The overall goal of this training strategy is to develop scientific leadership in HIV- and ART-associated cardiometabolic (CM) research in Rwanda through developing a dynamic team of scholars to implement well- designed contextually relevant studies, publish and present results at scientific meetings, and for networking, and develop expertise for independent research funding. Regional Alliance for Sustainable Development (RASD Rwanda) and University of Rwanda (UR) College of Medicine and Health Sciences (UR-CMHS) propose to collaborate with Washington University School of Medicine in St. Louis, MO, USA (WUSTL) to implement a mlange of long-, medium-, and short-term tailored didactic and hands-on training, balanced for Master's (MS) degree and non-degree face-to-face mentorships. We will provide MS in Clinical investigation training to postdoctoral scholars, followed by 3-months Mentored Career Development Fellowships, MS in Biostatistics, and MS in Biochemistry Laboratory Medicine. Research training in Endocrinology and Metabolism and advanced nursing techniques will be provided, plus technical training in stable isotope tracer methodologies for substrate kinetics measures, and echocardiographic measures of vascular and cardiac function. WUSTL Faculty assisted by previously trained mid-career Rwandan co-mentors will provide 4-weeks hands-on intensive didactic training to 15 mid-career investigators in Advanced Epidemiology & Biostatistics in Year 1, using existing Ministry of Health HIV datasets, resulting into publications. In Year 2, 4-week intensive workshop training to develop Grant Writing Skills will occur followed by post-training mentorships. Promising young and mid-career scientists will benefit from regular, custom-tailored and flexible mentoring from senior WUSTL Faculty and Rwandan co-mentors (the mentored become mentors) to enhance the research culture at UR-CMHS, while Rwandan co-mentors will gain a breadth of skills from more experienced Faculty to train junior scientists- a pool of future mentors. We envision that 4 WUSTL Faculty will mentor 4 young scientists each, resulting in 16 successful mentorships annually, with up to 80 mentorships in 5 years. Trainees' unique HIV research projects will be supported to accelerate novel findings. Furthermore, WUSTL Summer Fellowships (8 weeks) in the Public Health Advanced Summer Education Program for Research in Global Health, and Bench Fundamentals for Translational Laboratory Research course will each accept 2 trainees/year. Upon return to Rwanda, all trainees will be integrated into the vibrant HIV research infrastructure to contribute to rigorous investigations, and to eventually enable UR to become an African scientific leader in cardiovascular and metabolic research associated with HIV, nutrition, obesity, diabetes and other related co- morbidities, with improved independent scientific capacity to attract and manage grants, and ability to inform global community on HIV care and practice.
HIV- and ART-associated cardiometabolic complications (CM): insulin resistance (pre-diabetes), diabetes mellitus, dyslipidemias, hypertension, osteopenia, and anthropomorphic changes, combined with the rising incidence of non-communicable diseases in Rwanda, threaten to increase morbidity and mortality rates similar to what is occurring in other African and developed countries. Thus, training a generation of highly skilled Rwandan clinical investigators devoted to HIV- and ART-related CM research will accelerate novel investigations to elucidate these disease interactions to generate contextually relevant knowledge that guides policy and practice for chronic care of HIV-infected persons in Rwanda.
