September 28, 2007

Grant bolsters HIV/AIDS fight in Africa

Featured Image

The Nauela Health Center, in the District of Alto Molocué, Zambézia Province, is one of many Mozambique health clinics that will benefit from the CDC grant awarded to Vanderbilt. (photo by Paulo Pires)

Grant bolsters HIV/AIDS fight in Africa

Vanderbilt’s Mozambique program will expand to new areas, such as the Namagoa Health Center, in the District of Lugela, that is being refurbished and is expected to open early next year. (photo by Paulo Pires)

Vanderbilt’s Mozambique program will expand to new areas, such as the Namagoa Health Center, in the District of Lugela, that is being refurbished and is expected to open early next year. (photo by Paulo Pires)

Sten Vermund, M.D., Ph.D.

Sten Vermund, M.D., Ph.D.

Funding for a Vanderbilt-led effort to fight HIV/AIDS in Mozambique will effectively quadruple with a new grant from the Centers for Disease Control and Prevention (CDC) allowing a major expansion of health services in the African nation. The project, which is headed up by the Vanderbilt Institute for Global Health, received a $4.1 million PEPFAR (President's Emergency Plan for AIDS Relief) grant, as administered by the CDC.

Sten Vermund, M.D., Ph.D., director of the Institute for Global Health, is principal investigator of the project in Zambézia, the most populous province in Mozambique. The project launched last year with a $1 million PEPFAR grant to start up antireoviral treatment in three rural hospitals.

“The last year has been a very busy one,” Vermund said. “The work load is substantial and growing by the hour. With more than 2,000 rural Mozambicans in our care so far and more than 500 on antiretroviral and/or tuberculosis therapy, our nurse-practitioners and physicians are reporting many 'Lazarus syndromes' of poor farmers and wives and their children now functioning when they were at death's door just weeks ago. The plan with this new grant is to expand support to 12 clinics in six districts in the next year.”

Alfredo Vergara, Ph.D., who spent six years in Mozambique as CDC director before joining Vanderbilt as assistant professor of Preventive Medicine and deputy director of the Institute for Global Health, was named project director last year.

There are now eight full-time staff working to lay the groundwork in Zambézia, including two who have been hired by virtue of the new grant.

Vergara has been in Mozambique for most of September to help launch the programs in the newest clinics and to assess feasibility for added projects in tuberculosis, water, malaria control and micro-financing, among others.

In addition, a new faculty member in Pediatrics, Troy Moon, M.D., will be assigned full-time to the city of Quelimane, the provincial capital, Vermund said.

An estimated 18 percent of the adult population in Zambézia is infected with HIV. Vermund noted that VUMC's Mozambique project provides substantial support to the health care system in this remote and overwhelmingly rural province.

“In the districts where we work in Zambézia, there might only be one Mozambican physician for a district of 100,000 to 250,000 residents,” Vergara said. “In some rural clinics, you will find that two nurses attend to more than 60 patients per day and 50 deliveries per month, in many cases without electricity or running water.”

A portion of the new funds will support local Mozambican training institutions to increase the number and quality of health care graduates.

HIV/AIDS is the primary reason for opening the clinics, but Vermund says the benefits go much further.

By providing technical, financial and logistical support and training to health staff, residents are able to get:

• help for malaria, tuberculosis and other infections;

• education and support for disease prevention through clean water and adequate nutrition; and

• prenatal care, which includes antiretroviral medications for HIV-positive women so they can reduce the risk of passing the virus to their babies.

Vergara noted that the Institute for Global Health has been able to respond to the CDC's call for expansion in these districts and has set up key business infrastructure in the U.S. to support the project, including a group called Friends in Global Health, which was formed by Vanderbilt in July 2006 to provide insurance and human relations support for the staff in Mozambique.

“This vote of confidence from CDC in quadrupling our grant resources is a credit to the team of workers who have had such incredible early success,” said Vermund, also professor of Pediatrics at the Monroe Carell Jr. Children's Hospital at Vanderbilt.