Newswise — August 24, 2021—(BRONX, NY)—Researchers at Albert Einstein College of Medicine and the City University of New York Graduate School of Public Health and Health Policy (CUNY SPH) have been awarded a five-year, $14.5 million grant from the National Institutes of Health (NIH) to continue leading and expand their research on HIV treatment and care in five Central African nations.
The new award builds on previous NIH-funded work by the Central Africa International epidemiology Databases to Evaluate AIDS (CA-IeDEA), a large-scale study involving more than forty researchers and tens of thousands of patients living with HIV/AIDS in Burundi, Cameroon, the Democratic Republic of Congo, the Republic of Congo, and Rwanda. The effort began more than a decade ago and has been co-led by Kathryn Anastos, M.D., professor of medicine, of epidemiology & public health, of obstetrics & gynecology and women’s health at Einstein, co-director emerita of the Global Health Center, and an internist at Montefiore Health System.
CA-IeDEA is one of seven regional centers that belong to a larger global research consortium, the International epidemiology Databases to Evaluate AIDS (IeDEA). The IeDEA teams consolidate and analyze vast amounts of health data so that researchers can study high-priority questions on HIV treatment and care. CA-IeDEA focuses on determining successful strategies that lead to improved outcomes for people living with HIV. These approaches include timely diagnosis and enrollment into care, engaging and keeping patients in care, and rapid initiation of antiretroviral therapy (ART) to reduce the risk of death and further transmission of the virus.
More than 86,000 people have enrolled in CA-IeDEA at participating sites in the five countries since the program was launched in 2006. There are nearly 40,000 people currently receiving HIV care at 21 CA-IeDEA sites. The five countries that comprise the center are among those with the greatest burden of HIV infection in the world.
In addition to Dr. Anastos, the two other principal investigators on the new CA-IeDEA grant are Marcel Yotebieng, M.D., Ph.D., M.P.H. associate professor of medicine at Einstein, and Denis Nash, Ph.D., M.P.H., distinguished professor of epidemiology and executive director of the Institute for Implementation Science in Population Health (ISPH) at CUNY SPH.
Combating HIV/AIDS in Central Africa
The grant will provide continued support for CA-IeDEA’s existing projects and fund three new initiatives: the collection of data on cardiovascular and other noncommunicable diseases to understand how these conditions affect older African adults living with HIV; a research program for adolescents living with HIV, including those who were infected around the time of birth; and studies of people co-infected with tuberculosis that will measure lung function impairment and risk of recurrence after successful treatment.
“This new award will allow us to expand our clinical reach and research focus, enrolling more children and adults with HIV/AIDS who visit health clinics in urban and rural areas in our five partner countries,” Dr. Anastos said. “Our overall goal is to increase access to HIV services and improve outcomes for patients, including not only successful initiation of ART, but also diagnosis and treatment of metabolic and cardiovascular diseases.”
Researchers will share anonymized data sets with public health experts and non-governmental organizations such as the World Health Organization (WHO). “Larger samples from a variety of patients can help us understand critical questions,” said Dr. Yotebieng. “For example, what are the experiences of adolescents living with AIDS, how do they transition to adult care, and how can they benefit more from treatments? A major aim we have is leveraging implementation science approaches—looking at ways services are delivered, what gaps exist, and how to close them.”
A key part of the grant supports training local scientists and building capacity to sustain research initiatives. “In any country, it takes decades to ‘grow’ a new community of researchers, and it requires an infrastructure that can nurture them,” said Dr. Anastos. “We’re putting in place a system to mentor and provide statistical and study design assistance to junior investigators in Africa, so they can ask and answer the questions they want to tackle.”
Dr. Nash will lead the team’s involvement in multiregional research that includes assessing the varying success rates of antiretroviral therapy across the seven IeDEA regions. This has included CA-IeDEA’s leadership in assessing “Treat All,” the 2015 World Health Organization guidelines to treat all individuals upon diagnosis of HIV regardless of CD4 cell count, as well as the development of IeDEA’s consensus statement on research priorities to optimize the guideline’s impact on people living with HIV.
The CA-IeDEA team is also seeking additional funding to examine the influence of climate change on HIV care and outcomes among the more than 2 million patients who have enrolled at IeDEA-participating sites in 44 countries since 2004. The team will compare data on global temperature and rainfall with that from IeDEA to determine the effect of extreme weather, if any, on patients. “National governments, normative bodies, and global funders, including WHO, UNAIDS, and PEPFAR, have not adequately factored climate-related data into short- and long-term planning, largely because studies like the one we are planning have not been done,” said Dr. Nash.
The grant is titled “Central Africa International Epidemiology databases to Evaluate Aids” (2U01AI096299-13).
About Albert Einstein College of Medicine
Albert Einstein College of Medicine is one of the nation’s premier centers for research, medical education and clinical investigation. During the 2020-21 academic year, Einstein is home to 721 M.D. students, 178 Ph.D. students, 109 students in the combined M.D./Ph.D. program, and 265 postdoctoral research fellows. The College of Medicine has more than 1,900 full-time faculty members located on the main campus and at its clinical affiliates. In 2020, Einstein received more than $197 million in awards from the National Institutes of Health (NIH). This includes the funding of major research centers at Einstein in aging, intellectual development disorders, diabetes, cancer, clinical and translational research, liver disease, and AIDS. Other areas where the College of Medicine is concentrating its efforts include developmental brain research, neuroscience, cardiac disease, and initiatives to reduce and eliminate ethnic and racial health disparities. Its partnership with Montefiore, the University Hospital and academic medical center for Einstein, advances clinical and translational research to accelerate the pace at which new discoveries become the treatments and therapies that benefit patients. Einstein runs one of the largest residency and fellowship training programs in the medical and dental professions in the United States through Montefiore and an affiliation network involving hospitals and medical centers in the Bronx, Brooklyn and on Long Island. For more information, please visit einsteinmed.org, read our blog, follow us on Twitter, like us on Facebook, and view us on YouTube.
About the CUNY Graduate School of Public Health and Health Policy The CUNY Graduate School of Public Health and Health Policy (CUNY SPH) is committed to teaching, research and service that creates a healthier New York City and helps promote equitable, efficient and evidence-based solutions to pressing health problems facing cities around the world. For more information, visit sph.cuny.edu. Twitter @CUNYSPH.