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在低收入和中等收入国家推进艾滋病治愈研究需要增强下一代科学家的能力。

Advancing HIV cure research in low- and middle-income countries requires empowerment of the next generation of scientists.

作者信息

Tatoud Roger, Jones R Brad, Dong Krista, Ndung'u Thumbi, Deeks Steven, Tiemessen Caroline T

机构信息

Origena Consulting, Ferney Voltaire, France.

Weill Cornell Medicine Graduate School of Medical Sciences, New York, USA.

出版信息

J Virus Erad. 2024 Mar 6;10(1):100364. doi: 10.1016/j.jve.2024.100364. eCollection 2024 Mar.

Abstract

While low- and middle-income countries (LMICs), especially in Southern and Eastern Africa, bear the largest burden of the HIV globally, investigators working on the front lines in these regions are leading a limited number of research efforts, particularly related to HIV cure. Conducting HIV cure research in high-burden HIV LIMCs provides an unparalleled opportunity to formulate innovative research strategies, design trials tailored to the local context, evaluate clinical outcomes within key and vulnerable populations, meaningful involvement of stakeholders, and to shape policies in areas where HIV prevention and cure interventions can yield the most significant impact. Further, the high prevalence of infection, with varied HIV strains affecting large diverse populations, creates a unique environment for studies that would not be feasible in any other part of the world. This underscores the critical importance of addressing obstacles to unlock the full potential of research efforts in these regions. In this viewpoint, we identify significant challenges facing early career investigators in LMICs, particularly in Africa, that hinder their full engagement in HIV cure research. Drawing examples from the International AIDS Society's Research-for-Cure Academy, we provide practical recommendations to overcome barriers that include limited access to funding, effective mentors, educational and career development opportunities, coupled with inadequate investment in infrastructure that contribute towards the limited number of investigators from high-burden HIV LIMCs who are spearheading cutting-edge cure research. Addressing these challenges is crucial to empower investigators who possess unique insights and expertise, and who are well positioned to lead HIV cure-related research efforts. We acknowledge and welcome initiatives that promote capacity building and knowledge exchange between early-career investigators in LMICs and their peers and scientific leaders from high-income countries (HICs). Prioritizing investment in global collaboration and partnership will play a pivotal role in empowering the next generation of African scientists and clinicians. To expedite advancements of cure-related strategies that will be effective in high-burden HIV LMICs, we endorse the sustainable expansion of these pivotal initiatives in these regions, to enhance their effectiveness and hasten progress in the pursuit of a global HIV cure.

摘要

虽然低收入和中等收入国家(LMICs),尤其是撒哈拉以南非洲地区和东非地区,承担着全球最大的艾滋病毒负担,但在这些地区一线工作的研究人员所开展的研究工作数量有限,特别是在艾滋病毒治愈方面。在艾滋病毒负担沉重的低收入和中等收入国家开展艾滋病毒治愈研究,为制定创新研究策略、设计适合当地情况的试验、评估关键和弱势群体的临床结果、让利益相关者切实参与以及在艾滋病毒预防和治愈干预措施可能产生最大影响的领域制定政策,提供了无与伦比的机会。此外,高感染率以及影响大量不同人群的多种艾滋病毒毒株,为研究创造了一个独特的环境,而这在世界其他任何地方都是不可行的。这凸显了解决障碍以释放这些地区研究工作全部潜力的至关重要性。在本观点文章中,我们确定了低收入和中等收入国家,尤其是非洲的早期职业研究人员在艾滋病毒治愈研究中充分参与面临的重大挑战。我们从国际艾滋病学会的治愈研究学院选取实例,提供切实可行的建议以克服障碍,这些障碍包括资金获取有限、缺乏有效的导师、教育和职业发展机会,以及对基础设施的投资不足,这些因素导致来自艾滋病毒负担沉重的低收入和中等收入国家、率先开展前沿治愈研究的研究人员数量有限。应对这些挑战对于赋能拥有独特见解和专业知识、且有能力引领艾滋病毒治愈相关研究工作的研究人员至关重要。我们认可并欢迎促进低收入和中等收入国家早期职业研究人员与高收入国家(HICs)的同行及科学领袖之间能力建设和知识交流的举措。优先投资全球合作与伙伴关系将在赋能下一代非洲科学家和临床医生方面发挥关键作用。为加快在艾滋病毒负担沉重的低收入和中等收入国家有效的治愈相关策略的进展,我们支持在这些地区可持续地扩大这些关键举措,以提高其有效性并加速在全球范围内实现艾滋病毒治愈的进程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e006/10979089/37e68122e87c/gr1.jpg

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