NIMHD funds first NIH Rwandan research fellow, in new partnership with NIDDK

Dr. Utumatwishima is standing in front of lectern giving presentation.
Dr. Jean Nepo Utumatwishima, the first graduate of the NIMHD-NIDDK yearlong Rwanda fellowship program, delivers his graduation presentation on the campus of NIH, June 26, 2017.

Twenty-three years after the genocide that disrupted Rwanda’s fragile economic structure, Rwanda’s Ministry of Health has given Dr. Jean Nepo Utumatwishima the opportunity to travel abroad for training in medical research. Dr. Utumatwishima is the first graduate of the National Institutes of Health’s Rwanda fellowship, which serves as a yearlong program geared towards training a Rwandan physician to become a clinician scientist.

“You will never get a Nobel Prize for operating on people who have a disease that can be prevented,” said Dr. Utumatwishima during an interview about his transformational experience at NIH. Those words, spoken to him by a former colleague, emphasized that disease treatment was achieving the minimum, the goal was to prevent disease from occurring. Those words would spur Dr. Utumatwishima into the mindset of public health and ultimately on the journey from Rwanda to NIH.

DR. UTUMATWISHIMA MAKES RWANDA A GLOBAL LEADER IN FIGHT AGAINST AIDS
Dr. Utumatwishima’s public health impact, however, would be seen in 2016, before his fellowship with NIH. After performing more than 600 thyroid gland surgeries to remove goiters found in Rwandan natives caused by iodine deficiency, Dr. Utumatwishima decided to shift his focus to HIV/AIDS prevention.

“In Africa, we still have communicable diseases like HIV, TB, and malaria. There were still a large number of HIV-positive mother-to-child transmissions during pregnancy, “said Dr. Utumatwishima. “In my hospital, we wanted to focus on prevention, so from 2013 to 2016 we followed pregnant HIV-positive patients to make sure there was no transmission of the virus from mother to child.”

Dr. Utumatwishima’s facility, Kinihira Provincial Hospital, started a peer-education program in which HIV-positive women taught their pregnant HIV-positive peers how to properly take their medication and adhere to doctor visits. The results from the initiative were astounding, so much so that “PBS NewsHour” covered the findings in its series “The End of AIDS?” The hospital had achieved zero cases of mother-to-child transmission of the virus, instantly making Rwanda a global anti-AIDS leader.

It was during this successful work as a public health provider that Dr. Utumatwishima chose to apply for the one-year fellowship at NIH, hoping to gain skills that would help him establish a career as a public health and clinical research scientist in his country.

BRINGING AN INTERNATIONAL FELLOWSHIP TO FRUITION
In 2015, a chance meeting between three public health advocates sparked the idea to develop the Rwandan international fellowship program. Dr. Anne Sumner, a senior investigator at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), attended a lecture at NIH given by Rwanda’s then Minister of Health, Dr. Agnes Binagwaho. “The lecture was spellbinding,” said Dr. Sumner. In her talk, Dr. Binagwaho called for “research to come from big institutions in America to Africa.” She said that Rwanda was a “failed nation” after the genocide, which took place from April to July of 1994, to rebuild, the country started with immediate needs, such as a new infrastructure and health systems. She described the next step to be developing partnerships that could help fill the gap in research and build the research system.

Following the lecture, Dr. Margaret Udahogora, a Rwandan professor from the University of Maryland, introduced Dr. Sumner and Dr. Binagwaho. A week later, Dr. Sumner and Dr. Udahogora met again. “Dr. Udahogora asked me what I could do to help Rwanda,” said Dr. Sumner. “I replied, ‘I can train a Rwandan physician.’”

Dr. Sumner reached out to National Institute on Minority Health and Health Disparities (NIMHD) Director Dr. Eliseo J. Pérez-Stable, who was immediately interested in the program. According to Dr. Sumner, bringing the first yearlong fellowship for Rwandan physicians to NIH was a collaborative effort that NIDDK could not have achieved without the role NIMHD played and Dr. Pérez-Stable’s support.

“This fellowship supports research capacity building in a low-income country in Africa where millions of Americans trace their ancestry, said Dr. Pérez-Stable. “In a modest way, this effort supports health equity for U.S. minorities and Africans in Rwanda.”

NIMHD provided full salary support for Dr. Utumatwishima , and NIDDK provided the funds for research, travel, work space, and tuition for courses at NIH in addition to clinical training with Dr. Sumner. “We’re hoping that NIMHD and NIDDK can commit to making this an enduring effort, with an aim to last five years,” said Dr. Sumner. “We already have our second international fellow coming from Rwanda to replace Jean, and we are hoping to be granted a third.”

Although Dr. Sumner hopes to one day expand the international fellowship program to another country in need, for now, her focus is to make Rwanda a successful showcase.

PAYING IT FORWARD
As Dr. Utumatwishima prepared for his graduation presentation, he spoke of his intent to go home to combat diabetes among his people.

“We have knowledge on the communicable diseases and how to combat them,” he said. “Now, we want research on the non-communicable diseases such as stress, hypertension, diabetes, and heart disease. My immediate goal is to design a registry to have accurate data on diabetes in Rwanda and start a primary prevention program by measuring BMI and blood glucose among patients.”

Dr. Utumatwishima spoke of his goal to start a research lab in Rwanda to conduct his studies, noting that he would not be able to maintain the facility alone. Luckily, his Rwandan successor, Dr. Jean Damascene Kabakambira, arrived on July 3 to begin the second yearlong fellowship just as Dr. Utumatwishima departed.

During his graduation presentation, held on the campus of NIH on June 26, 2017, Dr. Utumatwishima credited his opportunity to Dr. Sumner and Dr. Pérez-Stable, as well as thanking NIDDK Director Dr. Griffin Rodgers, NIDDK Scientific Director Dr. Michael Krause, and Fogarty International Center Director Dr. Roger Glass.

“Dr. Sumner has proven that truly one person can make a difference,” Dr. Utumatwishima said, “and Dr. Pérez-Stable, through his support, has shown his dedication to advance minority health and his goal to make an impact, not only in America but globally.”

Dr. Utumatwishima poses for a picture with his NIH plaque and those involved with his NIH fellowship opportunity.
Dr. Utumatwishima poses for a picture with his NIH plaque and those involved with his NIH fellowship opportunity...(l-r) NIDDK Clinical Director of Intramural Research Dr. James Balow, NIDDK Scientific Director of Intramural Research Dr. Michael Krause, Dr. Margaret Udahogora from the University of Maryland, NIMHD Director Dr. Eliseo J. Pérez-Stable, Ambassador of the Republic of Rwanda Professor Mathilde Mukantabana, Dr. Jean Nepo Utumatwishima, Dr. Anne Sumner of NIDDK, and NIH Deputy Director for Intramural Research Dr. Michael Gottesman.

Posted September 28, 2017