Building on more than a decade of joint Fogarty and NIAID research and training support to our two universities, The UNC-Wits AIDS Implementation Science and Cohort Analyses Training Grant will train Wits junior faculty and advanced trainees and strengthen the MSc in Epidemiology by creating a new concentration of implementation science at the Wits School of Public Health. South Africa continues to have an HIV epidemic with 5.6 million living with HIV/ AIDS, the most of any country, and 270,000 deaths annually. Implementation science is crucial to understand how HIV programs are working and develop strategies for improved effectiveness, to determine how proven interventions can be scaled up effectively, to conduct research, and provide informed answers to SA government and international agencies. The current method of sending SA trainees overseas for long term training is costly, not sustainable, increases the risks of the trainees not returning, jeopardizes their jobs and families at home, and often exposes them to courses not directly relevant to their home countries. There are no implementation science training programs in Sub- Saharan Africa. Trainees from Wits Faculty of Health Science schools and its alumni from diverse backgrounds (nursing, public health, medicine, pharmacy, dental) will participate in a 3 year, 12 course curriculum (long- term) co-taught by UNC and Wits faculty leading to an MPH or MSc in Epidemiology with a concentration in Implementation Science. Additional students will take at least one course (medium and short-term) of the curriculum and receive a certificate. The content, identified by the Wits SPH faculty as gaps in their curriculum, include database development and management, longitudinal analysis and causal inference, health economics, spatial analysis and GIS in public health, m-health, systems analysis, monitoring and evaluation, qualitative and formative research. To save on costs, all courses will be taught on site in 2 week intensive blocks. During years 4 and 5, the courses would start over again, with more responsibility taken by the Wits faculty and previous Fogarty funded trainees ("train the trainers"). Those obtaining a Masters or a PhD would work on existing long term South African HIV cohorts including Right to Care, IeDEA, and Hlabisa. Advanced students would take a year-long grant writing program with the expectation of submitting a grant. Long term sustainability would be guaranteed by incorporating the courses into the Wits curriculum taught by Wits faculty. We have commitments of additional funding and in-kind contributions from UNC and Wits totaling $350,000 over 5 years. By the end of the 5 years we expect to have funded 20 MSc or MPH students, 4 PhD graduates, 6 Wits faculty in specific course methodologies, as well as up to 160 students taking at least one module. This proposal will increase the depth and breadth of this research training and develop a critical mass of South African investigators and Wits faculty who will conduct synergistic research.
South Africa has the highest number of people infected with HIV than in any other country. Gaps in treatment remain an obstacle in reducing the rate of transmission among individuals. In order to strengthen the healthcare services system where these gaps create missed opportunities to reach and test infected individuals we propose an educational program to address brain drain and an insufficient knowledge base. This program proposes to train South African researchers and practitioners at Masters and Doctoral levels at the University of Wits.