Doris Duke Charitable Foundation Selects Emory HIV/AIDS Research Team
for Innovation Award
ATLANTA–The Doris Duke Charitable Foundation has chosen a team
of scientists from Emory University School of Medicine as one of ten
recipients of the 2003 Doris Duke Innovation in Clinical Research Awards.
The awards will provide approximately $200,000 to investigators or teams
to develop "Point-of-Care" diagnostics and therapeutic monitoring tools
to care for AIDS patients in resource-poor areas of the world. The Emory
investigators will collaborate with Ethiopian AIDS researchers to develop
effective tests to monitor patients with HIV and AIDS by reconfiguring
and simplifying commonly used tests to accommodate the circumstances
and finances of resource-poor countries.
The effort to bring effective therapies for HIV and AIDS to developing
countries has received growing support within the past few years; however,
the efforts to lower the cost of drugs has had little impact on increasing
the availability of, or lowering the cost of essential monitoring tests.
As a result, the availability of these tests is exceedingly limited
in developing countries where the vast majority of HIV-infected people
live. The Emory research team will work with scientists at the Ethiopian
Netherlands AIDS Research Project in Addis Ababa and with investigators
at Addis Ababa University Faculty of Medicine to adapt technologies
already in use in the United States to clinical conditions in Ethiopia,
as well as to derive novel monitoring strategies that are designed to
be more readily implemented in resource-poor countries.
"The standard of care for monitoring antiretroviral therapy in the U.S.
is based on tracking CD4 T cell counts and conducting HIV viral load
measurements," explains Frances Priddy, MD, assistant professor of medicine
in Emory University School of Medicine and a co-investigator on the
Emory grant. "Our Emory team will take the technologies already used
for these tests and simplify and substantially reconfigure them for
countries where resources are scarce and where the electrical supply
and refrigeration may be intermittent. We want to develop tests that
can be used in resource-poor countries so they can also conduct high-quality
monitoring of antiretroviral therapy."
"All of the ongoing efforts to make antiretroviral therapy available
in developing countries will be compromised unless effective clinical
monitoring tools to determine who needs treatment most and how well
someone is responding to treatment are made available in these countries,"
says Mark Feinberg, MD, PhD, Emory professor of medicine and principal
investigator of the Emory project. "At present, HIV therapy in developed
countries can be highly effective when it is overseen by knowledgeable
clinicians, with the support of state-of-the art clinical monitoring
labs. Indeed, many lives are being saved as a result of therapeutic
advances. However, both the antiretroviral drugs and the clinical monitoring
tools are very expensive and complex to use. Further, the technology
needed for contemporary clinical monitoring tools involves complex,
expensive equipment that requires near-constant up-keep, and thus will
be difficult or impossible to sustain in resource-poor countries. It
is imperative that simpler and cheaper, yet reliable tests be developed
to enable HIV-infected individuals living in developing countries to
derive long-term benefit from the increased availability of antiretroviral
During the first year of the two-year project, the Emory investigators
will work to develop the reconfigured technologies; then, during the
second year, they will travel to Ethiopia to field test the new tools
to determine their feasibility and effectiveness in the Ethiopian population
and in HIV subtype C, the predominant HIV strain in Ethiopia. Subtype
B is the predominant strain in the United States.
In addition to Dr. Priddy and Dr. Feinberg, the Emory team includes
Angela Caliendo, MD, PhD and Sylvija Staprans, PhD.
If the pilot program is successful, the Emory scientists hope to test
their tools in other countries and in larger groups of patients.