Colorado doctors have been offering expertise and training to counterparts in Zimbabwe since 1998. Now a new grant from the National Cancer Institute will help extend this work, setting the stage for the development of a Regional Center for Research Excellence, called AfriCARE, meant to benefit the entire region of sub-Saharan Africa.
“We have a continuing training collaboration with the Department of Medicine at the University of Zimbabwe, building both intellectual and physical resources. Our residents have the opportunity to spend time in Zimbabwe and we bring Masters in Medicine students to study here. The hope has been that Zimbabweans come here to see what’s possible and then adapt the procedures as possible locally,” says Thomas Campbell, MD, investigator at the University of Colorado Cancer Center and professor in the CU School of Medicine Division of Infectious Diseases.
Campbell is an infectious disease physician by training and started working in Zimbabwe in the context of HIV/AIDS. Then in the 1990s, it was discovered that the cancer known as Kaposi’s sarcoma was caused by a virus and, in fact, often appeared in patients with immune systems suppressed by HIV. In 1998, Campbell received a grant from the Fogarty Center of the National Institutes of Health to study Kaposi’s sarcoma, in collaboration with Dr. Margaret Borok, researcher at the University of Zimbabwe, where the sarcoma was prevalent at the time.
When the collaboration started, Campbell remembers that mortality of patients one year from their first visit to Dr. Borok’s clinic in Zimbabwe was about 80 percent.
“The collaboration continued and University of Zimbabwe became a site for an international AIDS clinical trials unit,” Campbell says. With the use of antiretrovirals to treat HIV, one-year mortality for Kaposi’s sarcoma has fallen to about 15 percent.
While the project has always had research goals, Campbell says that the primary focus has been capacity building – “in guiding the capacity for clinical research, including the training of research personnel, lab assistants, pharmacists, research nurses, data managers, etc.,” Campbell says.
In 2010, the collaboration received funding from a program at the National Institutes of Health called the Medical Education Partnership Initiative (MEPI) to improve the quality of medical training in Africa. By design, awards went to collaborations between institutions in Africa paired with American counterparts. The result was a strengthened partnership between CU and U. Zimbabwe that included collaboration to improve faculty education and medical school curriculum.
In 2015, the MEPI program was not renewed, but at about the same time the National Institutes of Health released information about an award that would allow continued connection between CU and Zimbabwe.
“Applicants had to apply to build capacity in two non-communicable diseases, and one had to be cancer,” Campbell says. “We decided to propose AfriCARE as a new program that will build on our previous accomplishments in Kaposi’s sarcoma, and expand into capacity building for breast cancer research and treatment as well.”
It turns out that while both AIDS and Kaposi’s sarcoma are caused by viruses, treating AIDS with antiretroviral medications is not enough to cure the cancer. “Kaposi’s sarcoma still has to be managed with chemotherapy,” Campbell says, “and this is what’s still driving the morbidity and mortality of those HIV-positive patients in Zimbabwe.”
AfriCARE hopes to boost the ability of the University of Zimbabwe to make further inroads against cancer and heart disease.
“You can’t pack an MRI machine in your suitcase, but once see how people do cancer care and research here at CU, you have the vision to make better use of the resources you have,” Campbell says.
The award facilitates two years of communication and planning between the partner institutions, positioning CU and U. Zimbabwe to submit an application to create the full Regional Center for Research Excellence when the award becomes available, likely in 2018.