UM ex­pands ef­forts to com­bat HIV/AIDS

New cen­ter work­ing to build pro­grams in Africa launches with $138M in fed­eral funds

Baltimore Sun - - FRONT PAGE - By Mered­ith Cohn

The In­sti­tute of Hu­man Virol­ogy at the Univer­sity of Maryland School of Medicine will re­ceive $138 mil­lion in fed­eral funds that will sup­port the work of the newly cre­ated Cen­ter for In­ter­na­tional Health, Ed­u­ca­tion and Biose­cu­rity to build pro­grams in Africa to com­bat HIV/AIDS.

The money will en­able the Bal­ti­more­based in­sti­tute to con­tinue work­ing in coun­tries that per­sis­tently suf­fer from high rates of HIV in­fec­tions. The goal is to stem new in­fec­tions and to find and treat more peo­ple al­ready in­fected so the virus be­comes more of a chronic con­di­tion, much like it is in the United States, rather than a death sentence.

About 70 per­cent of the 36.7 mil­lion peo­ple world­wide liv­ing with HIV last year live in sub-Sa­ha­ran Africa, ac­cord­ing to the World Health Or­ga­ni­za­tion. Of the 1.1 mil­lion deaths re­lated to the dis­ease, 800,000 were in Africa.

“We’ve been do­ing this work, but with the cen­ter we will be able to pool our strengths,” said Dr. Deus Bazira Muban­gizi, an as­sis­tant pro­fes­sor of medicine in the Univer­sity of Maryland’s med­i­cal school and the cen­ter’s new di­rec­tor.

The money comes from the Cen­ters for Dis­ease Con­trol and Pre­ven­tion via the U.S. Pres­i­dent’s Emer­gency Plan for AIDS Re­lief, or PEPFAR, and is aimed at build­ing pro­grams in Kenya, Nige­ria, Tan­za­nia and Zam­bia. It will be doled out to six pro­grams over five years.

It adds to hun­dreds of mil­lions of dol­lars in gov­ern­ment fund­ing the univer­sity and the virol­ogy in­sti­tute have been granted

over more than a decade from var­i­ous fed­eral agen­cies through PEPFAR, a pro­gram ini­ti­ated by Pres­i­dent Ge­orge W. Bush to fo­cus more re­sources on HIV in Africa. Pres­i­dent Barack Obama con­tin­ued the pro­gram.

The new Cen­ter for In­ter­na­tional Health, al­ready in the works be­fore the grant was re­ceived, will con­tinue the in­sti­tute’s work to stem deaths from peo­ple in­fected with HIV. The cen­ter also will ex­tend its fo­cus beyond HIV to ad­dress other global health threats such as Ebola, Muban­gizi said.

Muban­gizi was in Kenya when the an­nounce­ment was made, work­ing on the be­gin­nings of projects in two parts of the coun­try aimed at test­ing and treat­ing peo­ple for HIV.

In a phone in­ter­view, he said the cen­ter won’t change the global health goals of those at the Univer­sity of Maryland, some of whom work in dif­fer­ent depart­ments. But its cre­ation will pull them all to­gether for bet­ter coordination, ad­min­is­tra­tion and vis­i­bil­ity. That could lead to more fund­ing and per­haps more per­son­nel at Maryland.

Dr. Chris Beyrer, an as­so­ciate di­rec­tor of the Johns Hop­kins Univer­sity Cen­ter for Global Health, said many uni­ver­si­ties are forg­ing al­liances to solve com­plex prob­lems around the world such as the spread of HIV. The cen­ters of­ten in­volve doc­tors, nurses and other clin­i­cians, as well as pro­fes­sion­als in en­gi­neer­ing who can cre­ate cheap di­ag­nos­tic equip­ment and busi­ness ex­perts who can come up with new fund­ing mod­els.

He said HIV can now be treated with a once-a-day pill, much like hy­per­ten­sion.

“But you have to have money and re­sources and sys­tems to get it to peo­ple,” said Beyrer, who has col­lab­o­rated with Univer­sity of Maryland sci­en­tists on HIVre­lated projects. “When we started this, ba­si­cally most peo­ple were in­fec­tious dis­ease doc­tors, but we re­al­ized we need many more kinds of peo­ple. This is what the global health move­ment has been about, bring­ing peo­ple from across disciplines to solve prob­lems in an in­te­grated way.”

A lot of in­fra­struc­ture has been built in Africa in the last 20 years, he said, but more is needed, par­tic­u­larly in a few large coun­tries such as Nige­ria.

Call­ing the new Maryland cen­ter and the fund­ing “won­der­ful,” he said, “that level of sup­port can al­low for sus­tained in­vest­ment in new ideas and ap­proaches.”

The $138 mil­lion in new grant funds from the CDC in­cludes:

$20 mil­lion to part­ner with the Kenya Med­i­cal Re­search In­sti­tute to sup­port the Kenyan Min­istry of Health’s ef­forts to im­prove pub­lic health prac­tices re­lated to in­fec­tion and non-in­fec­tious dis­eases.

$35 mil­lion to col­lab­o­rate with the Nairobi city coun­cil and Kenyan gov­ern­ment on boost­ing HIV and in­fec­tious dis­ease ser­vices and sup­port Kenya’s first methadone treat­ment cen­ter.

$50 mil­lion to sup­port HIV treat­ment ser­vices in Kenya’s Kisii and Mig­ori coun­ties.

$12.5 mil­lion to sup­port the ex­pan­sion of HIV ser­vices in 12 tar­get re­gions of Tan­za­nia.

$12.5 mil­lion to part­ner with the gov­ern­ment of Zam­bia on in­ter­ven­tions to end trans­mis­sion of HIV and pro­vide links to care.

$8 mil­lion to sup­port the gov­ern­ment of Nige­ria in de­vel­op­ing a ro­bust method of col­lect­ing and eval­u­at­ing data that could iden­tify gaps in HIV health care.

Each coun­try of­fers unique chal­lenges, Muban­gizi said. Some don’t have com­plete reg­u­la­tory sys­tems in place to al­low for ex­pan­sive pub­lic health projects or fully trained pro­fes­sion­als.

Muban­gizi said he and oth­ers will spend a lot of time on the ground in the coun­tries build­ing re­la­tion­ships with gov­ern­ments, aca­demics and community groups, and seek­ing ap­provals for projects, train­ing pro­fes­sion­als to con­duct their own re­search and gain­ing community sup­port.

Dr. Robert C. Gallo, co-founder and di­rec­tor of the In­sti­tute of Hu­man Virol­ogy, said the in­sti­tute has been awarded about $926 mil­lion un­der PEPFAR since 2004. Gallo is widely known for his co-dis­cov­ery of HIV as the cause of AIDS and for devel­op­ment of an HIV blood test.

“It goes with­out say­ing that the es­tab­lish­ment of our Cen­ter for In­ter­na­tional Health, Ed­u­ca­tion & Biose­cu­rity is long over­due,” Gallo said in a state­ment. “Dr. Muban­gizi has led much of our re­cent PEPFAR pro­gram suc­cess, and I have no doubt he will con­tinue to build upon the In­sti­tute’s ex­per­tise and ex­tend our reach in other re­gions of the world to end HIV/ AIDS and re­lated ill­nesses. I am proud of our fac­ulty and staff who are com­mit­ted to help­ing de­vel­op­ing na­tions pre­vent and ad­dress in­fec­tious dis­eases, and build in­fra­struc­tures that bet­ter pro­tect hu­man­ity from biose­cu­rity threats.”

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