NIH–Rwandan Partnership ‘Graduates’ Eighth Fellow

Global Collaboration Grows Expertise in Rwanda, Expands Research for Diabetes, Health Disparities, and More

BY THE NIH CATALYST STAFF

Year by year, program by program, fellow by fellow, Rwanda is building its public health infrastructure. And the NIH intramural research program is helping.

Since 2016, the NIMHD–NIDDK–Rwandan Health Program has offered a yearlong opportunity for an early-career clinician scientist from Rwanda to train at the NIH, learn from our global community, and return to the country with first-hand experience in clinical research.

On the Rwanda side, the program was initially coordinated by the Rwandan Ministry of Health. Currently, the University of Global Health Equity (UGHE) and nonprofit Partners In Health provide full support for travel to and from Rwanda and a guaranteed three-year university position at UGHE when the fellow returns to Rwanda. On the NIH side, NIMHD provides a stipend and benefits for the fellow through its intramural research program, and NIDDK, through the Section on Ethnicity and Health, provides space, equipment, and funding for the fellow’s research projects and travel.

The program has been led from its conception by Anne Sumner, a clinician scientist and chief of the Section on Ethnicity and Health in the NIDDK Diabetes, Endocrinology, and Obesity Branch, who has enthusiastically served as the fellows' primary mentor. Sumner noted that the Rwandan fellows have full access to all NIH resources—lectures, FAES courses and training, Fogarty International Center programs, and the rich NIH-based “Africans in America” epidemiological cohort (NCT00001853).

In short, the entire NIH scientific community provides guidance, advice, and mentoring. As the saying goes, it takes a village.

How it all started

Rwanda is a country increasingly recognized for its progressive public health policies and resilience in rebuilding its health care system since the 1994 genocide against the Tutsi. In 2015, the Rwandan Minister of Health, Agnes Binagwaho, described her country’s recovery at the annual David E. Barmes Global Health Lecture, sponsored by FIC and NIDCR. She spoke of dramatic improvements in child mortality, life expectancy, and reconciliation.

Sumner was in attendance and was riveted by the Binagwaho presentation. Also in the audience was Margaret Udahogora, a Rwandan-born nutritionist and researcher who teaches at the University of Maryland. Udahogora knew of Sumner's work, which focuses on preventing diabetes and heart disease in African immigrants, and recognized Sumner in the audience. As Sumner was leaving the Masur Auditorium at the end of the lecture, Udahogora introduced herself and asked if she could introduce Sumner to Health Minister Binagwaho.

Sumner was thrilled and in awe at the invitation. Udahogora inched up to Health Minister Binagwaho and her entourage and said a few words in Kinyarwanda, the language of Rwanda. Binagwaho turned and graciously spoke to Sumner at length, a bit to the latter’s surprise. And so, the seeds of an NIH–Rwandan partnership were planted.

Subsequently, Francis Collins and Roger Glass, then the directors of the NIH and FIC, respectively, gave Sumner permission to formally interact with Health Minister Binagwaho (to interact with foreign government officials, NIH investigators must have permission from NIH leadership). Within a year of that first fruitful meeting, the NIMHD–NIDDK–Rwandan Health Program began.

A program grows

Eight fellows have since sequentially completed one-year fellowships within the Section on Ethnicity and Health. The eighth was Claudine Kabeza, who holds a doctorate in public health with specialization in diabetes education and management from the Faculty of Medicine of Carl Gustav Carus at the Technical University of Dresden in Germany and a nursing degree from the University of Rwanda (Kigali, Rwanda). Kabeza gave her “graduation speech” on November 12 in the form of a lecture titled “Diabetes Screening and Physiology in Africans: Insight from the Africans in America Study,” sponsored by NIMHD and broadcast via Zoom to Rwanda.

“Diabetes education and care have been my lifelong passion,” said Kabeza, adding that conducting research in diabetes under the guidance of her mentor Sumner has been invaluable. “I was in the right place, at the right time, and working with the right people, and this [situation] has been a blessing and a success for me. I am excited to continue this impactful work as I return to Rwanda, where I look forward to making meaningful contributions to the field.”

Fellows in this program have so far published more than 20 papers on diabetes in African immigrants during their tenure with the Section on Ethnicity and Health. Since their graduation and return to Rwanda, each fellow has continued to publish and contribute to improved public health in Africa.

To enhance their growth and contribution to Rwandan health on the completion of the program, the fellows remain in close contact with each other, with Sumner, and with Dominic Reeds, a professor of medicine at Washington University School of Medicine in St. Louis, who provides African fellows with clinical training in the fields of nutrition and diabetes. In September 2024, the African Diabetes Alliance was established, to be based in Rwanda and run by the graduating fellows in Rwanda, UGHE, Partners in Health, the University of Rwanda, and other collaborators for the purpose of developing diabetes screening and care and remission protocols designed and implemented by Rwandans in Rwanda.

The advising faculty include Sumner, Reeds, Udahogora, and most recently Todd Cade from Duke University (Durham, North Carolina), an expert on the impact of physical activity on diabetes risk and treatment.

NIMHD Director Eliseo Pérez-Stable’s support helped to make the NIH–Rwandan Program possible. He said that when Sumner brought the idea to him in 2015, he could immediately see how the proposed program was aligned with the NIMHD mission to improve the health of minority populations experiencing health disparities, build research capacity, and expand workforce diversity.

For example, Kabeza's research on diabetes management among Africans in the United States can provide keen insights into the high rate of diabetes among African immigrants and African Americans.

“While the NIMHD–NIDDK–Rwandan Health Program has helped to build research capacity and the public health knowledge infrastructure in Rwanda, the benefits of this program have been bidirectional in many ways,” Pérez-Stable said. “By diversifying the NIH biomedical workforce with scientists and trainees from heterogenous backgrounds, we gain unique perspectives, creativity, and innovation in addressing health disparities among minority populations in the United States and globally, among other benefits.”

NIMHD Scientific Director Kelvin Choi noted that NIMHD support will continue through at least fiscal year 2029. A new fellow starts in the new year, and the fellow to start for 2026 already has been selected.

Back in Rwanda, the program is producing significant dividends. Utumatwishima Jean Nepo Abdallah, the first fellow, recruited in 2016, is now the Rwanda Health Minister of Youth, having served as director general of two Rwandan hospitals since his return. Several others are pursuing PhDs to complement their medical degrees, as the MD–PhD dual degree is highly valued for Rwandan leadership positions.

“Fogarty applauds the tremendous success of the NIH-Rwandan partnership and its emphasis on robust science, innovation, and capacity strengthening,” said Kathleen M. Neuzil, who was appointed the 13th FIC director in March 2024. “Diabetes adversely affects the quality of life of far too many people in the U.S., Rwanda, and around the globe. We look forward to following the contributions of these talented fellows as they bring fresh ideas to the study of diabetes prevention and control and move forward in their promising careers.”