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SUNY Global Health Training Program Battles HIV in Kazakhstan; Renewed NIH Funding will Expand Central Asian Country’s Education and Research Capacity
In-person exchange training resumes August 1 following delays due to COVID-19 travel restrictions
Brooklyn, NY – The New York State International Training and Research Program (NYS-ITRP), directed by SUNY Downstate Distinguished Service Professor and Principal Investigator Jack DeHovitz, MD, MPH, has received a five-year $1.5 renewal award from the federal National Institutes of Health that will allow NYS-ITRP to expand research partnerships and training opportunities in Kazakhstan, the largest country in Central Asia. Despite gains in HIV prevention and treatment programs, Kazakhstan continues to experience higher rates of new HIV infection.
Founded in 1994, NYS-ITRP is a multi-institutional, multi-national effort focused on implementing HIV research training programs in countries that once comprised the former Soviet Union. Cooperatively administered by SUNY Downstate Health Sciences University, the University at Albany School of Public Health, and the New York State Department of Health, it is the only HIV research training initiative in Eastern Europe and Central Asia supported by the National Institutes of Health Fogarty International Center. Since its launch, NYS-ITRP has sponsored programs in eleven countries, with programs currently active in Kazakhstan and Ukraine. The combined annual grant funding for both programs is approximately $600,000.
This past June, the United Nations General Assembly High-Level Meeting on AIDS reaffirmed its target of ending the AIDS epidemic by 2030, and in support of this goal, called on all countries to ensure that 95 percent of people living with HIV know their status; that 95 percent of people who know their status receive HIV treatment; and that 95 percent of people on HIV treatment be virally suppressed by 2025.
“In light of these targets, there is an urgent need to help under-resourced countries develop robust HIV/AIDS public health infrastructures,” said Dr. DeHovitz. “For maximum effectiveness, health professionals and scientists who know the unique factors contributing to the epidemic in their countries must be involved in the building effort; this is exactly what we are doing in Kazakhstan.”
Kazakhstan has experienced some of the most deleterious effects of the HIV epidemic. The country’s location along the historic Silk Road caravan trading route has increased its vulnerability to drug trafficking, resulting in severe health impacts. Increased drug use and unsafe injection practices have contributed to rising HIV and other sexually transmitted infections. Access to antiretroviral therapy remains low and institutional barriers impede access to care by substance users.
Since the NYS-ITRP program began in Kazakhstan five years ago, a dozen Kazakh students have been trained in public health. The new grant will allow NYS-ITRP to continue to build capacity at the Kazakh National Medical University (KazNMU) School of Public Health and to add new partners, which include the National Research and Clinical Center of Mental Health (which oversees substance use services) and the Kazakh Research Center of Dermatology and Infectious Disease (which governs HIV-related treatment and policy). The grant will also fund public health training for the Ministry of Health workforce.
The COVID-19 pandemic had a dramatic impact on the NYS-ITRP training program. For example, Kazakh students who usually would have traveled to the United States for in-person training transitioned to distance-learning platforms in the Spring and Fall 2020 semesters, while three trainees who completed their certificate programs in epidemiology in Albany in May 2020 faced multiple barriers in arranging transport back to Kazakhstan, which had imposed restrictions on incoming flights.
“Despite COVID-related challenges, NYS-ITRP trainees have remained productive," said Downstate STAR program Training and Education Director David Odegaard, MPH. The STAR program is a multidisciplinary and multifaceted umbrella program for HIV clinical care, education, and research. As an example, one NYS-ITRP trainee completed his online MPH degree in December, while another will complete her thesis, related to the intersection of HIV and COVID-19, over the summer.
Trainees also actively participated in research and public health promotional activities related to COVID-19. Program graduate Dr. Gaukhar Mergenova, for example, applied for and received a COVID-related research grant funded by the Kazakh government.
In-person teaching at the Albany campus will resume in August 2021, with four students, two from Kazakhstan and two from Ukraine.
To date, the overall results of the program have been impressive. In the previous five years, alumni of the program have published more than 50 articles in peer-reviewed research journals. In the past year, Dr. Mergenova was named head of the Department of Epidemiology at the KazNMU School of Public Health, while four other students now serve as faculty members. In addition, through ‘trainees' collaboration with the faculty at the University at Albany School of Public Health, new courses in epidemiology and biostatistics were launched that have become required coursework for public health students and medical students.
Dr. DeHovitz said, “I look forward to continued collaboration with NYS-ITRP faculty and staff at SUNY Downstate, the University at Albany's School of Public Health, and the Kazakh National Medical University. Our extensive work with the University at Albany in Eastern Europe and Central Asia has become a model for innovative approaches to HIV research training in the former Soviet Union."
About SUNY Downstate Health Sciences University
SUNY Downstate Health Sciences University is the borough’s only academic medical center for health education, research, and patient care, and is a 342-bed facility serving the healthcare needs of New York City, and Brooklyn’s 2.6 million residents. University Hospital of Brooklyn (UHB) is Downstate’s teaching hospital, backed by the expertise of an outstanding medical school and the research facilities of a world-class academic center. More than 800 physicians, representing 53 specialties and subspecialties—many of them ranked as tops in their fields—comprise Downstate's staff.
A regional center for cardiac care, neonatal and high-risk infant services, pediatric dialysis, and transplantation, Downstate also houses a major learning center for children with physical ailments or neurological disorders. In addition to UHB, Downstate comprises a College of Medicine, College of Nursing, School of Health Professions, a School of Graduate Studies, a School of Public Health, and a multifaceted biotechnology initiative, including the Downstate Biotechnology Incubator and BioBAT for early-stage and more mature companies, respectively. For more information, visit www.downstate.edu or follow us on Twitter at @sunydownstate.