Comprehensive International Program of Research on AIDSDate: December 1, 2001
Source: National Institutes of Health (NIH)
Author: National Institute of Allergy and Infectious Diseases (NIAID)
According to the latest figures released by the Joint United Nations Programme on HIV/AIDS (UNAIDS), approximately 40 million people worldwide are now living with AIDS. Ninety five percent of all people infected with HIV live in developing countries. Most of the 3 million deaths from HIV/AIDS-related illnesses in 2001 occurred in these countries, making AIDS the fourth leading cause of death worldwide and the leading cause of death in Africa. Children are not spared: in 2001, more than 800,000 were newly infected throughout the world. 1
In response to these realities, the National Institute of Allergy and Infectious Diseases (NIAID) has developed a multifaceted global HIV/AIDS research agenda. The agenda builds upon the Institute's longstanding commitment to international infectious disease research by assisting those countries hardest hit by the AIDS scourge to expand their basic and clinical research capacities, enhance partnerships for public health, and foster education of scientists and clinicians.
The Comprehensive International Program of Research on AIDS (CIPRA), which recently awarded its first group of grants, is a part of NIAID's HIV/AIDS global research agenda. The first five grants provide up to $50,000 for up to two years. As research capacity grows in grantee countries, investigators can choose to apply for other types of CIPRA grants. The new grants will help scientists plan research programs, establish collaborations, build administrative infrastructure, and assemble applications for larger CIPRA grants. "We view these first grants as a bright beginning in what we expect will be a long-term and very exciting program," says Rod Hoff, Ph.D., an official in NIAID's Division of AIDS.
CIPRA grants are given only to institutions and investigators located in countries with an annual per capita income of less than $5,000. The infrastructure for research, training, and data collection is often deficient in these countries and CIPRA seeks to provide the infrastructure support needed to help grantees become full partners with their colleagues in the United States and other developed countries.
Awards have been made to institutions in Trinidad, Peru, China, Zambia and the Russian Federation. Brief descriptions of these grants follow. The CIPRA Web site is http://www.niaid.nih.gov/daids/cipra.
Trinidad and Tobago
· HIV/AIDS Prevention and Treatment in Trinidad and Tobago. About 500,000 Caribbeans currently live with HIV/AIDS, and the disease has killed 8,000 people in the region, according to the Caribbean Task Force on HIV/AIDS. The average prevalence of HIV infection is 2 percent, making the region second only to sub-Saharan Africa.2 Most new infections in Trinidad and Tobago occur in heterosexuals 15 to 24 years old, resulting in a dramatic HIV increase in young women and children less than 15 years old.
This CIPRA grant will fund development of a program responsive to the particular needs of the epidemic in Trinidad and Tobago. Potentially, the program could serve as a model for other Caribbean countries with similar epidemiological and socioeconomic features. It will include assessment for site development and infrastructure needs, as well as plans for increasing the clinical and laboratory capacity needed to perform prevention and treatment intervention research, leading eventually to clinical trials.
· HIV Pathogenesis, Prevention, and Treatment in the Andes. The aim of the project is to develop a regional capacity for HIV prevention and vaccine research in the Peruvian Andes. The investigators plan to submit a subsequent grant application that will consider a wide range of topics. These will include the interaction of other sexually transmitted diseases and HIV; resistance to anti-HIV drugs; effectiveness of preventive behavioral interventions for men who have sex with men; transmission from high to lower-risk populations; assessment of multi-drug resistant tubercullosis in HIV-infected people; evaluation of rapid diagnostic tests for HIV infection; and prevention of mother-to-child transmission of HIV.
· CIPRA-CHINA Planning and Organization. China's health ministry estimates that about 600,000 Chinese were living with HIV/AIDS in 2000. Given the recently observed rises in reported HIV infections and infection rates in many sub-populations in several parts of the country, the total number of people living with HIV/AIDS in China could well exceed one million by the end of 2001.3 A consortium of Chinese research organizations, led by the National Center for AIDS Prevention and Control of the Chinese Academy of Preventive Medicine, will use this CIPRA grant to develop an agenda of integrated epidemiological, clinical and laboratory research; support the training of promising AIDS researchers; and develop a strong administrative and research infrastructure at the local, provincial, and national levels.
· Planning for Randomized Controlled Trials of ART in Lusaka, Zambia. Zambia has one of the highest rates of HIV seroprevalence in Africa. Due to recent government and drug company initiatives to reduce costs, it is expected that antiretroviral drugs will soon be more available to people needing them. However, minimal data are available on the best use of combination antiretroviral therapy (ART) in Zambia. The goal of this grant is to begin development of infrastructure and facilities for a research program on suitable ART for Zambia. In general, African countries have not previously developed systematic approaches to identifying simple and practical HIV treatment regimes. The grant represents the first effort in Zambia to undertake this task.
· Eastern Europe, and the Russian Federation in particular, are experiencing the fastest growing infection rate in the world. In St. Petersburg, Russia (which had an HIV infection incidence of 114 cases per 100,000 people in 2000), the spread of HIV/AIDS occurs primarily through intravenous drug use. The primary focus of this project will be epidemiological research and development of a prevention program, with a secondary focus on treating HIV/AIDS in intravenous drug users who have viral hepatitis and opportunistic infections.
1 UNAIDS. AIDS Epidemic Update. Dec. 2001.
2 UNAIDS. AIDS Epidemic Update. Dec. 2001.
3 UNAIDS. AIDS Epidemic Update. Dec. 2001.
NIAID is a component of the National Institutes of Health (NIH). NIAID supports basic and applied research to prevent, diagnose, and treat infectious and immune-mediated illnesses, including HIV/AIDS and other sexually transmitted diseases, tuberculosis, malaria, autoimmune disorders, asthma and allergies.