Dr. William Blattner, Associate Director of IHV and Principal Investigator for the PEPFAR collaboration
From West Baltimore to West Africa
This week, the U.S. Centers for Disease Control (CDC) Director, Dr. Tom Frieden, visited the Nigerian National TB and Leprosy Training Center (NTBLTC) to tour a multimillion dollar laboratory complex established by the Institute of Human Virology (IHV) of the University of Maryland School of Medicine in Baltimore, Maryland, and the Institute of Human Virology-Nigeria. This U.S.- Nigeria partnership was established in 2004 through funding from the CDC and the President’s Emergency Plan For AIDS Relief (PEPFAR).
The modular Biosafety Level Three (BSL-3) laboratory is the first of its kind on the African continent. Nigeria is ranked fourth in the world for TB and second for HIV -- a recipe for the multi-drug resistant form of tuberculosis (MDR-TB), an airborne disease that has emerged in South Africa. The level of MDR-TB is not known in West Africa because of the lack of suitable diagnostic facilities. The new laboratory provides a means of determining the prevalence of MDR-TB and a safe environment for detecting the more severe form of extremely drug resistant TB (XDRTB) that is untreatable but can only be detected in a laboratory of the type implemented in the CDC–IHV partnership with the government of Nigeria.
“HIV and TB have formed a formidable and dangerous alliance,” said Dr. William Blattner, Associate Director of IHV and Principal Investigator for the PEPFAR collaboration. “Our effort to eradicate these diseases must also be based on strong alliances demonstrated through partnerships with the government of Nigeria, and the CDC.”
During the tour the CDC Director, who was accompanied by the incoming CDC Director for Global Health, Dr. Kevin DeCock, and country Director, Dr. Nancy Knight, commended the partnership for providing elite laboratory training to Nigerian health care personnel from hospitals and Direct Observed Therapy (DOTs) clinics across the nation. With this new BSL-3 laboratory, Nigeria and neighboring countries can provide an accurate diagnosis of TB using simple, improved microscopy techniques. Further, a network has been established to report TB results –particularly the phenomena of MDR-TB – from various clinics across the nation and to send samples of TB tissue to the new, state-of-the-art BSL-3 laboratory, which has international clearance in its capacity to research such a deadly disease.
The laboratory is the brain child of Dr. Alash’le Abimiku, an Assistant Professor at IHV who works in partnership with Blattner and is originally from Nigeria. “This laboratory is very significant for Nigeria’s ability to monitor the spread of MDR-TB in the country for appropriate response especially with the planned roll out of second line TB drugs in the country,” she commented.
The BSL-3 laboratory adapted a new approach that involved the deployment of a high containment laboratory that was first built in the U.S. by Germfree, a US-based manufacturing company in Florida. The containerized laboratory has pre-filters to withstand the harsh dry and dusty winds in Zaria during the ‘Harmattan’ (the severe sub-Saharan dust storms) while providing a negatively pressured laboratory for the safe handling of MDR-TB cultures and other highly infectious agents. This will enable the Nigerian government to provide an immediate local response thus containing an emerging threat before it spreads to other parts of the country, and like that of HIV/AIDS, around the world.
Prior to touring the facility, Dr. Frieden led a roundtable discussion where he advocated strengthening of the public health response through establishing and maintaining surveillance and building epidemiological and laboratory capacity. He stressed the importance of taking practical measures to keep TB at bay by ensuring that there is an effective HIV prevention program; that there is a high quality treatment program for AIDS patients; that care providers work with the community to establish ways to keep patients adherent to their treatment and in care for both HIV and TB; and that the country has an effective TB control and surveillance program. Dr. Patrick Dakum, the IHV-Nigeria chief of Party, moderated the round table.
The Institute of Human Virology, Nigeria (IHVN) was established in 2004 to address the HIV/AIDS crisis in Nigeria through the development of infrastructure for treatment, care, prevention, and support to people living with and those affected by HIV/AIDS.
As a model local partner organization, it is also structured to maintain linkages with IHV-Baltimore and the University of Maryland School of Medicine to promote capacity development and collaboration within the health sector in Nigeria. IHVN also conducts research and training in research methodologies and ethics intended to enhance the capacity of Nigeria to effectively mitigate HIV/AIDS and other diseases.