The National Institutes of Health awarded Duke University Medical Center a $4 million grant last week to study infectious diseases in AIDS patients in Tanzania. University scholars say the grant is only the beginning for Duke�s renewed focus on global health care.
The National Institutes of Health awarded Duke University Medical Center a $4 million grant last week to study infectious diseases in AIDS patients in Tanzania. University scholars say the grant is only the beginning for Duke’s renewed focus on global health care.
“Duke is making major efforts in the area of international health,” said Dr. John Bartlett, professor of medicine in the division of infectious disease and principal investigator of the study.
Duke will receive the funds in $1 million increments for four years from the International Studies of AIDS-Associated Co-Infections program of NIH. The money, at least 60 percent of which must be spent in Tanzania, is the only grant awarded by the program this year.
The study will focus on opportunistic diseases that some AIDS patients develop due to their weakened immune systems. Such co-infections, which include hepatitis C, tuberculosis, meningitis and viral cervical cancer, are a leading cause of death in AIDS patients.
About 10 percent of Tanzania’s 10 million citizens are infected with HIV. The average Tanzanian earns about $365 USD a year, but only spends about $6 on health care, Bartlett said.
“The country is very overwhelmed in trying to provide care for everyone,” he said. “The grant is intended to fund the development of capacity to do clinical research... [and] to study those co-infections, to define those patients at highest risk and to intervene and help them in a cost-effective way.”
Bartlett recently stepped down as director of the infectious diseases clinic and will spend much of his time at the Kilimanjaro Christian Medical Centre in Tanzania coordinating the infrastructural buildup. Dr. Nathan Thielman, assistant professor of medicine, will take over from Bartlett but will also be involved in the epidemiological data collection portion of the grant.
One of the study’s major goals is to develop the infrastructure in Tanzania to allow an independent research team to continue clinical care after the NIH funding runs out. Much of the grant will be spent on equipment, laboratory space and the training of Tanzanian scientists.
“By developing research [in Tanzania], we provide a service that directly helps the population,” said Dr. Pascal Goldschmidt, chair of the Department of Medicine. “We won’t look like a parachute doctor group, take samples and go back home. We teach collaborators and learn from them the art of research.”
The grant is structured so that research will be done on several different topics. Dr. Gary Cox, assistant professor of medicine and a co-investigator focusing on fungal infections, believes that although the research will be challenging, Tanzanians will benefit from the work.
“There is a distribution program that allows for free anti-fungal drugs to be given to the patient population,” Cox said. “We just need a way to figure out how to target patients who would benefit most and [to] research on optimum doses for fungal infections. The most important part is to increase the capacity of the local population to identify and to formally diagnose these fungal infections so that they can implement the programs after we leave.”
The grant will also facilitate a doctor-exchange program that will allow Tanzanian physicians to learn from Duke effective ways to treat their patients. “The relationship that has been developed between our faculty and the doctors and nurses from these centers is a model for the way major academic institutions should think about global health,” Goldschmidt said.
Many say Duke’s recent push for international health is due to the guidance of its new leadership, Chancellor for Health Affairs Victor Dzau and University President Richard Brodhead.
“I think that Victor Dzau and Dick Brodhead are very keen on solving both local and worldwide medical problems—in particular those that relate to under-served communities,” Goldschmidt said.
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