The University of Pennsylvania (Penn), in collaboration with the University of Botswana and the Ministry of Health, submits this application to train a small cadre of Batswana health professionals in HIV clinical research. Studies will address issues in treatment of HIV disease and co-infections in HIV- infected adults and children, treatment of malignancies and aging-related non-communicable diseases HIV infected adults, complications of HIV-exposure in uninfected children, and risk reduction in highly exposed uninfected women. This program will act as a catalytic agent to establish an extended research group in Botswana to address some of its pressing health problems identified by the Botswana Ministry of Health and which are consonant with the agendas of both Fogarty and PEPFAR. This proposal includes a close working relationship with the large Center for Clinical Epidemiology and Biostatistics at Penn, which will enable the new research unit in Botswana to function at a highly professional level from its establishment. Training. The training will have tw pathways. (1) Independent Investigator training. Batswana trainees will enroll in Penn's Master of Science in Clinical Epidemiology (MSCE) of which the first year will be spent on coursework at Penn and the second year on a research project in Botswana. The program aims to take 8 trainees over the 5-year program. Trainees will be paired with epidemiology and biostatistics mentors, and Botswana-based clinical and research experts to create an ideal environment for both their intellectual development and practical hand-on application of principles in the pursuit of new knowledge. These trainees will ultimately form the core of an extended research group, which will take the quality and quantity of clinical HIV research emanating from the University of Botswana and the Ministry of Health to a new level. (2) Associate Investigator training. This pathway will provide a series of 1- to 5-day modules to be conducted in Botswana, for health administrators, health clinicians, and research coordinators. The goal is to build in- country capacity to conduct locally driven investigation by empowering Associate Investigators to join collaborative teams led by the Independent Investigator trainees in their current and future research projects. These teams will be strengthened by an innovative "teach-back" approach in which the projects are used as training examples for the Independent Investigators to implement teaching skills and the Associate Investigator trainees to be become more intellectually vested in the projects. Institutional participation. The proposed training program will involve three key institutions in Botswana: the Faculty of Health Sciences at the University of Botswana, the Ministry of Health of Botswana, and the Botswana-UPenn Partnership. Investigators will leverage ongoing federally funded projects at the Botswana- UPenn Partnership to accelerate the pace of the development of their own research programs. Independent Investigators will take positions at either the University of Botswana or the Ministry of Health, where they will be guaranteed supported time to conduct research projects, and will form the nucleus of an extended group dedicated to research on HIV and associated diseases clinical research.
The proposed program will identify and intensively train potential Independent Investigators from Botswana in clinical research skills with a focus on HIV-related questions critical to public health in Botswana. It will also train Associate Investigators who will form a cadre of collaborators to work with the Independent Investigators on their future projects in Botswana. This partnership between the University of Botswana, the Botswana Ministry of Health, and the University of Pennsylvania will strengthen local capacity to conduct HIV related research while building sustainable indigenous research capacity.