Infectious Diseases Institute College of Health Sciences Makerere University ANNUAL REPORT July 2014 – June 2015 MAKERERE UNIVERSITY Ugandan Districts in which IDI was active at the end of June 2015 54% Coverage Table of Contents IDI by the Numbers (by end of June 2015) 2 Foreword from the IDI Board Chair 3 Introduction from the IDI Executive Director 3 Prevention, Care and Treatment Programme 4 Contribution to National and Global HIV Care Services 5 Building Capacity through the IDI-Kampala Capital City Authority Twinning Programme 5 Standard Operating Procedures: Driving Clinical Excellence 5 Training & Capacity Development Programme 6 Expansion of the Infectious Diseases Training Profile 7 The Uganda Private Health Sector Support Project 7 Building Capacity for the Management of Especially Dangerous Pathogens 7 The Low Dose-High Frequency Project 7 Upgrade of the IDI Distance Learning Platform: Collaborations to Enhance Distance Learning 7 The Connect for Life Project 8 Research Programme 9 Dissemination of Research Programme Outputs 9 List of CROI 2015 Presentations 9 Active (On-going) Studies 9 Emerging Infectious Diseases: Beyond HIV, Tuberculosis, Malaria and Hepatitis B 10 Public Engagement in Science 10 Building for the Future of Africa: A First-hand Account of a Gilead Scholars Program Grantee 11 Research to Policy: A Specific Antiretroviral Therapy Drug-Drug Interaction Poses a Reproductive Health 11 Challenge Outreach Programme 12 Leveraging the PEPFAR Platform 13 IDI/Kampala Capital City Authority Project 14 Voluntary Medical Male Circumcision for HIV prevention 14 IDI-Outreach Laboratory Services, Lab Hub Activities and Accreditation Efforts 15 Laboratory Services Programme 16 Information Services 17 Strategic Planning and Development 18 Financial Summary 19 IDI Gets New Executive Director- Dr. Richard Brough 20 The Launch of IDI’s new McKinnell Knowledge Centre 20 Fundraising for IDI 21 Dr. Alex Coutinho: Impacting Africa and Beyond 22 Defying the Odds: A Young Volunteer Living with HIV/AIDS Becomes a Full-Fledged Counsellor 23 IDI Leadership 24 IDI by the Numbers (by end of June 2015) 7,852 active clients currently enrolled, and 266 average daily client visits at the IDI Mulago Clinic. 5,886 clients on first line antiretroviral therapy;1,181 clients on second line antiretroviral therapy (one of the largest second line single-centre cohorts in the region) and 453 clients on third line antiretroviral therapy at the IDI Mulago Clinic. sero-discordant couples receiving comprehensive counselling, care and treatment from an IDI 557 specialized clinic by June 2015. 101,082 clients on antiretroviral therapy and 15,141 clients not on antiretroviral therapy, plus 1,582,620 individuals counselled, tested for HIV (since 2007) in the IDI-supported outreach clinics in KCCA and in 7 districts in Western Uganda and in 10 Regional Referral Hospitals, 1 PNFP and 1 Health Centre IV. 190,064 men circumcised since April 2011. 17,556 participants trained in the areas of HIV/AIDS, malaria, tuberculosis, systems strengthening, pharmacy, laboratory, research and especially dangerous pathogens since 2002. 410 research articles published in peer-reviewed journals since 2001. active research grants, including clinical trials, observational studies and capacity 45 12building projects.18 15 126,863 units tested at IDI core and central labs between July 2014 and June 2015. 10,920 health workers reached through the IDI AIDS Information and Training Call Centre since 2004. 60 districts across Uganda and 2 African countries provided with technical assistance during the year. 817 staff employed by IDI by the end of June 2015. 79 current grants managed by IDI by the end of June 2015. 2 ANNUAL REPORT | INFECTIOUS DISEASES INSTITUTE, COLLEGE OF HEALTH SCIENCES, MAKERERE UNIVERSITY INFECTIOUS DISEASES INSTITUTE, COLLEGE OF HEALTH SCIENCES, MAKERERE UNIVERSITY | ANNUAL REPORT 3 Foreword from the IDI Board Chair Welcome to this year’s IDI Annual Report covering the year to June 2015. IDI has now been an integral part of the College of Health Sciences at Makerere University in Uganda for over ten years. The institution has developed rapidly in that time and in 2015 completed the IDI McKinnell Knowledge Centre which is a six storey building that was officially opened at an auspicious ceremony graced by the Prime Minister of the Republic of Uganda, the Rt. Hon Dr. Ruhakana Rugunda; the Vice Chancellor of Makerere University, Prof. John Ddumba-Ssentamu, and many distinguished dignitaries and guests. At the same ceremony, IDI bid farewell to Dr. Alex Coutinho who served as IDI Executive Director with distinction from 2007-2014 and welcomed the new Executive Director, Richard Brough PhD, who had been IDI Head of Strategic Planning & Development since 2005. However, despite the year being one of considerable change, IDI’s strategic aims remain the same - to support the strengthening of health systems in Africa, with strong emphasis on infectious diseases, through research and capacity development. IDI’s strategic stance is always to support Government of Uganda policies, strategies and priorities, at national and local levels; and to contribute to their further development when invited to do so. Equally, as an entity within Makerere University, IDI strives to support the strategies and enhance the good name of the University at all times. Prof. Nelson Sewankambo Introduction from the IDI Executive Director The year to June 2015 was a mix of consolidation and further programmatic expansion. IDI continues to develop its range of programmes (Research; Training; Prevention, Care and Treatment; Laboratory; and Systems Strengthening) backed by solid support departments (Finance & HR; Grants Management; and IT). Through these programmes, IDI (as at June 2015) was providing care and treatment services to over 110,000 people living with HIV in urban and rural settings in Uganda (directly through the IDI clinic, and in partnership with government and non-government health facilities). IDI also provides extensive HIV prevention services (including a major voluntary male medical circumcision programme) and is a national referral centre for complicated cases of HIV. IDI has trained over 17,000 health workers from Uganda and over 25 other African countries; and has published over 400 articles in peer-reviewed journals (thereby contributing to improving the global ranking of Makerere University). There were 15 presentations by IDI authors at the 2015 Conference on Retroviruses and Opportunistic Infections (CROI) as IDI sought to not only contribute to national programmes, but to influence policy and practice in the global context. In addition, our Outreach Programme witnessed the completion of a major CDC-funded project and the beginning of its successor. The year also saw a further broadening of IDI’s programmatic activities and funding sources, for example, the establishment of the Ugandan Health Academy for Health Innovation and Impact funded by Janssen Global Public Health through the Johnson & Johnson Citizen Trust. These achievements would have been impossible without the support of the Government of Uganda, Makerere University (of which we are an integral part - within the College of Health Sciences), our development partners, and our funders; to all of whom we express sincere gratitude. Richard Brough PhD 2 ANNUAL REPORT | INFECTIOUS DISEASES INSTITUTE, COLLEGE OF HEALTH SCIENCES, MAKERERE UNIVERSITY INFECTIOUS DISEASES INSTITUTE, COLLEGE OF HEALTH SCIENCES, MAKERERE UNIVERSITY | ANNUAL REPORT 3 Prevention, Care and Treatment Programme he mandate of the Prevention, Care and Treatment (PCT) Programme is to provide high quality multidisciplinary Tcare through sustainable and innovative systems, which can be used for research and capacity building. Dr. Isaac Lwanga attending to an elderly patient at Over the past couple of years, the PCT Programme has the IDI clinic at Mulago. conducted clinical capacity building activities in several lower-level health facilities, to strengthen their capacity to provide quality HIV care and treatment services. These Strengthening Sexual Reproductive Health facilities are now capable of taking on and managing less Services complex patients, but refer the most complex patients to the IDI clinic at Mulago, for expert and specialised care. The capacity to provide comprehensive Sexual Reproductive This year, the PCT Programme has continued to provide Health (SRH) services has been further strengthened at appropriate care to this growing patient population, at the the IDI clinic, through specialist visits. Dr. Emily Mabonga, IDI clinic. a visiting sexually transmitted infection (STI) specialist physician from King’s College Hospital in London, trained and mentored SRH clinic staff in modern approaches IDI Specialist Clinics Clients at end of June 2015 to screening and treating STIs. Under Dr. Mabonga’s guidance, an STI focal person who is to be stationed at Adolescents clinic 243 the IDI clinic has been identified. The STI focal person will Sexual Reproductive Health clinic 46 screen, investigate, treat and follow up all patients with Senior Citizens Clinic 241 STI symptoms as well as their sexual partners; this will Kaposi Sarcoma clinic 152 facilitate the centralisation of STI care to ensure prompt TB/HIV clinic 122 and proper diagnosis and treatment. Discordant clinic 557 MARPs clinic 158 An SRH clinic doctor conducting a patient examination. Hepatitis B clinic 307 Mental Health clinic 84 2nd line / 3rd line clinic 1,222 General