South America faces a changing epidemiological environment with a mix of endemic and emerging challenges. Past challenges have covered a broad range of ailments moving from SARS to avian and pandemic influenza and dengue hemorrhagic fever. We are now threatened by the imminent emergence of Chikungunya virus, the rise of artemisinin-resistant Plasmodium falciparum in the Guyana shield and the spread of visceral leishmaniasis in the southern cone. An adequate response to emerging infections requires epidemiologists with advanced research training. However, there are no doctoral programs of international caliber in resource- limited countries like Peru. The NAMRU-6/UPCH/UNMSM/UFMG/JHBSPH/USUHS/CDC consortium proposes to substantially expand our ability to train doctoral-level investigators in a cost-effective and sustainable way, fosterin a new generation of international-caliber scientists. Specifically, we will create a four-year doctorl program in Epidemiology in Peru and will enroll two four-student classes. Additionally, we will reinsert seven PhDs scientists in Peru upon completion of coursework while another seven PhD students/graduates enroll in world-class programs. Our Brazilian partners will prove to be critical for this activity. We will add another 90 graduates from our self-sustainable Epidemiology Masters' program, ~25% conducting infectious diseases research and ~20% working in the public sector. Finally, we will train 200 undergraduate students in short research methods courses or laboratory/field rotations to establish the foundation of a new generation of scientists in Peru who can address the control of emerging and parasitic infections. The viability of our approach is supported by our substantial track record accomplished during our previous awards. We have provided international doctoral training for eight Peruvian scientists and five additional Masters' graduates have started doctoral coursework. Furthermore, we have offered our Masters' program seven years in a row training 184 Latin American students. Our consortium has published 60 papers and our Masters' students have produced 152 papers after graduation, duplicating their rate of articles published per year as compared to before their training. Moving forward, competitive research funding from the Department of Defense will be critical to provide long-term career sustainability to our trainees. Training will take place in a ich environment supported by DoD and NIH collaborations in extensive multi-year research projects. Our proposal is supported by a large pool of highly trained local and foreign mentors, sophisticated laboratories, and diverse field and clinical sites: 45 organizations, 32 PhD scientists residing permanently in Peru and 116 letters of support documents a solid regional collaboration.
Emerging infections and parasitic diseases are primary concerns in Peru and South America. In the early 1990's Peru suffered a massive Cholera epidemic of great mortality and important economic effects. Dengue and malaria have re-emerged in the last 25 years and the H1N1 influenza pandemic caused important mortality. On the other hand, parasitic infections present both on epidemic and endemic contexts. Since the 2012 flood, malaria has increased substantially in the Amazon Basin, with twice as many cases of Plasmodium vivax and a three-fold increase in P. falciparum. Approximately 10,000 cases of leishmaniasis are seen annually, with a current focus in the Amazon region of Madre de Dios. Chagas disease, intestinal parasites and many other constitute endemic conditions of the country. Highly trained epidemiologists are needed to control the double threat of emerging and endemic infectious diseases.
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