We propose the Mbarara University Training Initiative (MURTI) at the Mbarara University of Science and Technology (MUST) to build the capacity of Ugandan junior faculty to conduct medical research focusing on health care disparities in rural Uganda. Over 90% of the population in sub-Saharan Africa lives in rural settings where health disparities are greatest due to limited access to health care combined with limited education and extreme poverty. With its rural location in southwest Uganda, MUST is uniquely positioned to advance the science needed to improve health in rural SSA - in contrast to most SSA research institutions, which are located in urban centers. MUST is a public university founded in 1989 that, with more than $3 million in annual research funding, has shown exponential growth in both its research productivity and its pool of developing junior faculty. In the last 5 years, MUST scientific productivity has grown from 30 to 80 publications yearly, generating 300 to 1200 annual citations. Based on this growth, MUST is now ranked among the top 5% of the 1,306 universities on the African continent. However, most of this scientific productivity has come from senior faculty, and there is a pressing need - as well as strong potential - to train the next generation of Ugandan junior faculty researchers. MURTI training will address three scientific areas of great public health significance in sub- Saharan Africa: HIV/AIDS, cardiovascular diseases, and mental health disorders. This training initiative will also build expertise in researh administration and research ethics. The proposed MURTI is innovative in its focus on building research capacity in rural settings. It will have particular impact because it will leverage $1.5M/year in ongoing NIH, Gates, and philanthropically funded research in partnership with Massachusetts General Hospital (MGH) and the Harvard School of Public Health (HSPH) to provide in-depth training to 20 Ugandan junior faculty who will conduct public sector investigation focused rural health issues. To reach our goal, we propose the following training aims: (1) To develop junior faculty research expertise in HIV prevention and treatment, particularly in rural southwestern Uganda; (2) To build the capacity of Ugandan junior faculty to develop novel, evidence-based diagnostic and treatment strategies for cardiovascular diseases in rural populations; (3) To prepare junior faculty for research careers addressing mental health disorders in rural Uganda; and (4) To equip junior faculty with the administrative, research ethics, and research communications capacities necessary to succeed as the next generation of independent investigators in Uganda. Through these aims, the MURTI will build the capacity of MUST junior faculty to conduct cutting edge social-behavioral, biomedical, and epidemiologic research. These four aims will be supported by technical expertise from leading North American institutions (MGH and the HSPH) that have developed decade-long collaborations with MUST and locally available expertise.
Sub-Saharan Africa (SSA) accounts for a disproportionate amount of the global burden of disease, and, although 90% of the population in SSA lives in rural area, the vast majority of medical research is led in urban settings. Rural settings have unique health determinants due to structural barriers to health care combined with limited education and severe poverty. MUST, a new and rapidly rising university, is situated in rural southwest Uganda and serves a catchment area of 10M people extending to the Democratic Republic of the Congo, Rwanda, and Tanzania. Our proposed program to build the capacity of junior Ugandan faculty to conduct medical research focusing on health care disparities in rural Uganda will thus have great potential impact both in Uganda and in other SSA settings. We will focus on HIV and two non-communicable diseases: cardiovascular disease and mental health disorders, which collectively account for 18% of the burden of disease in SSA.
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