In non-pandemic periods, tuberculosis is the leading killer from a curable infectious disease. Malnutrition, including adult undernutrition and diabetes mellitus, is the most important driver of tuberculosis globally. The UVA and KIDH teams chip away at the research that will alleviate these solvable crises, just one of many opportunities created by a long-term collaboration between the two institutions.

The partnership dates to the early 2000s with UVA Professor Eric Houpt’s collaboration in the Kilimanjaro region, which focused on developing diagnostic tests for infectious disease. In 2010, Houpt received an NIH training grant in collaboration with Professor Gibson Kibiki, a leading tuberculosis expert in the Kilimanjaro region with research activities at the KIDH. One of the initial trainees was Mpagama, currently a prominent researcher in Tanzania, a recipient of the Dr. Maria Kamm Best Female Scientist in Tanzania for 2022, visiting professor at UVA, and co-principal investigator with UVA for two recent NIH grants.

KIDH is in the process of transitioning from a hospital to a national infectious diseases institute. UVA is helping to support the transition, with a 2024 three-year NIH and Fogarty International Center G11 grant awarded to Amber Steen, associate director for research and global programs at CGHE, and Mpagama for the project “Transitioning to a National Infectious Diseases Institute in Tanzania.” This grant will establish critical research infrastructure at the Institute and develop a leading research administration training program to support Tanzanian and research partners throughout sub-Saharan Africa. Imagining health research, one may think of a scientist in a white lab coat and test tubes, or a nurse administering a medication, but much of the research depends upon obtaining and successfully stewarding funding and requires administrative expertise. This grant, coupled with the malnutrition and TB training grant for postdoctoral fellows and a three-year supplemental award to support UVA students, provides a unique opportunity for research administrators, Tanzanian post-doctoral fellows, and UVA undergrads to work collaboratively to advance key global health research. The emphasis on administrative professionals, in addition to research, is innovative and essential to building the infrastructure to support KIDH’s transition.

Saga works in the Office of Sponsored Projects, a newly established office as a result of the G11 funding, where he manages relationships and logistical coordination with both international and prospective partners. He said that thanks to the grants and the collaboration with UVA, KIDH has also strengthened their collaborations with both local and international partners. “Through programs like these grants, we are building research leaders and improving research administration capacity, particularly in areas like HIV, TB, malnutrition, and pandemics. Our long-term goal is to become a reference institution in developing interventions for both known and emerging infectious diseases, benefiting both Tanzania and the broader global health community,” Saga explained.

“International collaborations like our partnership with UVA address the gap in healthcare workers trained in research, as they become part of a global community with a shared local context. UVA brings in resources from its home country, supporting research initiatives that lead to locally relevant solutions. Through collaborations, we’re able to design sustainable, innovative approaches for health challenges that not only benefit Tanzania but also contribute to the global health landscape,” said Saga.

In Summer 2024, UVA Data Science Professor Dan Brown was part of a UVA coalition that traveled to Tanzania to work with the KIDH team. While there, Brown led a workshop on data science and grant writing. “The workshop was an exciting opportunity for our team,” said Saga. “This exposure has allowed us to approach complex research questions with new, innovative methods and helped us think creatively about alternative research pathways.”

The collaborative relationship has had a positive impact on UVA students and recent alumni as well. Sanjida Azad, who graduated in 2023 in global public health and cognitive science, is currently working on the team studying malnutrition among tuberculosis patients. The project compares the beneficial effects of cash transfers to TB patients versus in kind transfers, such as food supplementation. “I didn't realize how interested I was in this research until I got hands on experience with this project. I'm able to work with doctors from around the world. The doctors and scientists are so knowledgeable, and their skill is being transferred over to me, and I'm able to potentially teach other people about these skills,” described Azad. “We're learning bits and pieces of different perspectives and different ways to look at the data and different ways to digest it. You learn so much.”

“I have spent a lot of time reading and discussing issues related to tuberculosis, but that information does not compare to actually speaking to people experiencing the disease,” said Caroline Rich, a fourth-year student in global public health and applied statistics. Rich, who was able to travel to Tanzania in Summer 2024 through the CGHE University Scholar program, explained that she gained a much deeper understanding on how tuberculosis needs to be handled from beyond a medical model. “There are so many social determinants at play that impact a patient’s treatment outcomes. When speaking to patients, the conversation centered on their treatment and side effects for a few minutes. The rest of the conversations covered their community, relationships, employment, housing, and nutrition,” she said. Her experience emphasized how important interventions, such as nutritional support & financial assistance, are in supporting patients and their families.

As the experiences of Saga, Azad, and Rich demonstrate, the long-term reciprocal collaboration between UVA and KIDH allows partners on both sides to build their expertise to create global health solutions to problems that matter.