|
Intervention Clinical Operational and Health
Services Research
Specific Aims
To deal with the HIV/AIDS epidemic, Malawi urgently needs:-
- Clinical research to identify and test effective interventions for
primary, secondary and tertiary prevention related to HIV/AIDS that
are affordable in Malawi’s resource poor context;
- Operations research to scale-up these interventions in an
efficacious and cost-effective manner; and
- Health services research regarding the organization , financing,
management, and delivery of HIV health services, including innovative
strategies identified in clinical and operational research for
providing prevention, therapy, and care.
To meet these challenges, Phase I funding is requested to develop a
plan for developing a comprehensive international and interdisciplinary
clinical, operational and health services training program as a joint
project of the Kamuzu College of Nursing (KCN) and the College of
Medicine (CoM) at the University of Malawi, where most of the country’s
health professionals and health researchers are trained. Three U.S.
universities (The Johns Hopkins University, the University of Illinois
at Chicago, and the University of North Carolina) that current are
conducting AIDS related research and training in partnership with the
University of Malawi will be collaborating institutions in the proposed
ICOHRTA program.
The long range goal of the ICOHRTA program is to develop a comprehensive
international clinical, operational, and health services research
training program building on evidence-based practice to address the AIDS
epidemic in Malawi. The specific aims of this Phase I planning
application are:
Aim 1: To solidify ICOHRTA collaborative relationships and develop a
shared programmatic vision among all individual and institutional
partners.
Aim 2: To conduct a formal needs assessment that will identify the
strength and gaps in AIDS-related clinical, operational and health
services research and training in Malawi.
Aim 3: To plan and develop a Phase II application for implementing an
HIV/AIDS ICOHRTA Program at the University of Malawi in collaboration
with 3 U.S. Institutional Partners.
Aim 4: To integrate the proposed ICOHRTA Program with the University of
Malawi’s 10 Year Development Plan.
Aim 5: To prepare and submit an ICOHRTA-AIDS Cooperative Agreement Grant
Application The ICOHRTA’s Collaborating US
Institutions and their Relevant Programs in Malawi The
Johns Hopkins Univesiry: Opened in 1876 as America’s first research
university founded for the express purpose of expanding knowledge and
putting knowledge to work for the good of humanity. It remains a leader,
in both teaching and research. The school of Medicine is one of the
nation’s finest, and the Bloomberg School of Public health is renowned
for contributions worldwide to preventive medicine and the health of
large populations. In recent years, JHU has been awarded more federal
research and development funding than any other university.
The Johns Hopkins Forgery AIDS International Training and Research
Program (Director: Chris Brayer, Malawi Coordinator: Taha Taha) is the oldest
and largest of the existing 23 NIH/Fogarty International Centre AITRP
training grants. The Johns Hopkins AITRP is a campus-wide program
involving faculty and trainees in the Bloomberg School of Public health
and the School of Medicine. Its commitment to training in Malawi is a
natural extension of the research activities that the JHU Research
Project has been conducting in Malawi for more than a decade.
Johns Hopkins University Research project: The Johns Hopkins
University has been conducting HIV/STD research in Malawi since 1988.
The project started in collaboration with the Malawi Ministry of Health
9MoH), and the Malawi College of Medicine(CoM) Joined this collaboration
when it was established in 1991. The project has conducted studies on
HIV and STDs in a systematic manner. Earlier JHU studies examined the
prevalence and incidence of HIV/STDs, risk factors for HIV infection,
rates of HIV mother-to-child transmission, and the impact of HIV/AIDS on
mothers and children. More recently, clinical trials were conducted in
the fields of perinatal, female and male microbicides, and
antiretroviral treatment. Since 2002, the JHU project in Blantyre has
also started research on HIV vaccine trials.
The Bill and Melinda Gates Institute for population and Reproductive
Health (Director: Amy Tsui) was established in 1999 at JHU within
its School of Public Health. Its mission is to build individual and
institutional capacity in countries of the developing world, including
Malawi, to strengthen the effectiveness of population. Family planning,
and reproductive health policies and programs. The institute currently
plans to add an operations research component focusing on maternal
mortality and HIV/AIDS.
The University of Illinois at Chicago (UIC) is the largest
institution of higher learning in the Chicago area and one of the top
seventy research universities in the United States. The UIC campus and
the Health Sciences Centre are located in Chicago’s West Side Medical
Centre District, the world’s largest concentration of advanced public
and private health care facilities. UIC offers more graduate study in
dentistry, medicine, nursing, pharmacy, and public health than any other
health education institution in the nation.
The UIC-AIDS International Training and Research Program
(Director: Judith Levy; Malawi Country Coordinator: Kathleen Norr). One
of the five newest Fogarty AITRP programs funded in 2000, the UIC-AIRTP
partners for AIDS research capacity building with institutions in Chile,
China, Indonesia, and KCN at the University of Malawi. The UIC AITRP is
a joint program of the UIC College of Nursing and the School of Public
health. Currently, 3 PhD and 2 MS students from Malawi are studying at
UIC in HIV related studies and the AITRP will return its first MS
graduate to KCN this August 2004. Other Malawi AITRP training
opportunities include in-country training workshops in AIDS research
methods, ethics, HIV prevention, health care provider education,
post-doctoral studies for Malawi scholars at UIC, and US minority AIDS
research internships in Malawi.
The AIDS Research Program, funded by NCCAM through the NIH
Partnership in Africa Initiative (Kaponda, Malawi PI; Levy US PI), is
designed to build research excellence at KCN that facilitates innovative
behavioural science research to improve the effectiveness of AIDS
treatment and prevention in Malawi and throughout Africa. The program
offers research support to Malawi and international investigators and
sponsors 3 behavioural science HIV/AIDS pilot projects.
The FIC Minority International Research Training Program in Nursing
Science at UIC (Director; Beverly McElmurry) provides international
research experiences for minority nursing scholars and is designed to
develop leaders in nursing science and to increase collaboration to
resolve global health issues. In 2004, 2 MIRT scholars from the US spent
10 weeks helping to assess the needs of health workers delivering AIDS
care as part of a WORLD AIDS Foundation funded project (Norr, PI)
The University of North Carolina at Chapel Hill (UNC-CH), founded in
1789, is the flat-shop campus of the first public university in the
United States. Medical instruction has taken place here since the second
half of the nineteenth century. UNC-CH now ranks fifth among the
nation’s top public universities (US News & World Report, 2002).
Particularly germane to this application are the rankings of the School
of Public Health (#3)’ The School of Medicine (#22), the Department of
Health Services Administration (#2), The School of Information and
Library Sciences (#1).
The UNC Fogarty AIDS International Training Program (Directors:
Adaora Adimora and Myron S. Cohen) was first funded by Fogarty in 1998.
The UNC AITRP partners in its parent grant with host institutions in
China, Cameroon, and Malawi where investigators at UNC have worked since
1989. The UNC AITRP has been strongly instrumental in the development of
a new School of Public Health at the University of Malawi and in rapid
technology transfer to Malawi.
The UNC AIDS Project in Malawi. (Directors, Robin Ryder, Irving
Hoffman and Myron S. Cohen): UNC has been conducting HIV/STD research in
Malawi since 1990 and the program has grown into a partnership with the
Ministry f Health and LCH that provides HIV and STD clinical care,
training, and research opportunities. UNC employs a staff of over 200
employees housed in a new HIV Research, Care and training facility, a
building that grew directly out of 15 years of strong collaboration.
This facility is a unique partnership between the UNC Project, Lilongwe
Central Hospital (LCH) and the Malawi Ministry of Health and Population.
FIC Program in Infectious Disease Epidemiology Training for Malawians
(Director, Steven Meshnick). This Program provides training in
infectious disease epidemiology for Malawians through collaboration
between UNC and the new University of Malawi School of Community and
Public Health. Over the next 5 years, 2 Malawians will be partially
supported to obtain PhDs in infectious disease epidemiology at UNC. In
addition, a Center for Infectious Diseases Research was established
within the School of Community and Public health in Malawi. The program
also provides research fellowships to as many as 4 Malawian MPH students
annually to carry out their thesis research
|
