A commentary on establishing a local centre of excellence for research and training in pharmacometrics: Lessons from the pharmacometrics Africa–Uganda chapter

Pharmacometrics, the mathematical approaches to describe the transfer of drug through diﬀerent biological compartments, are essential tools in clinical pharmacology research. The ethical necessity to study drugs accurately in the populations where they are to be used is increasingly recognized. To maximise the value of clinical data, study design and analysis must be appropriate. Historically, many datasets have been sent from African countries to better-resourced settings for analysis, but in recent years it has been demonstrated that capacity can be built and sustained within low and middle-income countries (LMIC)3. We report the establishment of the Uganda Chapter of Pharmacometrics Africa, to share learning with other countries seeking to build similar capabilities.


| INTRODUCTION
Pharmacometrics involves the development and application of mathematical models, informed by knowledge on pharmacology, physiology and the disease process, to characterize the interactions between drugs and patients. It is applied to studying pharmacokinetics, pharmacodynamics and disease progression. The ethical necessity to study drugs in the populations where they are to be used is increasingly recognized.
To maximize the value of clinical data, study design and analysis must be appropriate. Historically, many datasets have been sent from African countries to better-resourced settings for analysis, but in recent years, it has been demonstrated that capacity can be built and sustained within low-and middle-income countries (LMIC) 1 We report the establishment of the Ugandan Chapter of Pharmacometrics Africa, to share learning with other countries seeking to build similar capabilities.   Of the 42 invited candidates, five did not start. Consequently, the course was attended by 37 participants from eight countries. Of the 37 participants, a further 5 withdrew during the course primarily due to competing demands on their time, 6 did not complete the course due to failure to complete the course tasks and 26 (71%) met the criteria for the award of a certificate of completion. The criteria for completion included completion of at least 70% of the tasks, consistently logging onto the online learning platform and engagement in discussions. To enhance participants' engagement, participants were placed T A B L E 1 Lessons learnt and how the Ugandan Chapter has consolidated the community of practice in pharmacometrics in Uganda.

Lessons learnt
1. Congregating factor: Establishment of a group needs to be motivated by a strong reason for people to work together. Organizing the course brought together several stakeholders and ignited further passion to work collaboratively.
2. There is a high but unmet demand for pharmacometrics training in Uganda: Most participants were students from academia. There is an unmet need for further scholarship opportunities (Masters and PhD level) within Uganda.

Multimodal and multimedia interactions via platforms like
WhatsApp, Zoom meetings and the interactive online course platform enabled better interactions and sharing of ideas. Many of these interactions continued beyond completion of the course.
4. Hierarchical and peer-to-peer mentorship frameworks. Senior pharmacometricians need to mentor junior pharmacometricians, and the junior pharmacometricians need to mentor the junior scholars. Peer mentorship between colleagues working at a similar level brings additional benefits in mastering and applying complex skills.
5. Need for practical, hands-on support. Sessions that were most challenging for students were those which comprised practical examples rather than theory alone. Through virtual platforms, hands-on support was provided, and a similar virtual hands-on approach forms the basis of ongoing 'lab meetings'.
into groups of about five, each with a mentor (one of the tutors) who offered guidance weekly. The assessment focused on identifying potential and interest in the discipline rather than on achieving a specific grade. Participants were granted extra time to complete tasks and engage with course materials. We adapted the course programme to include an additional 'consolidation week' between weeks 9 and 10 to enable participants to catch up and spend time working on the practical exercises with support from the tutors. Weekly feedback was almost universally positive, but the biggest area of concern reported by the students was the time required to complete the selfstudy materials and truly engage with the hands-on exercises. Table 1 below shows the lessons learnt and how this initial activity consoli- In the year since the inception of the Ugandan Chapter, several priorities to increase pharmacometrics research in Uganda have been established, as summarized in Table 2.
We currently seek to raise awareness among different potential We have demonstrated that it is possible to deliver an online course with a relatively young faculty team in Africa using an online platform. Establishing regional hubs for pharmacometrics training and collaboration will enable the development of strong, interactive partnerships, establishment of a vibrant research environment for the next generation of scientists and enable the sustained implementation of capabilities to address regional priorities in LMIC. Stronger industry partnerships most especially in PBPK which provides a mechanistic understanding of drug disposition in populations with limited data The priority of PBPK research of industry investment for earlier phase trials and internships that could be in both directions. Adoption of standards for the transparent reporting and data sharing from existing work and where such standards might not exist, to define them.