Africa Health Research Institute

Research at AHRI

AHRI’s research is shaped around three main, intersecting health areas: infection, adolescent mental health, and climate and health. Our multidisciplinary approaches draw on a broad value chain of scientific expertise, including basic and translational science, clinical trials, data, implementation and social sciences, epidemiology/population science, and indigenous knowledge/medicine. AHRI works in partnership with local communities, local traditional authorities, the South African government, and many other local and global academic, policy, and funding stakeholders.

AHRI’s research responds to urgent health challenges facing South African communities. In our research setting, >30% of the population is living with HIV, while lifetime TB disease prevalence exceeds 40% and the annual TB incidence – nearing 1% – is one of the highest in the world. In adolescent women, anxiety and depression cluster with violence, food poverty, alcohol use and HIV infection. Globally, mental health disorders impact HIV and TB control and commonly have an onset in adolescence.

Our faculty members have the freedom to pursue their own research agendas within the institute’s broader strategy.

Infection

Infection research focuses primarily on HIV and TB.

AHRI’s HIV research is focussed on prevention, with discovery of biological and social drivers of transmission of the virus, and testing of multiple interventions, including injectable pre-exposure prophylaxis (PrEP) and new vaccines. A large population-based surveillance effort aims to discover critical trends in the HIV epidemic and understand the longer-term impact of health policy and interventions. A focus on HIV cure aims to understand HIV persistence when people are on successful antiretroviral treatment, followed by clinical trials that test tailored interventions toward cure.

TB research at AHRI aims, first, to understand how the TB bacterium causes disease and how the body fights it by examining surgically excised human lung, accessed via long-term collaborations with local hospitals. Second, a population-based TB surveillance system aims to understand how the bacterium spreads. Next, asymptomatic TB disease is studied to understand whether people with this disease state spread the TB bacterium;  diagnosis, natural history, and intervention are also examined. Finally, clinical trials evaluate new TB vaccines, drugs, and diagnostics.

AHRI also has smaller programmes that address other sexually transmitted infections and emerging viral pathogens.

Adolescent mental health

AHRI’s adolescent mental health research aims, first, to define thriving adolescence in a rural, under-resourced setting. This work involves co-creating knowledge about mental health with young people from the area. Second, determinants of adolescent mental health are studied through longitudinal research, exploring biological, psychological, and social pathways. Third, young people are involved in developing and testing mental health interventions for adolescents which are fit for context and which target the mechanisms our research identifies.

Climate and health

Climate and health research at AHRI examines, first, the intersection between extreme climate events and the mental health of vulnerable populations. Second, health system resilience to climate change is explored. Finally, building on learnings, context-appropriate interventions are designed together with affected communities, and tested.

Multiple scientific platforms and core business structures support AHRI’s research endeavours. These include  a health and demographic surveillance system (HDSS) which has followed >120,000 people in northern KZN for ~25 years. The HDSS is leveraged as a platform for epidemiology, clinical trials, and implementation science research. AHRI’s clinical trials unit (CTU) conducts trials that primarily focus on TB and HIV prevention, treatment and cure. AHRI’s fully equipped CTU includes a pharmacy, and counselling and medical examination rooms. This is complemented by a fleet of mobile clinics and is supported by AHRI’s sophisticated laboratory infrastructure. The AHRI ISO15189-accredited clinical laboratory provides biorepository, microbiology,virology, and molecular laboratory services. AHRI’s basic and translational science is supported by superb laboratory infrastructure, including > 600m² of BSL-3 lab space. AHRI’s data science unit works with investigators in the design of studies and analysis of the data generated. Sophisticated data systems facilitate robust, high-quality research. Through rigorous, participatory research AHRI’s social science unit investigates how social factors shape health outcomes in our communities. The multidisciplinary unit brings diverse methodological expertise and perspectives, helping to strengthen community partnerships, enhance transparency, and ensure research remains rooted in lived realities. AHRI’s public and community engagement model encourages research participants to be active partners in the development of a research agenda that is meaningful and directly relevant to their lives.

AHRI is committed to providing a research environment that develops good research practice and nurtures a culture of research integrity.

We also welcome the wide variety of opportunities for research and cross-disciplinary innovation in working collaboratively or in partnership with other institutions in South Africa and elsewhere in Africa and the world.

If you want to collaborate or discuss our research we would love to hear from you.  Please get in touch via communication@ahri.org.