Developing research leaders at the intersection of malnutrition and tuberculosis in Tanzania

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PROJECT SUMMARY / ABSTRACT This application for a new Global Infectious Diseases Research Training program (GIDRTP) at the University of Virginia (UVA) extends decades of training global leaders in diseases of poverty and infectious diseases through cycles of support of International Training and Research in Emerging Infectious Diseases, Actions for Building Capacity, Minority Health International Research Training, and Fogarty GIDRTPs. These prior experiences provide lessons learned and tested mechanisms for developing trainees into independent public health scientists. Despite the prior focus on early stage trainees such as undergraduate, Masters or doctoral students, we have noted unique barriers in progression through postdoctoral training to research leadership in Tanzania. We performed a needs assessment among Tanzanian postdoctoral scientists in 2021 which confirmed this observation and outlined gaps and opportunities with which to structure a postdoctoral focused GIDRTP. UVA, the Division of Infectious Diseases and International Health, and the Center for Global Health Equity have been at the forefront of research and training in malnutrition and its infectious consequences for decades. In non- pandemic periods, tuberculosis (TB) is the leading killer from a curable infectious disease. COVID-19 has further disrupted TB care and is projected to increase deaths from TB by 20% over the next five years. Malnutrition, both undernutrition and poor nutrition leading to conditions such as diabetes mellitus, is the most important driver of TB disease globally. Therefore, this GIDRTP aims to strengthen existing educational and research linkages with the UVA and the Kilimanjaro Christian Medical University College/ Kilimanjaro Clinical Research Institute (KCMUCo/KCRI) in Tanzania, to support Tanzanian postdoctoral trainees' growth to research leaders working at the intersection of malnutrition and TB. We aim to train 6 postdoctoral scientists with 3 years of support each through an individualized research leadership plan based on the framework of the Path to Research Leadership in Africa Report (2020). In addition to matching postdoctoral fellows to Tanzanian and UVA mentors, the individualized research leadership plan will include assessment by Lead Educators and core programmatic faculty including a biostatistician to design personalized coursework and skills building toward the metric categories of research team management, communication, grant writing, professionalism and career trajectory. We will harness the current infrastructure of funding from the National Institutes of Health, Bill and Melinda Gates Foundation, European and Developing Countries Trials Partnership, World Health Organization and the Danish Ministry of Foreign Affairs for TB and malnutrition research in Tanzania, and we expect to launch the careers of junior scientists and content leaders that will compete for independent funding, set research agendas, make policy and benefit their communities in- line with the World Health Organization's End TB Strategy.