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Quantify and prepare for the double infectious and non-communicable disease burden in Zimbabwe.

Award Number: R21AG053093
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/30/2016
PERIOD OF PERFORMANCE END DATE: 07/31/2019

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Quantify and prepare for the double infectious and non-communicable disease burden in Zimbabwe. - ¿ DESCRIPTION (provided by applicant): With the successful scale-up of HIV treatment in hyper-endemic settings, and a disease prevalence that may remain high for decades, comes a long-term healthcare commitment to an ageing HIV-infected population. As HIV-infected individuals live longer they will increasingly be affected by a double burden of both infectious and non-infectious diseases. We hypothesize that the current HIV-specific vertical programs are unlikely to maximize the total health of the HIV-positive individual and that in the coming years more integrated health care management - incorporating testing and treatment for diabetes, cancer, renal insufficiency, cardiovascular disease and hepatitis, among other conditions - will be needed both to stop these diseases from undermining HIV programs and to maintain and improve the reductions in mortality that have begun in hyper-endemic settings. We know this shift in disease burden is coming, but we do not know its magnitude, timing or character in detail; nor are the implications of this shift well understood; no work has established the priorit that should be placed on potential changes in health system organization. The only tool available to examine these issues at a population-scale is mathematical modelling. Therefore, we propose to construct a new mathematical model for Zimbabwe, using data from a long-running population-based HIV cohort, to develop innovative translational analyses to inform the evolution the AIDS response must take. Our aims are: 1. To construct a multiple-disease model tailored specifically to the HIV hyper-endemic African setting of Zimbabwe. The model will build on existing analyses of demographic, epidemic and program changes occurring in Zimbabwe, incorporate interactions between HIV and ART with major non-communicable diseases in this population - diabetes, cancer, cardiovascular disease, kidney disease, osteoporosis and mental health issues - and major infectious diseases - tuberculosis, hepatitis B and C, herpes simplex virus, human papillomavirus, malaria, schistosomiasis. The model will also represent patterns of care-seeking behaviors and health system organization (screening different population, outreach to different group, integrating care across sectors to improve 'cascade' losses). 2. To use this model to forecast the changing disease burden in HIV-infected patients and the wider population. Specifically, the timing and scale of change and characterizing future patient profile (sex/age/multi-morbidities). 3. Identify optimal mode of integration of services across health areas. What screening and additional services will be required, for which patients; which demographics should outreach campaigns prioritize; where would integration of services and strengthening of the cascade of care be most valuable; what impact would these changes have on population health.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2022 ( Subtotal = -$661 )
2022	2017	IMPERIAL COLLEGE OF SCIENCE, TECHNOLOGY AND MEDICINE	FACULTY BUILDING SOUTH KENSINGTON CAMPUS	LONDON				GBR	Aging Research	000	2	6/29/2022	NON-COMPETING CONTINUATION	-$661
														Subtotal = -$661

Issue Date FY: 2019 ( Subtotal = $0 )
2019	2017	IMPERIAL COLLEGE OF SCIENCE, TECHNOLOGY AND MEDICINE	EXHIBITION ROAD	LONDON		SW7 2AZ		GBR	Aging Research	000	2	5/24/2019	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2017 ( Subtotal = $141,650 )
2017	2017	IMPERIAL COLLEGE OF SCIENCE, TECHNOLOGY AND MEDICINE	EXHIBITION ROAD	LONDON		SW7 2AZ		GBR	Aging Research	001	2	6/23/2017	NON-COMPETING CONTINUATION	$14,165
2017	2017	IMPERIAL COLLEGE OF SCIENCE, TECHNOLOGY AND MEDICINE	EXHIBITION ROAD	LONDON		SW7 2AZ		GBR	Aging Research	000	2	5/5/2017	NON-COMPETING CONTINUATION	$127,485
														Subtotal = $141,650

Issue Date FY: 2016 ( Subtotal = $146,093 )
2016	2016	IMPERIAL COLLEGE OF SCIENCE, TECHNOLOGY & MEDICINE	EXHIBITION ROAD	LONDON				GBR	Aging Research	000	1	9/27/2016	NEW	$146,093
														Subtotal = $146,093

Grand Total All Awards = $287,082

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Quantify and prepare for the double infectious and non-communicable disease burden in Zimbabwe.

Award Number: R21AG053093

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/30/2016

PERIOD OF PERFORMANCE END DATE: 07/31/2019

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