Over 25 years ago, the National Institutes of Health (NIH) embarked on a long-standing commitment to fighting what was then an emerging and untreatable infectious disease—HIV/AIDS. Over the next decades, NIH has invested in critical research on HIV prevention and treatment, which resulted in numerous landmark scientific advances and effective strategies to combat the disease. In this context, the Fogarty International Center has invested in innovative capacity-building programs that provided something transformative: the training of promising scientists from low- and middle-income countries in both HIV subject matter expertise and the skills in epidemiology, laboratory techniques, ethical research practices, and data analysis needed for on-the-ground research on HIV. Today, as we approach an “AIDS-free generation,” we understand that it is this kind of research and research training conducted in countries with different experiences with HIV transmission, testing, and patient care that has formed the backbone for the implementation of effective interventions against HIV.
Identification of effective treatments for HIV and expanded access to antiretroviral therapy has now resulted in a new global health challenge: increased noncommunicable disease (NCD) comorbidities in those living and aging with HIV/AIDS. This increase in NCDs is mirrored in the general population, where the rise of NCDs, combined with the persistent problem of infectious disease, has created a dual burden of disease around the world. Fogarty is committed to addressing this challenge, as articulated in its new Strategic Plan. In addition to advancing research related to this dual burden, we are also exploring ways in which to harness existing investments in communicable diseases to better address the multitude of NCDs that now confront low- and middle-income country populations. As we seek to respond to this evolving landscape, understanding the NCD burden among those with HIV is critical if we are to maintain the gains we have already made in the fight against HIV. The time is ripe to thoughtfully examine and move the HIV/NCD research and research training agenda forward, working within and building on the strengthened public health infrastructure and health systems that have accompanied efforts to address HIV. The articles in this supplement—a project spearheaded by Fogarty in close partnership with the NIH Office of AIDS Research—articulate an agenda from which we can begin to address the spectrum of research, training, effective implementation, and evidence-based policy needed to confront this new challenge.