NURTURE:Research Training and Mentoring Program for Career Development of Faculty at Makerere University College of Health Sciences

 描述(申请人提供)：撒哈拉以南非洲(SSA)承担着世界24%的疾病负担，是卫生工作者与人口比例最低的地区，不到全球财政资源的1%和人力资源需求的3%。全球有3500万艾滋病毒/艾滋病患者，其中970万人正在接受抗逆转录病毒治疗。艾滋病毒/艾滋病和相关疾病仍然是南沙地区健康面临的主要挑战，全球艾滋病毒疾病负担的69%居住在该地区。艾滋病毒/艾滋病混合感染，包括结核病和隐球菌性脑膜炎，仍然是艾滋病毒感染者发病和死亡的主要原因。在乌干达，据估计有140万艾滋病毒携带者，根据2013年世卫组织抗逆转录病毒治疗启动指南，只有38%的人接受抗逆转录病毒治疗。几十年来一直挑战非洲大陆的其他传染病仍然存在，而新的或旧的传染病再次出现。人们日益认识到，非传染性疾病是新出现的流行病，给我们脆弱的卫生系统增加了额外的负担，这些疾病已经因目前的艾滋病毒、结核病、疟疾和其他传染病而捉襟见肘。像乌干达的Makerere大学这样的土著机构需要在确定和寻找可持续和容易获得的干预措施方面发挥作用，以应对国家和区域的优先卫生挑战。包括Makerere大学在内的研究所正在努力解决训练有素的研究人员数量不足的问题，特别是初级和中级研究人员。在过去20-30年里，乌干达在与区域相关的优先卫生挑战有关的研究方面取得了重大进展并作出了重大贡献。其中一些研究成果为艾滋病毒/艾滋病、结核病和疟疾领域的国家和全球政策做出了贡献。Makerere大学健康科学学院(MakCHS)在建设乌干达的研究能力方面发挥了核心作用。医学教育伙伴关系(MEPI)赠款及其两个相关奖项(赠款#5R24TW008886、#5R24TW008861和#4R25N5080968)提供的五年资金显著增加了以乌干达人为第一作者的出版物的比例。这表明，环境已经准备好为加强研究能力进行额外投资，这将支持乌干达机构跃升到下一个研究生产力水平。MakCHS和其他4名乌干达人培训和指导了15名博士生和68名硕士实习生，还支持了29个非学位指导型教员研究奖学金。然而，我们的培训机构的研究能力仍然存在重大差距，这是加速改善该国健康状况所必需的。我们建议为初级和中级教师提供五年的培训和指导计划，特别关注三个相互关联的主题：艾滋病毒/艾滋病及其相关的共同感染、包括疟疾在内的其他传染病和非传染性疾病。这项提议的目标是发展一种可持续的文化，以支持在MakCHS促进独立研究人员持续发展和留住的环境中，为即将到来的教师的职业发展提供研究、培训和指导。为了实现这一目标，我们的计划有三个具体目标：目标1：为初级和中级教师的个性化研究能力发展提供有针对性的培训和指导，使其成为能够应对区域相关健康挑战并影响政策和实践的独立研究领导者。目标2：通过加强现有的和新兴的专注于艾滋病毒/艾滋病相关疾病、其他传染病和非传染性疾病的研究小组，促进研究事业的发展，从而增加教师的留住。目标3：通过机构研究政策、基础设施、激励措施和服务，促进MakCHS继续发展有利的研究环境，以支持研究人员在进行高质量研究方面具有国际竞争力。拟议的能力建设计划是为了实现我们的长期愿景，即MakCHS成为非洲卫生科学领域学术卓越和创新的领先和变革性机构。在这个为期5年的培训计划结束时，我们的总体目标是巩固由多产的独立科学家组成的研究团队，他们能够在获得国际资金方面具有竞争力地出类拔萃，加强Makerere的研究文化，并建立支持其在乌干达的合作大学的能力。MakCHS日益被认为是艾滋病毒及其相关联合感染、包括疟疾和新出现的非传染性疾病在内的其他感染领域的研究领先者。

 DESCRIPTION (provided by applicant): Sub-Saharan Africa (SSA) bears 24% of the world's burden of disease, the lowest health worker to population ratio and has less than 1% of the global financial resources and 3% of the human resource needs. Globally 35 million people are living with HIV/AIDS, of whom 9.7 million are receiving antiretroviral therapy. HIV/AIDS and related illnesses remain major challenges to health in SSA, where 69% of the global HIV disease burden resides. HIV/AIDS Co-infections including tuberculosis and cryptococcal meningitis remain major causes of morbidity and mortality among HIV-infected individuals. In Uganda, 1.4 million people were estimated to be living with HIV and only 38% are receiving ART according to the 2013 WHO guidelines for ART initiation. The other infectious diseases that have challenged the continent for decades still remain while new ones emerge or old ones re-emerge. Non- communicable diseases (NCDs) are increasingly recognized as emerging epidemics that add an additional burden to our weak health systems already stretched by the ongoing HIV, tuberculosis, malaria and other infectious diseases. Indigenous institutions like Makerere University in Uganda need to play their role in identifying and finding sustainable and easily accessible interventions to the priority national and regional health challenges. Institutios including Makerere University grapple with the inadequate numbers of well-trained researchers particularly at the junior and mid-level. In the last 20-30 years Uganda has made significant advances and substantial contributions to research related to regionally relevant priority health challenges. Some of the research findings have contributed to national and global policies in the areas of HIV/AIDS, tuberculosis (TB) and malaria. Makerere University College of Health Sciences (MakCHS) has played a central role in building Uganda's research capacity. The five-year funding from the Medical Education Partnership (MEPI) grant and its two linked awards (grants # 5R24TW008886, # 5R24TW008861 and # 4R25N5080968) have led to a remarkable further increase in the proportion of publications that have Ugandans as first authors. This demonstrates that the environment is ready for additional investments for research capacity enhancements that will support Ugandan institutions to leapfrog to the next level of research productivity. MakCHS and 4 other Ugandan have trained and mentored 15 PhD students and 68 masters' degree trainees and also supported 29 non-degree mentored faculty research fellowships. There are, however still major gaps in the research capacity of our training institutions required to accelerate improvements in the country's health status. We propose a five year training and mentoring program for junior and mid-level faculty with a particular focus on the three interlinked themes of HIV/AIDS and its associated co-infections, other infectious diseases including malaria, and NCDs. The goal of this proposal is to develop a sustainable culture for supporting research training and mentoring for career development of upcoming faculty in an environment at MakCHS that fosters continuous development and retention of independent researchers. To achieve this goal our program has three specific aims: Aim 1: To provide targeted training and mentorship for individualized research capacity development of junior and mid-level faculty to become independent research leaders capable of addressing regionally relevant health challenges and influence policy and practice. Aim 2: To increase faculty retention by facilitating research career progression through strengthening existing and emerging research groups focusing on HIV/AIDS-related illness, other infectious diseases and NCDs. Aim 3: To facilitate continued development of a conducive research environment at MakCHS with institutional research policies, infrastructure, incentives and services that support researchers to become internationally competitive in conducting high quality research. The proposed capacity building program is to contribute towards the realization of our long term vision for MakCHS to be a leading and transformational institution for academic excellence and innovation in health sciences in Africa. At the end of this 5-year training program, our overarching objective is to solidify research groups of productive, independent scientists who can competitively excel in securing international funding, strengthen the research culture at Makerere and build the capacity to support its partner universities in Uganda. MakCHS is increasingly recognized as a research leader in the area of HIV and associated co-infections, other infections including malaria and the emerging non-communicable diseases.