Uncovering the Legacy of CDC’s Retro-CI Laboratory on Public Health

In an interconnected world, the fight against HIV/AIDS knows no borders – which is why Project Retro-CI (Retrovirus Côte d’Ivoire: Retro-CI), a global hub for cutting-edge HIV research and training, transcended geographical boundaries to create a lasting impact on the United States’ response to the HIV epidemic for nearly four decades.

A Vital Partnership

In 1987, the Centers for Disease Control and Prevention began the exploratory work to establish a research field station in Côte d’Ivoire to address the emerging HIV epidemic. CDC began collaborating with Côte d’Ivoire’s Ministry of Health and Public Hygiene (MSHP) to develop critical laboratory and epidemiology capacity in response to the HIV pandemic, establishing the Retro-CI laboratory in Abidjan in 1988. Over the next thirty-six years, the collaboration blossomed into a national laboratory network, with Retro-CI providing HIV diagnosis to hundreds of thousands of Ivoirians annually.  Then, in 2013, the U.S. Health and Human Services Assistant Secretary for Global Affairs, Dr. Nils Daulaire, and Côte d’Ivoire’s Minister of Health and Public Hygiene, Dr. Raymonde Coffie, signed an implementation agreement outlining roles and responsibilities for each government and a mutual commitment to scientific and administrative collaboration.

A Lab on a Mission to Change the World

From the outset, the mission of Retro-CI was clear: to better understand HIV— including the differences between HIV-1 and HIV-2 dual infections, and mother-to-child transmission.  Early research conducted at the Retro-CI laboratory contributed to a large body of global research, directly impacting work in the United States, particularly around HIV-2 treatment and the prevention of mother-to-child transmission.

Côte d’Ivoire was one of the few counties in the world whose epidemics featured two strains for the virus (HIV-1 and HIV-2) – making it a prime location for a field station. In terms of clinical progression and response to certain medications, HIV-2 behaved very differently from HIV-1, and Retro-CI was instrumental in illustrating this to the global HIV community through genotyping and drug resistance studies.

According to Dr. Kevin M. De Cock, founding director of Retro-CI, in an interview with the Global Health Chronicles, he stated, A number of important studies were done, including two very important clinical trials: the co-trimoxazole study that really changed global practice and a study on short-course [azidothymidine] AZT for the prevention of mother-to-child transmission. Now, all of that was based on the early work and the infrastructure and so on.” Such work at Retro-CI had a ripple effect globally, influencing HIV research and policy in Western Africa and worldwide.  The project’s research findings were published and presented at international conferences—helping to inform the development of international guidelines for HIV prevention, care, and treatment for people living with HIV/AIDS.  “If Retro-CI were not created, some of the programs being implemented would not have existed,” stated Dr. Natacha Kohemun, current Acting Retro-CI Laboratory Branch Chief.

Recognizing the significant concern of drug resistance in long-term HIV treatment, Retro-CI researched the mechanisms and patterns of drug resistance – providing valuable insights into optimizing treatment strategies and preventing resistance.  The research helped in understanding the modes of HIV transmission, like sexual transmission and mother-to-child transmission, leading to informed prevention strategies in Cote d’Ivoire and the United States.  Retro-CI’s HIV research had far-reaching impacts, including enhancing the understanding of the virus, informing treatment strategies, and influencing public health policies and guidelines globally.

Retro-CI’s contribution to antiretroviral therapy (ART) and its efficacy in treating HIV led to the development and optimization of ART regimens in sub-Saharan Africa and the United States.  The lessons learned, and additional knowledge resulted in better treatment outcomes for individuals living with HIV.  Research findings also informed the development of public health policies and guidelines for HIV prevention, testing, and treatment worldwide, improving the overall management of the HIV epidemic and ensuring timely access to appropriate healthcare services.

A team of passionate and dedicated researchers, including key global leaders such as Drs. Kevin M. De Cock, John Nkengasong, Stefan Wiktor, and Alan Greenberg set out to gain a deeper insight into the HIV epidemic.  “Project Retro-CI was an unprecedented partnership between the United States, through CDC, and Côte d’Ivoire through its Ministry of Health and Public Hygiene. As a state-of-the-art research facility, from its inception through today, Project Retro-CI has advanced the field of HIV research,” explained Ambassador John Nkengasong.  “It is a model for enabling local research and testing, as well as building local capacity.”

Through partnerships with the CDC, among others, Retro-CI has been instrumental in providing training and mentorship to a new generation of researchers, ensuring the sustainability of HIV research and intervention efforts in both Africa and America.  The lab’s scientists, past and present Retro-CI staff, have been widely recognized globally with numerous awards and accolades from international health organizations and governments, highlighting their significant contributions.  Retro-CI facilitated collaborations between researchers, healthcare providers, and public health officials in Côte d’Ivoire and the United States. This resulted in the vital exchange of research findings, best practices, and innovations in HIV prevention and treatment, ultimately benefiting both countries.  With unwavering determination, the lab made significant strides in HIV research, working tirelessly towards a future where HIV/AIDS is no longer a global health crisis.

The Way Forward

Retro-CI’s visionary work inspired the US to recommit to HIV research and funding, resulting in increased resources and support for other public health initiatives.  Additionally, the laboratory made significant strides in improving HIV testing and diagnostic tools, benefiting both Côte d’Ivoire and the United States by enabling early detection and diagnosis of HIV infection.

Through its singular vision and global partnerships, Retro-CI demonstrates how perseverance can transcend borders and create a brighter future for those affected by HIV.  The groundbreaking research and initiatives conducted by Retro-CI have brought hope and positive change to the lives of countless individuals in Cote d’Ivoire and the United States.  Retro-CI showcases the power of scientific dedication, innovation, and global collaboration in the fight against HIV, one of the most challenging health crises of our time.  What started as a field station grew into a crucial collaborator in advancing HIV research and understanding, leading to improvements in HIV prevention, testing, treatment, and policy development in the United States.