In this edition:

Greetings from Jack DeHovitz:

reflections and updates from a year of challenge

Greetings to NYS-ITRP alumni and faculty-

It’s been a while since we have last communicated, and I wanted to bring you up to date on a number of events that have impacted our program.

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Recent students

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Aizhan Kyzayeva, Kazakhstan

Pictured (left to right):

John Justino, MS, Director of the Center for Global Health, School of Public Health, UA SUNY;

Harvey Charles, PhD, Dean for International Education and Vice Provost for Global Strategy, UA SUNY; Olzhas Abishev, MD, Deputy Minister of Healthcare of the Republic of Kazakhstan;

Jack DeHovitz, MD, MPH, Professor, SUNY Downstate Medical University

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Maria Shvab, Ukraine

 
 
 

Update on new program in Georgia

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Strategic Training Partnership to End AIDS in Georgia – Project Launch

By Tamar Zurashvili

In June 2020, Partnership for Research and Action for Health (PRAH) initiated implementation of the new grant project “Strategic Training Partnership to End AIDS in Georgia” supported by NIH/Fogarty International Center (FIC).  The aim of the project is to address the HIV care continuum gaps through training the next generation of Georgian scientists in public health and implementation science.

The 5-year project plan includes three main components:

(1)   Long-term training: 10 Tbilisi State University (TSU) doctoral students will be trained for eight months in the US, four months completing selected public health coursework at University at Albany School of Public Health (UAlbany SPH) and four months in a practice-based internship at New York State Department of Health AIDS Institute (NYSDOH-AI).  All 10 doctoral students will be trained and mentored at the public health doctoral program at TSU. In turn TSU will be strengthened by improving the existing core public health courses as well as adding a new implementation science course developed within the framework of the proposed grant project

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Ivane Javakhishvili Tbilisi State University (TSU) represented by rector George Sharvashidze and Partnership for Research and Action for Health (PRAH) represented by director Mamuka Djibuti signed a Memorandum of Understanding (MOU) on Thursday, March 4, 2021.

(2)   Short-term training: 30 post-doctoral students/researchers and faculty will receive implementation research training conducted jointly by US and TSU faculty and NGO partners, featuring hands-on learning and case examples using Georgian HIV/AIDS policies and data.

(3)   Build institutional capacity of TSU doctoral program to deliver implementation science training.  

We faced some challenges due to the COVID pandemic. However, we have adapted our activities and carried them out in compliance with the COVID safety norms. All workshops and meetings with the participation of US partners were shifted to an online mode due to travel restrictions.

Some of our accomplishments/milestones during the first year of project implementation include:  

  • Convened the project launch conference: the meeting went online and was attended by representatives of the international, governmental and non-governmental sectors working in the field of HIV/AIDS, TB and Hepatitis. The meeting underlined the importance of the project for the successful implementation of the National HIV/AIDS Response measures in Georgia, as well as for continuing/strengthening international collaboration.

  • Conducted two workshops with the participation of US and Georgian partners.

  • Initiated adapting the core doctoral courses with the technical assistance of SUNY-DHSU and UAlbany faculty members.

  • Announced the admission of the first cohort long-term trainees.  

  • Signed the Memorandum of Understanding (MoU) with TSU:

    • On March 4, 2021 TSU rector Mr. George Sharvashidze and PRAH director, Dr. Mamuka Djibuti signed a Memorandum of Understanding (MOU) to facilitate cooperation between the parties in the frames of the project with the aim to support and further develop students and faculty members, as well as scientific and educational processes at TSU. Dr. Jack DeHovitz, Distinguished Service Professor, Director of HIV Center for Women and Children, SUNY Downstate Medical Center remotely participated in the event.

Jack DeHovitz says of the project launch, “We’re excited to be working again with our colleagues in Georgia.   It shows the strength of our accomplishments and 20 year investment in Georgian resources  that this new program is led by NYS-ITRP’s first in-country Principle Investigator, Mamuka Djibuti.” 

In addition to training individual investigators, we are working with our partners to produce a public health certificate program that meets the demands of current national health reform goals in Ukraine. 

 

Kazakhstan Program renewal

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SUNY Global Health Training Program Battles HIV in Kazakhstan; Renewed NIH Funding will Expand Central Asian Country’s Education and Research Capacity

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Students in Kazakh Medical University’s main auditorium

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Our partner, Kazakh National Medical University.

The New York State International Training and Research Program (NYS-ITRP), directed by SUNY Downstate Distinguished Service Professor and Principal Investigator Jack DeHovitz, MD, MPH, has received a five-year $1.5 renewal award from the federal National Institutes of Health that will allow NYS-ITRP to expand research partnerships and training opportunities in Kazakhstan, the largest country in Central Asia. Despite gains in HIV prevention and treatment programs, Kazakhstan continues to experience higher rates of new HIV infection.

Founded in 1994, NYS-ITRP is a multi-institutional, multi-national effort focused on implementing HIV research training programs in countries that once comprised the former Soviet Union. Cooperatively administered by SUNY Downstate Health Sciences University, the University at Albany School of Public Health, and the New York State Department of Health, it is the only HIV research training initiative in Eastern Europe and Central Asia supported by the National Institutes of Health Fogarty International Center. In the years since its launch, NYS-ITRP has sponsored programs in eleven countries, with programs currently active in Kazakhstan and Ukraine. The combined annual grant funding for both programs is roughly $600,000.

This past June, the United Nations General Assembly High-Level Meeting on AIDS reaffirmed its target of ending the AIDS epidemic by 2030, and in support of this goal called on all countries to ensure that 95% of people living with HIV know their status; that 95% of people who know their status be on HIV treatment; and that 95% of people on HIV treatment be virally suppressed by 2025.

“In light of these targets, there is an urgent need help under-resourced countries develop strong HIV/AIDS public health infrastructures,” says Dr. DeHovitz. “To be most effective, health professionals and scientists who know the unique factors contributing to the epidemic in their countries need to be involved in the building effort. This is what we’re doing in Kazakhstan.”

Kazakhstan has experienced some of the most deleterious effects of the HIV epidemic. The country’s location along the historic Silk Road caravan trading route has increased its vulnerability to drug trafficking, which in turn has had serious health impacts. Increased drug use and unsafe injection practices have contributed to rising rates of HIV and other sexually transmitted infections. Access to antiretroviral therapy remains low and institutional barriers impede access to care by substance users.

Since the start of NYS-ITRP’s program in Kazakhstan five years ago, a dozen Kazakh students have been trained in public health. The new grant will allow NYS-ITRP to continue to build capacity at the Kazakh National Medical University (KazNMU) School of Public Health and to add new partners, including the National Research and Clinical Center of Mental Health (which oversees substance use services) and the Kazakh Research Center of Dermatology and Infectious Disease (which governs HIV-related treatment and policy). It will also fund public health training to the Ministry of Health workforce.  This new grant uses a Multiple Principle Investigator format that includes  Zhamilya Nugmanova MD, Professor and Chair, Division of HIV Infection and Infection Control, at KazNMU’s School of Public Health.  

 

The COVID-19 pandemic had a dramatic impact on the NYS-ITRP training program. Kazakh students who normally would have travelled to the United States for in-person training transitioned to distance-learning platforms in the Spring and Fall 2020 semesters, while three trainees who completed their certificate programs in epidemiology in Albany in May 2020 faced multiple barriers in arranging transport back to Kazakhstan, which had imposed restrictions on incoming flights.

“Despite COVID-related challenges, NYS-ITRP trainees have remained productive,” says David Odegaard, MPH, Director, Training and Education, STAR Program. One trainee completed his online MPH degree in December, while another will complete her thesis, related to the intersection of HIV and COVID-19, over the summer.

Trainees also actively participated in research and public health promotional activities related to COVID-19. Program graduate Dr. Gaukhar Mergenova, for example, applied for and received a COVID-related research grant funded by the Kazakh government.

In person teaching at the Albany campus will resume in August 2021, with four students, two Kazakhs and one Ukrainian, starting classes.

To date, the overall results of the program have been impressive. In the previous five years, alumni of the program have published more than 50 articles in peer-reviewed research journals.  In the past year, Dr. Mergenova was named head of the Department of Epidemiology at the KazNMU School of Public Health, while four other students now serve as faculty members. Through trainees’ collaboration with the faculty at University at Albany School of Public Health new courses in epidemiology and biostatistics were launched that have become required coursework for not only public health students, but medical students as well.

Dr. DeHovitz says, “I look forward to continued collaboration with NYS-ITRP faculty and staff at SUNY Downstate, University of Albany’s School of Public Health, and the Kazakh National Medical University. Our extensive work with the University at Albany in Eastern Europe and Central Asia has become a model for innovative approaches to HIV research training in the former Soviet Union.”

 

Kazakhstan faculty promote COVID prevention

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In May 2021 some of our former trainees and current faculty at the Asfendiyarova Kazakh National Medical University (KNMU) helped contribute to a public service announcement to promote vaccination for COVID-19.  Former trainees include: Gaukhar Mergenova, Akbota Tolegenova, Asel Bukharbayeva. Balnur Iskakova.  Also one of our key collaborators and colleagues, the Rector of KNMU, Talgat Nurgozhin, MD, PhD, contributes the final message.

 

Ukraine Program: new Health Administration Certificate Program

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Ukraine Health Administration Certificate Program Training Program

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New York State International Research and Training Program (NYS-ITRP) partnered closely with the Center for Global Health at Albany School of Public Health to develop and deliver a Health Administration Certificate Program (HACP) for hospital managers from across Ukraine in 2019.  This program, funded by USAID through Deloitte Consulting Overseas, was aimed at training a new generation of health administrators in the context of the many health reform efforts currently taking place in Ukraine.   Our faculty also included colleagues from the SUNY Center for International Development and the Cluj School of Public Health in Romania.   Our in-country Ukrainian partner institution was the Lviv Business Scholl (LvBS) at the Ukrainian Catholic University.  Topics included healthcare financing, healthcare reform, organizational models, human resource management and leadership skills.  The first four training program modules were developed and delivered in Lviv, Ukraine as planned in February and March 2020.  The 125 hour certificate program was delivered to 25 hospital administrators from all regions of Ukraine. 

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And then, once again, COVID-19 changed all the plans!  Due pandemic travel restrictions, the delivery of the final two modules was transferred from SUNY faculty to the Lviv Business School faculty members.   SUNY faculty worked with their counterparts to ensure they were prepared to deliver the training module materials on their own.  The Lviv Business School faculty via remote instruction completed the training in June 2020.

One of the key aspirations of this project was to ensure that the certificate program is transferred to a platform that provides for continuity of training in the post-funding environment.  Based on the LvBS faculty’s experiences and the trainees’ intense interest in Health Administration Certificate Course, Ukrainian Catholic University adapted the certificate material into a concentration within the Masters degrees of Lviv Business School and the School of Public Management.   This jointly-administered and accredited Healthcare Administration concentration, drawing on the expertise of both faculty groups launched in Fall 2020. The concentration is designed to provide foundational training for the next generation of hospital and healthcare institution administrators in the flourishing healthcare reform movement in Ukraine.    We particularly want to acknowledge the work of John Justino, MS, Director of the Center for Global Health, for his coordination of this project and his wide-reaching connections to recruit the best possible faculty for this exciting project.    Also we’re grateful to Ihor Zastavnyi, MD, Head of Medical Management Programs at Lviv Business School; his boundless enthusiasm and expertise helped us meet the challenges of the COVID-19 disruptions, ensuring a successful continuity of the program.

 

The Center for Collaborative HIV Research in Practice and Policy (CCHRPP)

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Guthrie (Gus) Birkhead, MD, MPH, Professor Emeritus;

Epidemiology & Biostatistics, Albany SPH, CCHRPP Director

In 2019 SUNY Albany School of Public Health faculty with HIV expertise partnered with the director and scientific staff of the NYSDOH AIDS Institute to formalize their shared commitment to HIV prevention and treatment as the Center for Collaborative HIV Research in Practice and Policy (CCHRPP). The Center, directed by Dr. Guthrie Birkhead aims to reset how HIV and the related epidemics of HCV, STI and substance use are approached. Dr. Birkhead, Emeritus Professor in the Department of Epidemiology and Biostatistics at the School of Public Health, also served as the Director of the NYSDOH AIDS Institute and subsequently the Deputy Commissioner and Director of the Office of Public Health.  Jack DeHovitz MD MPH, NYS-ITRP Director, serves on the CCHRPP steering committee. This is collaborative effort includes the New York State Department of Health AIDS Institute, SUNY Albany’s Rockefeller College, and SUNY Downstate Health Sciences University, to combine significant policy, programmatic, clinical and epidemiologic expertise.

The Center’s work will encompass research that translates into policies, programs and practices; formal academic programs and internships that prepare students for careers in public health; and continuing education for professionals. It has also established thought leadership to see the completion of the aggressive end-the-epidemic initiatives for HIV and HCV currently underway in New York.  

CCHRPP’s mission is “to expand health department and academic collaborations to address the public health and social justice challenges in persons at risk for or living with HIV infection and related diseases such as hepatitis C and sexually transmitted infections. The populations affected by these diseases share common underlying risk factors such as substance use, mental illness, and suffer from discrimination and social inequities based on factors such as race, ethnicity, gender, and sexual orientation.” Through CCHRPP initiatives, NYS-ITRP students may have expanded opportunities for their trainee internships, curricula development in their home institutions, and research collaborations.

See CCHRRP’s affiliated faculty members at https://www.albany.edu/cchrpp/researchers.   Many of the affiliated faculty recently collaborated with NYSDOH AIDS Institute staff to help create a research agenda, which, when finalized may be used to direct small research grants to appropriate researchers.  

One immediate benefit of CCHRPP for NYS-ITRP students and alumni is CCHRPP’s monthly contribution to the HIV/ID Research Seminar Series.  The weekly Thursday Seminar, established by Infectious Diseases Division at SUNY Downstate Health Sciences University, was transferred to an on-line platform in response to COVID-19.   NYS-ITRP alumni and current students have access to this weekly series, which in the past few months has featured presentations such as the impact of COVID-19 on people with HIV and interaction between COVID-19, gonorrhea and syphilis rates.  To receive weekly Seminar announcements, contact David Odegaard at david.odegaard@downstate.edu