Training Sites:
The goal of the ICID Training Program was to expose trainees to the issues and challenges of international infectious disease research. While highly successful in that objective, it provided only a few trainees with an opportunity to actually experience international research. This renewal application proposes to establish training sites at each of the UM’s major international research centres (Winnipeg, Canada; Nairobi, Kenya; Bangalore, India; and Medellin, Colombia). At these sites, the trainees will be able to perform their major research projects, select a research practicum and take the major course offerings. While well established sites (Winnipeg, Nairobi and Bangalore) will be offering courses, newer sites (like Medellin) will be taking trainees into the program but not expected to offer a Major Course until the final three years of the program. This will not overburden the newer sites and yet still allow them to participate and grow. The other sites are already fully functional. The Centre for Global Public Health has existing collaborations in China. The Training Program will consider expanding to include a training site in China once the scientific and programmatic collaborations have had some time to become established. China has huge needs and huge potential, and could be a very important training site in the future but that is for future consideration.

University of Manitoba/University of Nairobi collaboration:
The University of Manitoba has been collaborating with the University of Nairobi since 1980 in the field of sexually transmitted infections (STI). This collaboration’s strength is the quality of its cohorts and its laboratory capacity. In 1985 they jointly established the Pumwani Sex Worker Cohort. This is an open cohort and over 2800 women have been enrolled since that time. It was from this cohort that result results emerged describing the first heterosexual transmission of HIV in Africa, STIs as HIV transmission co-factors, rapid HIV progression in sex workers, and women who although exposed to HIV were not infected(11-13). A second cohort, the Mother to Child HIV Transmission cohort, led to some of the first reports on mother to child HIV transmission, the role of breast milk in transmission and the differential susceptibility to vertical HIV-1 infection and its link to MHC alleles and mother-child MHC discordance(14-16). The third cohort is the Kisumu Circumcision Cohort which has been seminal in clearly establishing the protective role male circumcision plays in preventing HIV infection(17). Continuing the UM’s tradition of technology transfer and capacity building at the University of Nairobi, the Canadian Foundation for Innovation has funded a $3.7 million dollar (CDN) to expand laboratory facilities at our University of Nairobi site. The expanded facility is a state-of-the-art laboratory hat has significantly expanded our capacity, allowing for more sophisticated analyses on fresh specimens. The project includes a BSL 3 labs, immunology, genetics and flow cytometry labs. The clinics and labs are operated by 40 Kenyan clinicians, nurses, lab techs, IT techs, and administrators. Human capacity development is also a priority and the UM/UN have established the University of Nairobi/University of Manitoba Basic Medical Sciences Training Program. In this model senior UM trainees (such as those involved in the IID&GH) who are working in Nairobi are partnered with a Masters of Science trainee at the UN. UN students are given a project and a jointly supervised by UN/UM faculty. These cohort, laboratories and training opportunities allow trainees of the Training Program to perform cutting-edge research in the heart of the HIV epidemic. Through this collaboration trainees have access to a research program with a multi-year budget of over $19M (see letter from Dr. Ball and budget justification). This model of collaboration was held up in a Science article, as a model for North-South collaboration(18). As further evidence of the impact of the collaboration, several members of the collaboration - Kenyan and Canadian - were profiled in a special issue of Science on AIDS in Africa(19).

U. of Manitoba/Karnataka Health Promotion Trust/St. John’s National Academy of Health Sciences collaboration:
The UM/St. John’s collaboration was first formalized in a Memorandum of Understanding (MOU) in 2003. Major collaborative projects have included: establishing a state-wide Regional Resource and Training Centre System for training STI care providers and supervising STI care services; conductin integrated behavioural and biological assessments involving female sex workers and their clients, and men who have sex with men; various capacity building activities for HIV/AIDS-related care and support; and a variety of research studies, including an STI etiology study, mathematical modeling studies of HIV transmission dynamics, and a phase III female microbicide clinical trial (for details see letter from Dr. Anura Kurpad).

Training Program leaders Drs. Moses and Blanchard have also led the development of the Karnataka Health Promotion Trust (KHPT), which operates in collaboration with St. John's and the University of Manitoba, but is an independent entity. KHPT currently manages over $65M in multi-year contracts and grants in HIV prevention, care and support, and these projects are is funded by a variety of donors, including the Bill & Melinda Gates Foundation, USAID and the Indian National AIDS Control Organisation (for details see letter from Ms Bhattacharjee).

Together, these organizations provide HIV prevention, care and support services involving a catchment population of over 30 million in the states of Karnataka, Maharashtra and Andhra Pradesh. Trainees of the IID&GH training program will have the opportunity to undertake courses, practica, learning visits and research with one of the most active HIV/AIDS prevention and care programs that Canadians are involved with anywhere in the world.

University of Manitoba/University of Antioquia collaboration:
The collaboration is focused on the University of Antioquia (UDEA) in Medellin, Colombia and the University of Manitoba (UM) in Winnipeg, Canada. Researchers from several departments within the Faculties of Medicine (UM) and Human Ecology (UM) and the Faculty of Public Health (UDEA) are working on developing a series of collaborative projects between the two countries, with a common theme of HIV/STI research, surveillance and prevention. This collaboration has now been active for two years and has achieved several milestones:
1. UM and UDEA researchers successfully collaborated to obtain travel funds from UM. A team of UM investigators (John Wylie, Javier Mignone, Carole Beaudoin) traveled to Medellin, Colombia for one week (March 2008) to meet with local university, government and NGO representatives. Workshops were given to UDEA staff and students on social epidemiology research methods.
2. One UDEA researcher (Carlos Rojas) obtained training funds and traveled to Winnipeg, Manitoba for three weeks to obtain practical experience in molecular laboratory methods (in John Wylie’s laboratory) and to meet with Canadian university, government, and NGO representatives.
3. UM and UDEA researchers (those identified above plus additional UM/UDEA academic staff) collaborated on a Canadian International Development Agency call for proposals. This CIDA development grant is meant as a human resources capacity grant and involves travel of a team of Canadian and Colombian researchers and NGO representatives to India to view firsthand the programs that have been jointly developed by UM and Indian NGOs to address HIV in that country. The intention is to build human resource capacity in Colombia for the development and implementation of “made in Colombia” solutions to HIV, based on firsthand experience of successful HIV control programs in other regions.
4. UM and UDEA researchers (Wylie and Rojas) have submitted a proposal for a CIHR catalyst grant in the area of population and public health. The focus of the proposal is on HIV point-of-care testing in field-based settings for vulnerable populations (commercial sex workers in Medellin and aboriginal populations in rural areas of Colombia) and the development of educational material for urban street-involved youth in Medellin.
5. As described in this proposal, Colombia is now being included as a fourth training site for IID&GH. As a new partner, the intention is to develop this country as the Latin American training site in the disease training network.