The program will strengthen patient-oriented HIV clinical investigation training of physician-scientists and other exceptional clinicians in Mwanza, in northwestern Tanzania. The program builds upon two decades of collaboration and capacity building by the partner institutions. The primary research institution in Tanzania will be the Mwanza Intervention Trials Unit (MITU), which is a unit of Tanzania’s National Institute for Medical Research (NIMR). MITU was established in 2006 as a collaboration between NIMR and the London School of Hygiene and Tropical Medicine (LSHTM) to strengthen HIV interventional research in Tanzania. MITU collaborates closely with the Weill Bugando School of Medicine, which is also located in Mwanza. Weill Bugando was established in 2003 to train physicians for northwestern Tanzania. MITU and Weill Bugando have collaborated with Weill Cornell Medical College since their founding. This research training program aims to fill a critical gap in Mwanza: the need for Tanzanian physicians with rigorous training in patient-oriented HIV clinical investigation. We use the NIH definition of clinical investigation as research which directly interacts with individual patients or clusters of patients in Phase I, II, or III clinical trials, pragmatic trials, or formative epidemiologic or behavioral research in preparation for clinical trials. The goals of the proposed training program are: 1.To increase the number of clinical investigators at MITU and thereby increase institutional capacity for HIV clinical investigation 2. Establish Weill Bugando/MITU as a sustainable training center for HIV clinical investigation. The ultimate goal is to prevent new HIV infections, provide effective HIV care, and improve HIV outcomes in Tanzania and East Africa. We will provide long-term training to fifteen outstanding clinician scientists to conduct patient-oriented HIV clinical investigation. We will primarily train physicians but will also train exceptional other clinicians (PharmD, DMD). We will train 10 PhDs, and 5 MS degree candidates. Tanzanian trainees will benefit from participation in 17 active research projects in five synergistic areas of HIV investigation including HIV prevention and vaccine research, implementation of HIV testing and treatment, women’s health, HIV related co-infections, and HIV and cardiovascular disease. We will also strengthen the PhD program in clinical investigation at Weill Bugando by introducing 4 new graduate courses in clinical investigation. Weill Cornell is committing institutional funds so that 4 of the best PhD graduates can have 2-year post-doctoral appointments as MITU research scientists after their Fogarty training. At the end of the 5-year training program, MITU will have a cadre of clinical investigators and a greater depth and breadth of externally funded HIV patient-oriented research. MITU/Weill Bugando will be a training hub for HIV clinical investigators in East Africa.

PROJECT NARRATIVE The objective of this training program is to increase the number of Tanzania physician scientists with rigorous training in patient-oriented HIV clinical investigation. Mwanza Intervention Trials Unit (MITU) and Weill Bugando will establish courses in clinical investigation, advanced biostatistics, and epidemiology to be offered in Mwanza and 15 long-term trainees will conduct mentored research in one of the following HIV research priority areas: HIV prevention and vaccine research, implementation of HIV testing and treatment, women’s health, and management of HIV related opportunistic infections and cardiovascular disease. The goal is to establish MITU/Weill Bugando as a training hub for HIV clinical investigation in East Africa.