1. Transforming Medical Education to Strengthen Clinical Care in Sub- Saharan Africa
FOGARTY INTERNATIONAL CENTRE AT IAS
50th Anniversary
James Hakim, MBChB, FRCP, DSc(HC)
Department of Medicine, University of Zimbabwe
IAS, Paris, France-25 July, 2017

2. Disclosure
I have received consultant fees from Mylan Pharmaceuticals, Gilead and Johnson & Johnson
I receive research support from NIH/Fogarty

3. Early Research Career-1990’s
Passionate about research
Lack of opportunities
My professional training lacked broad training in research
Undertook clinical epidemiology training under INCLEN
International Clinical Epidemiology Network (INCLEN)
Rockefeller Foundation
Vibrant network of researchers from low-income and high-income countries
“Learning” network, hands-on workshops, regular meetings around the world
Training in research methodology, biostatistics, health social science, health economics, etc.

4. Intersection of INCLEN with Fogarty International (2000-2010)
I met Jeanne McDermott
A Fogarty stalwart
Facilitated training opportunities, including grant writing, research courses, etc.
Facilitated networking opportunities with African, US researchers
Fogarty ( )
Played a pivotal role in shaping my research career
ICHORTA (International Clinical, Operational and Health Services Research Training Award for AIDS/TB)
Research training
Peer mentoring
Leadership training

5. MEPI Program-13 Sub-Saharan African Medical Schools 2010-2015
PEPFAR/NIH Funding
6th MEPI/NEPI
Symposium Nairobi 2016

6. MEPI Objectives Improve Education Capacity
Increase output of medical Schools
Improve quality of medical education
Promote Regionally Relevant Research
Improve Retention
Ensure Sustainability
Build communities of practice

7. MEPI Program in Sub-Saharan Africa
Academic Medicine Suppl 2014
MEPI Program in Sub-Saharan Africa
Empowered medical schools in sub-Saharan Africa
Direct funding to medical schools in Africa
North-South Collaboration
South-South Collaboration
Sharing of best practices
Established a continent wide Forum at the end of MEPI
AFREhealth (African Forum for Research and Education in health)
MEPI PI COUNCIL Harare, ZIMBABWE

8. From MEPI To AFREhealth

9. Implementation of the Zimbabwe MEPI Program
NECTAR
IMHERZ
CHRIS
Visiting Professors Program
Mentored Scholars Programs
Research Support
Community- based
Education
Faculty Development
Information Communication Technology

10. Achievements of MEPI in Zimbabwe
More than 150 scholars trained
Improved quality of medical Education & Research
Enhanced role of local Faculty leadership
Engendered greater support from MOH, MOE
Broadened stakeholder base
Ensured sustainability of key MEPI programs

11. PERFECT: Promoting Excellence in Research & Faculty Enhanced Career Training
An NIH/Fogarty supported award designed to train junior faculty to become accomplished independent researcher
NEW

12. Training Programme CORE RESEARCH SKILLS Research methodology
Health information literacy
Bioethics
Research administration
Grant writing
Scientific writing for publication
Presentation skills
ASSOCIATED SKILLS TRAINING
Leadership/management/governance
Bioinformatics
Biosafety
Intellectual property rights
Technology transfer
PRACTICAL TRAINING
Mentorship, Mentored research projects, Electives, Attachments

13. DART Study The Lancet 2010;375:123-131
HPTN 052
The early initiation of antiretroviral therapy reduced rates of sexual transmission of HIV and clinical events, indicating both personal
and public health benefits from such therapy.
NEJM 2011;365:2618

14. EARNEST Study REALITY NEJM 2014;371:234
When given with a PI in 2nd therapy, NRTIs retained substantial virologic activity without evidence of increased toxicity, and there was no advantage to replacing them with RAL. Virologic control was inferior with PI monotherapy.
REALITY
Among HIV-infected patients with advanced immunosuppression, enhanced antimicrobial prophylaxis combined with ART resulted in reduced rates of death at both 24 weeks and 48 weeks without compromising viral suppression or increasing toxic effects.

15. Summary and Conclusions
Fogarty played an important role in my:
Early Training and mentoring
Facilitated peer mentoring
Fostered collaborative research and international networking
Enabled acquisition of leadership skills-visioning and implementation
Enabled me to assist in capacity building for research at my institution and beyond
FUTURE FOR FOGARTY AND TRAINING INSTITUTIONS-Continue to
Recognize Potential Provide Training Opportunities Enable Platform for Research career growth through training in Leadership and Networking skills.

16. Acknowledgements Roger Glass Dianne Gibb Peter Kilmarx Ian Weller
J McDermott
Tom Campbell
Ahmed Latif
M. Borok
Kumarasamy
Kevin de Cock
Mary Basset
Dianne Gibb
Ian Weller
Frances Cowan
Mike Chirenje
Nancy Padian
Tsungai Chipato
Mike Mbizvo
Andrew Reid

19. Thank
You
For
Listening