Developing research training in Zambia to address the epidemic of cardiovascular disease and mental illness amongst HIV infected populations.

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Project Summary/Abstract: The overarching goal of this D71 planning grant is to develop a D43 research-training program in cardiac disease and mental illness amongst HIV infected individuals enrolled in the National HIV Care and Treatment Program in Zambia. In 2018, 1.2 million people in Zambia were living with HIV1. In 2016, life expectancy for men was 60 years and for women 64 years, a considerable increase from 49.4 years in 2012, partly due to improved access to antiretroviral treatment (ART). 2 However, despite the considerable increase in life expectancy, mortality amongst the HIV infected population remains significant. Non-communicable diseases (NCDs), in particular cardio-vascular disease (incorporating hypertensive heart disease, myocardial infarction and congestive cardiac failure), aging and mental illness are increasingly responsible for high morbidity and mortality in low- and middle- income countries (LMICs) such as Zambia. CIDRZ, an indigenous research organization in Zambia, has been leading the efforts to establish and maintain high quality, comprehensive care for HIV infected individuals across the country. The significant investment into HIV services (including PEPFAR) have resulted in a cadre of well trained, skilled and confident HIV care providers and clinicians. However, the specificity of their training has meant that there is a dearth of trained researchers and investigators to identify the relevant research questions and also a shortage of competent and trained clinicians to deal with significant co- morbidities including diabetes, cardiovascular disease, aging and, of note, mental health issues. More recently, these gains are being eroded by the outbreak of SARS-CoV-2 infection whose impact on HIV-infected individuals particularly in our resource constrained setting remains unknown. CIDRZ, in collaboration with Washington University in St. Louis, proposes to partner with the University of Zambia, the University of Lusaka, Levy Mwanawasa Medical University, the Ministry of Health, and the National Health Research Authority to establish a training platform for ongoing high-quality HIV/ NCD research. We are requesting funding under this D71 to prepare for, and ultimately construct, a D43 that would aim to: 1. Increase the pool of qualified, competent researchers and principal investigators; 2. Increase and enhance locally-generated NCDs prevalence and risk factor data amongst HIV infected individuals; 3. develop dissemination and implementation strategies and 4. Develop collaborations with other research institutions and universities both locally and within the sub-region to leverage off current capacity and enhance the research capability.