Columbia University-Southern African AIDS International Training/Research Program

描述（由申请人提供）：这项拟议的培训计划建立在过去14年的成功和教训，以满足在南部非洲，全球艾滋病毒流行病的震中成熟的艾滋病毒流行的新出现和不断变化的挑战。目前项目的125名长期和186名短期受训人员继续通过他们在全球和当地的领导作用产生重大影响，因为他们的研究在急性艾滋病毒感染的艾滋病毒发病机制，新的预防技术等领域产生了新的知识。（包括预防母乳喂养传播的抗逆转录病毒药物、基于病媒的艾滋病毒疫苗和抗逆转录病毒杀微生物剂），以及治疗艾滋病和结核病合并感染的新方法。受训人员发表了894篇同行评议的论文，其中包括几篇在《科学》、《自然》和《柳叶刀》等高影响力期刊上发表的论文。 艾滋病毒相关耐药结核病的出现，世界上最大的艾滋病治疗计划的实施，以及南非从否认过去过渡到新卫生部长领导下的政治开明未来，迫切需要证据来指导决策，为该计划的下一个周期创造了一系列新的挑战和机遇。在通过该方案建立的实质性科学基础、广泛的研究基础设施和当地专业知识、国内艾滋病和结核病研究的丰富成果、南非内外的战略合作以及利用其他机构资金的新机会的基础上，拟议的方案将继续确定最有潜力的受训人员，在南非和美国为他们提供高质量的培训，并为他们提供持续的支持，以建立有效应对南部非洲艾滋病毒和结核病流行的临界质量。拟议的方案充分利用了过去十年中吸取的最宝贵的经验教训，如长期国内指导的重要性、赠款编写和管理方面的持续培训、最大限度地增加培训机会的战略伙伴关系，与当地生产性研究团体协商招聘候选人，以及美国和南非联合教师在提高国际教育水平方面的价值。国家培训。 在对培训优先事项进行持续评估的指导下，并在平衡的美国-南非培训咨询委员会（其中包括几名以前的学员，现在是高级调查员）的仔细监督下，我们将继续酌情提供各种短期到中期，以及在美国、南非、斯威士兰、纳米比亚和莱索托的长期培训机会。下一个周期该计划的重点是：i）解决南非现有艾滋病毒和结核病卓越研究中心的关键培训差距，以应对艾滋病毒流行的新挑战，ii）为年轻研究人员，特别是医学生提供支持和指导，以及iii）为南非艾滋病研究从目前依赖多中心研究过渡到更广泛的研究提供至关重要的培训。可持续的平衡投资组合，增加了研究人员发起的研究水平。目标是加强和扩大南部非洲现有的独立艾滋病毒和结核病研究小组的数量;加强当地能力，以承担更多的区域培训需求，并发展必要的技能，以协助决策者提供证据，实施和监测艾滋病毒/艾滋病预防和治疗方案的扩大。

DESCRIPTION (provided by applicant): This proposed training program builds on the successes and lessons of the previous 14 years to meet the new emerging and evolving challenges of a maturing HIV epidemic in southern Africa, the epicenter of the global HIV pandemic. The 125 long-term and 186 short-term trainees of the current program continue to have a major impact through their leadership roles globally and locally, as their research generates new knowledge in areas such as HIV pathogenesis in acute HIV infection, new prevention technologies (including antiretrovirals to prevent breastfeeding transmission, vector-based HIV vaccines and antiretroviral microbicides), and new approaches to treating HIV-TB co-infection. The trainees have published 894 peer- reviewed papers including several in high impact journals like Science, Nature and the Lancet. The emergence of HIV-associated drug-resistant tuberculosis (TB), the implementation of the largest AIDS treatment program in the world and the dire need for evidence to guide decision-making as South Africa transitions from its denialist past to a politically enlightened future under a new Minister of Health, have created a set of new challenges and opportunities for the next cycle of this program. Building on the substantive science base, extensive research infrastructure and local expertise created through this program, the rich tapestry of in-country AIDS and TB studies, the strategic collaborations within and outside South Africa, and the new opportunities to leverage funding from other agencies, the proposed program will continue to identify trainees with the most potential, offer them high quality training both in South Africa and the USA and provide them with ongoing support to create a critical mass for an effective response to the HIV and TB epidemics in southern Africa. The proposed program sets about this task well armed with the most valuable lessons learnt in the past decade such as the importance of long-term in-country mentorship, ongoing training in grant writing and administration, strategic partnering to maximize training opportunities, recruitment of candidates in consultation with local productive research groups and the value of having joint USA and South African faculty in raising the standard of in-country training. Guided by the ongoing assessment of training priorities and with careful oversight from a balanced US- SA Training Advisory Committee, that includes several previous trainees who are now senior investigators, we will continue to provide, as appropriate, a variety of short-to-medium, and long-term training opportunities in the USA, South Africa, Swaziland, Namibia and Lesotho. The emphasis of the program in the next cycle is to i) address critical training gaps in existing HIV and TB centers of research excellence in South Africa to meet the new emerging challenges in the HIV epidemic, ii) provide support and mentorship for young investigators, especially medical students, and iii) provide the training critical to the efforts of South African AIDS research to transition from the current reliance on multicenter studies to a more sustainable balanced portfolio with increased levels of investigator-initiated research. The goal is to strengthen and expand the existing number of independent HIV and TB research teams in southem Africa; strengthen local capacity to assume more of the region's training needs and developing the skills needed to assist policy makers with evidence to implement and monitor the scale-up of HIV/AIDS prevention and treatment programs.