2003 has been a ground-breaking year for Dr. Sewankambo. His vision of an institution that is both a training center for doctors, nurses and other health care professionals in the treatment of HIV/AIDS and a model for the treatment and prevention of AIDS in a resource-limited environment has come together over the past two years in the formation of the Academic Alliance and the planning of state-of-the-art clinical care facility at the Makerere University Medical School. This facility, which will be the product of a partnership of the Academic Alliance, Pfizer Inc, Makerere University, and Pangaea Global AIDS Foundation, will train health-care workers, provide treatment to people living with HIV/AIDS, conduct research to strengthen protocols of care, and support prevention programs. Construction on the facility began in early 2003 and will be completed by mid-2004. (See Pfizer Provides $11 Million to Build AIDS Clinic in Uganda, Global View, April 2003)

According to Dr. Sewankambo, "We have started training doctors from all over Africa in the care and treatment of HIV/AIDS, but the clinic will allow us to expand our current programs at Makerere and increase the number of physician trainees. We also plan to diversify our programs and eventually train nurses and technicians, as well. But it's not just about training -- we'll also be able to expand the clinical care we'll be able to provide. The clinic, which will include a world-class laboratory facility, will truly be a model for how to treat people with HIV/AIDS."

In the current environment where world attention is focused on the AIDS pandemic in Africa and many countries are ramping up their efforts to fight the disease, one of the biggest issues facing African governments and health care administrators is building local capacity for fighting it. Dr. Sewankambo doesn't think that there are many shortcuts: "We know that if we can get the antiretroviral drugs to our patients that we can turn AIDS from a death sentence into a chronic disease, but there are obviously huge barriers to access. One of the primary issues is the shortage of human resources - physicians who know how to use ARV's. Our effort is to try and address some of these shortcomings and produce more individuals who know how to use the drugs effectively."

"There are many factors in play -- using ARV's and treating opportunistic infections is a very challenging enterprise," according to Dr. Sewankambo. "Even though the cost of the drugs is going down, they're still too expensive. Laboratory tests are also costly and not widely available. We are looking to develop standards of care that are both effective and realistic -- part of our objective here is to identify key issues and questions that need to be addressed so as to provide the answers that then can be translated and used to provide quality care in this environment. Our role is to pose the questions -- design good studies that provide answers and then inform the region about what is possible."

Dr. Sewankambo speaks highly of Pfizer's willingness to fund the clinic and provide ongoing support over the next 5 years. He is hopeful that in the current environment both governments and private industry, especially multinational pharmaceutical companies like Pfizer, will dedicate the resources that are needed to build and sustain HIV/AIDS care and treatment programs like the Infectious Diseases Institute at Makerere and then replicate them on a wide scale. "The primary goal of the Academic Alliance is to create a network of people who have excellent skills in the provision of prevention and care of HIV/AIDS. We envisage that this network will provide a continuing education for its members as new drugs emerge, side effects are identified, and new approaches are developed. Our hope is that the people that we have trained will themselves become trainers and train many more people in their environment. If we can train a hundred, then they will train thousands and that will help in trying to build capacity. If we can give them the skills and resources needed, they will start clinics throughout Africa providing quality care."

Dr. Sewankambo is focused on providing long-term solutions to the HIV/AIDS crisis. "The advent of AIDS has discouraged young people from coming into health care in Africa over the last ten years. How would you feel if you walked into a hospital full of dying people with little hope of doing anything to help them? But now, we can show that taking care of AIDS patients can have its rewards. If we can turn AIDS into a chronic disease that is as treatable as diabetes or high blood pressure, if these young people can see that successful treatment is possible, we can get our best and brightest youth to come into medicine. It's starting to happen now. My message to the U.S. and the rest of the developed world is this -- give us your experience with the epidemic, give us the drugs and the resources to build programs. If you do that, we'll provide the discipline, the good science, the careful planning and hard work to win the fight."