Summary of the RHSP 2025 Annual Report
The Rakai Health Sciences Program (RHSP), founded in 1987, continued in 2025 to advance population health through high-impact research, evidence generation, service delivery, and community partnership. The year was described as both challenging and defining, shaped by global funding constraints and emerging public health threats, but RHSP remained focused on rigorous science, integrated health systems, innovation, and community-centered impact.
Major accomplishments included the expansion of RHSP’s research portfolio into epidemic preparedness, climate-health resilience, STI/HIV prevention, post-TB lung disease, HIV/NCD/urbanization, adolescent research ethics, orphanhood and HIV risk, and HIV latent reservoir science. The SeroMARV study enrolled 1,000 participants across 10 Kyotera communities and validated a scalable, fully digital serosurveillance platform for Marburg virus and other WHO-priority pathogens. The Climate Shock Study enrolled 400 households from agrarian and fishing communities, achieved strong follow-up retention, and generated evidence on how climate shocks affect health, livelihoods, mobility, and community resilience.
RHSP also deepened its work in HIV and non-communicable disease research. The VICINITY study continued to examine the intersection of HIV, NCDs, urbanization, air pollution, mobility, and lived environments, with 7,000 participants enrolled over five years, 2,847 cardiac evaluations, and air quality monitoring for more than 1,200 participants. INSTEP advanced integrated curable STI testing as a pathway to improve PrEP uptake among African women, while the Post-TB Lung Disease study launched as a five-year NIH-supported effort using RCCS and VICINITY platforms to follow approximately 24,500 participants with pre-TB lung function data.
On service delivery, RHSP’s HIV clinic sustained strong treatment outcomes despite restrictions that reduced HIV testing volume. The clinic tested 2,040 individuals, identified 80 new HIV diagnoses, linked all newly diagnosed clients to care, initiated 241 clients on PrEP, and maintained 2,693 people living with HIV on ART. Viral-load monitoring remained strong, with 93% testing coverage among eligible clients and 99% viral suppression among those tested. Integrated care also included cervical cancer screening for 318 women, treatment of 52 women with precancerous lesions, TB screening for all 2,693 ART clients, diagnosis of 41 TB cases, 100% TB treatment initiation, and enrollment of 131 ART clients in TB preventive therapy.
RHSP’s counselling team provided comprehensive counselling, prevention, linkage, and psychosocial support to 9,337 clients. This included HIV testing for 7,893 clients, linkage to HIV care for 101 newly diagnosed clients, PEP services for 25 clients, intensive adherence counselling for 78 virally non-suppressed clients, couples counselling for 168 clients, partner notification support, and GBV response services for 20 survivors.
A major institutional achievement was the continued digital transformation of RHSP’s research systems. The Data Management and Biostatistics Department completed the migration of field-based quantitative data collection from legacy systems such as FoxPro and MS Access to REDCap, improving real-time validation, reporting, remote support, data quality, and operational efficiency. RCCS experienced an operational slowdown due to funding constraints, but RHSP preserved the cohort’s core infrastructure through a reduced census and abridged survey model while digitizing household enumeration and mobility data collection for Round 22.
The RHSP laboratory remained central to research and clinical service delivery. In 2025, it supported RCCS, VICINITY, INSTEP, SeroMARV, HIV latent reservoir research, TB, HIV, HPV, viral load, chemistry, and sample archival activities. The laboratory achieved ISO 15189:2022 re-accreditation for another four-year cycle, expanded testing innovations such as dry-spot viral load testing and HPV swab testing, conducted 12 CME sessions, and strengthened quality management, feedback systems, biosafety, and workforce capacity.
Community engagement remained a defining strength. RHSP implemented engagement activities across multiple study regions to support Round 22, ROC, ICARE, INSTEP, and VICINITY, using sports, drama, sensitization meetings, and Community Advisory Board consultations. Women’s football attracted more than 3,000 attendees at the Kasasa-Sanje finals, while drama and CAB engagement strengthened trust, reduced stigma, supported informed participation, and improved research acceptability.
Internally, RHSP strengthened operations, HR, finance, and IT systems. Operations achieved energy savings of 37.89% at headquarters and 69.26% for the freezer banks through solar systems, along with 38.28% general operational cost savings from improved water and toiletries management. HR rolled out HRIS, conducted HR clinics, supported promotions, received NSSF recognition, and trained 24 interns, including 13 local and 11 international students. Finance reported total funding of approximately US$3.3 million for FY 2024/2025, with NIH contributing US$2.6 million, CDC-PEPFAR US$0.38 million, and other sources US$0.32 million.
RHSP’s IT section, supported by RDCT within the OCICB/NIAID/NIH collaboration framework, strengthened the digital backbone of research through improved connectivity, security, backup, monitoring, and infrastructure resilience. Key upgrades included the RENU microwave backup circuit, DicksonOne temperature monitoring for freezer and laboratory sample protection, VMware vSAN hyper-converged infrastructure, HPE MSL 2024 tape autoloader with LTO-9 drives, Windows Hello for Business, Microsoft Intune, Exchange upgrades, and SATOSA for secure platform access.
Key Highlights Include
Mission, Values & Institutional Resilience
RHSP reaffirmed its mission of improving population health through knowledge generation and translation, guided by teamwork, innovation, people-centeredness, integrity, and equitable collaboration. The year emphasized resilience amid global funding constraints and emerging public health threats.
Research Portfolio Expansion
Continued and expanded studies included HIV latent reservoir research, VICINITY, INSTEP, Climate Shock Study, SeroMARV, Post-TB Lung Disease, ROC, ICARE, and women’s STI care-seeking research.
Rakai Community Cohort Study (RCCS)
RCCS experienced a funding-driven slowdown, implemented a reduced cohort census and abridged survey model, digitized household enumeration and mobility data using REDCap, and trained staff for Round 22.
Digital Data Management
Completed migration of field-based quantitative data collection from FoxPro/MS Access to REDCap, reducing paper costs, eliminating manual data entry, improving end-of-day reporting, and strengthening real-time data validation.
Laboratory & Diagnostics
Achieved ISO 15189:2022 re-accreditation for four years; supported RCCS, VICINITY, INSTEP, SeroMARV, latent reservoir, TB, HIV, HPV, syphilis, viral load, and chemistry testing; advanced dry-spot viral load testing, HPV swab testing, field-based cold-chain innovations, and quality-management systems.
Epidemic Preparedness
SeroMARV enrolled 1,000 participants across 10 communities, used 100% digital data capture, established a biospecimen repository, trained over 30 staff, and validated a platform for future WHO-priority pathogen surveillance.
Climate and Health Research
The Climate Shock Study enrolled 400 households, maintained more than 90% retention through the final quarter, achieved an average response rate of 95%, and strengthened RHSP capacity in mobile data collection, GPS capture, and climate-sensitive field research.
HIV Clinic Performance
Tested 2,040 individuals for HIV; identified and linked 80 newly diagnosed clients to care; initiated 241 people on PrEP; maintained 2,693 PLHIV on ART; achieved 99.8% proxy retention; reached 93% viral load testing coverage; and recorded 99% viral suppression among those tested.
Integrated HIV, Cervical Cancer & TB Services
Screened 318 women for cervical cancer, treated 52 women with thermocoagulation or LEEP, screened all 2,693 ART clients for TB, diagnosed 41 TB cases, initiated 100% of diagnosed TB clients on treatment, and enrolled 131 ART clients in TB preventive therapy.
Counselling & Psychosocial Services
Provided counselling and psychosocial services to 9,337 clients; tested 7,893 clients for HIV; linked 101 newly diagnosed clients to care; provided PEP to 25 clients; supported 78 clients through intensive adherence counselling; reached 168 clients through couples counselling; and supported 20 GBV survivors.
Community Engagement
Prepared communities for Round 22 and affiliated studies through sensitization meetings, women’s football, drama, and quarterly CAB meetings. Women’s football drew more than 3,000 attendees at the Kasasa-Sanje finals.
Scientific Presentations & Publications
RHSP presented at IAS 2025 in Kigali, SANTHE 2025, CROI 2025 in San Francisco, and ANREC 2025, contributing evidence on HIV care gaps, viral rebound, drug resistance, PrEP uptake, HIV self-testing, maternal triple elimination, and community-centered care.
Administration, Finance & Operations
Recorded approximately US$3.3 million in total funding; maintained prudent financial management; achieved major solar-energy and operational cost savings; rolled out HRIS; received NSSF recognition; and supported 24 interns.
IT and Infrastructure
Strengthened research infrastructure through connectivity failover, cloud-based temperature monitoring, VMware vSAN modernization, automated tape backup, endpoint security, device management, email system upgrades, and secure access systems.