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HEALTH POLICY AND PLANNING; 17(2): 196–201 © Oxford University Press 2002

Translating HIV/AIDS research findings into policy: lessons

from a case study of ‘the Mwanza trial’
ANNE PHILPOTT,1,2 DERMOT MAHER3,4 AND HEINER GROSSKURTH 5,6
1Female Health Foundation, Sri Lanka and UK, 2International Family Health, London,UK, 3Department for
International Development, London, UK, 4World Health Organization, Geneva, Switzerland, 5London School of
Hygiene and Tropical Medicine, London, UK and 6Population Council, New Delhi, India

The scale and severity of the impact of the global HIV/AIDS pandemic on low-income countries, mainly those
in sub-Saharan Africa, is almost unimaginable to people in high-income countries. There is a particularly
pressing need to understand better how to ensure the translation into policy and practice of important
research findings in HIV/AIDS prevention and care in countries threatened by fast spreading HIV epidemics.
The purpose of this paper is to review the findings and implications of a policy analysis case study of an
HIV/AIDS clinical trial that has been successful in influencing HIV prevention policy relevant to low-income
countries, in order to identify illustrative lessons for HIV/AIDS researchers in the future. The case study
sought to detail the interaction between researchers and policy-makers for this particular case study to ascer-
tain detailed analysis by these two groups on the interaction between research and policy.

The major findings of the policy analysis case study were that policy shift was a cumulative but non-linear
process, with the Mwanza trial placing a crucial role in both boosting and confirming existing policy move-
ments. Researchers and policy-makers held similar longitudinal views of the process and political environ-
ment. Key moments of communication tended to involve personal contact. The important role played by
people and organizations who could work in both the research and policy communities was often mentioned
as crucial in enabling research relevant policy shifts.

Researchers may absorb themselves in the technicalities of their study without considering their role in pur-
suing the wider policy implications. The impact of research on policy must be an integral element of every
stage of the research process. The case study illustrates the need to take a contextual view of the interaction
between research and policy, and understand how changing political contexts affect receptivity to research
outcomes. This will increase the likelihood of research findings having an impact on policy.

The review reflects the authors’ experiences of working for organizations in non-governmental organization,
bilateral development agency and academic settings.

Key words: STI, HIV prevention, research into policy, Mwanza

Introduction research has influenced policy,6,7 and investigation of such

The relationship between researchers and policy-makers is
often assumed and mis-understood but rarely analyzed. A
common view among researchers is that if their research is of
good quality, rigorous and conclusive, then it will influence
policy. They may prefer to stay in the realm of pure academia,
perceiving policy work as subject to interpretations beyond
their control. For policy-makers, research may seem one of
the less relevant and more impenetrable of the many influ-
ences, including political pressures, to which they are sub-
jected. Much of the literature about the transfer of research
findings into policy focuses on examples of the failure of
research and researchers to have a significant impact on the
wider world of implementation and practice.1–5 Surprise is
expressed that research that rigorously demonstrates effec-
tive and beneficial interventions does not necessarily lead to
policy change. However, there are also examples where
success stories can generate lessons for future transfer of
knowledge between research and policy-making.
Policy analysis case study of ‘the Mwanza trial’
One notable success story in developing an effective relation-
ship between research and policy is what has become popu-
larly known as ‘the Mwanza trial’. This randomized
controlled trial (RCT) was conducted from 1991–1994 in
Mwanza, Tanzania by the London School of Hygiene and
Tropical Medicine, the African Medical and Research Foun-
dation (AMREF) and various institutions of the Government
of Tanzania. It demonstrated the effectiveness of improved
treatment services for sexually transmitted infections (STIs)
in preventing HIV infection.9 Improved case management of
STIs in rural health units decreased the prevalence of some
STIs,9 and reduced the incidence of HIV infection by about
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From research to policy – lessons from Mwanza
40% in the general population.8,10 The intervention, inte-
grated into existing primary health care services available in
rural communities, was shown to be both feasible and highly
cost-effective.11
The case study reported here explored what was felt to be a
widely held perception within the HIV community that the
results of this study published in 1995 greatly influenced HIV
prevention policy. STI control was commonly adopted as one
of the main components of HIV prevention programmes,
along with educational and condom promotion activities. It
was given high priority by a variety of players: the World
Health Organization (WHO), the joint United Nations Pro-
gramme on HIV/AIDS (UNAIDS), the World Bank, bilat-
eral development agencies, non-governmental organizations
and Ministries of Health in numerous low-income coun-
tries.12–15 The implementation of the syndromic approach to
the management of STIs (whereby an STI is treated simul-
taneously for the most likely causative pathogens16,17)
became broadly accepted as the appropriate strategy for STI
control in areas where high quality STI laboratory services
are not available. Many donor organizations made additional
funds available for STI interventions. For example, during
the five fiscal years following 1994/95 (the year before the trial
results were published), annual spending on STI control in
developing countries by the UK Department for Inter-
national Development (DFID) increased more than six-fold,
reaching almost 11 million pounds by 1999/2000.
The results of another RCT (of STI mass treatment) con-
ducted in the Rakai District of Uganda showed a modest
impact on STI, but none on HIV infection, and for some time
stirred a debate about the effectiveness of STI control for
HIV prevention. The subsequent questioning of the Mwanza
results as clearly indicating a relationship between reduced
STIs and HIV transmission adjusted views on policy
recommendations, with some indicating that differing epi-
demiological backgrounds of the two studies led to comple-
mentary results and others contradictory.18,19 This debate and
the subsequent still ongoing policy refinement process is
interesting in itself in terms of influence of the research on
policy. However, at the time of the case study described here,
this process had not yet started. It is also not relevant for the
conclusions of this case study.
In a case study of perceptions of how and why the Mwanza
trial influenced policy, interviews were conducted with
researchers and policy-makers (representatives of bilateral
and multilateral development assistance agencies) concerned
with the planning, implementation or implications of the
Mwanza trial.20 The location of the research led to a particu-
lar focus on British researchers and subsequent impact on
British aid policy.
Methods
In total ten interviews were completed during April and May
1999. Interviewees were recruited systematically from three
broad groups: (1) policy-makers from DFID, (2) researchers
closely involved with the planning and the implementation
of the Mwanza trial or health policy researchers, and (3)
197
independent consultants who had worked for international
agencies (WHO, EC) or for a donor organization (DFID).
All interviewees were based in London. They were informed
that in the planned report and publication, no individual
names would be given. A semi-structured questionnaire,
generated in consultation with health policy analysis and
research specialists, was used alongside a timeline to discuss
the chronology of critical events. Interviews lasted between
30 minutes and 2 hours. Responses were recorded manually
by the researcher, word processed immediately after the
interviews and categorized subsequently under emerging key
themes. Events reported by participants were triangulated
with data from policy documents. Further information was
requested and received by mail and Email from additional
informants from the same groups.
Results
There were three key findings, drawn from interviewee’s
perceptions, as to how and why the Mwanza trial had such a
significant policy impact: (1) the policy environment was
favourable, (2) the researchers and policy-makers formed
strategic alliances for policy shift and (3) it was possible to
present the data in an easily understandable form.
The policy environment was favourable
There were no major differences in the way the participants
viewed the process, all interviews included a discussion of
pre-Mwanza events that were important for policy shift. The
majority saw the process as ‘cumulative but non-linear’ with
a variety of factors influencing the higher prominence of STI.
These included previous aetiological studies illustrating the
connection between STI and HIV, STI professionals moving
into the HIV field and the priorities formulated at the Cairo
ICPD Conference. When discussing the process of internal
change in their organization, a policy-maker stated that this
phenomenon was ‘like a sponge soaking up water’.
Policy-makers felt that the study enabled a heavy investment
in STI services and provided ‘hard data to support an existing
contention’. One participant pointed to the dynamics that
were created by STI specialists when they became increasingly
involved in HIV control during the late ’80s to early ’90s and
introduced a biomedical (treatment) dimension to the field of
HIV prevention. This was seen as contributing to the medical-
ization of AIDS and also to a shift which saw HIV classified
not only as a systemic viral infection but as an STI itself.
Others quoted the WHO consensus statement, on the import-
ance of STI prevention as a measure for HIV control, as
indicative of a pre-Mwanza policy shift. It was also stated that
STI syndromic guidelines (enabling non-laboratory based
treatment) had already been recommended by WHO before
the results of the Mwanza trial became available.16,17 One
participant pointed out that these guidelines moved treatment
of STIs into the realm of Primary Health Care for the first
time, an important pre-condition for the Mwanza success.
A variety of larger political contextual issues were raised, such
as the growing importance of evidence-based medicine, the
invention of single dose antibiotics for STIs pushing the STI
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198 Anne Philpott et al.
treatment agenda and the British conservative government’s
drive for ‘value for money’ in research, translating into the
desire for cost-effectiveness studies. The felt need for a bio-
medical HIV intervention of proven effectiveness in addition
to behavioural interventions, the drive to advocate the syn-
dromic STI treatment approach, curiosity about why the HIV
epidemic was spreading disproportionately quickly in Africa
and the mounting evidence of an aetiological link between
STIs and HIV infection were all cited as affecting the per-
ceived necessity for and the timing of an RCT. Donors’ flexi-
bility, explained in one case as resulting from the emergence
of a new fatal illness and epidemic, enabled researchers to
becoming proactive in investigating research sites and design-
ing an initiative. After completion of the Mwanza trial, a
variety of reasons and occasions were identified by the inter-
viewees as supportive elements that drove policy change,
including: the post-Cairo need for evidence for integration of
STI care into MCH, publication of key articles, an air of
optimism at the Vancouver World AIDS conference of 1996
and the re-structuring of the UN in the mid to late ’80s, which
brought STI and HIV professionals together as a working
group within the same department in the Global Programme
on AIDS.
Many participants talked in emotional terms about the results
of the trial as ‘a light in a dark tunnel’. The mood of the HIV
community before, during and after the trial was described as
one of desperation in the face of soaring HIV figures and the
lack of solutions, and this first community-based RCT
appeared to provide a clear simple answer for resource poor
settings. Although, as mentioned previously, the majority of
participants located the policy shift pre-Mwanza, the results
were still greeted with ‘relief’, ‘delight’ and seen as ‘too good
to be true’. One policy-maker felt that the scarcity of know-
ledge at the time increased Mwanza’s impact atypically. Their
observation was that research rarely impacts on policy as
significantly as Mwanza did.
Researchers and policy-makers formed an effective strategic
alliance
The multiple donors and research partners for the trial were
seen as important in enabling communication about the
research process and leading to broad ownership of the
results. One policy-maker felt that personally knowing the
research team and institutions meant that the results were
greeted with enthusiasm, whereas if it had been produced by
a research team unknown to the policy-makers, it may not
have been so warmly received. All the policy-makers inter-
viewed felt it was important for the changing of British policy
that the trial had British co-funding.
Work opportunities, such as consultancies, were mentioned
as having led to increased communication between
researchers and policy-makers, as did the preparation of
technical documents for donors. The more standard academic
communication channels, such as journal articles, were rarely
mentioned as useful for communication, although some key
articles were cited as ‘events’ when it came to discussing
policy shift. Also important were links and trust that existed
from having studied together and from social contact.
The major theme expressed in relation to this topic was
cross-boundary interest, whereby a previous research interest
would mean a continuing interest in this area of work for a
policy-maker. Many key actors in the HIV field were cited as
having been previously involved as STI professionals, which
motivated the policy shift.
Practical issues mentioned as facilitating these communi-
cation links included the professional background of policy-
makers, in that if they had a personal interest in the subject
area or had previously been researchers themselves this
enabled effective communication between ‘camps’. Similarly
if researchers were interested in getting involved with the
public health implications of their work and pushing for
further implementation, this enabled further communication
across the communities. These participants felt that inter-
mediary organizations, with strong contacts in both the
research and policy fields, such as NGOs, were important in
enabling a bridging between the two worlds.
In this case the ‘foot in both camps’ advantage was supple-
mented by the majority of the research funds coming from a
development aid arm of the EC (Department General VIII)
rather than a research fund. This meant that the research
needed to be named as an ‘intervention with evaluation’, and
therefore crossed over the research and implementation
fields. It was described by one policy-maker as pragmatic
public health research, as opposed to ‘petri-dish village’
research. Being funded by a routine aid donor was mentioned
by a couple of participants as increasing the credibility of the
potential research, in Tanzania especially.
It was possible to present the data in an easily digestible way
The ability to demonstrate a clear relationship between STI
intervention and a reduction of HIV transmission at the
population level, and to provide proof of a reduction of HIV
incidence by 42%, was often cited as important for the trial’s
success. One researcher called this the ‘worship of the 42%’
as a magic number; others called it ‘staggering’. In addition
researchers felt that the evidence of cost-effectiveness and
the fact that the Mwanza trial had been community-based was
important to enhance policy shift. The fact that the Mwanza
results were perceived by some policy audiences, both as a
‘magic bullet’ of clinical treatment and as realistic public
health intervention was also seen as increasing its popularity,
although members of the research team were wary of the
impact of the research being perceived as a magic bullet that
would have the same results in every setting.
Interestingly, a policy-maker discussed the importance of the
research being ‘easy to buy’ for all levels of the civil service
hierarchy up to Cabinet Ministers. It is intuitively easy to
understand and enabled all to talk coherently about the clear
relationship and tangible results, whereas a technically
complex breakthrough might not have travelled as well
through the hierarchy.
Policy-makers discussed the difficulty they faced in general
in filtering the mass of research information received and
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From research to policy – lessons from Mwanza
therefore the way in which institutional and work programme
links were often more effective in translating information.
One researcher discussed his rounds of international policy
meetings after the results were published. He felt like a
‘vacuum cleaner salesman’ selling the results and their impli-
cations. He sometimes found that policy audiences were keen
to replicate exactly the same results, but in a different context,
and that they thus disregarded the 95% confidence interval
around the central estimate of the observed impact.
Another participant involved in writing documents for
policy-makers working with researchers’ input mentioned
that often research did not provide this kind of ‘digestible
material’.
In terms of content it was felt the issues that did the most to
change people’s minds were the ‘clear’, ‘quantifiable’ results,
the reiteration of ‘40% reduced HIV transmission’, the cost-
effectiveness data and the possibility of replicating the initia-
tive in a resource-poor setting. The evidence arising from a
large scale RCT as strong ‘proof’ seemed crucial in convinc-
ing appropriate audiences that STI treatment had a direct
demonstrable impact on HIV transmission in a way that
smaller experiments did not.
Discussion
Below we discuss the limitations of the study and each of the
key findings in turn. A major limitation of the study was that
all interviewees were based and working in London, which
may have created a bias towards British perspectives of inter-
national policy and indeed a more in-depth discussion of the
research’s impact on DFID policy. The study was performed
within the context of a summer project as part of the post-
graduate training of one of the authors. For this reason,
policy-makers or researchers from Tanzania were not
included among those interviewed. However, a variety of
professional groups were covered, and a number of key
findings were apparent.
Favourable policy environment (‘Mwanza fell into a ready
made bed’)
The Mwanza trial is often cited as the sole justification for
policy shift. However, a variety of factors prior to the time of
publication created an audience particularly receptive to the
trial results. The idea for the trial arose from consensus that
other STIs were likely to play an important role in HIV trans-
mission, partly accounting for the disproportionate rise of
HIV in sub-Saharan Africa. Clinical studies showing that
other STIs might enhance the sexual transmission of HIV had
been reported as early as 1988/9.21–23 Syndromic management
of STIs had been recommended by WHO for some time.16,17
A series of circumstances facilitated the policy impact of the
trial. User-friendly options were available for the treatment
of STIs. Donors were flexible in mobilizing resources in
response to the crisis brought about by a new epidemic
because this epidemic was perceived as a major threat to the
public health and the development of many low-income
countries.
199
One donor funded the research from a non-research budget,
by classifying the trial as ‘intervention with evaluation’ which
helped to mobilize funds that otherwise might not have been
accessible. One researcher involved in the study felt that the
trial provided ‘hard data to support an existing contention’.
However, perceptions were that, outside an already con-
vinced core group, the results proved useful to convince the
‘doubters’, defined by one policy-maker as ‘the social
development people and the accountants’. The results came
at a time when many policy-makers, programme managers
and interventionists faced with the depressing situation
of a rapidly expanding epidemic were sceptical that any
interventions were really having an effect, and were keen to
identify an intervention of proven efficacy. A rigorous trial
demonstrating a reduction in HIV was therefore warmly
welcomed. The Mwanza trial was a push to an already rolling
policy stone.
Strategic alliances between researchers and policy-makers
There was close contact and shared ownership between the
researchers, the government of the country that hosted
the trial, donors and NGOs during the trial. This was
further facilitated by long-standing networks between key
researchers and policy-makers who were linked by both
conviction and interest throughout, not only at the post-
research stage. At different times, various key researchers
and policy-makers had worked together, lived in East Africa
or studied together. One policy-maker felt that it was crucial
that they ‘knew the researchers personally and could there-
fore trust the results’. The researchers were alert to policy-
makers’ needs and in addition some had worked alongside
them whilst ideas were generated and proposals developed.
Availability of easily digestible data (‘worship of the 42%’)
The complex epidemiological data produced as a result of the
RCT were reduced to a single fact as they were translated
within different audiences. The Mwanza trial became com-
monly known for one particular statistical result, a reduction
of HIV incidence by 42% in the intervention as compared with
the control communities. Researchers perceived this as a
mixed blessing. An advantage was that such a simplified result
was ‘easily digestible’, and facilitated advocacy. This proved
vital when explaining the importance of the research to
Members of Parliament and high-level civil servants, as it was
‘easy to buy’ and ‘intuitively understood’. However, it was a
disadvantage that this simplification disregarded the 95% con-
fidence interval around the central estimate of the observed
impact (the result was consistent with a reduction of as little as
21% or as much as 58%).10 ‘Worship of the 42%’ was also
potentially dangerous in raising the false expectation that the
result would be immutable and entirely translatable into other
demographic, epidemiological and behavioural contexts.
Conclusions – implications of the policy analysis
case study
This case study explored in detail the interaction between a
group of researchers and policy-makers involved in the
research policy interaction and their perceptions of that
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200 Anne Philpott et al.
process. The detailed analysis of their comments lead to
emerging lessons from the Mwanza trial which may be of
relevance to other researchers who are concerned that their
studies should have policy impact. These are:
• From an early stage, researchers should be aware of the
policy environment, historical context and other enhancing
factors, and use these as forces to drive policy change, if
trial results demonstrate the effectiveness of an inter-
vention.
• Researchers should try to build strategic alliances with
those likely to have an academic, geographical, political or
development interest in the policy implications of the
research, to discuss initial ideas, develop proposals and dis-
seminate results.
• Presentation of easily digestible data from the Mwanza
trial certainly helped to influence policy worldwide. This
demonstrates that results that can be presented simply and
clearly, and understood by those with a non-research back-
ground, can have a major impact. Key study results should
be translated into points easily digested by policy-makers,
while trying to avoid the pitfalls of over-simplification.
Researchers may absorb themselves in the technicalities of
their study without considering their role in pursuing the
wider policy implications. It is important to consider how
research will have an impact on policy not as an afterthought
or a footnote in a post-results dissemination strategy, but as
an integral element of every stage of the research process.
The case study of the Mwanza trial illustrates the importance
of researchers taking a contextual view of the interaction
between research and policy, and understanding how chang-
ing political contexts affect receptivity to research outcomes.
This will increase the likelihood of their research findings
having an impact on policy.
References
1 Appleby J, Walschee K, Ham C. Acting on the evidence. Birming-
ham, UK: Health Service Management Centre, 1995.
2 Crosswaite C, Curtice L. Dissemination research results – the
challenge of bridging the gap between health research and
health action. Health Promotion International 1994; 9 (4):
289–97.
3 Frenk J. Balancing relevance and excellence: organizational
responses to link research with decision making. Social Science
and Medicine 1992; 35 (11): 1397–401.
4 Garner P, Kale R, Dickson R, Dans T, Salinas R. Getting research
findings into practice: implementing research findings in
developing countries. British Medical Journal 1998; 317: 531–5.
5 King L, Hawe P, Wise M. Making dissemination a two-way
process. Health Promotion International 1998; 13 (3): 237–44.
6 Peabody JW, Hesketh TM, Steiberg PS. Translating clinical prac-
tice into health policy: an example from China. Health Policy
1996; 35: 107–21.
7 Adibo A, Misra R, Bengzon A. How can research influence health
policy: reports from policymakers in three countries. Washington
DC: International Health Policy Program, 1996.
8 Grosskurth H, Mosha F, Todd J et al. Impact of improved treat-
ment of sexually transmitted diseases on HIV Infection in rural
Tanzania: randomised controlled trial. The Lancet 1995; 346:
530–6.
9 Mayaud P, Mosha F, Todd J et al. Improved treatment services
significantly reduce the prevalence of sexually transmitted
diseases in rural Tanzania: results of a randomised controlled
trial. AIDS 1997; 11: 1873–80.
10 Hayes R, Grosskurth H, ka-Gina G. Impact of improved manage-
ment of STI (letter). The Lancet 1995; 346: 1159–60.
11 Gilson L, Mkanje R, Grosskurth H et al. Cost-effectiveness of
improved treatment services for sexually transmitted diseases in
preventing HIV-1 infection in Mwanza Region, Tanzania. The
Lancet 1997; 350: 1805–9.
12 UNAIDS/WHO. Sexually transmitted diseases: policies and prin-
ciples for prevention and care. UNAIDS Best Practice Collec-
tion, UNAIDS/97.6. Geneva: UNAIDS, 1997.
13 AIDSCAP/USAID/Family Health International. Control of sexu-
ally transmitted diseases. A handbook for the design and
management of programs. Family Health International, 1997.
14 Overseas Development Administration. Sexual health and care;
sexually transmitted infections. Guidelines for prevention and
treatment. London: ODA (DFID)/International Family Health,
1996.
15 National AIDS Control Organisation. Country Scenario 1997–98.
Ministry of Health and Family Welfare, Government of India
1997.
16 WHO. Management of patients with sexually transmitted diseases:
report of a WHO Steering group. WHO Technical Report Series
810. Geneva: WHO, 1991.
17 WHO. Management of sexually transmitted diseases. WHO/GPA/-
TEM/94.1. Geneva: WHO, 1994.
18 UNAIDS/WHO. Consultation on STD interventions for prevent-
ing HIV: what is the evidence? UNAIDS Best Practice
Collection, UNAIDS/00.06E – WHO/HIS/2000.02. Geneva:
UNAIDS, 2000.
19 Grosskurth H, Gray R, Hayes R, Mabey D, Wawer M. Control of
sexually transmitted diseases for HIV-1 prevention: under-
standing the implications of the Mwanza and Rakai trials. The
Lancet 2000; 355: 1981–7.
20 Philpott A. Observations of the research policy interface: the
Mwanza story. Thesis completed as an element of MSc in
Health Policy, Planning and Financing at the London School
of Hygiene and Tropical Medicine and London School of
Economics in June 1999. Copies available on request.
21 Cameron DW, Simonsen JN, D’Costa LJ et al. Female to male
transmission of human immunodeficiency virus type 1: risk
factors for seroconversion in men. Lancet 1989; ii: 403–7.
22 Pepin J, Plummer FA, Brunham RC. The interaction of HIV infec-
tion and other sexually transmitted diseases: an opportunity for
intervention. AIDS 1989; 3: 3–9.
23 Schrijvers D, Delaporte E, Peeters M, Meheus A. Role of sexually
transmissible pathogens in transmitting HIV I. Genitourinary
Medicine 1988; 64 (6): 395–6.
Acknowledgements
This policy case study was presented at the XIII International AIDS
Conference in Durban in July 2000. One of the authors (AP)
received the Young Investigators Award for track E (abstract
TuOrE281) for this work from the International AIDS Society.
Anne Philpott would like to thank Hilary Goodman for her guidance
during the original case study. The authors would like to acknow-
ledge the helpful comments of Gill Walt, Richard Hayes and David
Ross on earlier versions of the manuscript. We thank all those who
contributed to this work as interviewees or by providing data.
Disclaimer: The views expressed by Dr Maher are not necessarily
those of the United Kingdom Department for International
Development or the World Health Organization.
Biographies
Anne Philpott is currently the Manager for International Pro-
grammes at the Female Health Foundation, the non-profit associ-
ation funded by the Female Health Company, manufacturer of the
female condom, and is based in Sri Lanka. At the time the case study
09 Philpott (JG/d) 11/4/02 1:51 pm Page 201
From research to policy – lessons from Mwanza
was conducted she was working in the Programmes Department of
International Family Health, a British based international sexual
health organization responsible for management of an
HIV/AIDS/STIs and Reproductive Health Programme in Africa and
Asia. The case study was the thesis for her MSc in Health Policy,
Planning and Financing at the London School of Hygiene and
Tropical Medicine.
Dr Dermot Maher was previously Senior Public Health Specialist in
the Health and Population Department, United Kingdom Depart-
ment for International Development. He is currently Medical
Officer with the Stop TB Department, World Health Organization,
Geneva, Switzerland.
201
Heiner Grosskurth is Senior Lecturer in the Department of Infec-
tious and Tropical Diseases at the London School of Hygiene and
Tropical Medicine. He has been involved in STD and HIV related
research and interventions in Africa and Asia and was one of the
Principal Investigators of the Mwanza trial. At present he has been
seconded to the Population Council in India where he heads a new
research programme aiming at the development and evaluation of
innovative interventions against HIV infection and other STIs.
Correspondence: Anne Philpott, Female Health Foundation, 4
Kalinga Place, Suliaman Avenue, Jawatte Road, Colombo 5, Sri
Lanka. Tel: +94 (0) 1 501358, +94 (0) 77 880488. Fax: +94 (0) 1 589225.
Email: Anniephilpott@hotmail.com