Clinical trial and interventional research networks offer the promise that a coordinated research effort targeting critical national health problems can be mounted in such a way as to have a high likelihood of affecting health policy, health care delivery, and patient outcomes. This promise is best realized by a network that facilitates informal networking and promotes formal collaborations among basic and translational scientists and clinical researchers. Our approach in this proposed ACT for TB/HIV collaboration reflects this general strategy of creating public health benefit by accelerating translational research through a trials network. We hope to see impact from this collaboration on the following:
- National reduction in TB incidence in HIV+ persons through implementation of periodic 3HP
- Shortening of DS-TB treatment to 4 months and prevention of TB-related lung disability by the addition of TB HDT to TB antimicrobial chemotherapy
- National improvement in treatment success rates using a 6 month DS-TB treatment that includes once weekly, fully supervised high dose MP in the continuation phase in HIV+TB
- Improved outcomes in DR-TB through early detection of emerging heteroresistance
- Improved outcomes in highly DR-TB through use of adjunctive imatinib HDT
- Initiation of research to develop aT cell-based vaccine to prevent Mtb infection
- We cannot predict the extent to which this effort will be successful. However, we will bring to bear our extensive combined expertise in clinical trials to maximize chances for success. We believe that the TB and HIV scientists, researchers, and clinical sites forming the ACT for TB/HIV collaboration are without equal in South Africa or globally, and that no one is more likely to achieve these important goals than we are.