History
Overview of Tuberculosis Research Unit
An NIAID contract that established the Tuberculosis Research Unit (TBRU) was awarded to Case Western Reserve University in September 1994. This first contract continued through 1999, led by Jerrold Ellner, MD as Director with Kathleen Eisenach, PhD of the University of Arkansas for Medical Sciences as Co-Director. This first contract created a multidisciplinary, international team, to translate basic research findings into useful tools to improve the treatment and control of tuberculosis. During the first five years, partners included researchers in the US, India, Uganda, and Brazil. The NIAID contract was re-competed for two additional cycles (2000-2015) under the direction of W. Henry Boom, MD, continuing the interdisciplinary research teams with new, additional scientific leaders and expanding the Data and Administrative Coordinating Center and Specimen Repository based at CWRU in Cleveland. Partners expanded to the Philippines and South Africa for clinical studies. The last cycle (2007-2015) evolved to address changing TB research needs and specifically built on human TB immunology, human genetics, and vaccine evaluation with U.S., European, Ugandan, and South African partners.
During TBRU’s NIAID contract cycles, the scientific leaders at CWRU with their well-established Coordinating Center secured additional research awards for TB and related areas of international research and training. These new opportunities were possible due to CWRU’s long-standing Collaboration with Makerere University in Uganda, namely the Uganda-CWRU Research Collaboration.
The Evolving TBRU at CWRU
The TBRU at CWRU continues to lead worldwide efforts conducting vital clinical studies for TB and addressing critical gaps in TB translational research. Our U.S. and international partners expand as our work in TB changes to meet global challenges. Our Coordinating Center continues to evolve beyond our TB research, supporting CWRU researchers from all disciplines as well as supporting operations of the Uganda-CWRU Research Collaboration. The TBRU at CWRU continues to tackle the challenges of our international research agenda.
The Uganda-CWRU Research Collaboration began in 1986 after a Presidential invitation to the late Dr. Frederick C. Robbins, CWRU Professor, and Nobel Laureate, to visit Uganda and assist with the HIV/AIDS epidemic. Dr. Robbins’ vision of multi-disciplinary research collaboration on HIV/AIDS and its complications officially began with grant funding from the U.S. National Institutes of Health in 1988. The Collaboration has since then evolved into a multi-project, multi-disciplinary research organization funded by US and European grants to investigators at Makerere University, Joint Clinical Research Centre and CWRU. From the beginning, the Collaboration’s focus has been to build capacity and provide training through research on HIV/AIDS and TB and thereby improve care. The Collaboration’s diverse disciplines include epidemiology, biomedical sciences, clinical trials, nursing, anthropology and bioethics with recent expansions into biomedical engineering, cancer, and cardiovascular disease. Training has been key for the Collaboration with former trainees now in leadership positions in Ugandan Ministries, Universities, and NGOs. The Collaboration is proud to have contributed to Uganda’s emergence as a leader in biomedical research and training. Collaborative ties between Uganda and CWRU remain strong and continue to grow.
Research Highlights
- Successful international partnership for over 30 years in public health, clinical and biomedical research, training, and capacity building
- 1988 - first U.S. NIH grant awarded - International Collaboration for AIDS Research-(ICAR) – studied HIV natural history, impact on pediatric growth and neurodevelopment, social impact of risk behaviors, HIV-TB, and HIV malignancy; TB and HIV-TB Research become a core foundation for the Collaboration
- Initiated key research and intervention studies to prevent mother-to-child transmission of HIV
- 1st HIV/AIDS vaccine clinical trial conducted in Africa (1997-2000).
- 50+ clinical studies (clinical trials, epidemiologic studies, multidisciplinary observational studies) in Tuberculosis and HIV/AIDS - the largest research focus of the Collaboration.
- Care provided to 25,000+ adults and children in the collaboration’s HIV and TB prevention and treatment studies.
- Pivotal study conducted demonstrating the benefits of preventive therapy against TB in HIV-infected adults
- Research in social sciences and ethics of the HIV/AIDS epidemic
- 1st HIV/AIDS international clinical trial conducted through the AIDS Clinical Trials Group (ACTG) to determine third line antiretroviral (ARV) drug recommendations through genotyping
- Expansion into non-communicable diseases with prevention and treatment in rheumatic heart disease prevention and head & neck cancer
- Expansion into the impact of malnutrition on respiratory diseases, including TB, in newborns and infants
- 350+ peer-reviewed collaborative publications and 400+ scientific abstracts
Training
- 1988 – first U.S. Fogarty International Center training grant awarded, with continued funding since for training in public health, nursing, bioethics, social and biomedical sciences.
- Since 1988, 100+ students trained through Fogarty grants for degrees and short-term technical training; former students have leadership positions in the Ministry of Health, Makerere University, and major NGOs; over 50 of these trainees are CWRU alumni.
Capacity Building
- 100+ awards from NIH, CDC, Bill & Melinda Gates Foundation, Fogarty International Center, Medtronic Foundation and additional foundations/private sponsors
- $200,000,000+ in funding for research and training since 1988
- State-of-the-art HIV virology, immunology and M. tuberculosis microbiology laboratories at Makerere University and the Joint Clinical Research Centre
- Developed capacity for grants administration, human resources, and financial management in Uganda
- Developed capacity for large scale clinical trials, epidemiological studies and laboratory-intensive translational studies in infectious diseases
- Helped Makerere University’s School of Medicine, Mulago Hospital, the Ugandan National TB Program and the Joint Clinical Research Center in Kampala regain leadership in sub-Saharan Africa for clinical, public health and biomedical research in HIV and TB.