JCRC at 25 Years Magazine

JCRC @ 25 The birth, growth and evolution of the centre

 A successful journey that started 25 years ago  Testimonies from the beneficiaries  What the partners say JCRC @25 Contents eDiToR: Conan Businge Messages (Conan Events Co Ltd) Message from Chairman Board 4 Message from Executive Director 6

DeSign & LAYoUT Diana Kambedha Carol Kabega Features JCRC’s 25-year journey 10 Abou Kisige A story of success and great sacrifice 11 Courtesy Photos

cooRDinAToR Fred Byaruhanga Profiles JcRc Board members of the years 8 coMMUnicATionS TeAM 12 Christine Matama Senior management

JCRC, Plot 101, Lubowa E s t a t e s , O ff E n t e b b e R o a d Partners P.O. Box 10005, Kampala, Uganda UK Medical research Council Tel: 256-414-201147/48 Clinical Trail Unit 31 Fax: 256-414-342632 E-Mail: [email protected] Website: http://www.jcrc.co.ug Interviews With Dr James Makumbi 32 With Dr Justine Jita 33

Research JCRC publications 36

JCRC @25 2 JCRC @25 Contents eDiToR: Conan Businge Messages (Conan Events Co Ltd) Message from Chairman Board 4 Message from Executive Director 6

DeSign & LAYoUT Diana Kambedha Carol Kabega Features JCRC’s 25-year journey 10 Abou Kisige A story of success and great sacrifice 11 Courtesy Photos cooRDinAToR Fred Byaruhanga Profiles JcRc Board members of the years 8 coMMUnicATionS TeAM 12 Christine Matama Senior management

Research Patron JCRC publications 36 H.E. President Yoweri Kaguta Museveni, Patron , First Board Chairman

JCRC @25 JCRC @25 2 3 Foreword

he Ministry of Health scale up in the country between 2003 joins all Ugandans in and 2010 where underprivileged congratulating JCRC as the communities were reached for the centre marks 25 years of the first time including areas of Bwindi, fi g h t a g a i n s t t h e H I V / A I D S s c o u r g e . Kalangala, Moyo, Karamoja among T Established in 1991 by H.E.Yoweri others. Kaguta Museveni to provide a The fight against HIV/AIDS still scientific solution to the HIV/AIDS goes on. The Ministry of Health will scourge which was at its peak at the continue to provide the necessary time, JCRC’s 25 years journey of support for JCRC to continue her work scientific research in HIV/AIDS in and we look forward to more service Uganda has significantly changed the and research in HIV/AIDS and other management of HIV/AIDS nationally diseases. and internationally. JCRC is also credited for being the first centre in Uganda to introduce Yours Sincerely, Anti-Retroviral Therapy (ART) and H o n . D r . J a n e R u t h A c e n g contributing significantly to ART Minister of Health

JCRC @25 4 Foreword Message from Prof. Justin Opio, Chairman Board of Trustees ABoUt ProF. JUstin oPio  He is the Chairperson of the Board of the JCRC  He is also the Vice-chairperson of the st. Augusti ne internati onal University Council.  He holds a PhD in reproducti ve Biology from Makerere University.  He also holds a Master’s Degree in Veterinary Anatomy and a Bachelor of veterinary Medicine from the University of nairobi  Prof. opio has worked with both the University of nairobi and Makerere University.  At Makerere University, he rose through the ranks from lecturer, senior lecturer, dean, associate professor, professor and deputy Vice-Chancellor at Makerere University  He then served in the positi on of acti ng vice chancellor between 1993 and 2004 A unique centre  He will also be remembered, for having helped in the restorati on COMES OF AGE of peace in the Teso region

t has been 25 years of success and time we started, so many other people which can be used to fi ght and research challenges for the Joint Clinical were illegally importing fake drugs about so many other diseases. Research centre. We had to start and taking advantage of the people People should be grateful for the the fi ght against HIV/AIDS from who were suff ering with the terrible setting up of the JCRC. he Ministry of Health scale up in the country between 2003 almost nowhere. pandemic which had hit the country. I’m proud of having been part of this joins all Ugandans in and 2010 where underprivileged iI have taken 18 years with the Joint We, however, persisted and succeeded. big and important dream for all these congratulating JCRC as the communities were reached for the Clinical Research Centre, serving as the It is at this point that I give special years. centre marks 25 years of the first time including areas of Bwindi, Chairman of the board. Th is Centre was thanks to the board members and the I also believe that the Government fi g h t a g a i n s t t h e H I V / A I D S s c o u r g e . Kalangala, Moyo, Karamoja among unique from the start, owing to the kind technical team for their commitment to needs to recognise so many staff T Established in 1991 by H.E.Yoweri others. of work it had been established for. make this Centre succeed. members and board members who Kaguta Museveni to provide a The fight against HIV/AIDS still It had its own full autonomy of its If there is a place I have seen started this fi ght against the HIV/ scientific solution to the HIV/AIDS goes on. The Ministry of Health will operations from the Government right Ugandans work so hard and with so AIDS scourge from the JCRC. scourge which was at its peak at the continue to provide the necessary from the start. Part of our greatest much commitment, it is at this Centre. Over years, we have supported a time, JCRC’s 25 years journey of support for JCRC to continue her work challenge was to start a centre without Th e team was committed. number of our staff to go back for scientific research in HIV/AIDS in and we look forward to more service using funds from the Government or As of today, there are so many further studies. Th is was part of our Uganda has significantly changed the and research in HIV/AIDS and other the tax payers. organisations which are dealing with agenda to ensure that the staff also management of HIV/AIDS nationally diseases. I saw the establishment of the the HIV/AIDS research, treatment and develop their careers as they support our and internationally. new home for JCRC, right from care. Th is is commendable, since it has country to overcome the HIV scourge. JCRC is also credited for being the the breaking of the ground. It was a also helped save so many lives over the We have over years also set up first centre in Uganda to introduce Yours Sincerely, complete bush on this hill, before we set years. We are proud that we were the structures for JCRC to smoothen its Anti-Retroviral Therapy (ART) and H o n . D r . J a n e R u t h A c e n g up this Centre. pioneers in this HIV/AIDS fi ght. operations. Th is was part of the strategy contributing significantly to ART Minister of Health I recall that this was not an easy We now provide advanced services to strengthen the physical and human assignment to start JCRC. At the and do have high-tech laboratories resource of the Company.

JCRC @25 JCRC @25 4 5 Message from Prof. Peter Mugyenyi, Executive Director

t has been a diffi cult journey Lubowa. In 2008, we were able to Th e laboratory also has facilities for to make it this far. It has been move to our new premises. From a genetic sequencing of the DNA assay to 25 years of relentless work, residential house owned by Buganda determine the HIV resistance. commitment and teamwork. Kingdom, JCRC is now housed in a Over years, this centre has also As a team we took on a fi ght of the multi-purpose built campus, with the created regional centres to scale up the world’si most dangerous disease. It was state-of-the art laboratories. We now distribution of ARVs. Th e regional killing millions of people all over the have the P3 laboratories, which are one centres are in Gulu district to cover world. of the highest safety pressure controlled the North, two other centres in Mbale When I took over the job in 1992 laboratories for the safe handling of and Kakira for the eastern part of the as Joint Clinical Research Centre’s multi-resistant TB and other diseases. country, another centre in Fort Portal Executive Director, I had absolutely no idea that this was close to what one many described as “Mission Impossible.” But the work had to be done. We could not stand by and accept a horrible status quo. We had to use all possible scientifi c and human methods to fi nd a solution to the devastating national crisis. Th is was not a health crisis only in Uganda, but it was headline news all over the world. At the time, around the early 1990’s, there was nothing killing Ugandans as much as the HIV/AIDS. We started our journey in a building at Butikiro House. Th is was the Uganda National Resistance Army (which came to be named Uganda People’s Defence Forces) headquarters following the 1966 Buganda Crisis. But, due to the importance of the matter of HIV/ AIDS, the army vacated the premises, to create way for the Joint Clinical Research Centre. When the Government retuned Buganda Kingdom’s properties, we became tenants of Buganda Kingdom. For all the years that we spent at Butikiiro, His Majesty the Kabaka of Buganda Ronald Muwenda Mutebi was an excellent landlord. He also allowed us to expand the facilities and put up a ward, outpatient clinic, staff offi ces, and freezer rooms. All these were established on Buganda Kingdom’s premises. We donated the buildings to the Kingdom at the time when we were leaving. After sometime, we started to raise funds to put up our own home in

JCRC @25 6 Message from Prof. Peter Mugyenyi, Executive Director t has been a diffi cult journey Lubowa. In 2008, we were able to Th e laboratory also has facilities for to make it this far. It has been move to our new premises. From a genetic sequencing of the DNA assay to to cover the western region and other centres Mini ProFiLe 25 years of relentless work, residential house owned by Buganda determine the HIV resistance. in Kabale and Mbarara to cover the southern l Professor Mugyenyi is the executi ve commitment and teamwork. Kingdom, JCRC is now housed in a Over years, this centre has also region. Another centre was set up in Mubende Director of the Joint Clinical Research As a team we took on a fi ght of the multi-purpose built campus, with the created regional centres to scale up the to cover the central region of the country. Centre (JCRC). world’s most dangerous disease. It was state-of-the art laboratories. We now distribution of ARVs. Th e regional Th e Joint Clinical Research Centre has also i killing millions of people all over the have the P3 laboratories, which are one centres are in Gulu district to cover managed to broaden the country’s capacity in l He was awarded a Doctor of Science (ScD) world. of the highest safety pressure controlled the North, two other centres in Mbale the treatment and care for the HIV-positive from Mbarara University of science and When I took over the job in 1992 laboratories for the safe handling of and Kakira for the eastern part of the patients. Among some of its tasks, the centre technology in 2003; honoured fellow of as Joint Clinical Research Centre’s multi-resistant TB and other diseases. country, another centre in Fort Portal managed to establish 75 satellite centres which the third World Academy of sciences Executive Director, I had absolutely were later passed on to the ministry of health. in 2004; and fellow of the royal College no idea that this was close to what one At the time we passed on these sites, 100,000 of Physicians of edinburgh FrCP.edin. in many described as “Mission Impossible.” patients were already under our care. March 2005. But the work had to be done. We could More so, JCRC was consulted by a Special not stand by and accept a horrible status Team set up by the former President of the l He is a renowned scienti ﬁ c researcher on quo. We had to use all possible scientifi c United States of America to determine the HIV/AIDS. He has provided leadership to and human methods to fi nd a solution feasibility of ARVs distribution all over the the JCrC since 1992. JCrC has become to the devastating national crisis. world. an internati onally recognised scienti ﬁ c Th is was not a health crisis only in Centre of excellence, providing leadership Uganda, but it was headline news all DReAM coMe TRUe in AIDS care, treatment research over the world. At the time, around the I do believe that this was not my personal and preventi on thus making a major early 1990’s, there was nothing killing dream. It was team’s dream to get this far. We contributi on to the Uganda AiDs Control Ugandans as much as the HIV/AIDS. have achieved a lot as a team and I cannot claim programme. Prof. Mugyenyi pioneered We started our journey in a building all this success as an individual. HIV vaccine trials and treatment for the at Butikiro House. Th is was the Uganda I thank various team members, without management of HIV/AIDS in the region. National Resistance Army (which whom, this dream would be impossible. came to be named Uganda People’s We have also benefi ted greatly from national l in December 2003, the Parliament of Defence Forces) headquarters following and international collaborations with centres Uganda unanimously passed a moti on the 1966 Buganda Crisis. But, due to of excellence. Th e scientifi c cross fertilisation of to recognise and honour prof. Mugyenyi the importance of the matter of HIV/ expertise achieved from partners has also been for his outstanding contributi on to AIDS, the army vacated the premises, greatly vital in our success story. science, especially in the area of HiV/AiDs to create way for the Joint Clinical Th e JCRC is now poised to expand as an research and treatment. Research Centre. international centre of excellence in medical When the Government retuned research. It is now equipped to undertake l He has initi ated and parti cipated in Buganda Kingdom’s properties, we research in emerging diseases. several eff orts geared towards the became tenants of Buganda Kingdom. We are also well established on promoti on of excellence in research For all the years that we spent at a network of international health among young African scienti sts and Butikiiro, His Majesty the Kabaka of researchers and organisations. insti lling in them a standard of best Buganda Ronald Muwenda Mutebi was We are committed to move on practi ces in the preventi on, care and an excellent landlord. He also allowed with this fi ght. treatment of HIV such of which include us to expand the facilities and put up a the Africa Dialogue on AIDS (ADAC) and ward, outpatient clinic, staff offi ces, and AIDS Care Research in Africa (ACRiA) all freezer rooms. All these were established African lead initi ati ves that he chairs. on Buganda Kingdom’s premises. We donated the buildings to the Kingdom l He has held important responsibiliti es in at the time when we were leaving. academic insti tuti ons as well as nati onal After sometime, we started to raise and internati onal organisati ons, including funds to put up our own home in Chair of the University Council and visiti ng Professor at the Faculty of Medicine, Mbarara University.

l Prof. Mugyenyi has published extensively with over 60 scienti ﬁ c papers and abstracts in nati onal and internati onal journals.

JCRC @25 JCRC @25 6 7 The board members over the years

Dr. Ben Mbonye, Founder member

H.E. President Yoweri Kaguta Museveni, Patron , First Board Chairman Gen.Salim Saleh, Founder member

Dr. Jagdish, Prof. Manfred Dietrich, Hon. Dr. Chrispus Kiyonga Hon. Amama Mbabazi, Founder member Founder member Second Board Chairman Third Board Chairman JCRC @25 8 TheThe boardboard membersmembers overover thethe yearsyears

Dr. Ben Mbonye, Prof. epelu-opio Justi n, Dr. James Makumbi, Dr. Jesse Kagimba, Founder member Fourth and Current Board Chairman Member Member

H.E. President Yoweri Kaguta Museveni, Patron , First Board Chairman Gen.Salim Saleh, Mr. Ben okello Luwum, Prof. nelson sewankambo Hon. Dr. Jane Aceng, Prof. ibingira Charles, Founder member Member Member Member Member

FORMER BOARD MEMBERS

1. stephen Kavuma

2. Lukanga ndawula

3. Dr. roy Mugerwa

4. Bart Katureebe

5. Ms. Monica Mukasa

Dr. Jagdish, Prof. Manfred Dietrich, Hon. Dr. Chrispus Kiyonga Hon. Amama Mbabazi, Dr. Jessica Jita, Mr. richard Masereje Prof. Peter Mugyenyi, Founder member Founder member Second Board Chairman Third Board Chairman Member Board secretary executi ve Director JCRC @25 JCRC @25 8 9 JCRC’s 25-year journey Joint Clinical Research enveloping the centre, JCRC stands as Centre fights the spread the nation’s top referral centre for patients of HIV with clinical with more complex strains of the virus. It currently has about 200,000 HIV/AIDS trials, treatment and patients under its care. studies ReSeARcH s Uganda was being ravaged Even with their impressive care and by the HIVAIDS pandemic, treatment strategies, the Centre is best medical personnel and known for groundbreaking research in committed Ugandans took it dozens of studies concentrated on HIV/ upon themselves to find a solution to save AIDS. theA nation. In 1991, new adult HIV infections At the time, whoever got infected, were at an all-time high in Uganda. To would surely, a few months or years later AIDS epidemic, there were doubts about combat the growing numbers, the JCRC die; since there was no treatment for developing countries and their abilities carried out the first African antiretroviral HIV in the country. to conduct quality research on the virus. drug trial on zidovudine, more commonly It is then that President Yoweri But, JCRC put Uganda on the map and known as AZT. Because of the study’s Museveni, in 1990, with the help of other has over the years been used as a model result, AZT dosages were lowered people, started this Centre of Excellence. for so many countries. significantly to the current dosages that The institute was started with the Since those days in the early 1990s, the are safely set today. collaborative effort of the Ministry of Joint Clinical Research Centre ( JCRC), Throughout the late 90s and early Defence, Ministry of Health, and the has heightened international confidence 2000s, the JCRC continued to investigate Makerere University Medical School. in the country’s research and it’s care of the newly discovered virus with vaccine Over the past years, various institutions its HIV-positive population. trials, planned ARV-dosage interruptions such as the World Health Organisation, The executive director of JCRC Prof. and studies on pediatric HIV cases. CWRU, Family Health Institutional, Peter Mugyenyi says: “It has been a These days, ongoing research ranges US National Institute of Health, difficult journey. We have been dealing from prevention of mother to child University of California San Francisco, with the world’s most sophisticated transmission of HIV/AIDS to the Johns Hopkins University, the Institute disease that was killing millions of people advantages home-based care, from of Tropical Medicine in Antwerp and all over the world. So many homes were sustainability of healthcare in rural in Hamburg, EDCTP, MRC, have left with orphans and it was paralysing communities to second-line treatments. partnered with the JCRC. every sector in the country.” After nearly 25 years of service, the The Centre has been at the forefront of He says when he took over the job in Centre has served over 200,000 clients ARV distribution to HIV-positive. The 1992, little did he know that the work on first, second and third-line ARVs at JCRC is, additionally, a medical research before him was so complicated. seven locations nationwide. site, having conducted multiple studies Today, the JCRC headquarters sit on Though their research has saved many on drug resistance and second-line. Lubowa hill, a quiet suburb just outside lives around the world, JCRC clinicians At the beginning of Uganda’s HIV/ the capital city. and health workers heed that there is no With a quiet and silent environment cure for HIV. JCRC @25 10 A story of great sacrifice, commitment Uganda was leading the world with the highest rate of HIV/AIDS prevalence

By ProF. MAnFreD DietriCH campaign against HIV/AIDS paid off When the institute began work, the years later, when the number of people motivation and engagement of the staff n the aftermath of the bush war, getting infected, started devlining. was fantastic. Not only were diagnostic rebuilding of the nation was tests available as HIV antibodies and started. However, besides all the ReSeARcH biRTHeD differentiation of T-Lymphocytes by post-war deficits like lack of The President was interested in having a monoclonal antibodies (chief laboratory infrastructure, run down administration, linkage between research and treatment technician Tugume had received some andI the financial mess; nothing came of people. He started an institute training in Hamburg) but patient care JCRC’s 25-year journey close to the ravaging effect of the HIV/ and named Dr Ben Mbonye — then was also initiated, including social and AIDS pandemic. Surgeon General of NRA — as the psychological talks by a retired major of Joint Clinical Research President Yoweri Museveni being responsible partner for first realisation. NRA. enveloping the centre, JCRC stands as deeply worried about the tragedy caging A one-storey building in Mengo Since ARVS were not available, Centre fights the spread the nation’s top referral centre for patients his people, he asked for advice on how was rehabilitated and prepared for much effort was concentrated on the of HIV with clinical with more complex strains of the virus. It to cope with the disaster. Almost every laboratory work (my brother, an treatment of opportunistic infections. currently has about 200,000 HIV/AIDS family was hit by the deadly disease, architect in Hamburg, designed the The first scientific patient study trials, treatment and patients under its care. leaving children without parents. plans for the renovation at no cost), compared two anti TB combinations. studies At the time, Uganda was leading the and some laboratory instruments Medications and study design as well ReSeARcH world with the highest rate of HIV/ were donated by private sources from as the study coordinator came from s Uganda was being ravaged Even with their impressive care and AIDS prevalence and incidence. The Hamburg. Hamburg. by the HIVAIDS pandemic, treatment strategies, the Centre is best strategy adopted by the President More so, technical laboratory This study received the first prize as medical personnel and known for groundbreaking research in included disseminating information equipment was planned and installed by best poster when it was presented at the committed Ugandans took it dozens of studies concentrated on HIV/ about the disease and the ways of Mr Mittelsten-Scheid from Solingen Glasgow International HIV Therapy upon themselves to find a solution to save AIDS. transmission, caution against the Germany (a member of Rotary) Congress. Later the results were theA nation. In 1991, new adult HIV infections promiscuous behaviour and founding who had done comparable work for published in the peer reviewed journal At the time, whoever got infected, were at an all-time high in Uganda. To of a research institute for both patient a research laboratory in Lambarene/ Tubercle and Lung Disease. would surely, a few months or years later AIDS epidemic, there were doubts about combat the growing numbers, the JCRC diagnostics and care. Gabon. The good start described above die; since there was no treatment for developing countries and their abilities carried out the first African antiretroviral From the beginning, it was an exceeded even optimistic expectations HIV in the country. to conduct quality research on the virus. drug trial on zidovudine, more commonly FigHTing HiV/AiDS important decision that the institute and could not have happened without It is then that President Yoweri But, JCRC put Uganda on the map and known as AZT. Because of the study’s The President impressed it on himself, should be directed by Ugandan the excellent engagement of Dr. Ben Museveni, in 1990, with the help of other has over the years been used as a model result, AZT dosages were lowered to spread the campaign on information scientists (not Westerners). Mbonye and all the staff from the people, started this Centre of Excellence. for so many countries. significantly to the current dosages that dissemination, on almost every platform beginning. The institute was started with the Since those days in the early 1990s, the are safely set today. he had to speak. gooD START The past 25 years comprise a story collaborative effort of the Ministry of Joint Clinical Research Centre ( JCRC), Throughout the late 90s and early More so, the Uganda AIDS of success which proves the ability Defence, Ministry of Health, and the has heightened international confidence 2000s, the JCRC continued to investigate Commission and other agencies did and high class work of Prof. Dr. Peter Makerere University Medical School. in the country’s research and it’s care of the newly discovered virus with vaccine well in helping the President disperse tHings to note Mugenyi, as the Executive Director, and Over the past years, various institutions its HIV-positive population. trials, planned ARV-dosage interruptions the message on the deadly AIDS that his staff. such as the World Health Organisation, The executive director of JCRC Prof. and studies on pediatric HIV cases. had hit the country. l President Yoweri Museveni He has created substantial research CWRU, Family Health Institutional, Peter Mugyenyi says: “It has been a These days, ongoing research ranges The aim of this centre, which being deeply worried about the cooperations with foreign universities. US National Institute of Health, difficult journey. We have been dealing from prevention of mother to child was later named as JCRC, was to tragedy caging his people. He has also managed the survival of the University of California San Francisco, with the world’s most sophisticated transmission of HIV/AIDS to the offer proper virological diagnosis to institute by finding financial support Johns Hopkins University, the Institute disease that was killing millions of people advantages home-based care, from everybody, to take care of HIV patients. l since ArVs were not available, worldwide. He has also been behind the of Tropical Medicine in Antwerp and all over the world. So many homes were sustainability of healthcare in rural One of the main reasons for much effort was concentrated on construction of the new and modern in Hamburg, EDCTP, MRC, have left with orphans and it was paralysing communities to second-line treatments. establihing the institute, was to enable the treatment of opportunistic buildings for the Centre, necessary for partnered with the JCRC. every sector in the country.” After nearly 25 years of service, the Uganda get on the forefront of HIV infections. the tremendous workload of research The Centre has been at the forefront of He says when he took over the job in Centre has served over 200,000 clients control and treatment; by having and clinical care. ARV distribution to HIV-positive. The 1992, little did he know that the work on first, second and third-line ARVs at first-hand knowledge of worldwide l The good start could not have In summary, it may be concluded JCRC is, additionally, a medical research before him was so complicated. seven locations nationwide. discoveries. happened without the excellent that the original idea of JCRC has been site, having conducted multiple studies Today, the JCRC headquarters sit on Though their research has saved many The other reason was to train doctors engagement of Dr. Ben Mbonye followed and developed. on drug resistance and second-line. Lubowa hill, a quiet suburb just outside lives around the world, JCRC clinicians and medical support staff, including and staff from the beginning. The team has fulfilled the At the beginning of Uganda’s HIV/ the capital city. and health workers heed that there is no laboratory technicians. In fact the expectations to best of our expectations. With a quiet and silent environment cure for HIV. JCRC @25 JCRC @25 10 11 Current senior management

Dr. Cissy Kityo , Deputy executive Director

Benson Ouma Dr. Victor Musiime incharge Dr Francis Ssali, Director Laboratory services directorate of research Director Clinical

JCRC @20 12 CurrentCurrent seniorsenior managementmanagement

Dr. Henry Mugerwa Head of research and Deputy Dr. William Tamale Dr iva natukunda, Incharge Research Directorate Clinical Manager Head pediatrics

Dr. Cissy Kityo , Deputy executive Director

Deborah Masiira rose Byaruhanga Paul ocitti Head of nursing Head Counseling Head Pharmacy

Benson Ouma Dr. Victor Musiime incharge Dr Francis Ssali, M/s Ameria natukunda Collins Makanga, Fred Byaruhanga Director Laboratory services directorate of research Director Clinical Head of Human Resources Finance Manager Business Development Manager

JCRC @20 JCRC @20 12 13 nelson Kakande godfrey Kuboi training Quality Assurance Boaz Wakabi Chief Programmer Specialist Head of Procurement

Annet namara Alfred tumwesigye Head of Stores Head Transport

nicholas Matsiko James rusoke Head of Data Head of Estates

JCRC @25 14 Regional heads

nelson Kakande godfrey Kuboi training Quality Assurance Boaz Wakabi Chief Programmer Specialist Head of Procurement

Dr.Abbas Lugemwa Dr. Keith Baleta Head Mbarara Head Mbale

Dr Allan Musinguzi Fort portal RCE

Dr. James Abach Faith Balmoi Annet namara Alfred tumwesigye Head Gulu Head Kakira Head of Stores Head Transport

nicholas Matsiko James rusoke Head of Data Head of Estates Michael Kabugo george Abongomera tHALAs C.o.P sCiPHA Project Manager JCRC @25 JCRC @25 14 15 VISION

A vibrant self sustaining centre of excellence in medical research, training and health care services

In brief MISSION The Joint Clinical Research Centre (JCRC) is an Organisati on established in 1991 as a limited liability not-for-profi t company. To conduct quality medical It is a joint-venture between the Uganda Ministry of Health, Defence and Makerere College of Health Sciences. research and training, provide equitable and sustainable HIV/ The Centre was established to respond and provide a scienti fi c approach to the nati onal HIV/AIDS crisis. Over the years, AIDS care and other health care insti tuti ons and organisati ons such as USAID, WHO, Case Western Reserve University (CWRU), FHI, NIH, European services in Uganda and other and Developing Countries Clinical Trials Partnership, Medical parts of Africa Research Council have partnered with JCRC for medical research grants to study HIV, tuberculosis (TB), malaria and other tropical diseases.

JCRC implements HIV/AIDS projects and was the fi rst recipient CORE VALUES of PEPFAR funding in December 2013 for ART scale-up across Uganda under the TREAT programme. Between December 2003  Integrity to June 2010, JCRC established 52 ART sites and 25 outreaches  countrywide and is the largest provider of ART in Africa. Confi dentiality  Compassion A 5-year project (THALAS) which ends in June 2016 won an  award. JCRC also implemented a community project across 19 Mutual Respect districts (SCIPHA) increasing the mobilisati on towards increased  HIV/AIDS treatment. Much as JCRC’s core work is research, Teamwork eff orts are underway to establish a fully ﬂ edged hospital  Accountability providing advanced care to HIV/AIDS pati ents and general  medical care. Continuous Learning and Excellence

“ For Quality Laboratory & Medical Supplies”

“BETTER RESULTS in less than half the time”

Simple. Better.

Plot 15 Ntinda 11 Road,Lower Naguru East, P.O.Box 33326, Kampala (U)

Tel: +256 414 342 073 Fax: +256 414 250 352 Mob.: 0754 900 044 Alere Healthcare (Pty) Ltd Helping all people Eastwood Office Park, 11B Riley Road, live healthy lives Bedfordview 2007, E-mail: [email protected] http//: www.precisediagnostic.co.ug South Africa

JCRC @25 16 VISION

A vibrant self sustaining centre of excellence in medical research, training and health care services

“ For Quality Laboratory & Medical Supplies”

“BETTER RESULTS in less than half the time”

Simple. Better.

Plot 15 Ntinda 11 Road,Lower Naguru East, P.O.Box 33326, Kampala (U)

The Mbarara regional Centre of Excellence JCRC @25 JCRC @25 16 17 Ban Ki-Moon’s visit to JCRC in 2010

Dr Steve Wiersma (centre), the country director for Centre for Disease Control during a visit to JCRC in June 2016

JCRC @25 18 Ban Ki-Moon’s visit to JCRC in 2010

JCRC welcomes the Dr Steve Assistant secretary Wiersma for African Affairs, (centre), Ambassador Linda the country Thomas-Greenfield director for Centre for Disease Control during a visit to JCRC in June 2016

The International Nurses Day 2016

JCRC @25 JCRC @25 18 19 Without JCRC we would not have told this story

t is a few hours to dusk and the Joint Clinic Research Centre is less busy. Almost the day’s work is done. But, at the back of one of the buildings, three youths, can be heardi giggling. They are immersed in a conversation. The youths; one female and two males are later joined by a lady in her early 40s, whom I first mistake for a medical officer on her routine work. I later learn that the four, are just some of the 200,000 patients that have been receiving medical and social support from JCRC. They have actually stayed and lived amongst the staff and patients at the Centre for the last two to three decades. Flavia Namukwaya is one of the youths on this evening’s group discussions. She laughs her heart out during their discussion and I keep wondering what they are really discussing. Well, 10 years ago, she realised she was HIV-positive and decided to start ARVs treatment. This 24-year-old started her treatment at Mildmay and three years later in 2002, started getting the services at the JCRC. “My companions helped me with open-disclosure since there are my peers namuwaya and her colleagues at the centre at this Centre who are even involved in the JCRC Youth Base; which is an association of HIV-positive youth,” she We thank the Like her, Erick Zziwa, who is the head says. of the JCRC Youth Base got to know Years down the road, she is now the Government and that he was HIV-positive in 2007 when deputy coordinator of the JCRC Youth he was in Senior One. Base. This association helps the youth “the people running “I went to the health centre for a learn various skills that can help the this centre for having check-up and the doctor told me that I youth live positively. It offers knowledge was HIV-positive. To me, it was a routine about HIV but also entrepreneurship helped us at our great check-up,”Zziwa skills. point of need narrates. “We now need to start a He was later Clients Board, which recommended looks at the issues by a family of all patients and with reality,” Namukwaya says. friend to join makes decisions She is committed to live positively and JCRC for which help us plan is proud to be part of the JCRC clientele. for our lives. We She has just graduated from Makerere also need University with a Bachelor of Arts in to help Social Sciences. other “I now want to further studies by HIV pursuing a Masters of Laws, so that I positive can become an international advocate,” people Namukwaya adds. come She says that she will use her education to terms to defend the HIV-positive people. ruth namigadde erick Zziwa 20 WithoutWithout JCRCJCRC wewe wouldwould notnot havehave toldtold thisthis storystory t is a few hours to dusk and the treatment. He is now about to graduate. Joint Clinic Research Centre is He is proud of JCRC for the support it less busy. Almost the day’s work has given him. is done. But, at the back of one “This is our home. It has helped us in of the buildings, three youths, can be so many ways. It also helped me discover heardi giggling. They are immersed in a my talent in music and built my ability to conversation. write proposals,” he explains. The youths; one female and two males He now heads the JCRC Youth Base are later joined by a lady in her early 40s, which has about 700 youths. He is also whom I first mistake for a medical officer a Community Liaison Volunteer. He on her routine work. helps other HIV-positive youths to live I later learn that the four, are just some positively. of the 200,000 patients that have been He believes that there is need to do receiving medical and social support from more awareness in communities, to help JCRC. the youths come out and test for HIV. They have actually stayed and lived “Those who are positive, should be amongst the staff and patients at the helped to learn to live positively, and Centre for the last two to three decades. those who are not, to be more careful Flavia Namukwaya is one of the youths with their lives,” he says. on this evening’s group discussions. Their colleague, the 28-year-old She laughs her heart out during their Vincent Byamukama, also got to know discussion and I keep wondering what that he was HIV-positive several years they are really discussing. ago. At the time, he was just a child. He Well, 10 years ago, she realised she was is now a graduate of Fashion and Design. HIV-positive and decided to start ARVs As a child, after the death of his mother, treatment. This 24-year-old started her a relative who was a doctor got him treatment at Mildmay and three years tested and found HIV-positive. later in 2002, started getting the services As a child, he kept on taking drugs, at the JCRC. until he realised, what it meant to be “My companions helped me with HIV-positive. open-disclosure since there are my peers namuwaya and her colleagues at the centre “When I realised I was HIV-positive, at this Centre who are even involved I first resisted taking the drugs. I was in the JCRC Youth Base; which is an however, later on convinced to resume association of HIV-positive youth,” she We thank the Like her, Erick Zziwa, who is the head my dosages,” Byamukama narrates. says. of the JCRC Youth Base got to know Nowadays, he says, “ARVs are my Years down the road, she is now the Government and that he was HIV-positive in 2007 when mother. This Centre has given me deputy coordinator of the JCRC Youth he was in Senior One. another chance to live, even without my Base. This association helps the youth “the people running “I went to the health centre for a mother, who would have been taking care learn various skills that can help the this centre for having check-up and the doctor told me that I of me. youth live positively. It offers knowledge was HIV-positive. To me, it was a routine He now runs HIV-fight campaigns about HIV but also entrepreneurship helped us at our great check-up,”Zziwa in schools. “We need to tell the youths skills. point of need narrates. about HIV, if we are to save this country Vincent “We now need to start a He was later from this scourge,” Byamukama adds. Byamukama Clients Board, which recommended It is not only youths that are helped at looks at the issues by a family this centre. There are also adults. A case like this! We thank the Government of all patients and with reality,” Namukwaya says. friend to join in point is Ruth Namigadde, who joined and the people running this centre for makes decisions She is committed to live positively and JCRC for JCRC through a clinical trial in 1997; having helped us at our great point of which help us plan is proud to be part of the JCRC clientele. after she had developed resistant TB. She need.” for our lives. We She has just graduated from Makerere was treated and around the same time, She is also a Community Liaison also need University with a Bachelor of Arts in also learnt she was HIV-positive. Volunteer. to help Social Sciences. She has been on ARV treatment at These are just a drop in the other “I now want to further studies by JCRC since 1997 and she is all praises ocean, for the thousands of HIV pursuing a Masters of Laws, so that I for the centre. people, who have for several positive can become an international advocate,” “We are a sign to show people the years, been supported by the people Namukwaya adds. value of this place. Just imagine how life JCRC, through its treatment come She says that she will use her education would have been without institutions and care.. to terms to defend the HIV-positive people. Flavia namukwaya ruth namigadde erickerick Zziwa Zziwa JCRC @25 20 21 Mubende Regional Hospital HIV clinic is one of the 52 ART clinics JCRC is supporting in Uganda From a tent to a powerful HIV clinic in Mubende

n old barefooted woman, Currently 2,562 TREAT project, which later gave probably in her 60s, walks birth to the Targeted HIV/AIDS with a support to Mubende patients are accessing and laboratory services (THALAS) Regional Hospital HIV project, says that the HIV clinic has clinic to get more Antiretroviral for her “HIV care and been equipped with drugs, furniture, treatment.A treatment from the clinical and laboratory equipment. She is one of the fi rst benefi ciaries A satellite link, providing of this clinic, when it opened its doors, new building internet connection is in use. in a small tent, outside the hospital 12 JCRC has provided computers and years ago. But, it has now grown leaps internet access. Th is has improved and bounds. launched on September 14, 2007, communication and networking Mubende Regional Hospital HIV by Hon. Nyombi Tembo the then among health workers. clinic is one of the 52 ART clinics and Minister of State in the Offi ce of the Mubende health care providers can 25 outreaches JCRC is supporting in Prime Minister. access up to date knowledge, health Uganda. Micheal Kabugo the Chief of Part care practices, from world leading By 2008, the Joint Clinical Research for THALAS Project, says currently health institutions, available online. Centre had the largest laboratory 2,562 patients are accessing HIV care Th e JCRC TREAT program has network for other centres providing and treatment from the new building. worked closely with the ministry ARVs in Uganda with capacity to Th is includes OVCs, caretakers, of health and other implementing carry out sophisticated tests required health workers, widows and all partners to increase access and build for ARV therapy and monitoring. the poor. With PEPFAR support, capacity for ART in government and JCRC stared supporting Mubende the Mubende clinic team is now faith based hospitals. ART clinic in July 2004, and the supporting 10 outreaches, taking Since July 2004, Mubende health clinic was being run in a tent. With services nearer to the people. workers have benefi ted from a overwhelming patient numbers, the Th ese include; Mubende Military number of JCRC trainings such as tent was overfl owing with patients, and Rehabilitation Center, Kabamba, comprehensive care for clinicians, an extension to the HIV clinic was health centres in Kabyuma, Data collection and M&E, Logistics necessary. Kamusenene, Butawata, Maduudu, management, BD-Laboratory With support from USAID/ Butoloogo and Kakigando. technology. PEPFAR, a modern HIV clinic was Kabugo, who was also behind the Before PEPFAR support, Mubende JCRC @25 22 MubendeMubende Regional Regional Hospital Hospital HIV HIV clinic clinic is is one one of of the the 52 52 ART ART clinics clinics JCRC JCRC is is supporting supporting in in Uganda Uganda From a tent to a powerful HIV clinic in Mubende

JCrC in Mubende. Below are the laboratories at the Centre

Hospital used to transport blood specimens to Kampala for advanced HIV laboratory tests with support from USAID. Critical laboratory equipment is now available at the hospital and n old barefooted woman, Currently 2,562 TREAT project, which later gave other health facilities in theregion probably in her 60s, walks birth to the Targeted HIV/AIDS (Kibale and Mityana,districts) are with a support to Mubende patients are accessing and laboratory services (THALAS) accessing the laboratory services. Regional Hospital HIV project, says that the HIV clinic has For advanced PCR for viral load clinic to get more Antiretroviral for her “HIV care and been equipped with drugs, furniture, and DNA assays, the JCRC Fort treatment.A treatment from the clinical and laboratory equipment. portal Region Center of Excellence She is one of the fi rst benefi ciaries A satellite link, providing is providing the service. of this clinic, when it opened its doors, new building internet connection is in use. JCRC has contributed to health in a small tent, outside the hospital 12 JCRC has provided computers and system strengthening by providing a years ago. But, it has now grown leaps internet access. Th is has improved full time medical doctor, laboratory and bounds. launched on September 14, 2007, communication and networking technicians and counselors to Mubende Regional Hospital HIV by Hon. Nyombi Tembo the then among health workers. support the existing Ministry clinic is one of the 52 ART clinics and Minister of State in the Offi ce of the Mubende health care providers can of Health staff in handling the 25 outreaches JCRC is supporting in Prime Minister. access up to date knowledge, health increased patient numbers. Uganda. Micheal Kabugo the Chief of Part care practices, from world leading Information, education and By 2008, the Joint Clinical Research for THALAS Project, says currently health institutions, available online. communication (IEC) materials to Centre had the largest laboratory 2,562 patients are accessing HIV care Th e JCRC TREAT program has promote clients awareness about network for other centres providing and treatment from the new building. worked closely with the ministry HIV/AIDS, and to promote early ARVs in Uganda with capacity to Th is includes OVCs, caretakers, of health and other implementing treatment seeking behavior has been carry out sophisticated tests required health workers, widows and all partners to increase access and build availed to the hospital. for ARV therapy and monitoring. the poor. With PEPFAR support, capacity for ART in government and Since 2006, radio programs JCRC stared supporting Mubende the Mubende clinic team is now faith based hospitals. have been running to sensitize the ART clinic in July 2004, and the supporting 10 outreaches, taking Since July 2004, Mubende health community about the availability of clinic was being run in a tent. With services nearer to the people. workers have benefi ted from a ART, most recent one on September overwhelming patient numbers, the Th ese include; Mubende Military number of JCRC trainings such as 13, 3007 when the JCRC doctor tent was overfl owing with patients, and Rehabilitation Center, Kabamba, comprehensive care for clinicians, was hosted on Mubende Radio an extension to the HIV clinic was health centres in Kabyuma, Data collection and M&E, Logistics for a talk show, people called in to necessary. Kamusenene, Butawata, Maduudu, management, BD-Laboratory have questions answered, and this is With support from USAID/ Butoloogo and Kakigando. technology. aimed at increasing ART awareness. PEPFAR, a modern HIV clinic was Kabugo, who was also behind the Before PEPFAR support, Mubende JCRC @25 JCRC @25 22 23 JCRC’s THALAS project stretches to 11 regional referral hospitals and 14 districts

he Joint Clinical Research centre, has over years, been supporting several patients and services under a new programme dubbed –Targeted HIV/AIDST and Laboratory Services (THALAS) project. This five-year programme is implemented through a co-operative agreement between USAID/Uganda and The Joint Clinical Research Center ( JCRC). THALAS project builds on the success of the TREAT programme which started in 2004 and ended in 2010. The new programme focuses on maintaining quality HIV/AIDS care and treatment, laboratory, PMTCT and TB/HIV services. JCRC support of The project works closely with the SUSTAIN project to expand TREAT achievements in 11 regional referral HIV treatment hospitals, 13 districts and JCRC Kampala clinic. THALAS continues to provide integrated TB and HIV/ AIDS services to over 15,000 patients at JCRC Kampala, ensure smooth and seamless transition of 29 TREAT sites yIeldIng to SUSTAIN by end of year one and transition patients at RCES by end of has ensured; Key acTiviTies n year two. The provision of HV/AIDS care Transitioning clients under THALAS also provides ART and treatment, laboratory, PMTCT TREAT to SUSTAIN and and laboratory services during the and TB/HIV services within regional 1USAID supported district – based transition period to over 32,000 referral and district hospitals n partners. patients that are on ART from the Quality of HIV/AIDS care and Maintain current client base of TREAT programme. It also handles treatment, laboratory, PMTCT and 32,200 clients on antiretroviral external quality assurance (EQA), TB/HIV services at regional referral 2therapy (ART) with essential ART coaching, mentoring and training for district hospitals n and laboratory services through the laboratories supported by SUSTAIN. Stewardship by MoH to provide transition of clients serviced under Working with the health ministry, sustainable HIV/AIDS care and TREAT to SUSTAIN and USAID the SUSTAIN project and the regional treatment, laboratory, PMTCT and supported district-based partners. referral hospitals, THALAS project TB/HIV services. Provision of integrated TB/HIV/ AIDS services at the Kampala site 3to an estimated 6,000 clients. Provision of specialised laboratory services through seven sites in 4Kampala, Gulu, Mbale, Kakira, Fort Portal, Mbarara and Kabale. Provide external quality assurance (EQA) and coaching, mentoring 5and training for laboratories supported by SUSTAIN. Develop sustainability or exit strategy for provision of TB/HIV/ Kakira Regional Centre of Excellence 6AIDS services at the Kampala site. JCRC @25 24 JCRC’s THALAS project stretches to 11 regional referral hospitals and 14 districts Unprecedented powerful he Joint Clinical Research start of HIV/AIDS fight centre, has over years, been supporting several patients and services under he journey for the fight a new programme dubbed –Targeted against HIV/AIDS in HIV/AIDST and Laboratory Services Uganda received a massive (THALAS) project. boost in the early years of This five-year programme is the Joint Clinical Research Centre, implemented through a co-operative whenT it received support from USAID. agreement between USAID/Uganda One of the major projects that saw and The Joint Clinical Research Center the rise of the JCRC was the regional ( JCRC). expansion of antiretroviral therapy THALAS project builds on the (TREAT). This was a seven-year success of the TREAT programme USAID supported programme that which started in 2004 and ended in started in December 2003 and ended 2010. The new programme focuses on on 30 September, 2010, as part of the A health worker talking to patients at one of JCRC centres maintaining quality HIV/AIDS care Presidential Emergence Plan for the and treatment, laboratory, PMTCT AIDS relief (PEPFAR). established in IDP camps in Gulu nationwide, from four sites in 2003 and TB/HIV services. JCRC support of The overall TREAT programme and Pader districts; the marginalised to 52 sites by September 2010. Over The project works closely with the aimed at providing universal ART communities of Batwa in Bwindi; 90,000 people received HIV/AIDS SUSTAIN project to expand TREAT for all in need through an equitable, the fishing community in Kalangala treatment under the programme hence achievements in 11 regional referral HIV treatment high quality and sustainable national and Sesse islands; and hard-to-reach exceeding expectations for expansion hospitals, 13 districts and JCRC programme based on the Ministry of areas like Kaabong, Kisoro and Moyo of ART nationally. Kampala clinic. THALAS continues Health policy and guidelines. hospitals. Other HIV/AIDS partners TREAT was implemented in seven to provide integrated TB and HIV/ The TREAT programme worked carried this work forward. Twenty five regional centers of excellence (Kakira, AIDS services to over 15,000 patients closely with the health ministry outreach sites were established in key Mbale, Gulu, Fort Portal, Mubende, at JCRC Kampala, ensure smooth and and other implementing partners to regions of Uganda. Mbarara, Kabale), that worked closely seamless transition of 29 TREAT sites yIeldIng increase access and build capacity for USAID/Uganda amended its co- with the regional referral hospitals to SUSTAIN by end of year one and ART to at least 42 centers. operative agreement with JCRC to in their respective locations. The transition patients at RCES by end of has ensured; Key acTiviTies For the first time in Uganda, extend TREAT programme activities programme expanded access to ART, n year two. The provision of HV/AIDS care Transitioning clients under TREAT reached a number of remote from a three-year to a seven-year increasing the number of people on THALAS also provides ART and treatment, laboratory, PMTCT TREAT to SUSTAIN and and hard-to-reach areas with high programme. This was due to JCRC’s ART from less than 10,000 in 2003 to and laboratory services during the and TB/HIV services within regional 1USAID supported district – based HIV prevalence. ART sites were success in expanding ART services over 90,000 by 2020. transition period to over 32,000 referral and district hospitals n partners. patients that are on ART from the Quality of HIV/AIDS care and Maintain current client base of tREat aChiEvEmEnts so faR TREAT programme. It also handles treatment, laboratory, PMTCT and 32,200 clients on antiretroviral l Rapidly scaled up and expanded quality HIV/AIDS care centres of excellence, and all HIV/AIDS partners relied on external quality assurance (EQA), TB/HIV services at regional referral 2therapy (ART) with essential ART coaching, mentoring and training for district hospitals and treatment services to 52 ART sites and 25 outreaches this system for provision of quality laboratory services. n and laboratory services through the in all regions of Uganda, as early as December 2003, l Greatly contributed to health system strengthening laboratories supported by SUSTAIN. Stewardship by MoH to provide transition of clients serviced under Working with the health ministry, sustainable HIV/AIDS care and before ART services became available outside Kampala. of ministry of health facilities through renovations and TREAT to SUSTAIN and USAID l Initiated over 90,000 Ugandans on ART and saved extensions of health facilities. Over 30 HIV/AIDs clinics the SUSTAIN project and the regional treatment, laboratory, PMTCT and supported district-based partners. referral hospitals, THALAS project TB/HIV services. thousands of Ugandan lives. Saved children from being were renovated, provided with furniture and clinical Provision of integrated TB/HIV/ orphans, families were able to see their children grow into equipment. AIDS services at the Kampala site adulthood. l Trained over 2,000 health care providers in all the 3to an estimated 6,000 clients. l Patients prevented from repeated TB attacks and other regions of Uganda, focusing on ART management, data Provision of specialised laboratory OIs. management, psycho-social support and community services through seven sites in l Greatly improved quality of life of HIV positive patients involvement. 4Kampala, Gulu, Mbale, Kakira, Fort l Provided advanced care and standard laboratory l Introduced a robust community based adherence Portal, Mbarara and Kabale. services in urban and hard-to-reach areas. strategy, and best practices in community mobilisation Provide external quality assurance l Introduced DNA PCR capacity in Uganda and greatly and engaging PLHIV as peer support groups to reduce (EQA) and coaching, mentoring supported MoH EID project, and all PMTCT partners in the stigma, encourage disclosure and behaviour change 5and training for laboratories supported country relied on the JCRC laboratory capacity. Therefore, communication. Strategies include edutainment, thematic by SUSTAIN. many infants were born HIV free. music, dance and drama and community mobilisation Develop sustainability or exit l Pioneered and strengthened laboratory specimen to raise awareness and engaged the private sector to strategy for provision of TB/HIV/ referral system from lower health centres to the regional support unfunded activities. Kakira Regional Centre of Excellence 6AIDS services at the Kampala site. JCRC @25 JCRC @25 24 25 Ê Ê Ê Around JCRC

Some of the JCRC Lubowa Laboratory Scientists

Dr. Yusuf Hamid (Cipla founder Member) extreme right plants a palm tree upon his visit to JCRC on the 10th/August/2015

JCRC @25 28 AroundAround JCRCJCRC

Some of the nurses at JCRC Lubowa

Some of the JCRC Lubowa Laboratory Scientists

JCRC dental sergion examining a patient using an intra oral camera

Mr. Tuhaise Paul (senior driver), Mr. Tumwesigye Alfred (transport officer), the colleague on the Dr. Yusuf Hamid (Cipla founder Member) extreme right plants a palm tree upon his visit to JCRC on the 10th/August/2015 right is deceased. These two have been at the JCRC Staff in a group discussion at Country Lake Garuga centre since it started in 1991. where they attended the Strategic Plan Review exercise JCRC @25 JCRC @25 28 29 The management and staff of the Medical Research Council/ Uganda Virus Research Institute Uganda Re- search Unit on AIDS congratulate the Joint Clinical Research Center on their 25th Anniversary The MRC/UVRI Uganda Research Unit on AIDS is proud to be a partner with JCRC. Among the research projects jointly achieved are HIV basic science, prevention and treatment intervention and social science studies that have contributed new knowledge and informed the formulation of HIV control policy and practices in Africa and beyond. Some of the areas of our collaboration HIV Vaccine Trial; MRC/ National Surveillance of HIV Drug Development of AntiRetroviral UVRI and JCRC conducted Resistance; Together we provide Therapy (DART) Trial; DART was the first HIV Vaccine trial in data on the prevalence of transmit- the largest antiretroviral therapy Africa; in which we not only ted and acquired resistance to HIV (ART) trial ever conducted in Africa. demonstrated that vaccine tri- medicines among treated and un- It showed that ART can be safely and als can be successfully con- treated individuals. At the same we effectively delivered in Africa using ducted in Africa but also con- contribute to documentation of early minimal laboratory monitoring. It al- tributed to ethical guidelines warning indicators for HIV drug re- so showed that it is not recommended and built capacity for HIV sistance in national HIV service pro- to interrupt ART. Vaccine Research in Africa vision.

Strategic Timing of AntiRetroviral Treatment (START) Trial The START Trial demonstrated that, compared to waiting until the CD4 count declines to 350 cells/mm3; im- mediate ART initiation in asymptomatic HIV infected individuals is significantly beneficial and reduces the risk of AIDS, serious AIDS related illnesses and death. The results of START directly influenced global treatment guidelines which now recommend “treatment for all” HIV infected individuals.

Other areas of collaboration include Social sciences and capacity building and ensuring our research informs policy

Our study locations

ENTEBBE MASAKA KAMPALA KYAMULIBWA– KALUNGU UVRI Campus Plot 2-5 Ntiko Hill Road Plot No. 616 Musajja Alumbwa Gomba Road– Kyamulibwa Town Plot 51-59 Nakiwogo Road Road Mengo– Kisenyi Council | Tel: 04814 21211 Tel: 0417704000/ 312262910 Tel: 0414-2697150/0414 272953 Tel: 0392-720042

Email: [email protected] | www.mrcuganda.com Thumbs up partners The management and staff of the Medical Research Council/ Uganda Virus Research Institute Uganda Re- bY DI GIbb, SARAH WALKeR, search Unit on AIDS congratulate the Joint Clinical Research Center on their 25th Anniversary MAGS THOMASOn AnD ALL YOuR The MRC/UVRI Uganda Research Unit on AIDS is proud to be a partner with JCRC. Among the research projects jointly FRIenDS AT MRC CTu achieved are HIV basic science, prevention and treatment intervention and social science studies that have contributed new ongratulations from the knowledge and informed the formulation of HIV control policy and practices in Africa and beyond. UK Medical Research Council Clinical Trials Unit (now at University Some of the areas of our collaboration College London) – proud partners HIV Vaccine Trial; MRC/ National Surveillance of HIV Drug Development of AntiRetroviral withc JCRC over the last 15 years. On the 25th anniversary of the UVRI and JCRC conducted Resistance; Together we provide Therapy (DART) Trial; DART was Joint Clinical Trials Center, those the first HIV Vaccine trial in data on the prevalence of transmit- of us who have been fortunate to the largest antiretroviral therapy work with JCRC over the last 15 Africa; in which we not only years would like to express how ted and acquired resistance to HIV (ART) trial ever conducted in Africa. demonstrated that vaccine tri- much we have benefi tted from our medicines among treated and un- It showed that ART can be safely and mutual collaborations with Prof. Peter als can be successfully con- treated individuals. At the same we Mugyenyi, Dr. Cissy Kityo, Dr. Victor DART ﬁ les effectively delivered in Africa using Musiime and many others at JCRC. ducted in Africa but also con- contribute to documentation of early minimal laboratory monitoring. It al- Our partnership started with the to test whether the questions about adolescents and children starting tributed to ethical guidelines warning indicators for HIV drug re- DART clinical trial, which randomised management strategies DART was treatment with low CD4 counts) – and so showed that it is not recommended 3,316 HIV-positive adults from answering in adults would have most recently a new trial, ODYSSEY, and built capacity for HIV sistance in national HIV service pro- to interrupt ART. Uganda and Zimbabwe with low CD4 diff erent answers in children. However, which has just started recruited HIV- Vaccine Research in Africa vision. counts and symptoms of AIDS to ARROW also answered three other positive children to investigate the best ascertain clinical monitoring strategies. questions about how best to manage way to use dolutegravir. JCRC rose to the challenge of HIV-positive children on treatment – Th e trials have availed opportunities Strategic Timing of AntiRetroviral Treatment (START) Trial recruiting 1,000 patients per year, and was the British Medical Journal’s for collaborations in other areas and demonstrated enthusiasm in Paper of the Year in 2012. such as virology and immunology 3 The START Trial demonstrated that, compared to waiting until the CD4 count declines to 350 cells/mm ; im- the subsequent six years of follow- DART and ARROW were laboratories, as well as developing mediate ART initiation in asymptomatic HIV infected individuals is significantly beneficial and reduces the risk up, including putting up the famous followed by the EARNEST clinical capacity to conduct high-quality Mengo ‘tent’. Th e importance of this trial (investigating various second- pharmacokinetic studies and social of AIDS, serious AIDS related illnesses and death. The results of START directly influenced global treatment fi rst joint endeavour was recognised by line treatments in 1,277 HIV- science studies. guidelines which now recommend “treatment for all” HIV infected individuals. the main trial paper being runner in positive adults and adolescents), Th is would not have been possible the Lancet’s Paper of the year 2009. the CHAPAS-3 trial (investigating without the drive of JCRC’s visionary DART was the foundation on diff erent fi rst-line regimes in leaders and hard work of staff . We look Other areas of collaboration include Social sciences and capacity building and ensuring our research informs policy which many other collaborations 478 HIV-positive children), the forward to having more collaborations have been built – fi rst, the ARROW recently completed REALITY trial over the next 25 years! Our study locations clinical trial, which recruited 1,206 (investigating ways to reduce early HIV-positive children and adolescents deaths in 1,806 HIV-positive adults,

JCRC @25 Email: [email protected] | www.mrcuganda.com 31 Interview with Dr. James Makumbi Thank you for building JCRC

n 1990, we were sending so many of our solders to be trained abroad, and several of them would always be returned when they are in a critical condition due to ithe HIV/AIDS scourge. They would get infected with HIV and would not easily finish the training. More so, there were several people in the country who were also succumbing to HIV/AIDS. We felt that there was need to do something fast to save our nation. This is the same time that JCRC started and President Yoweri Museveni asked the Centre to help with the treatment of the soldiers. We worked tirelessly to start the JCRC. It is partly standing, because of the commitment of the President and some of the people that gave it their best to see it live to the great level it is on today. After 25 years, there is need to support the Centre to continue with JCRC is standing the Director of Mulago Hospital by research. The Centre will need more President Tito Okello Lutwa. But funds and human resource to carry on because of the this was short lived, because when the great work that was started almost President Yoweri Museveni took three decades ago. “commitment of the over, he was appointed the Managing There is also need for continued President and some Director of the Coffee marketing support from Government and the Board. He served in this position for peers in this fight of epidemics that are people who gave it two years up to 1987. sweeping through our countries. their best.” He was later appointed a The JCRC was very instrumental in Presidential nominee in the National supporting several other organisations Resistance Council. In 1990, he was to fight HIV/AIDS. It was also appointed as the Director of Mulago appointed to the Government Cabinet instrumental in building this country’s Hospital until the bush war under of ministers as a Health Minister, for capacity in this HIV fight. A case in Yoweri Museveni got him to leave seven years. point was Mildmay; which was started his office to get on the frontline too In 1996, he became a Member of with our support. I personally invited in the bush-related activities. He quit Parliament for Bbaale Constituency them to come support us in the fight his profession, alongside some other in Kayunga. He was them appointed a against HIV. comrades of his, to join the country’s Senior Presidential Advisor – Medical, I am confident that if there is good liberation struggle. By the way, he is given the military rank and assigned leadership as it is now, the Centre’s silent about his army rank, although Chief of Medical Services in the future is bright. proud of it– He is a Brigadier General. UPDF. At the time he joined the bush, he He was instrumental, during his WHO IS DR. JAMES had been fired by Godfrey Binaisa, time as health minister in starting MAKUMBI when he became President. Dr. Jack the Joint Clinical Research Centre, He is a consultant physician. He Barlow had been killed, allegedly by with the help of people like Dr. joined politics and leadership when the then Government. He joined the Ben Mbonye. He is one of the core he was called on to serve, under doctors and other medics who were founders of the JCRC. He also helped the current Government. His first protesting and this cost him his job as start the Uganda AIDS Commission, appearance in top administrative Director at Mulago Hospital. National Drug Authority and the positions was in 1978 when he was He was interestingly, re-appointed National Medical Stores. JCRC @25 32 Interview with Dr. James Makumbi Thank you for building JCRC n 1990, we were sending so many of our solders to be trained abroad, and several of them would always be returned when they are in a critical condition due to ithe HIV/AIDS scourge. They would get infected with HIV and would not easily finish the training. More so, there were several people in the country who were also succumbing to HIV/AIDS. We felt that there was need to do something fast to save our nation. This is the same time that JCRC started and President Yoweri Museveni asked the Centre to help with the treatment of the soldiers. We worked tirelessly to start the JCRC. It is partly standing, because of Interview with the commitment of the President and Dr Jessica Jita, some of the people that gave it their best to see it live to the great level it is on today. Mulago Hospital After 25 years, there is need to support the Centre to continue with JCRC is standing the Director of Mulago Hospital by research. The Centre will need more President Tito Okello Lutwa. But funds and human resource to carry on because of the this was short lived, because when the great work that was started almost President Yoweri Museveni took JCRC has campaigned for three decades ago. “commitment of the over, he was appointed the Managing There is also need for continued President and some Director of the Coffee marketing support from Government and the people who gave it Board. He served in this position for peers in this fight of epidemics that are two years up to 1987. our country internationally sweeping through our countries. their best.” He was later appointed a The JCRC was very instrumental in Presidential nominee in the National supporting several other organisations Resistance Council. In 1990, he was served the Joint Clinical When HIV/AIDS supporting the treatment care of the to fight HIV/AIDS. It was also appointed as the Director of Mulago appointed to the Government Cabinet Research as a member of the HIV/AIDS patients in the country. instrumental in building this country’s Hospital until the bush war under of ministers as a Health Minister, for Research Clearance Committee. hit our country, Issues to do with the people’s health capacity in this HIV fight. A case in Yoweri Museveni got him to leave seven years. It is now two years and I have are very important and should be given point was Mildmay; which was started his office to get on the frontline too In 1996, he became a Member of just got on the Board for about two- “all people seemed utmost attention, a reason why the with our support. I personally invited in the bush-related activities. He quit Parliament for Bbaale Constituency and-a-halfi years. confused and did not pioneers of this HIV fight need to be them to come support us in the fight his profession, alongside some other in Kayunga. He was them appointed a This organisation has helped shape kept on this assignment. against HIV. comrades of his, to join the country’s Senior Presidential Advisor – Medical, the fight against HIV/AIDS in the know what to do. It When HIV/AIDS hit our country, I am confident that if there is good liberation struggle. By the way, he is given the military rank and assigned country. It has done a commendable took the initiative of all people seemed confused and did not leadership as it is now, the Centre’s silent about his army rank, although Chief of Medical Services in the job and needs to be applauded. know what took. It took the initiative future is bright. proud of it– He is a Brigadier General. UPDF. It will be noted that JCRC has the JCRC to make a of the JCRC to make a difference. At the time he joined the bush, he He was instrumental, during his campaigned for our country on the difference.” We still have a tough job to do for WHO IS DR. JAMES had been fired by Godfrey Binaisa, time as health minister in starting international scale to get ARVs to the country to ably overcome what MAKUMBI when he became President. Dr. Jack the Joint Clinical Research Centre, the people, even at the time people this scourge. Every other day comes at He is a consultant physician. He Barlow had been killed, allegedly by with the help of people like Dr. thought this was impossible. So many times with new challenges in the world joined politics and leadership when the then Government. He joined the Ben Mbonye. He is one of the core patients need these drugs in the of medicine. This is more reason we he was called on to serve, under doctors and other medics who were founders of the JCRC. He also helped country. The challenge is that once want to have the capacity of JCRC to the current Government. His first protesting and this cost him his job as start the Uganda AIDS Commission, someone has started using the drugs, I do believe that with the 25 years’ be kept growing, to be able to take on appearance in top administrative Director at Mulago Hospital. National Drug Authority and the they have to keep on it, almost till experience, there is hope that they the likely challenges now and in the positions was in 1978 when he was He was interestingly, re-appointed National Medical Stores. death. can still take a lead in research and future. JCRC @25 JCRC @25 32 33 JCRC’s relentless effect on Uganda The Joint Clinical Research Centre’s contribution has for years been felt all over the country. bY FReD bYARuHAnGA

o improve monitoring of ART sites, JCRC established Regional Centres of ExcellenceT (RCES) in all regions of Uganda in Mbale, Gulu, Mubende, JCRC offices Mbale Kakira, Mbarara, Kabale and F/Portal. These centres co-ordinated all activities relating to the ART sites in There is every their respective sites. After evidence to the programme, the RCES are now concentrating on “demonstrate research. that JCRC When asked about what he made of the 25 years has lived to its of JCRC existence, Prof. mission. Epelu-Opio the current and longest-serving JCRC Chairman of the board of trustees said, “These have adherence programmes have been years of great success, helped many of us to live.” but also challenges, which The patient, before have been overcome by passing on, added that, having in place capable “The staff are committed JCRC offices Gulu leadership.” and professional and once One of the clients a patient joins JCRC, you offering of other services to and ECG services). There who joined the care and regain your hope to live.” the public. are also inpatient services treatment years ago, while Besides research which The services include; including admissions; on her death bed applauded is the core call for JCRC, General medical care laboratory services, private JCRC saying, “They the centre embraced (outpatient consultations pharmacy and radiology ( JCRC)are the saviours of sustainability strategies and treatment, in-patient services offered using the the recent times. I wouldn’t aimed at reducing services, including current technology in the be alive without them. They overreliance on donor admissions, dental services, country. always have the drugs in funding, which informed x-ray services, ultra sound According to Dr. Ian their full doses and their the opening up and the scans, echo cardiology scans Mugisa the JCRC dental

JCRC @25 34 JCRC’sJCRC’s relentlessrelentless effecteffect onon UgandaUganda The Joint Clinical Research Centre’s SUDAN contribution has for years Yumbe Moyo Kitgum been felt Adjumani Arua Kotido all over the Gulu Pader DEMOCRATIC country. Moroto Nebbi REPUBLIC CONGO Lira bY FReD bYARuHAnGA Apac Katakwi Nakapiripirit Masindi Kaberamaido o improve Soroti Kumi Kapchorwa monitoring of Nakasongola Sironko Pallisa ART sites, JCRC Kiboga Kamuli Kibaale Luwero Kayunga established Fort Portal Iganga Tororo Mbale Kabarole Bugiri Regional Centres of Kyenjojo Mubende Jinja Mayuge Busia Excellence (RCES) in Waikiso Mukono Kasese Kamwenge Kampala T Mpigi all regions of Uganda in Sembabule KENYA Mbale, Gulu, Mubende, Masaka JCRC offices Mbale Kakira, Mbarara, Kabale Bushenyi Mbarara and F/Portal. These centres Rukungiri Rakai Kalangala co-ordinated all activities There is every Kanungu Ntungamo relating to the ART sites in Kabale their respective sites. After evidence to Kisoro the programme, the RCES TANZANIA are now concentrating on “demonstrate KEY research. that JCRC RWANDA JCRC Site Mbarara region When asked about what Centre of excellence RCES Kabale region he made of the 25 years has lived to its Kampala region of JCRC existence, Prof. mission. Fort Portal region Epelu-Opio the current Mbale region Gulu region and longest-serving JCRC Chairman of the board of trustees said, “These have adherence programmes have been years of great success, helped many of us to live.” surgeon, “The dental services first HIV client that came founder staff members says, and having served as the but also challenges, which The patient, before offered have enhanced for HIV/AIDS testing and “I could hardly see JCRC’s first chairman of the board. have been overcome by passing on, added that, infection control procedures counselling in 1991 and her growth to an international He is still the Patron of having in place capable “The staff are committed JCRC offices Gulu and meet universal infection greatest joy is seeing HIV/ organisation. I am proud JCRC. Commendation leadership.” and professional and once control standards” AIDS clients regain hope to have contributed to this also goes to the Ministry One of the clients a patient joins JCRC, you offering of other services to and ECG services). There The Centre has one of and live a normal life. transformation.” of Health; partners and who joined the care and regain your hope to live.” the public. are also inpatient services the highest staff retention She says, “Clients come There is every evidence to collaborators for supporting treatment years ago, while Besides research which The services include; including admissions; rates in the country with when they have lost hope demonstrate that JCRC has JCRC. on her death bed applauded is the core call for JCRC, General medical care laboratory services, private a number of founder staff but gradually improve and lived to its mission. Management assures JCRC saying, “They the centre embraced (outpatient consultations pharmacy and radiology still working at JCRC. Mrs. live a normal life.” The board of trustees and Ugandans and the ( JCRC)are the saviours of sustainability strategies and treatment, in-patient services offered using the Byaruhanga Rose (the chief Her only regret is the the management of Joint international community of the recent times. I wouldn’t aimed at reducing services, including current technology in the councillor) who received and failure to find the HIV/ Clinical Research Centre continued quality services. be alive without them. They overreliance on donor admissions, dental services, country. counselled the first HIV/ AIDS cure, as of today. thank His Excellence always have the drugs in funding, which informed x-ray services, ultra sound According to Dr. Ian AIDS client at JCRC is One other staff, Alfred Yoweri Kaguta Museveni The writer is a business their full doses and their the opening up and the scans, echo cardiology scans Mugisa the JCRC dental proud to have received the Tumwesigye, one of the for the vision to start JCRC Development Manager

JCRC @25 JCRC @25 34 35 JCRC Research publications

Before The year 2000 regimens to prevent tuberculosis in short course chemotherapy in human Uganda adults infected with the human immunodeficiency virus-infected and 1. Riley JP, Pestano GA, Hosford K, immunodeficiency virus. N Engl J Med non-infected adults with pulmonary Francis C, Xie JM, Mugyenyi P, Kataaha 1997; 337 (12):801-8. tuberculosis. The international journal of P, Katongole-Mbidde E, Anokbonggo tuberculosis and lung disease: the official WW, Guyden J, et al. Relative reactivity 8. Wieland U, Seelhoff A, Hofmann journal of the International Union of the V3 loop PND of HIV-1 subtypes A, Kühn JE, Eggers HJ, Mugyenyi P, against Tuberculosis and Lung Disease A, B, C, D, and F with sera from Schwander S. Diversity of the vif gene of 2000; 4(6):528-36. selected Ugandan localities. Arch Virol. human immunodeficiency virus type 1 1995;140(8):1393-404. in Uganda. Gen Virol. 1997 Feb;78 ( Pt 14. Joloba M L; Whalen C C; Cave D 2):393-400. M; Eisenach K D; Johnson J L; Okwera 2. Schwander S, Rüsch-Gerdes S, A; Morrissey A; Bajaksouzian S; Feagin Mateega A, Lutalo T, Tugume S, 9. Johnson JL, Nyole S, Okwera A, J; Mugerwa R; Ellner J; Jacobs M R. Kityo C, Rubaramira R, Mugyenyi Whalen CC, Nsubuga P, Pekovic V, Determination of drug susceptibility P, Okwera A, Mugerwa R. A pilot Huebner R, Wallis RS, Mugyenyi PN, and DNA fingerprint patterns of clinical study of antituberculosis combinations Mugerwa RD, Ellner JJ. Instability isolates of Mycobacterium tuberculosis comparing rifabutin with rifampicin of tuberculin and Candida skin test from Kampala, Uganda. East African in the treatment of HIV-1 associated reactivity in HIV-infected Ugandans. Medical Journal 2000;77(2):111-5. tuberculosis. A single-blind randomized The Uganda-Case Western Reserve 15. Oishi K, Hayano M, Yoshimine H, evaluation in Ugandan patients with University Research Collaboration. Tugume SB, Kebba A, Mugerwa R, HIV-1 infection and pulmonary Am J Respir Crit Care Med. 1998 Mugyenyi P, Kumatori A, Matsushima tuberculosis. Tuber Lung Dis. 1995 Jun; Dec;158(6):1790-6. K, Nagatake T. Expression of chemokine 76(3):210-8. receptors on CD4+ T cells in peripheral 10. Hirsch CS, Toossi Z, Vanham blood from HIV-infected individuals in 3. Tugume SB, Piwowar EM, Lutalo G, Johnson JL, Peters P, Okwera A, Uganda. J Interferon Cytokine Res. 2000 T, Mugyenyi PN, Grant RM, Mangeni Mugerwa R, Mugyenyi P, Ellner JJ. Jun; 20(6):597-602. FW, Pattishall K, Katongole-Mbidde E. Apoptosis and T cell hyporesponsiveness Hematological reference ranges among in pulmonary tuberculosis. J Infect Dis. 16. Hirsch CS, Toossi Z, Johnson JL, healthy Ugandans. Clin Diagn Lab 1999 Apr;179(4):945-53. Luzze H, Ntambi L, Peters P, McHugh Immunol. 1995 Mar;2(2):233-5. Year 2000 – 2001. M, Okwera A, Joloba M, Mugyenyi 4. Colebunders R, Karita E, Taelman H, P, Mugerwa RD, Terebuh P, Ellner Mugyenyi P. Antiretroviral treatment in 11. Cao H, Mani I, Vincent R, JJ. Augmentation of apoptosis and Africa. AIDS. 1997;11 Suppl B:S107- Mugerwa R, Mugyenyi P, Kanki P, interferon-gamma production at sites 13. Review. Ellner J, Walker BD. Cellular immunity of active Mycobacterium tuberculosis to human immunodeficiency virus type infection in human tuberculosis. J Infect 5. Hom D, Johnson J, Mugyenyi P, 1 (HIV-1) clades: relevance to HIV-1 Dis. 2001 Mar 1;183(5):779-88. Epub Byaruhanga R, Kityo C, Loughlin vaccine trials in Uganda. J Infect Dis. 2001 Feb 8. A, Svilar GM, Vjecha M, Mugerwa 2000 Nov;182(5):1350-6. Epub 2000 R, Ellner J. HIV-1 Risk and Vaccine Oct 9. 17. Johnson JL, Okwera A, Hom Acceptability in the Ugandan Military. DL, Mayanja H, Mutuluuza Kityo Journal of AIDS and Human 12. Hertoghe T, Wajja A, Ntambi L, C, Nsubuga P, Nakibali JG, Loughlin Retroviruses 1997; 15:375-80. Okwera A, Aziz MA, Hirsch C, Johnson AM, Yun H, Mugyenyi PN, Vernon J, Toossi Z, Mugerwa R, Mugyenyi P, A, Mugerwa RD, Ellner JJ, Whalen 6. Schwander SK, Dietrich M, Colebunders R, Ellner J, Vanham G. T CC; Uganda-Case Western Reserve Mugyenyi P, Kityo C, Okwera A, cell activation, apoptosis and cytokine University Research Collaboration. Johnson J, Nsubuga P, Ruesch-Gerdes dysregulation in the (co)pathogenesis Duration of efficacy of treatment of S, Whalen C. Clinical course of of HIV and pulmonary tuberculosis latent tuberculosis infection in HIV- human immunodeficiency virus type 1 (TB). Clin Exp Immunol. 2000 infected adults. AIDS. 2001 Nov associated pulmonary tuberculosis during Dec;122(3):350-7. 9;15(16):2137-47. short-course antituberculosis therapy. East Afr Med J. 1997 Sep;74(9):543-8. 13. Joloba M L; Johnson J L; Namale 18. Joloba M L; Johnson J L; Namale A; A; Morrissey A; Assegghai A E; Morrissey A; Assegghai A E; Rüsch- 7. Whalen CC, Johnson JL, Okwera Mugerwa R D; Ellner J J; Eisenach Gerdes S; Mugerwa R D; Ellner J J; A, Hom DL, Mugyenyi P, Kityo C, K D. Quantitative sputum bacillary Eisenach K D. Quantitative bacillary Mugerwa RD, Ellner JJ. A Trial of three load during rifampin-containing response to treatment in Mycobacterium JCRC @20 36 JCRCJCRC ResearchResearch publicationspublications

tuberculosis infected and M. africanum 25. Nieman S, Rusch-Gerdes S, Joloba I, Seruyange R, Kabwongera E, Before The year 2000 regimens to prevent tuberculosis in short course chemotherapy in human infected adults with pulmonary ML, Whalen CC, Guwatudde D, Mugyenyi P, Talisuna A. Impact Uganda adults infected with the human immunodeficiency virus-infected and tuberculosis. The international journal Ellner JJ, Eisenach K, Fomukong N, of mass measles campaigns among 1. Riley JP, Pestano GA, Hosford K, immunodeficiency virus. N Engl J Med non-infected adults with pulmonary of tuberculosis and lung disease : the Johnson JL, Mugerwa RD, Okwera children less than 5 years old in Uganda. Francis C, Xie JM, Mugyenyi P, Kataaha 1997; 337 (12):801-8. tuberculosis. The international journal of official journal of the International A, Schwander SK. Mycobacterium J Infect Dis. 2003 May 15;187 Suppl P, Katongole-Mbidde E, Anokbonggo tuberculosis and lung disease: the official Union against Tuberculosis and Lung africanum subtype II is associated 1:S63-8. WW, Guyden J, et al. Relative reactivity 8. Wieland U, Seelhoff A, Hofmann journal of the International Union Disease 2001;5(6):579-82. with two distinct genotypes and is a of the V3 loop PND of HIV-1 subtypes A, Kühn JE, Eggers HJ, Mugyenyi P, against Tuberculosis and Lung Disease major cause of human tuberculosis in 31. Takahashi H, Oishi K, Yoshimine A, B, C, D, and F with sera from Schwander S. Diversity of the vif gene of 2000; 4(6):528-36. 19. Toossi Z, Johnson JL, Kanost RA, Kampala, Uganda. J Clin Microbiol H, Kumatori A, Moji K, Watanabe K, selected Ugandan localities. Arch Virol. human immunodeficiency virus type 1 Wu M, Luzze H, Peters P, Okwera 2002; 40:3398-3405. Nalwoga H, Tugume SB, Kebba A, 1995;140(8):1393-404. in Uganda. Gen Virol. 1997 Feb;78 ( Pt 14. Joloba M L; Whalen C C; Cave D A, Joloba M, Mugyenyi P, Mugerwa Mugerwa R, Mugyenyi P, Nagatake 2):393-400. M; Eisenach K D; Johnson J L; Okwera RD, Aung H, Ellner JJ, Hirsch CS. 26. Rabkin M, El-Sadr W, Katzenstein T. Decreased serum opsonic activity 2. Schwander S, Rüsch-Gerdes S, A; Morrissey A; Bajaksouzian S; Feagin Increased replication of HIV-1 at DA, Mukherjee J, Masur H, against Streptococcus pneumoniae Mateega A, Lutalo T, Tugume S, 9. Johnson JL, Nyole S, Okwera A, J; Mugerwa R; Ellner J; Jacobs M R. sites of Mycobacterium tuberculosis Mugyenyi P, Munderi P, Darbyshire J. in human immunodeficiency virus- Kityo C, Rubaramira R, Mugyenyi Whalen CC, Nsubuga P, Pekovic V, Determination of drug susceptibility infection: potential mechanisms of viral Antiretroviral treatment in resource- infected Ugandan adults. Clin Infect P, Okwera A, Mugerwa R. A pilot Huebner R, Wallis RS, Mugyenyi PN, and DNA fingerprint patterns of clinical activation. J Acquir Immune Defic poor settings: clinical research priorities. Dis. 2003 Dec 1;37(11):1534-40. Epub study of antituberculosis combinations Mugerwa RD, Ellner JJ. Instability isolates of Mycobacterium tuberculosis Syndr. 2001 Sep 1;28(1):1-8. Lancet. 2002 Nov 9; 360 (9344):1503- 2003 Nov 6. comparing rifabutin with rifampicin of tuberculin and Candida skin test from Kampala, Uganda. East African 5. in the treatment of HIV-1 associated reactivity in HIV-infected Ugandans. Medical Journal 2000;77(2):111-5. 20. Toossi Z, Mayanja-Kizza H, Hirsch year 2004 tuberculosis. A single-blind randomized The Uganda-Case Western Reserve 15. Oishi K, Hayano M, Yoshimine H, CS, Edmonds KL, Spahlinger T, Hom 27. Weidle PJ, Malamba S, Mwebaze 32. Bateganya M, Colfax G, Shafer evaluation in Ugandan patients with University Research Collaboration. Tugume SB, Kebba A, Mugerwa R, DL, Aung H, Mugyenyi P, Ellner JJ, R, Sozi C, Rukundo G, Downing LA, Kityo C, Mugyenyi P, Serwadda HIV-1 infection and pulmonary Am J Respir Crit Care Med. 1998 Mugyenyi P, Kumatori A, Matsushima Whalen CW. Impact of tuberculosis R, Hanson D, Ochola D, Mugyenyi D, Mayanja H, Bangsberg D. tuberculosis. Tuber Lung Dis. 1995 Jun; Dec;158(6):1790-6. K, Nagatake T. Expression of chemokine (TB) on HIV-1 activity in dually P, Mermin J, Samb B, Lackritz E. Antiretroviral therapy and sexual 76(3):210-8. receptors on CD4+ T cells in peripheral infected patients. Clin Exp Immunol. Assessment of a pilot antiretroviral behavior: a comparative study 10. Hirsch CS, Toossi Z, Vanham blood from HIV-infected individuals in 2001 Feb; 123(2):233-8. drug therapy programme in Uganda: between antiretroviral- naive and 3. Tugume SB, Piwowar EM, Lutalo G, Johnson JL, Peters P, Okwera A, Uganda. J Interferon Cytokine Res. 2000 patients' response, survival, and -experienced patients at an urban T, Mugyenyi PN, Grant RM, Mangeni Mugerwa R, Mugyenyi P, Ellner JJ. Jun; 20(6):597-602. 21. Weidle PJ, Kityo CM, Mugyenyi drug resistance. Lancet. 2002 Jul 6; HIV/AIDS care High prevalence FW, Pattishall K, Katongole-Mbidde E. Apoptosis and T cell hyporesponsiveness P, Downing R, Kebba A, Pieniazek 360(9326):34-40. of antiretroviral resistance in treated Hematological reference ranges among in pulmonary tuberculosis. J Infect Dis. 16. Hirsch CS, Toossi Z, Johnson JL, D, Respess R, Hertogs K, De Vroey Ugandans infected with non-subtype healthy Ugandans. Clin Diagn Lab 1999 Apr;179(4):945-53. Luzze H, Ntambi L, Peters P, McHugh V, Dehertogh P, Bloor S, Larder B, 28. Cao H, Kaleebu P, Hom D, Flores B human immunodeficiency virus type Immunol. 1995 Mar;2(2):233-5. Year 2000 – 2001. M, Okwera A, Joloba M, Mugyenyi Lackritz E. Resistance to antiretroviral J, Agrawal D, Jones N, Serwanga 1.AIDS Res Hum Retroviruses. 2004 4. Colebunders R, Karita E, Taelman H, P, Mugerwa RD, Terebuh P, Ellner therapy among patients in Uganda. J J, Okello M, Walker C, Sheppard Apr;20(4):355-64. Mugyenyi P. Antiretroviral treatment in 11. Cao H, Mani I, Vincent R, JJ. Augmentation of apoptosis and Acquir Immune Defic Syndr. 2001 Apr H, El-Habib R, Klein M, Mbidde Africa. AIDS. 1997;11 Suppl B:S107- Mugerwa R, Mugyenyi P, Kanki P, interferon-gamma production at sites 15;26(5):495-500. E, Mugyenyi P, Walker B, Ellner 33. Gao Y, Paxinos E, Galovich J, 13. Review. Ellner J, Walker BD. Cellular immunity of active Mycobacterium tuberculosis J, Mugerwa R; HIV Network for Troyer R, Baird H, Abreha M, Kityo to human immunodeficiency virus type infection in human tuberculosis. J Infect year 2002/2003 Prevention Trials. Immunogenicity of a C, Mugyenyi P, Petropoulos C, Arts 5. Hom D, Johnson J, Mugyenyi P, 1 (HIV-1) clades: relevance to HIV-1 Dis. 2001 Mar 1;183(5):779-88. Epub 22. Kebba A, Atwine D, Mwebaze recombinant human immunodeficiency EJ. Characterization of a subtype D Byaruhanga R, Kityo C, Loughlin vaccine trials in Uganda. J Infect Dis. 2001 Feb 8. R, Kityo C, Nakityo R, Peter M. virus (HIV)-canarypox vaccine in human immunodeficiency virus type A, Svilar GM, Vjecha M, Mugerwa 2000 Nov;182(5):1350-6. Epub 2000 Therapeutic responses to AZT + 3TC HIV-seronegative Ugandan volunteers: 1 isolate that was obtained from an R, Ellner J. HIV-1 Risk and Vaccine Oct 9. 17. Johnson JL, Okwera A, Hom + EFV in advanced antiretroviral naive results of the HIV Network for untreated individual and that is highly Acceptability in the Ugandan Military. DL, Mayanja H, Mutuluuza Kityo HIV type 1-infected Ugandan patients. Prevention Trials 007 Vaccine Study. J resistant to nonnucleoside reverse Journal of AIDS and Human 12. Hertoghe T, Wajja A, Ntambi L, C, Nsubuga P, Nakibali JG, Loughlin AIDS Res Hum Retroviruses. 2002 Infect Dis. 2003 Mar 15;187(6):887-95. transcriptase inhibitors. J Virol. 2004 Retroviruses 1997; 15:375-80. Okwera A, Aziz MA, Hirsch C, Johnson AM, Yun H, Mugyenyi PN, Vernon Nov 1;18(16):1181-7. May;78(10):5390-401. J, Toossi Z, Mugerwa R, Mugyenyi P, A, Mugerwa RD, Ellner JJ, Whalen 29. Johnson JL, Ssekasanvu E, Okwera 6. Schwander SK, Dietrich M, Colebunders R, Ellner J, Vanham G. T CC; Uganda-Case Western Reserve 23. Mugerwa RD, Kaleebu P, A, Mayanja H, Hirsch CS, Nakibali 34. Motomura K, Toyoda N, Oishi Mugyenyi P, Kityo C, Okwera A, cell activation, apoptosis and cytokine University Research Collaboration. Mugyenyi P, Katongole-Mbidde E, J, Drzayich Jankus D, Eisenach KD, K, Sato H, Nagai S, Hashimoto S, Johnson J, Nsubuga P, Ruesch-Gerdes dysregulation in the (co)pathogenesis Duration of efficacy of treatment of Hom DL, Byaruhanga R, Salata RA, Boom WH, Ellner JJ, Mugerwa RD Tugume SB, Enzama R, Mugewa R, S, Whalen C. Clinical course of of HIV and pulmonary tuberculosis latent tuberculosis infection in HIV- Ellner JJ; HIV-1 Vaccine Trial Group. for the Uganda-Case Western Reserve Mutuluuza CK, Mugyeyi P, Nagatake human immunodeficiency virus type 1 (TB). Clin Exp Immunol. 2000 infected adults. AIDS. 2001 Nov First trial of the HIV-1 vaccine in University Research Collaboration. T, Matsushima K. Identification associated pulmonary tuberculosis during Dec;122(3):350-7. 9;15(16):2137-47. Africa: Ugandan experience. BMJ. 2002 Randomized trial of adjunctive of a host gene subset related to short-course antituberculosis therapy. Jan 26;324(7331):226-9. interleukin-2 in adults with pulmonary disease prognosis of HIV-1 infected East Afr Med J. 1997 Sep;74(9):543-8. 13. Joloba M L; Johnson J L; Namale 18. Joloba M L; Johnson J L; Namale A; tuberculosis. Am J Respir Crit Care individuals. Int Immunopharmacol. A; Morrissey A; Assegghai A E; Morrissey A; Assegghai A E; Rüsch- 24. Mugyenyi PN. HIV vaccines: the Med 2003; 168:185-191. 2004 Dec 20;4(14):1829-36. 7. Whalen CC, Johnson JL, Okwera Mugerwa R D; Ellner J J; Eisenach Gerdes S; Mugerwa R D; Ellner J J; Uganda experience. Vaccine. 2002 May A, Hom DL, Mugyenyi P, Kityo C, K D. Quantitative sputum bacillary Eisenach K D. Quantitative bacillary 6;20(15):1905-8. Review. 30. Nanyunja M, Lewis RF, Makumbi 35. Mugyenyi P. Highly active Mugerwa RD, Ellner JJ. A Trial of three load during rifampin-containing response to treatment in Mycobacterium JCRC @20 JCRC @20 36 37 antiretroviral therapy. BMJ. 2004 Nov Nov;19(11):760-8. Inhibition of human immunodeficiency 13;329(7475):1118-9. virus-1 (HIV-1) by beta-chemokine 42. Byakika-Tusiime J, Oyugi JH, analogues in mononuclear cells from 36. Oyugi JH, Byakika-Tusiime J, Tumwikirize WA, Katabira ET, HIV-1-infected patients with active Charlebois ED, Kityo C, Mugerwa R, Mugyenyi PN, Bangsberg DR. tuberculosis. Clin Exp Immunol. 2005 Mugyenyi P, Bangsberg DR. Multiple Adherence to HIV antiretroviral therapy Nov;142(2):327-32. validated measures of adherence indicate in HIV+ Ugandan patients purchasing high levels of adherence to generic HIV therapy. Int J STD AIDS. 2005 year 2006 antiretroviral therapy in a resource- Jan;16(1):38-41. 50. Blossom DB, Namayanja-Kaye limited setting. J Acquir Immune Defic G, Nankya-Mutyoba J, Mukasa JB, Syndr. 2004 Aug 15;36(5):1100-2. 43. Eggena MP, Barugahare B, Jones Bakka H, Rwambuya S, Windau A, N, Okello M, Mutalya S, Kityo C, Bajaksouzian S, Walker CJ, Joloba ML, 37. Richard N, Juntilla M, Abraha Mugyenyi P, Cao H. Depletion of Kityo C, Mugyenyi P, Whalen CC, A, Demers K, Paxinos E, Galovich J, regulatory T cells in HIV infection is Jacobs MR, Salata RA. Oropharyngeal Petropoulos C, Whalen CC, Kyeyune associated with immune activation. J colonization by Streptococcus F, Atwine D, Kityo C, Mugyenyi Immunol. 2005 Apr 1;174(7):4407-14. pneumoniae among HIV-infected adults P, Arts EJ. High prevalence of in Uganda: assessing prevalence and antiretroviral resistance in treated 44. Eggena MP, Barugahare B, Okello antimicrobial susceptibility. Int J Infect Ugandans infected with non-subtype M, Mutyala S, Jones N, Ma Y, Kityo C, Dis. 2006 Nov;10(6):458-64. B human immunodeficiency virus type Mugyenyi P, Cao H. T cell activation in 1. AIDS Res Hum Retroviruses. 2004 HIV-seropositive Ugandans: differential 51. DART Virology Group and Trial Apr;20(4):355-64. associations with viral load, CD4+ T cell Team. Virological response to a triple depletion, and coinfection. 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HIV Med. 2007 Mar; antiretroviral- naive and -experienced Preventive Therapy on HIV Disease Chomba E, Allen S, Fei L, Kamali 8(2):86-91. patients at an urban HIV/AIDS care 49. Toossi Z, Mayanja-Kizza H, Progression and Survival in HIV- A, Sanders EJ, Anzala O, Katende and research center in Kampala, Uganda. Baseke J, Peters P, Wu M, Abraha A, Infected Adults. HIV Clin Trials. 2006; M, Ketter N; the IAVI Collaborative 69. Sow PS, Otieno LF, Bissagnene AIDS Patient Care STDS. 2005 Aung H, Okwera A, Hirsch C, Arts E. 7 (4):172-83. Seroprevalence and Incidence Study E, Kityo C, Bennink R, Clevenbergh More publications on jcrc website

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