University Partnership Aims to Fight HIV/AIDS More Effectively

University Partnership Aims to Fight HIV/AIDS More Effectively. By Erika Gebel
Gates Foundation grant supports joint effort by Johns Hopkins, Makerere

Baltimore — A new partnership between universities in the United States and Africa aims to be an agent for change in improving health outcomes for those afflicted with HIV-related diseases.
With help from a $4.97 million grant from the Bill & Melinda Gates Foundation, a collaborative effort between Johns Hopkins University in Baltimore and Makerere University in Kampala, Uganda, seeks to enhance research and improve health in Uganda and East Africa.

There are 33 million existing cases of HIV/AIDS worldwide and that number is growing by millions each year, according to the World Health Organization. In 2007 alone, AIDS took the lives of 2 million people; 1.5 million of the victims lived in Africa.

To combat this growing epidemic, the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), initially passed in 2003 and then reauthorized in 2008 for an additional five years, has provided $18.8 billion for the fight against AIDS. It is the largest commitment by any nation in history against a single disease. (See “Bush’s Successful HIV/AIDS Program Looks to Next Five Years.”)

Universities, corporations and private foundations in the United States also are joining in the battle against AIDS through funding and research programs.

Makerere University, established in 1922, is one of Africa’s oldest universities. It has 30,000 undergraduate and 3,000 postgraduate students. Through international collaborations with a number of institutions — including a 25-year relationship with Johns Hopkins — Makerere has established itself as a global center for research, especially concerning HIV-related health outcomes.

Makerere University has also made community outreach a central part of its mission.

“Makerere has a very active place in Uganda. They are very progressive,” said Dr. David Peters, an associate professor in the Department of International Health at the Johns Hopkins Bloomberg School of Public Health. “At Makerere, they don’t just sit in ivory towers. There are very few institutions that want to think that way.”

Peters, along with George Pariyo, head of the Department of Health Policy, Planning, and Management at the Makerere University School of Public Health, leads the study.

On December 1, Makerere University established a College of Health Sciences as a semi-autonomous unit within the university. The college houses the School of Biomedical Sciences, the School of Public Health, the School of Medicine and the School of Allied Health Sciences.

This change in structure demonstrated to Peters that the place was ripe for other changes he hopes will come as a part of the new funding.

“With this grant,” Peters said, “we want to plan how to, in the future, make the Makerere College of Health Sciences a leader, with a focus on improving health outcomes.”


INITIAL STEPS

The project is still in its infancy. The initial phase, scheduled to last two years, includes a needs assessment that will be followed by development and implementation of a strategic plan over the following eight years as a joint enterprise between an advisory panel (made up of deans from each school in Makerere’s College of Health Sciences and Johns Hopkins faculty) and an advisory council drawn from Ugandan government and civil society.

Ground work and data gathering for the project’s needs assessment phase will be accomplished by teams made up largely of students and led by Makerere faculty members and support personnel from Johns Hopkins, according to Peters.

Peters said part of the team’s work will involve evaluating the community-based health training currently in Uganda and determining how the university might promote local health initiatives involving HIV most effectively. The team also plans to test innovative strategies, such as a voucher system, to see if the university can influence Uganda’s health systems.

Another aim is identifying how the university can support implementation of research-based health programs. A few years ago, researchers from Makerere University led a study that found circumcision could reduce the risk of acquiring an HIV infection by 48 percent. Peters wants to know how such research could influence policies that could improve the health of Ugandans.

Some research arising from the initiative could be used in scholarly articles, but Peters emphasized new information will have multiple uses.

“The audience isn’t always scientists,” he said. “You may want to put policy briefs in places read by policymakers. We plan to have a range of products.”

After identifying Uganda’s health needs and coming up with a plan to meet them, Peters is optimistic that Makerere University will expand its capacity to improve health outcomes in Uganda and East Africa.

“So it’s very much ‘Stay tuned,’” Peters said. “We have a lot to learn about what it means to be a change agent.”