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MHRP's Walter Reed Program–Tanzania (WRP-T) works in collaboration with the Ministry of Health and Social Welfare to advance HIV research, prevention and care in Tanzania. Research is conducted collaboratively with the National Institute for Medical Research, the University of Munich (LMU), the Mbeya Regional Medical Office, and the Mbeya Referral Hospital. Together, these institutions comprise the Mbeya Medical Research Program (MMRP).
MHRP supports both civilian and military counterpart organizations in Tanzania to fight HIV and has recently expanded research efforts on other infectious diseases.
MHRP has conducted HIV research in Tanzania since 1999, including extensive cohort studies and a Phase I/II vaccine study that was completed in 2007. Current vaccine studies include:
The Tanzanian Peoples Defence Forces (TPDF) requested additional support for medical research and disease control. This led to the establishment of pandemic influenza surveillance activities with TPDF and has been expanded to include malaria surveillance. These collaborative medical research opportunities have led to several high-level meetings between the U.S. and Tanzanian officials.
Walter Reed Program-Tanzania is working closely with the Malaria Program at WRAIR to build capacity within Tanzania to strengthen malaria diagnostic capabilities. This collaborative program leverages WRP-T’s established infrastructure, strong local relationships and experience in capacity building with WRAIR’s expertise in malaria diagnostics and quality assurance and control. These programs are part of the US President’s Malaria Initiative (PMI).
Additionally, MHRP and WRAIR are conducting site assessments and laboratory strengthening initiatives within the TPDF and in two regions of Tanzania using new assessment tools developed at WRAIR.
Influenza Surveillance and Response
The Global Emerging Infections System (GEIS), part of the U.S. Department of Defense (DoD), is building influenza surveillance and response capabilities in Tanzania. WRP-T is assisting GEIS in this effort by building on established relationships with the TPDF and providing assistance in developing scientific capabilities.
DoD is collaborating with the Tanzanian Ministry of Health & Social Welfare’s (MOHSW) National Influenza Center reference laboratory to establish a comprehensive network of influenza surveillance sites including activities.
MMRP designed and launched a first-of-its-kind mobile diagnostic lab and training center (MDTC) to fight tuberculosis and HIV in Tanzania. This initiative may help enhance collaborative HIV/TB research and activities in the Mbeya region. The lab is funded through EuropeAid/European Commission, the German Ministry of Health, WHO and PEPFAR.
Coupled with a mobilization and awareness campaign, the well-equipped MDTC can, in just 24 hours, diagnose and stage a number of TB and HIV cases. Newly diagnosed cases can then obtain treatment through HIV and TB services offered at the sub-district level. This results in quicker and easier access to diagnosis and treatment for rural populations.
In addition to the mobile laboratory, MMRP conducts a variety of TB diagnostic and therapeutic research in adults and children and boasts a fully-equipped, state-of-the-art tuberculosis laboratory.
For mor information about the mobile lab or MMRP, visit www.mmrp.org.
WRP-T conducts scientific activities at the Mbeya Referral Hospital, one of the four consultant hospitals in Tanzania. Laboratory capabilities at the site include:
MHRP's Walter Reed HIV Care Program Southern Highlands–Tanzania (WRP-T) supports both military and civilian counterpart organizations in Tanzania to fight HIV/AIDS through PEPFAR-funded prevention, care and treatment programs. These programs enhance and support ongoing HIV research activities in the Southern Highlands Zone (Mbeya, Rukwa, and Ruvuma regions). Through these programs, the U.S. Department of Defense (DoD) has enhanced local capacity to support care and treatment efforts, and now cares for a quarter of all USG-supported patients on ART in Tanzania.
HIV services for people living in the rural areas of Tanzania have always been hampered by the need to travel long distances to health facilities. MHRP and PEPFAR have helped address this challenge by developing infrastructure and capacity to provide effective prevention, care and treatment services in the Southern Highlands Zone including:
MHRP overseas the US Army activities executed by PharmAccess International (PAI, a Dutch non-profit) in support of the Tanzania People’s Defence Forces program. PAI works with the TPDF to help ensure that all men and women who serve in the Tanzanian military remain HIV-negative throughout their military career. This comprehensive program serves servicemen and women, their dependents, and civilians living near military posts and barracks.
The civilian PEPFAR program was developed with local partners in the Southern Highlands, including the regions of Mbeya, Rukwa and Ruvuma, where MHRP has conducted research since 1999. The civilian program is executed in collaboration with the Mbeya Referral Hospital (MRH) and the Mbeya, Rukwa and Ruvuma Regional Medical Offices in close coordination with the Ministry of Health and the National AIDS Control Programme (NACP).
A system of linkages with local NGOs allows patients to receive support at the community level with services ranging from home-based care and nutrition assistance to participation in support groups/clubs where connections can be made with other people and organizations in the community. The NGOs, in addition, serve as a way to locate and refer HIV-positive individuals in the community through voluntary counseling and testing services to the hospital facilities for care and treatment.
In 2009, MHRP helped build a center for infectious disease (CID) at the Mbeya Referral Hospital (MRH) in Mbeya. It was opened by the U.S. Ambassador and dedicated by Tanzanian President Jakaya Kikwete. The CID serves Mbeya and the surrounding areas, providing quality care in a comfortable and practical setting.
While the primary purpose of the CID is to serve the HIV positive population of Mbeya and the surrounding areas, it has allowed the capacity to service a greater number of patients. In addition, MRH clinicians have a venue to evaluate other clinical areas such as skin diseases, pediatrics, high blood pressure, and diabetes via weekly clinical reviews. The capability to use the building for a variety of clinical services has also reduced stigma and affords HIV-positive patients a sense of anonymity among patients seeking other services at the hospital. The incorporation of the CID has not only increased clinical capacity and capability but also efficiency, confidentiality, and personal attention to patients.
This study (RV 279) is an evaluation of the linkage between early infant diagnosis (EID) results and care and treatment programs in the Southern Highlands program. The evaluation not only assesses the linkage of HIV-positive EID results (obtained via dry blood spot PCR test) to care and treatment centers as well as turnaround time to order and deliver results, but also looks at the training and implementation procedures of the EID program throughout the zone. The evaluation is conducted in close collaboration with the MRH staff and leadership.
A collaborative program between MHRP’s site in Tanzania and WRAIR’s malaria program is building capacity and infrastructure within Tanzania to strengthen malaria diagnostic capabilities.
In Southwestern Tanzania, just steps from the Malawi border lies the bustling port town of Kyela, one of eight districts in the Mbeya region. A bustling commercial hub, Kyela endures an HIV prevalence rate well above the national average, which leaves a staggering number of children orphaned and vulnerable.
A gene variant found almost exclusively in East Africa may provide protection from acquiring HIV-1 and inhibit the progression of the disease in those already infected.
Gender, genetic background, and multiple HIV infections all factor into the level of virus found in the blood at viral load setpoint (VLS) of HIV-infected individuals in Sub-Saharan Africa.
Known locally as the Walter Reed Program-Tanzania, our program is part of a global effort to advance research for an HIV vaccine in Tanzania.