The Howard Hughes Medical Institute partnered with the University of KwaZulu-Natal in Durban, South Africa, to build an international research center focused on fighting co-infection of tuberculosis and HIV, two diseases that are ravaging that area of the world. Called the KwaZulu-Natal Research Institute for Tuberculosis and HIV (known as K-RITH), the new center will serve as a facility for basic, clinical, and translational research as well as a training ground for local African scientists to treat this co-epidemic. HHMI will put $60 million into the initiative during the next 10 years.
In 2008, HHMI awarded seed grants totaling more than $1.1 million to scientists in the US and South Africa, and this year, it will donate an estimated $3 million in grant funding as well as support construction of temporary laboratory facilities to support the TB research program. The K-RITH institute will be located on the campus of the Nelson R. Mandela School of Medicine, next to the Doris Duke Medical Research Institute, which was established in 2003 to study HIV infection.
"It's incredibly visionary of HHMI and bold of them to do this [because] nobody's ever really made this kind of investment in Africa," says Bruce Walker, an HHMI investigator at Massachusetts General Hospital who will participate in research with the new institute. "TB has become such an integral part of HIV infection that we really need to study both of those diseases together. There's no place in the world where there's a combined TB-HIV research center, and [K-RITH] not only creates that model, where you bring researchers from those two fields together, but it does it right in the middle of the worst part of both of those epidemics in the world."
South Africa has more people infected with HIV than any other country in the world. The recent emergence of both multi-drug resident (MDR) and extensively drug resistant (XDR) strains of tuberculosis in people already infected with HIV has become a major epidemic. "We've known for a while as a global community that HIV infection is making the TB epidemic much worse," Walker says. "HIV breaks down the ability to defend against a lot of different things, including TB. You're much more likely to get active TB if you have HIV infection."
The institute will focus on four main areas of research: development of more rapid, effective tests for TB; investigations into both MDR and XDR strains of TB; analysis of the immune response to TB, especially in light of co-infection with HIV; and study of recurrent TB in HIV-infected patients. Walker will lead the team studying the immune response to TB infection in HIV-infected patients, with the ultimate goal of developing and testing vaccines for both HIV and TB.
Systems biology fits squarely within the research structure of the new institute, Walker adds. "We're bringing together research groups with differing areas of expertise," he says. "We're taking a systems approach to both of these diseases where we're trying to understand the disease in the context of all the different immune responses that are generated and in the context of the host genetics which are influencing the ability of a person to respond."