UB’s University of Zimbabwe visit focuses on clinical pharmacology, lab programs and health care informatics initiatives

BUFFALO, N.Y. – With 14 percent of Zimbabwe's population living with HIV/AIDS, the need for prevention programs for the entire country, as well as new drugs, treatment and support of those living with HIV, is essential.

Because of these numbers, the University at Buffalo has been working with the University of Zimbabwe (UZ) to establish training programs for scientists and citizens in an ongoing effort to study, reduce and treat the incidence of HIV in Zimbabwe.

Recently, as part of its ongoing collaboration with UZ, a team of researchers from the University at Buffalo visited Zimbabwe – some for the fourth time – to work with collaborating scientists and meet with adult and adolescent HIV community support groups.

The UB team, led by Gene Morse, professor and associate director of UB’s New York State Center of Excellence in Bioinformatics and Life Sciences, included: Venu Govindaraju, a SUNY Distinguished Professor of Computer Science and Engineering; Robin DiFrancesco research assistant professor; Kelly Tooley, senior research support specialist and program administrator for CPQA and AITRP; and Samantha Sithole, a current HIV implementation research fellow in the Translational Pharmacology Research Core in the Center of Excellence.

During the visit, the UB Clinical Pharmacology Quality Assurance Program (CPQA) and the UB-UZ AIDS International Training & Research Program (AITRP) worked with researchers and laboratory technicians at the National Institutes of Health (NIH)-funded Harare International Pharmacology Specialty Laboratory (HIPSL) at UZ.

The HIPSL at UZ, directed by Professor Charles C. Maponga, ’88, is one of six pharmacology specialty laboratories in the AIDS Clinical Trials Group (ACTG) Laboratory Center Network that provides clinical pharmacology expertise and a bioanalytical resource to conduct drug assays for samples collected from ACTG clinical studies.

The UB CPQA provides technical guidance for analytical aspects of drug assays and conducts a comprehensive on-site assessment as part of its mission to seek consistency across pharmacology laboratories in the network.

The HIPSL, located in the same building with the Medicines Control Authority of Zimbabwe, is a growing laboratory facility that will provide an important research core laboratory for the National Institute of Allergy and Infectious Diseases (NIAID) HIV Research Networks. In addition to building the research facility, capacity building efforts have focused on training young scientists and laboratory technologists that will increase HIV research capacity.

A second component of the visit included the continued growth of the UB-UZ AITRP, which is funded by the Fogarty International Center at the NIH and has a primary goal of increasing HIV clinical pharmacology research capacity at UZ through mentored training of UZ graduate students and faculty in HIV clinical pharmacology research methodology, laboratory sciences and applied therapeutics.

This team was led by Tinashe Mudzviti, an AITRP mentor at UZ, and visited the Opportunistic Infections (OI) Clinic at the Parirenyatwa Hospital and the Newlands Clinic to review the current approach to medical records and the status of implementation of electronic medical records (EMR) systems. The UB-UZ AITRP previously received a supplemental award to develop standardized approaches to the use of EMRs to facilitate clinical research.

Govindaraju is planning pilot implementation research projects that will employ the handwriting recognition technology he developed at UB to create legacy records from paper medical charts that can be incorporated with growing EMR use.

The UB group additionally met with the PARI Support Group, a group of adult HIV-infected patients who meet at the OI Clinic and provide support for its members to be adherent to anti-retroviral drugs, achieve viral suppression and participate in clinical research projects.

Morse led a week-long workshop on HIV Research Publications. The workshop included informal group and individual meetings and provided an opportunity for direct mentoring in preparing a research manuscript, criteria for identifying peer-reviewed journals, identifying and facilitating co-author contributions and establishing timelines for manuscript writing and submission. All current AITRP fellows participated in the workshop and each has a manuscript that is being finalized for journal submission.

The UB investigators then gathered with faculty of the UZ College of Health Sciences during the initial meeting of the AITRP with the leaders of the UZ Medical Education Partnership Initiative (MEPI).

The UZ MEPI is home to the Novel Education and Clinical Trainees and Researchers (NECTAR) Program that is an NIH-PEPFAR supported grant.

NECTAR is a grant awarded to the UZ College of Health Sciences (UZCHS) for the implementation of a program to improve medical education and strengthen research capacity at the college for the period 2010-15.

The AITRP and NECTAR have jointly established an Implementation Sciences and Research Committee that will focus on including education, training and research opportunities within the curriculum as well as development of multidisciplinary pilot implementation research projects for faculty and graduate students. The members of the committee include Maponga, Mudzviti and Dexter Chegwena (UZ-AITRP), Morse (UB-AITRP), James Hakim, Zvavahara (Mike) Chirenje, Kusum Nathoo, Jonathan Gandari and Gibson Mandozana (all from UZ-MEPI).

The AITRP mentors and fellows contribute to this effort by working with the members to complete various agricultural projects that are aimed at increasing food security, thereby improving patient retention in care, treatment and medication adherence. 

Through his AITRP mentoring at the Newlands Clinic, Mudzviti has also established a community leadership role at Africaid Zvandiri, a support group for HIV-infected children and adolescents in the Harare area.

The Zvandiri program provides community-based prevention, care and psychosocial support for HIV-positive children and adolescents. These services complement the care provided in clinics and promote a continuum of care for children and their families. The Zvandiri model is headed by HIV-positive adolescents who lead and plan services for counselors, trainers and advocates for their HIV-positive peers.

The Zvandiri group has gained international recognition for its recent release of a music video, “How to Dance” (http://www.africaid-zvandiri.org/howtodance), focusing the public’s awareness on the needs and hopes of children who have grown up with HIV infection, achieved sustained viral suppression with combination antiretrovirals and are now planning their future as members of the local community.

During the visit to the Zvandiri group, Morse discussed the outstanding contributions the group is making toward assisting HIV-infected children in Zimbabwe and considered the opportunities for networking with UB programs that will foster medication adherence, peer counseling, vocational training and small business development models.

Tooley met with a pediatric AIDS support group in the community setting, which is also assisted by Africaid and meets every month to teach HIV-infected adolescents and children the critical life lessons necessary to be well equipped to address issues of growing up with HIV.

“This trip provided an opportunity to discuss the important progress that has been made through the UB partnership with UZ,” said Morse.

“The UZ group of researchers have become leaders within their academic community through their focus on building pharmacology laboratory resources for research, clinical programs for HIV-infected individuals and by linking patient support groups to clinical researchers who work closely with the government ministries to advance the national effort to conduct the Evidence to Action (ETA) project that was announced at our meetings last March.

“Great progress is being made through the perseverance and dedication of the newly trained researchers to achieve the national goals of Zimbabwe.”