Dr. Shah is a physician-scientist with 15 years of experience leading patient-oriented research (POR) on diagnosis, treatment, and prevention of tuberculosis (TB) globally, including drug-resistant TB and TB/HIV co- infection. Her experience with U.S. and international public health programs, including the Centers for Disease Control & Prevention (CDC) where she trained and worked for a decade, provides a strong foundation for integrating research into policy and patient care. This K24 award will allow her to enhance and expand her successful mentorship in POR by providing vital protected time for training in advanced methods for studying TB transmission, and developing a structured mentoring program. Worldwide, TB is the leading cause of death among people living with HIV, with drug-resistant TB threatening decades of progress in TB and HIV control. Drug-resistant TB epidemics are driven primarily by person-to-person transmission of resistant strains, and innovative approaches to improve our understanding of TB transmission are urgently needed to guide effective interventions. Similarly, there is a need to train the next generation of scientists in multidisciplinary TB/HIV and global health POR. Dr. Shah’s robust research program supported by NIH, Gates Foundation, and CDC provides exciting training opportunities that attract trainees interested in multidisciplinary TB & HIV POR. She has a strong track record of mentorship of U.S. and international trainees in diverse areas of TB & HIV clinical research, and many of her mentees have pursued academic careers and K awards. In addition, through her role as Director of the Clinical Core for the NIH P30 Emory/Georgia TB Research Advancement Center and mentor on D43 and T32 programs, she is well placed to provide outstanding research and training opportunities. Biospecimens, clinical, and epidemiologic data from Dr. Shah’s ongoing NIH R01-funded CONTEXT study provide new opportunities for insights into TB transmission, including the impact of the COVID-19 pandemic on social contact patterns that are a key factor in disease spread. The CONTEXT study will serve as the parent study for the new research proposed in this K24 that will: 1) characterize Mtb genomic relatedness using long-read sequencing and evaluate the impact on transmission networks; and 2) characterize changes in social contact patterns during the COVID-19 pandemic and estimate the impact on TB incidence. Each aim is designed to integrate mentees who have experience and interest in growing their careers in these emerging areas of TB transmission science. Dr. Shah’s research and mentoring program is facilitated by her long-standing, cross-disciplinary collaborations with leading experts in mycobacterial genomics, pharmacology, immunology, clinical trials, and mathematical modeling. In addition, the outstanding training resources, funding opportunities, and research infrastructure at Emory will be integrated into Dr. Shah’s mentoring program to create an environment that enables the success of her trainees to pursue independent, impactful careers in TB, HIV, and global health POR.

PROJECT NARRATIVE Tuberculosis (TB) is the leading cause of death among people with HIV, with drug-resistant TB threatening decades of progress in TB and HIV control. Dr. Sarita Shah is a physician-scientist at Emory University whose research spans clinical, translational, and public health studies to reduce the burden of TB & HIV globally. This K24 award builds on her long-standing commitment to mentorship in patient-oriented TB & HIV research and will provide vital protected time to 1) expand her mentoring program for physicians and scientists who are pursuing these fields, and 2) enhance her knowledge of epidemiologic and genomic methods to aid in the understanding of drug-resistant TB transmission and prevention.