Summary of the Award
The Alliance for African Partnership (AAP) award was a catalytic institutional investment that transformed the trajectory of my global health research program. Nested within the International AIDS Society–funded CIPHER study, the AAP award (RN100284; $100,000) supported a focused investigation of micronutrient deficiency—specifically vitamin D and long-chain polyunsaturated fatty acids (PUFAs)—as modifiable determinants of functional outcomes among school-aged Ugandan children with and without perinatal HIV exposure or infection. This strategic expansion sharpened our hypotheses, deepened cross-continental partnerships, and laid the empirical foundation for a sustained, externally funded program spanning child development and aging with chronic HIV.
Advancing Global Health and Nutrition Science
The award enabled systematic measurement of nutritional biomarkers in the full cohort rather than a limited subsample. This strengthened statistical power and allowed us to determine whether micronutrient deficits compounded baseline impairments and influenced trajectories of cognitive, socioemotional, and quality-of-life outcomes over 12 months. Importantly, AAP funds supported comprehensive assessment of physiologic stress and detailed abstraction of antiretroviral therapy exposure histories—critical for disentangling nutritional, immunologic, and psychosocial influences on child development in HIV-affected settings.
Our findings demonstrated that variation in vitamin D status and fatty acid profiles were biologically meaningful contributors to growth, executive function, and socioemotional adjustment. Nutrition emerged not as a background covariate but as a mechanistic driver of morbidity risk. In sub-Saharan Africa—where perinatal HIV exposure remains common and nutritional vulnerability persists—identifying modifiable micronutrient pathways has direct implications for scalable intervention strategies that complement antiretroviral therapy.
The scientific impact extended beyond childhood. Signals observed in the AAP-supported analyses informed refined hypotheses regarding the vitamin D metabolome as a determinant of cognitive development and decline across the life course. This work directly supported successful NIH funding, including an R21 in adolescents (R21HD088169), extended longitudinal follow-up in children (R01NS122510), and a recent R01 in older adults (R01AG087191) with and without chronic HIV infection. Across these awards and supplements, more than $8.0 million in extramural support has been secured, all building on the mechanistic insights strengthened by the AAP investment. Together, these projects examine nutrition, immune dysregulation, microbiome variation, and neurocognitive outcomes within a unified framework of functional survival.
Partnership and Collaboration Dynamics
The AAP award was intentionally structured to deepen equitable partnership between Michigan State University and the Uganda Society for Health Scientists (USHS). By co-leading the nutrition-focused expansion with Ugandan collaborators, including Dr. Sarah Zalwango and Dr. Philippa Musoke, we ensured that research questions were locally relevant, operationally feasible, and mutually beneficial. The award supported dedicated in-country research personnel and reinforced long-standing cohort infrastructure, strengthening data quality and local capacity.
This infrastructure proved especially critical during the turbulent global research policy environment of 2025. Because of the systems and trust built through AAP-supported collaboration, our team was positioned to absorb external shocks while maintaining continuity of data collection and scientific productivity. The partnership model fostered bidirectional learning and reinforced a sustainable framework for global research engagement.
Within MSU, the award deepened collaboration across Nutrition, Epidemiology, Psychiatry, Neuropsychology, and Biostatistics. Engagement with colleagues such as Dr. Jenifer Fenton and multidisciplinary collaborators created synergy that directly contributed to subsequent NIH R21 and R01 successes. The integration of nutritional epidemiology with neuropsychology, immunology, and global mental health allowed us to move beyond siloed inquiry toward a biopsychosocial model of risk and resilience. Support for student training was another critical dimension of impact. AAP-supported data generated dissertation research for two PhD students focused on fatty acids, vitamin D, and neurodevelopment, and supported a postdoctoral fellow whose ongoing work extends our African partnership into microbiome and metabolomic investigation. These investments align with MSU’s land-grant mission and AAP’s commitment to sustainable, capacity-enhancing collaboration.
Follow-Up Work and Field Advancement
The momentum generated by the AAP award continues to shape our research trajectory. In children, the R01NS122510 study is developing and validating a composite risk index to identify adolescents at high risk for neurocognitive impairment, integrating nutritional, immunologic, and virologic predictors. In older adults, the R01AG087191 project examines vitamin D bioavailability, gut microbiota composition, and dementia risk among individuals aging with chronic HIV infection. Together, these studies represent a life-course continuum directly traceable to the original AAP-supported mechanistic inquiry.
We are also translating these findings into intervention strategies. For children, we are designing biopsychosocial supportive care models that incorporate nutritional optimization alongside psychosocial stress mitigation. For adults, we are investigating modifiable determinants of premature cognitive aging—including micronutrient status and gut dysbiosis—with the goal of preventive intervention. Emerging data on variation in the vitamin D metabolome position our team to address critical gaps in understanding how vitamin D functions within mechanistic nutrition trials, further strengthening our competitive edge.
In sum, the AAP award was more than seed funding; it was a strategic inflection point for my research program. It strengthened transcontinental collaboration, refined mechanistic hypotheses, expanded training pipelines, and positioned our team for sustained NIH funding success. By providing early support that led to our appreciation of consequential variations in vitamin D metabolome, this project has positioned us to continue advancing health globally and domestically with the United States. Specifically, clinical guidelines (Endocrine Society Clinical Practice guidelines and the United States Health and Preventive Task force) on vitamin D has recently been updated and the excitingly, these updates and emphasized knowledge gaps directly align with the innovative insight on vitamin D metabolome we observed as part of the AAP supported projects. There is no doubt that the scientific, collaborative, and translational ripple effects of this investment continue to shape our contribution to global health and nutrition science as we increasingly move towards interventions informed by them.
