DESCRIPTION (provided by applicant): Tuberculosis is the leading cause of death among persons with HIV infection in Tanzania. Clinical and operational research to improve prevention and treatment of both adult and pediatric HIV-TB is a defined national priority but there is no specifically designated and staffed institute to plan, coordinate and conduct such research. The objective of the Dartmouth-Boston University (DBU) application is to provide the training to develop a premier HIV-TB clinical and operational research institute: MUHAS leadership, the Tanzanian National Tuberculosis and Leprosy Program (NTLP) and former Fogarty trainees have all contributed to planning the new institute. The program will consolidate the expertise of past Fogarty trainees with a new focused plan to train the requisite professionals to fully staff TRIM-TB. The institute will be based a new office complex at MUHAS with additional staffing located at the NTLP. An initial faculty core at MUHAS (Director, Associate Director) will be augmented by the addition of trainees who will complete the following degrees determined to be necessary for providing the necessary research expertise for the institute: 3 MPH degrees at Dartmouth, 3 MPH degrees at MUHAS, 1 master's degree at BU (pharmacology) and 2 doctoral degrees at BU (epidemiology, public health). Additional short and medium term training in ethics, good clinical practice and HIV-TB research methods will be provided for investigators. Advanced TB microbiology and TB immunology training will be provided for research microbiologists who will staff the TRIM-TB core laboratory. Pilot grant funding will be available for HIV-TB research projects and investigators will coordinate efforts thru monthly research seminars at MUHAS linked by teleconference to Dartmouth and BU. Defined performance measures focused on development of independent HIV-TB research capacity have been developed and will be monitored. An extensive candidate pool will be recruited from health science students at MUHAS, prior DBU AITRP trainees, Fogarty alumni, public presentations and focused advertising. Performance sites for research will include adult and pediatric DarDar Programs, NTLP clinical sites, and the Fogarty African Consortium on Tuberculosis (FACT, developed by the DBU AITRP). Faculty for the program have extensive experience in HIV-TB research, actively funded research projects, and wide experience training and mentoring junior colleagues. An expert Training Advisory Committee will oversee the program. After 5 years TRIM-TB will have set HIV-TB research priorities for Tanzania and have secured independent funding for research on these priorities.

PUBLIC HEALTH RELEVANCE: Tuberculosis (TB) is the leading cause of death from HIV in Tanzania. Public health and medical school leaders have determined that capacity is needed to conduct clinical trials and operational research on ways to reduce illness and death from HIV-TB. The present proposal from Dartmouth and Boston University would provide the necessary professional training to create a new TB-HIV research institute at the main medical school (MUHAS). The TB Research Institute at MUHAS (TRIM-TB) will allow Tanzanian researchers to address the important issues to improve outcomes for HIV-TB.