PROJECT SUMMARY/ABSTRACT HIV/AIDS is at epidemic proportions in Zambia, where approximately 1.2 million people – representing about 12% of the country's adult population – are infected. Concomitant with this epidemic, the widespread availability of free anti-retroviral treatment in-country has increased the lifespan of HIV-1 infected individuals, resulting in prolonged chronic immunosuppression and increased occurrence of HIV-associated cancers. However, in-country efforts to prevent, diagnose, and manage cancer in Zambia have been hindered by a lack of laboratory facilities, insufficient cancer research infrastructure, and a shortage of trained personnel. Recognizing these critical gaps, the University of Zambia School of Medicine, the University Teaching Hospitals, and the University of Nebraska-Lincoln leveraged the success of a previous Fogarty partnership to establish the AIDS Malignancies Training and Research International Program (AMTRIP) in collaboration with a new lead partner, the Cancer Diseases Hospital (CDH). This unique program aims to enhance Zambia's cancer research infrastructure and capacity by training Zambian biomedical researchers and health care providers in laboratory techniques and research methodology related to basic cancer biology, molecular genomics, and bioinformatics. Now in its fifth year, AMTRIP has made significant strides by providing intensive long-term graduate degree training and short- and medium-term technical training for a diverse group of 25 trainees; hosting workshops for over 300 health care professionals; successfully transitioning trainees into mentorship roles; adapting program activities to meet the needs of trainees and the rapidly changing cancer research landscape; and leveraging partnerships with other D43 programs to expand the program's impact. Building on these accomplishments, this renewal application seeks to further enhance cancer research capacity in Zambia by: 1) continuing to provide long-term academic instruction and research experiences for eight current master's and three current PhD students in Zambia and recruiting four additional master's and two additional PhD students; 2) providing medium-term (six months to one year) technical training for trainees in topics related to molecular pathology, cancer biology, bioinformatics and genomics; and 3) delivering short- term training (less than three months) and technical workshops (3-5 days) designed to enhance basic, clinical, implementation, genomics, bioinformatics, and behavioral cancer research in collaboration with other regional partners and programs. Expected outcomes of this renewal include the graduation of eight current master's and three current PhD candidates; recruitment and training of an additional four master's and two PhD students in relevant cancer research fields; the transition of trainees into mentorship roles; enhanced infrastructure at Zambian institutions, including the completion of a CDH laboratory renovation; and expanded partnerships with other D43 programs. Given current progress and anticipated renewal outcomes, AMTRIP is on track to transition program leadership to the next generation of cancer researchers in a future renewal.

NARRATIVE While AIDS-associated cancers are a major cause of death around the globe, those in low- and middle-income countries (LMICs), particularly in sub-Saharan Africa, are much more likely to die from cancer due to shortages of trained cancer researchers, oncologists, and support staff and a lack of healthcare infrastructure and expertise for diagnosing and treating cancers. The AIDS Malignancies Training and Research International Program (AMTRIP) seeks to address these challenges by training a cadre of Zambian basic biomedical researchers and practitioners from the Cancer Diseases Hospital (the main LMIC institution) and partnering organizations in the skills necessary to further the country's research agenda in cancer biology and genomics, which will translate to better clinical care for cancer patients. Upon completion of master's and doctoral training, program fellows will be provided employment in Zambian medical institutions in order to begin addressing these challenges in-country.