HHMI and the University of KwaZulu-Natal

In 2007, Bruce Walker was five years into his first term as an HHMI Investigator and was growing increasingly involved in collaborative HIV research in Durban, South Africa, which had among the highest levels of HIV transmission in the world. When an outbreak of treatment-resistant tuberculosis occurred in a community outside the city, Walker met with HHMI Investigator William R. Jacobs, Jr., who was studying tuberculosis in the country. After recognizing the heightened risk of HIV and tuberculosis co-infection to this community and the relative lack of healthcare infrastructure in the region, Walker and Jacobs made an unusual ask to the HHMI Board of Trustees: Would the Institute fund a facility that could revolutionize AIDS research and treatment in an area where tuberculosis and HIV still raged, and where social stigma remained an enormous barrier to care? Their pitch was successful, and in 2008, HHMI initiated a 10-year funding commitment to create the KwaZulu-Natal Research Institute for Tuberculosis and HIV (K-RITH) in partnership with the University of KwaZulu-Natal. When the state-of-the-art research and treatment hub opened in 2012, 5.7 million South Africans were infected with HIV, more than in any other country. Approximately 17 percent of adults were infected, a rate that ran as high as 50 percent for women aged 25. A Local Approach Dennis McKearin joined HHMI as a Scientific Officer in 2008, and soon K-RITH became his primary focus. After traveling back and forth to oversee its development, McKearin moved to Durban full-time in 2013, where he became the facility’s acting director. “It’s an international project, which isn’t typical for HHMI,” McKearin said. “But the Board saw the need to put a very strong footprint of basic science in the midst of these epidemics. That’s different from the typical model, which is to collect samples there locally and bring them back to Western labs for analysis. At K-RITH, we actually have the people in Durban there involved in solving these problems with the kind of equipment and resources they could have in a more highly developed setting.” McKearin’s leadership lasted three years, during which K-RITH partnered with the Africa Centre for Population Health to become the Africa Health Research Institute (AHRI), an interdisciplinary institute to fight tuberculosis, HIV, and related diseases. AHRI is also supported by the Wellcome Trust, with academic partnership from University College London and the University of KwaZulu-Natal. HHMI extended its financial commitment to the K-RITH project for an additional five years, ending in 2023. But McKearin says the investment paid off in big ways and small. “We put those state-of-the-art resources in a place where there were co-epidemics so we could apply those resources to future pandemics and pathogens,” he explains. “And as it happens, the next pandemic that hit South Africa was COVID.” “Several scientists in the K-RITH building were the first to discover and describe the Omega SARS-CoV-2 variant, which had considerable capacity to evade our immune responses," he says. "Those K-RITH scientists and their colleagues made those discoveries because they had those resources onsite.” He also says that the nature of HHMI’s K-RITH collaboration – a special project spearheaded by Walker and Jacobs – was a steppingstone to HHMI’s Emerging Pathogens Initiative. “Like the Durban project, Emerging Pathogens was directed at a particular scientific problem and we brought teams of people to bear on it," McKearin says. Most of all, he sees K-RITH as a lasting monument to HHMI’s commitment to capacity-building and developing others. “You can see what people in resource-limited environments achieve and be impressed with the breakthroughs they make,” he says. "It’s remarkable, but it also underlines the importance of giving them more to work with. In Durban, we helped to build a scientific enterprise that could train a lot of African and South African scientists.”