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Development of research capability in Ethiopia: the Ethio-Netherlands HIV/AIDS Research Project (ENARP), 1994-2002
Abstract
In 1992, HIV/AIDS researchers in Amsterdam were invited to work in partnership with researchers in Ethiopia to build an HIV/AIDS research infrastructure in Addis Ababa. This project, which began in 1994, was envisioned to contribute meaningfully to fighting the HIV pandemic in the decades to come. Its immediate objective was to establish an HIV research laboratory to serve international partnerships pursuing HIV vaccine research in Ethiopia and to support national health authorities fighting the HIV epidemic in Ethiopia. The overall goal was to develop research capacity at the Ethiopian Health and Nutrition Research Institute (EHNRI) by improving facilities, training technical and academic personnel at the Ph.D., M.Sc., and M.P.H. levels, establishing cohort studies to study HIV infection progression, and helping the government to implement a national HIV surveillance program.
During the period 1994-2002, the projected HIV/AIDS research laboratory was built and several existing sections of EHNRI were renovated and upgraded. An active HIV-research program also was established. Staff grew to more than 60, including three Ethiopian and three expatriate researcher/managers. Two Ph.D. students graduated in immunology and virology (University of Amsterdam, 2000), and five are currently in training. Several technical persons were trained, and over 19 M.Sc./M.P.H. programs were supported at Addis Ababa University (AAU). The first Ethiopian Ph.D. graduate became the national program manager for ENARP. Two ENARP cohort studies and several HIV-prevalence studies have helped document the severity of the HIV epidemic in Ethiopia, assisting national authorities in formulating national and regional policies to prevent HIV transmission.
Initial funding for ENARP from the Netherlands government was for eight years, to end by 2003. It was expected that management responsibilities would then be transferred from expatriate to Ethiopian staff and all ENARP activities integrated into EHNRI.
Researchers into HIV/AIDS face a gamut of ethical as well as scientific challenges. By viewing the gathering of data as a reciprocal activity between researchers, participants, and their communities, the expert contributors to Case Studies in Ethics and HIV Research bring these challenges to the fore. Studies from the United States and abroad depict the ongoing balance of risks and benefits while analyzing issues that range from confidentiality and informed consent to conducting studies with minority and other marginalized populations, from dealing with government and other funding agencies to ownership of findings. The book's 25 collaborators offer readers new templates for devising and conducting studies that are valid, meaningful, and morally sound, with critical implications for all research involving human subjects. © 2007 Springer Science + Business Media, LLC. All rights reserved.
The Horn of Africa is a vast, diverse, impoverished and troubled region of 125 million people beset by famine, floods, conflict and disease. For the purposes of this chapter, we will consider the Horn to include Somalia, Djibouti, Ethiopia, Eritrea and Sudan; while it is not strictly located in the Horn, Libya will also be mentioned. Ethiopia and Sudan are the largest and most populous of the nations in the region, and have felt the brunt of its HIV epidemic. Unfortunately, instability in most of the region has made conduct of research and surveillance on HIV/AIDS particularly difficult. Ethiopia, however, has been a center of HIV research, most notably by the Ethiopia-Netherlands AIDS Research Project (ENARP). It is this research by Ethiopian and international investigators that provides the source of much of our knowledge about the regional epidemic. This chapter offers an overview of the regional epidemiology and social and environmental factors that affect it, as well as a country-bycountry assessment of epidemiologic trends and efforts to combat the epidemic, with a particular emphasis on Ethiopia.
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