African and European researchers launch phase 3 of the largest trial of metformin for the prevention of diabetes in people living with HIV in resource-limited settings

Patients receiving diabetes prevention education, in Dar es Salaam, Tanzania

Investigators of the EDCTP-funded research study group met virtually on 23 June 2020 to kick off a phase 3 randomised placebo-controlled double-blind trial of metformin in HIV-infected persons with pre-diabetes (META Phase 3). The study will take place in Tanzania and is led by  the International Research Group on Prevention and Management of NCDs and HIV-infection which includes collaborators from the Ministry of Health of Tanzania and local research institutes (National Institute of Medical Research Tanzania and Shree Hindu Mandal Hospital).

Africa is undergoing a rapid health transition and chronic conditions will overtake that of infectious diseases within the next 10-20 years. Diabetes is one chronic condition of grave concern. The aim of the study is to identify a low-cost intervention for preventing and delaying the development of diabetes among people living with HIV on antiretroviral therapy (ART) in Africa.

This is a unique trial both in terms of being the largest trial in a low-resource setting and in Africa, and because it builds on a strong partnership. Prof Shabbar Jaffar noted that “We are already running several studies including MOCCA and INTE-AFRICA in Tanzania and neighbouring Uganda,  and will build on the research capacity and improved health services we have created there.”

The kick-off meeting included presentations from project leaders Prof Sayoki Mfinanga, Prof Kaushik Ramaiya, Dr Sokoine Lesikari, Dr Anu Garrib, and Prof Jeffrey Lazarus, highlighting important topics for the project’s success, including a strong communication strategy to leverage study results of META-TRIAL. The project kick-off meeting was also attended by EDCTP, which is funding the project, and Merck.

This EDCTP-funded  project runs until Dec 2024 and brings together international partners : National Institute for Medical Research (NIMR), Tanzania; the Ministry of Health of Tanzania; Shree Hindu Mandal Hospital, Tanzania; the Barcelona Institute for Global Health (ISGlobal), Spain; University of Bergen, Norway; and the Liverpool School of Tropical Medicine (LSTM).

 To stay up to date on study results as they become available, visit or follow the hashtag #METATRIAL on twitter.