Combating Uganda’s HIV, TB epidemic

Chances are you know about cancer because it’s impacted someone you know. This personal connection makes it easy, then, for Americans to identify with their struggles and be sympathetic to efforts to combat cancer.

Few of us, however, know someone with tuberculosis or TB. Thanks to advances in medicine and public health, the disease does not pose a serious health risk to the general population. This isn’t to say the U.S. isn’t vulnerable, as there have been isolated instances of TB in Georgia’s schools, prisons and homeless shelters. In August, an outbreak of drug-resistant TB at the Peachtree-Pine Homeless Shelter in Atlanta prompted calls from elected officials to shut down the facility and raised concerns across the state.

As with any infectious disease, our communities are always mindful of the seriousness of these health threats, but the remarkable job done by our public health professionals in identifying and containing the disease puts us at considerably low risk.

Beyond our borders, however, the story is very different. Among the leading causes of global death and disability, TB is so common in Africa and Asia that it affects the lives of nearly every person. In East Africa alone, more than 50,000 people die each year from the disease. This health crisis is exacerbated in places where epidemics of TB collide with HIV, as individuals with weakened immune systems can contract – and transmit – the highly contagious disease.

Spread by something as simple as a cough, TB can run through an African community quickly, leaving lasting consequences in its wake. Infectious diseases must be contained at their source, limiting the threat of transmission and minimizing the risk of it spreading beyond the initial outbreak source. This is especially true for TB. Since most of the modern cases of TB occur in Africa and Asia, it makes sense for public health institutions to collaborate with countries from these regions to assist with control efforts.

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Seven years ago, the University of Georgia’s College of Public Health launched a collaboration with Makerere University, in Kampala, Uganda, to conduct research as well as train future scientists and public health professionals to deal with epidemics of HIV and TB.

This partnership took a major step forward recently when it received a training grant from the Fogarty International Center, National Institutes of Health. This grant supports Ugandan and U.S. researchers in the fields of TB and HIV, providing them with state-of-the-art training in research methods such as bioinformatics and mathematical modeling.

Through mentored research projects, trainees will apply these methods to understand how and where TB and HIV spread in the community. The students will return to their respective institutions with this new expertise, continuing their research under the mentorship of faculty from each university. With this knowledge, new ways of interrupting the spread can be developed and tested.

Why does this matter?

Infectious diseases do not respect man-made borders. An outbreak of disease in Africa today could spread to the U.S. tomorrow. The events surrounding last year’s Ebola outbreak opened the world’s eyes to the importance of building up a global health infrastructure that can effectively identify, address and contain deadly diseases. To achieve this, we must go to the places where these diseases are most serious and build the necessary capacity to address them. Unless we do this, the infectious disease threats that affect us all will never be resolved.

Chris Whalen is a University of Georgia professor of infectious disease epidemiology.

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