University of Virginia Health System

U.VA. DOCTOR HELPING TO ESTABLISH AFRICA'S FIRST AIDS TRAINING FACILITY

Disturbing figures on the HIV/AIDS epidemic came to light during last month's United Nations AIDS Conference in New York. Of the nearly 36 million people worldwide infected with HIV, 25 million are in Africa. And of those 25 million, only about 10,000 receive treatment for the disease.

Despite a few African countries' efforts to prevent the disease, HIV/AIDS is spreading at an alarming rate with few resources to treat the disease. But now, an alliance of infectious disease experts from Africa and North America is partnering to build Africa's first HIV/AIDS medical training facility to help combat the disease. The facility will be located at Makerere University in Kampala, Uganda and is scheduled to open in April, 2002.

Dr. Michael Scheld, professor of internal medicine and clinical neurosurgery at the University of Virginia Health System and vice-president of the Infectious Disease Society of America (IDSA), is one of the co-founders of the Academic Alliance for Aids Care and Prevention in Africa (AAACP). Along with a financial commitment from Pfizer Pharmaceuticals, the AAACP will build the center to train medical personnel in the most appropriate techniques and to bring the highest standard of care to patients, including the newest anti-retroviral drugs, which treat AIDS and prevent the spread of HIV. Scheld was in Uganda most recently in June to meet with the architects to help design the building, and will return in September to assist with the development of the center's curriculum.

If everything goes according to plan, this building will open by April of next year and it could be even earlier than that, Scheld said. The primary focus of this program is patient care and medical training but we also have a very ambitious research agenda.

Construction of the building is being funded with $500,000 from the Pfizer Foundation, the philanthropic arm of Pfizer Pharmaceuticals, which donated an additional $10.5 million for the center's operation over the next two-and-half years.

The center will train approximately 80 clinicians a year in the latest AIDS treatment. These practitioners will return to their posts in Uganda and other African countries to train more doctors and other medical personnel, Scheld said. The center also will house a clinic that can treat up to 50,000 HIV/AIDS patients with readily available lab results and drugs. These drugs have not been widely used in Africa because of the high cost and lack of infrastructure to distribute the drugs.

We have commitments for some drugs, but not all that we need. We will be introducing fluconazole into Uganda and it will be our responsibility to make sure that distribution happens in an appropriate way, Scheld said. While fluconazole is not a treatment for AIDS, it has been proven to be highly effective in treating two opportunistic infections: cryptococcal meningitis, an infection of the lining of the brain that afflicts 10 percent of AIDS patients, and esophageal candidiasis, an infection of the esophagus that afflicts more than 30 percent of AIDS patients. The mortality rate of those suffering from untreated meningitis is more than 90 percent.

Uganda, a nation of 23 million people, was selected for the center because of the country's early commitment to combat AIDS. Scheld said that Ugandan President Yoweri K. Museveni has been personally committed to fighting the epidemic since 1989 when he formed the Office of AIDS. Before President Museveni instituted an AIDS prevention campaign, 30 percent of the population was living with the disease as compared with only 8 percent today. With the exception of Senegal, the remaining African countries have not been as successful with HIV/AIDS prevention.

The AAACP is a collaboration of international non-governmental organizations (NGOs), the San Francisco AIDS Foundation, participating pharmaceutical research companies and the Infectious Disease Society of America (IDSA). In addition to Dr. Scheld, the doctors involved in the alliance are: Dr. Merle A. Sande, chairman of the Department of Medicine at the University of Utah; Dr. Thomas Quinn, professor of medicine at Johns Hopkins University and National Institute of Health Senior Investigator; Dr. Allan Ronald, professor of medicine at the University of Winnepeg, Manitoba, Canada; Dr. Jerry Ellner, director of the Institute for Emerging Pathogens at the New Jersey Medical School; Dr. Nelson Sewankambo, dean of the Makerere University Medical School; Dr. Elly Katabira, associate dean of the Makerere University Medical School; Dr. Fred Wabire-Mangen of the Insitute of Public Health in Uganda; and Makerere Medical School faculty members Dr. Edward Katongole-Mbidde, Dr. Roy Mugerwa, Dr. Moses R. Kamya and Dr. Harriet Mayanja-Kizza.

July 10, 2001