameroon. I was ranked as a senior scientist at my home institution upon return and I established a young team with 2 staff. I created the VIROFORUM to monitor the project implementation with clinical sites, to disseminate findings, and strengthen the capacity of clinicians to manage HIV drug resistance, took a position as a part-time lecturer at the school of medicine to train and supervise students and joined the national HIV drug resistance working group as the technical secretariat, and our research team was able to move from three to over 10 members by the end of the project. We trained over 20 students with the project (1 PhD, 5 MSc, 6 MD, 2 PharmD and over 10 interns). We presented abstracts over 20 conference abstracts so far, about 10 peer-reviewed scientific articles (some after the project lifetime) have been published, and strategic information from our study was addressed by the Ministry of Public Health for contributing into improved HIV management in Cameroon. I became an Editor in PLoS ONE and Current HIV Research and have currently joined the Nature Scientific Reports and BMC Infectious Diseases. I became a member of the scientific review committee of EDCTP2 and Global Health EDCTP for proposal review, a member of the WHO guideline development group, a member of the scientific committee of several international conferences including the HIV drug resistance workshop and treatment strategies. I received several awards from conferences, Best Health Staff in Cameroon, I have a full-time position as a senior lecturer, and I now mentor several young scientists who have also defended their PhD (8 in total) and are managing grants.

How has this fellowship helped you to establish new collaborations and engage in national activities? Could you please provide an example of a collaboration that started from your fellowship?
The fellowship helped me develop partnerships with several national universities, and I currently moved from part-time to full-time lecturer. With the VIROFORUM created during the project, we have been able to strengthen collaboration through an official recognition by the Ministry of Public Health, I joined the national HIV drug resistance working, and I currently represent Cameroon at the WHO HIV guideline development group, at the WHO HIV drug resistance working group. The platform established with the project serves as a response to COVID-19 response in the country and I served as the national virologist for the pandemic response. This led to a second grant from EDCTP for response to COVID-19 (the PERFECT-Study, RIA2020 EF3000), serving as the project coordinator with four collaborating countries (Cameroon, Italy, France, Ethiopia through Africa CDC). I am currently a member of several professional organisations (IAS, International AIDS Society; African Society for Laboratory Medicine, ASLM; American Society for Microbiology, ASM; Cameroon Academic of Young Scientists, CAYS; etc).

You also lead another EDCTP-funded project, the PERFECT study, which is evaluating a range of SARS-CoV-2 assays and building local capacity in diagnostics assessment. How was this study conducted and what are the main outcomes?
The EDCTP PERFECT-Study is a contribution to the global response to COVID-19 pandemic. We have so far published 9 scientific articles (others are under review and development). The project contributed to proposing effective molecular assays and suitable thresholds for the interpretation and case identification; the evaluation of point-mutation assays for variant detection guided genomic surveillance. It also contributed to characterising the dynamics of SARS-CoV-2 variants and their implications on viral transmission and severity and helped detect the very first case of Omicron in the country which contributed to strengthening timely preventive measures. Several rapid diagnostic assays were evaluated and the findings contributed to the World Health Organisation’s emergency use approval. Several strategic pieces of information from the project were addressed to the Ministry of Public Health for contribution to policy-making. Beyond upgrading our molecular and genomic surveillance system, the project trained several young scientists (1 PhD, four MSc, and over 40 academic interns). My award as the best health staff was due to the contribution from COVID-19, largely linked to the PERFECT-Study. The project paved the way for new networks for pathogens surveillance under the sponsorship of the Bill & Melinda Gates Foundation (with ICGEB coordination), through a collaborative network with 10 African countries on the surveillance of pathogens with pandemic potentials (arbovirus and others). Our institution is, therefore, a reference centre for our national network for molecular diagnosis and genomic surveillance.

Tell us about your current position and the health research activities in which you are involved. And how will you use your new role to promote the career development of young local scientists starting out in research?
My current position is the Permanent Secretary of the National AIDS Control Committee in Cameroon. In this position, I oversee and coordinate the national response strategy against HIV/AIDS, define the national priority to achieve HIV elimination, strengthen community engagement and strategic communication to improve national performance and implement impactful interventions driven by scientific evidence. Thus, experience from the EDCTP project management has helped in shaping my pathway to leadership and my current managerial position. In this role, I have been able to establish a scientific council to strategically guide the country towards HIV elimination; coordinate with global fund and PEPFAR partners; updating HIV estimates for public health policies and clinical management in the general and key populations through innovation. Therefore, we now follow the science to ensure only highly impact public health actions are being implemented, using monitoring and evaluation for shaping the future of our national response.

What challenges (personal and/or professional) have you encountered during your research career and/or after your EDCTP Fellowship? How did you overcome them?
The main challenge that I have encountered is the growing workload for leadership positions. For example, team management and task delegation have been quite demanding. In this line, I have been lucky to receive support from the general directorate through the training and retention of 8 junior staff that I have trained, providing additional workspace with new projects, and upgrading my scientific ranking. Also, strengthening my relationship with my mentor has been very helpful in shaping my leadership potential and governance at both national and international levels. I therefore strongly believe hard work, self-discipline, loyalty, and adherence to mentor’s advice have been key in overcoming the challenges and in timely designing our national strategic plan.

What advice do you have for researchers starting out?
For early career researchers, I would strongly advice to always:

  • Have a clear career development plan with early, mid, and long-term goals;
  • work on diseases of public health importance to their community;
  • share their key findings to support evidence-based decision-making;
  • collaborate with health authorities at the beginning, during and after the project to ensure strengthened community-engagement and optimal ownership of interventions;
  • keep a mentorship throughout the way to gain maturing in every decision while growing;
  • Build up a network with experts in your area to gain multi-disciplinarity;
  • set up a plan to mentor younger scientists and healthcare professionals to build-up local capacity and national ownership and competitiveness;
  • ensure monitoring and evaluation of your career pathway.


What are your future career aspirations?
My aspirations remain the same: contributing to health solutions through evidence-based decision-making. This will be achieved through:

  • helping my country to achieve HIV elimination as a public health threat, as I move toward a senior program manager position;
  • work with younger scientists to expand our national capacity-building frame as I move toward a senior scientific director role;
  • strengthening collaboration with national/international academics and industries as I move towards a professorship.


What would you like your legacy to be?
My main legacy is my commitment to ensuring “Africa-led initiatives in solving health challenges in Africa”.