As one of the founders of Penta in 1991, Diana Gibb has led us through a journey of impactful research and medical management change. Here she reflects on how challenges in 2021 further shaped our work and organisation.
What has changed in these 30 years? What has not changed and keeps driving us?
The biggest change over the last 30 years since Penta started, has been the evolution in the landscape of paediatric HIV. In 1991 I remember looking after incredibly sick young children with HIV who often died and we had no specific treatments. There was no prevention of HIV transmission from mother- to-child and mothers often didn’t know they had HIV.
This is unrecognisable today where, with ART, transmission from mother-to-child is rare and most HIV-infected children are reaching adulthood. This is all very good news, and Penta trials and research have contributed significantly to bringing better treatments to children. Sadly, there is still no cure, and children need lifelong treatment, so there is more work to do. Our trials have become more innovative and collaborations have expanded globally, particularly to African partners. Penta has expanded from being solely HIV-focused to other infections including antimicrobial resistance, sepsis, hepatitis, fungal infections and of course, more recently, COVID-19.
We undertake many forms of research from large cohort collaborations, pharmacokinetic studies to basic science, these also being efficiently nested within trials. What hasn’t changed with expansion and improvements in structure and oversight, is Penta’s commitment and enthusiasm for research, and the unswerving sense from individuals of belonging to Penta.
How has Penta evolved in 2021?
In 2021 in the midst of the COVID-19 pandemic, Penta, collaborating clinical centres, trial and study coordinating teams at trial units have found innovative ways to continue research more or less on track. Penta has continued to successfully obtain new funding, particularly for COVID-19 research, thereby ensuring women and children are not left behind. Other highlights have been the wonderful work of the Youth Trials Board, first set up within the ODYSSEY trial, but expanding to other trials, with global (particularly African) representation, and the start of a vibrant early career researcher group, including members from low- and middle-income countries. All these activities owe much to dedication and support from the core Penta Foundation team in Italy.
What would you personally mention as a key achievement of 2021?
I have to mention completion of both the global main ODYSSEY trial evaluating new treatment with dolutegravir for children, published in New England Journal of Medicine at the end of 2021, and the ‘baby ODYSSEY trial’ which will be published in 2022. ODYSSEY has informed WHO and other global ART guidelines, has contributed significantly to licensing simplified dolutegravir dosing for children and used a new innovative Baysean design of borrowing information from the older children in the main trial to inform the baby cohort. I think this could be an important new way forward for paediatric trials in the future.
Coming full circle, has COVID-19 changed the way Penta works and how?
COVID-19 has changed everything for everyone! Some things are better – less travelling and more inclusion in on-line meetings particularly for centres in LMICs. PentaTr@ining has continued and Penta ‘Aperitivo’ – our monthly online scientific webinars – have been vibrant. Of course, we are all very much looking forward to meeting again face to face. COVID-19 is here to stay but Penta is thriving and in addition to all its other activities, will, I am sure, contribute enormously to our understanding of COVID-19 in children.
Read more stories in our 2021 Social Report