Clinical Laboratory and Training Center
Rakai District, Uganda
The new Rakai facility
For the last 17 years, the Rakai Health Sciences Program has conducted clinical research and provided medical services to a rural population in the Rakai District of southwestern Uganda. This program, which has collected some of the earliest epidemiologic data on the AIDS epidemic in Africa, is a collaboration between the Uganda Virus Research Institute of the Ministry of Health and researchers at Makerere University, Columbia University and Johns Hopkins University.
With grants from the DDCF, the National Institutes of Health and the Gates Foundation (plus loans from Johns Hopkins and Columbia universities), the Rakai Program is completing the construction of a new building in the rural Rakai district for clinical and laboratory uses, data management and administration. The new facility, which is expected to officially open in May 2005, will be among the most advanced in rural Africa. It will allow for an expanded research and training program and provision of care, particularly for antiretroviral therapy and tuberculosis.
In addition to supporting the construction of the new laboratory and training center, the DDCF’s grant provides training stipends for African researchers working on Rakai Program projects. With the provision of antiretroviral therapy (ART) made possible by the Presidential Emergency Program for AIDS Relief, the researchers at the Rakai Health Sciences Center anticipate that some 200 to 400 HIV-positive persons will be placed on ART in the coming year.
These patients will come predominantly from the Rakai Community Cohort Study, which conducts annual surveillance in a population of 12,000 adults from 50 different rural communities. Thus, studies are being planned to track the effectiveness of implementing point-of-care ART in a rural setting, and to determine the impact of ART on HIV incidence, risk behaviors, emergence of resistant virus, and the sociodemographic effects of ARTs. This research will provide critical information on the population-level effects of ART in rural Africa, which can be used to plan future services and to project the course of the epidemic.
From left: Godfrey Kigozi, Heena Brahmbhatt, Noah Kiwanuka, David Serwadda, Fred Nalugoda, and other Rakai staff