Leveraging North-South Partnerships toAdvance Cell and Gene Therapy for HIV Research Training Capacity in Uganda (C and GT-Uganda) - PROJECT SUMMARY/ABSTRACT According to the United Nations Progamme on HIV/AIDS, the global response to HIV/AIDS is described as “in Danger” considering current trends, meaning that attaining epidemic control by 2030 is unlikely. As of 2021, 45% of the 1.5 million new cases of HIV and 43% of the 650,000 deaths from AIDS globally were in sub-Saharan Africa. Despite availability of successful antiretroviral therapy, many do not have access or are unable to adhere to this treatment for life. While seven people have so far been functionally cured of HIV using allogeneic blood stem cell transplant techniques (all in high-income countries), this treatment is predicted to be useful for <1% of people living with HIV globally. Moreover, these individuals were treated with allogeneic transplant for a cancer diagnosis. In the absence of cancer, the risk-to-benefit ratio of such a treatment is not justified. A novel approach to HIV cure which could be applied in people living with HIV who do not have cancer would be transformative to epidemic control. Genetic engineering techniques (i.e. gene therapy) can be used to make blood cell treatment more widely available, since genetic engineering can be done on the patient’s own blood cells without the need of a donor. Indeed, more than 46 clinical trials for some kind of gene therapy to treat HIV have been registered to date. However, none of these has been conducted in sub-Saharan Africa, nor has the research and development of these approaches included African researchers or Africans living with HIV. To address this gap, capacity for cell and gene therapy research towards HIV cure must be built locally. This proposal leverages the expertise of Ugandan institutions which have led the HIV response in education, training, research and clinical intervention to develop personnel (i.e. manpower), research, advocacy and excellence in cell and gene therapy for HIV cure in partnership with leading institutions in the U.S. actively developing these treatments. To achieve capacity in Uganda, this proposal will train both degree and non-degree fellows in cell and gene therapy through courses, research training both locally and internationally, and in certificate conferring and informational webinars and short courses. Trainees will be part of a growing global cell and gene therapy network to build partnerships between the global north and south, to create foundations for advocacy and policy needed to implement cell and gene therapy, and to foster a center of excellence which will allow dissemination of cell and gene therapy for HIV cure to other countries in sub-Saharan Africa. Altogether, this training grant will build critical capacity for cell and gene therapy for HIV cure in the places where it is most needed, and where it’s success will most likely translate to a more meaningful global response to the HIV epidemic.
