Although significant resources have been invested in HIV programs, Uganda is still far from the universal access-to-care target of 80%. While Uganda has developed highly successful research collaborations in HIV, tuberculosis, and malaria over the last 30 years, most of this work has been focused on clinical research, and the findings have not always translated into policy and practice changes. At present, we need an urgent and comparable investment in implementation science (ImS) research to strengthen the response to the HIV epidemic. Effective service delivery by HIV/AIDS programs and engagement in care among HIV-infected individuals will allow antiretroviral medications to reach their optimal public health impact. Makerere University College of Health Sciences (MakCHS) has collaborated with the University of California, San Francisco (UCSF) for over three decades on a range of scientific studies. We plan to leverage this foundation and build a multi-disciplinary team to create a world-class training program for ImS focused on delivery of HIV/AIDS services and engagement in care. Building on the findings of our planning grant, we propose a unique multi-disciplinary ImS research training program at Makerere University School of Medicine. The goals of the proposed program are to: 1) provide training and mentoring in the field of implementation science to Ugandan scholars 2) establish an ImS training site at Makerere University School of Medicine for Uganda and other institutions in Africa. The specific objectives of this training program are to: 1) strengthen the scientific leadership and expertise needed for implementation science research; 2) strengthen the sustainability of implementation science research at Makerere University by integrating ImS research into on-going capacity building programs; 3) promote collaborations between academic research institutions and faculty in Uganda and those in the US; 4) Strengthen trainee contributions to evidence-based decision making related to HIV prevention, care and treatment services through regular interactions with policy makers and HIV program implementers; 5) optimize training through utilization of additional available resources in Uganda (including projects funded by the NIH, PEPFAR and other international agencies); 6) strengthen research capacity in Uganda by helping trainees to integrate into Ugandan institutions and pursue independently-supported scientific careers; 7) create a Centre of Excellence for ImS at MakCHS to serve as a training site for other institutions in Africa. The proposed ImS training program will build on existing relationships between scientists at MakCHS and its affiliated HIV programs (medical), the Makerere University College of Humanities and Social Sciences (non-medical), UCSF and UCB. During our five year program, we anticipate training Ugandan trainees as follows: 2 candidates in master's degree programs at UCSF, 8 candidates in master's degree programs at Makerere University, 4 candidates in long-term non-degree training (including post-doc training), 20 candidates in a modular certificate program and over 700 candidates in short-term non-degree programs.

Public Health Relevance

The emerging field of implementation science seeks to identify strategies that promote the translation of scientific advances into improvements in health care. Building on existing partnerships between Makerere University College of Health Sciences (MakCHS) and its affiliated HIV programs, Makerere University College of Humanities and Social Sciences (MakCHUSS), the University of California, San Francisco (UCSF) and the University of California at Berkeley (UCB), we propose to establish a Research Training Program aimed at building capacity in implementation science at Makerere University School of Medicine in Uganda. The Program will focus on understanding how to enhance HIV/AIDS service delivery and patient engagement throughout the cascade of HIV care, both of which are essential for strengthening the response to the HIV/AIDS epidemic in Uganda.

National Institute of Health (NIH)
Fogarty International Center (FIC)
International Research Training Grants (D43)
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Special Emphasis Panel (ZRG1)
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Mcdermott, Jeanne
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Makerere University
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Semitala, Fred C; Camlin, Carol S; Wallenta, Jeanna et al. (2017) Understanding uptake of an intervention to accelerate antiretroviral therapy initiation in Uganda via qualitative inquiry. J Int AIDS Soc 20:
Nangendo, Joanita; Obuku, Ekwaro A; Kawooya, Ismael et al. (2017) Diagnostic accuracy and acceptability of rapid HIV oral testing among adults attending an urban public health facility in Kampala, Uganda. PLoS One 12:e0182050
Kalema, Nelson; Lindan, Christina; Glidden, Dave et al. (2017) Predictors and short-term outcomes of recurrent pulmonary tuberculosis, Uganda: a cohort study. S Afr Respir J 23:106-112
Walter, Nicholas D; de Jong, Bouke C; Garcia, Benjamin J et al. (2016) Adaptation of Mycobacterium tuberculosis to Impaired Host Immunity in HIV-Infected Patients. J Infect Dis 214:1205-11