August 1, 2008

Grant paves way to take AIDS fight to Nigeria

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

Grant paves way to take AIDS fight to Nigeria

Vanderbilt University School of Medicine's Institute for Global Health has received a one-year, $3 million federal grant to provide AIDS treatment and prevention services in Nigeria.

This is the second major treatment grant the institute has received under PEPFAR, the President's Emergency Plan for AIDS Relief, which was established by President George Bush in 2003.

The institute received a $1 million pilot grant under PEPFAR in 2006 to provide AIDS treatment and other services in three rural hospitals in Mozambique. That program was expanded to about 10 clinics throughout the country last year with the help of another $4.1 million in PEPFAR funding.

PEPFAR “is the best thing the Bush administration has done,” said institute director Sten Vermund, M.D., Ph.D., who also is principal investigator of the grants. “It's saving lives. It's restoring families. It's giving people hope,” he said.

In Nigeria and Mozambique as of 2005, nearly 5 million people were living with the AIDS-causing human immunodeficiency virus (HIV), and approximately 1.4 million children had been orphaned by the disease, according to the 2006 UNAIDS Report on the Global AIDS Epidemic.

Prevention efforts are crucial, Vermund said, noting that for every person who is put on anti-retroviral treatment in sub-Saharan Africa, four more people are newly infected with HIV.

“But treatment is an essential stopgap to stem the devastation,” he said. “We must offer care and treatment even as we strive to expand prevention approaches.”

Anti-retroviral drugs block HIV, a retrovirus, from infecting — and killing — the white blood cells of its host.

As of March 31, PEPFAR had supported anti-retroviral treatment for more than 1.6 million people in 15 “focus countries” in sub-Saharan Africa, Asia and the Caribbean, according to the program's Web site,

The Vanderbilt-led program in west-central Nigeria was developed with the help of two Vanderbilt couples: John Tarpley, M.D., professor of Surgery; his wife, Margaret Tarpley, senior associate in Surgery; Andy Norman, M.D., assistant professor of Obstetrics and Gynecology; and his wife, Judy Norman, R.N., who works in the Vanderbilt International Travel Medicine Clinic.

They have spent many years in Nigeria providing medical and educational services, and John Tarpley continues to train physicians there.

With the help of their contacts, the institute established partnerships with Baptist Medical Center in Ogbomoso, a city of 1.2 million people, and Sobi Specialist Hospital in Ilorin, population 850,000.

Services also will be provided at five satellite sites, Vermund said, and will include HIV counseling and testing, treatment to prevent HIV-positive women from infecting their babies, and services for people co-infected with HIV and tuberculosis.

“We will support essential community-based promotion of prevention messages and awareness of all these new services,” he added. “Our program will emphasize close collaboration with national, state and local leadership, including traditional (tribal) rulers.”

Other partners include:

• Friends in Global Health, a limited liability corporation and non-governmental organization established by Vanderbilt University that facilitates and oversees financial and administrative support provided to the Mozambican Ministry of Health under the Mozambique program;

• Two physicians from Nigeria associated with Vanderbilt and Meharry Medical College — Muktar Aliyu, M.D., DrPH, who will lead the Nigerian program, and Flora Ukoli, M.D., Dr.P.H., associate professor of Surgery at Meharry;

• Karen Megazzini, Dr.P.H., of Rockville, Md.-based Westat Inc., who will provide research monitoring and evaluation services, and leadership in preventing mother-to-child HIV transmission; and

• The University of Maryland's Institute for Human Virology-Nigeria, led by William Blattner, M.D., which will provide laboratory quality control services.