Project Phidisa: development of clinical research capacity within the South African National Defence Force

In December 2002, a decision was reached between the South African Military Health Service of the South African National Defence Force and the US Ambassador to South Africa that the USA and the Republic of South Africa would explore the possibility of initiating a collaborative effort to build the capacity to conduct clinical research within the South African military environment and that the area of initial focus would be HIV/AIDS. Three and a half years later, a clinical research program now known as Project Phidisa has enrolled over 4000 patients on Institutional Review Board-approved protocols, and provided antiretroviral therapy to approximately 1400 members of the South African National Defence Force and their dependents. The purpose of this article is to present some of the challenges faced in the development of this program and provide the lessons learned as these challenges were and continue to be addressed.