Kaposi Sarcoma in the Era of ART in Africa Program (KEAAP) - There are currently over 1.2 million people in Zambia and 1.7 million in Tanzania living with HIV/AIDS, with a high incidence of HIV/AIDS-associated malignancies (HIVAM) in both countries. Even in the era of antiretroviral therapy (ART), Kaposi sarcoma (KS) remains one of the most common HIVAM, underscoring the critical need to understand, diagnose, manage, and prevent KS in the context of ART-mediated changes in the HIV epidemic. The “Kaposi Sarcoma in the Era of ART in Africa Program (KEAAP)” addresses this need through a collaborative network among the Cancer Diseases Hospital (CDH) and University Teaching Hospitals (UTH) in Zambia, the Ocean Road Cancer Institute (ORCI) in Tanzania, and the Stanley S. Scott Cancer Center at Louisiana State University Health Sciences Center-New Orleans (LSUHSC-NO). KEAAP focuses on critical gaps across the KS disease spectrum, from detection and staging to treatment outcomes, pathogenesis, immune response, and KSHV tissue reservoirs. The consortium will: 1) establish and enhance three core facilities; support two hypothesis-driven KS research projects led by former Fogarty-trained fellows; and 2) develop the next generation of U.S. and LMIC cancer researchers through in-country workshops, pilot funding, and U.S. and in-country training. The foreign component is essential to KEAAP because the unique study populations, clinical environments, longitudinal specimens, and in-country expertise established through sustained prior U.S. government investment in HIV/AIDS-associated malignancy research in Zambia and Tanzania cannot be replicated in the United States. Research conducted at CDH/UTH and ORCI provides critical insight into KS biology, immune responses, treatment, and disease outcomes in populations experiencing a substantial burden of HIV and KS, while strengthening scientific and clinical expertise that enables bidirectional transfer of knowledge and technology. Importantly, discoveries generated through these foreign research and training activities have direct relevance to urgent cancer-control priorities in the United States. The knowledge, biospecimens, research approaches, and expertise developed through these established partnerships will inform the diagnosis, prevention, treatment, and risk factors of KS and other HIV-associated malignancies in U.S. populations, including Louisiana and other Southern states where HIV disproportionately affects underserved communities and where the burden of HIV-associated cancers remains an important public health concern. Thus, the foreign activities are not ancillary to the U.S. research; they provide unique scientific capabilities and populations necessary to generate knowledge that can be directly translated to reduce the burden of HIV-associated cancers in the United States. KEAAP builds on successful Fogarty and NCI investments to create a sustainable, cross-disciplinary, trilateral research and training program driven by Zambian, Tanzanian, and U.S. investigators, with benefits extending to cancer research and clinical care in both SSA and the United States.
