2010 AAFP Family Medicine Global Health Workshop Coral

2010 AAFP Family Medicine Global Health Workshop Coral Gables, Florida Pierce Gardner, MD, FACP Senior Consultant for Clinical Training and Research Fogarty International Center, NIH

Global Health Training Opportunitie s In the Health Professions Sten Vermund, MD, Ph. D Myat Htoo Razak, MBBS, MPH, Ph. D Pierce Gardner, MD Aron Primack, MD Douglas Heimburger, MD Catherine Lem, MPH Fogarty International Clinical Research Scholars & Fellows Support Center @ Vanderbilt, National Institutes of Health

National Institutes of Health The National Institutes of Health is the steward of medical and behavioral research for the nation.

Fogarty International Center, NIH Mission: Promote and support scientific research and training internationally to reduce disparities in global health “Science for Global Health”

Underlying tenets of the programs; Programmatic Roots – The magnitude of global health disparities has spurred the world’s interest, activity, and resource allocation in response to the crisis. – Acute and chronic human resource needs limit the response and must be addressed in any sustainable effort.

Programmatic Roots (cont. ) – Clinical, public health and research activities are intertwined and mutually dependent. – In professional training, early in-depth experiences are often powerful determinants of future career choices. – Strong clinical research training centers have developed in many low and middle income countries (often abetted by FIC training programs, NIH funded research, and many other sources).

Programmatic Roots (cont. ) – The excellence of these centers provides an opportunity to provide well-mentored training experiences to individuals considering global health careers (both U. S. and incountry). – The cadre of trainees will create a network of future leaders in global health. Kyle Luman and Simon Luzige working together in Uganda

Purpose of the Fogarty International Clinical Research Fellows Program • To provide mentored clinical research training opportunities to post-doctoral graduates, residents, fellows, and postdocs in NIH-funded research centers in low- or middle-income countries (LMIC)

Clinical Research Includes – Patient-Oriented Research • Research conducted with human subjects (or on material of human origin such as tissues, specimens, and cognitive phenomena) for which an investigator (or colleague) directly interacts with human subjects … includes: – Development of new technologies – Mechanisms of human disease – Therapeutic interventions – Clinical Trials – Epidemiological and Behavioral Studies – Outcomes Research and Health Services Research *From NIH Director’s Panel on Clinical Research, 1996

Criteria for Eligible Training Sites – A strong track record of clinical research and research training – Strong mentoring capacity – Attention to health and safety issues

Countries with Pre-Approved Fellows Sites – – – – – Argentina Bangladesh Botswana Bolivia Brazil China Guatemala Haiti Honduras – – – – India Jamaica Kenya Malawi Mali Mexico Mozambique Nigeria – – – – – Peru Rwanda South Africa Tanzania Tunisia Thailand Uganda Vietnam Zambia

Criteria for Eligible Training Sites – Ongoing clinical research activities supported by U. S. government funding – A strong track record of clinical research and research training – Support from one or more training grants for research capacity building at the site – Strong mentoring capacity – Willingness to collaborate with a designated US institution and the program steering committee – Attention to health and safety issues – Ability to draw upon other educational and scientific strengths of the host institution and other facilities in the community – Suitable infrastructure arrangements for housing, food, and transportation – Attention to language issues

Trainee Activities – 1 -week orientation program at NIH and U. S. domestic program (July) – Clinical research at designated site (10+ months) – Clinical research training via distance learning and contact – Summary report of activities and research accomplishments at the end of the training year – After completion of the research year, the trainee competes to present results at the annual NIH meeting in March – Alumni remain connected via continuing relationship with mentors and collaborators and through an FIC alumni tracking/program evaluation system

Fellows at Orientation 2009

Thanks for our generous co-funders The following institutes partner with the Fogarty International Center to fund ICRF through the Support Center: • • Office of AIDS Research National Cancer Institute National Heart Lung and Blood Institute National Eye Institute National Institute of Mental Health National Institute for Nursing Research National Institute for Dental and Craniofacial Research National Institute of Arthritis and Musculoskeletal and Skin Diseases

Fundable Research Topics • HIV/AIDS-related research including STDs, tuberculosis, opportunistic infections, opportunistic malignancies or behavioral research including substance (drug and/or alcohol) use. • Cancer-related research including oncology, radiation therapy, physiology, and other cancer-related issues, including but not limited to HIV-related oncology research. • Diseases of the heart, vessels, lungs, and blood, including blood resources and sleep disorders. • Ophthalmology and any eye-related research • Mental health research, e. g. , basic, clinical, and translational research to advance understanding of the diagnosis, causes, treatment, and prevention of mental disorders • Research into the causes, treatment, and prevention of arthritis, rheumatic diseases, and other musculoskeletal and skin diseases. These diseases found in HIV/AIDS populations would also be of interest. • Other topics depending on funding availability

Examples of Fellows & Projects • Joseph Tucker, MD Syphilis and HIV in the People's Republic of China. National Center for STD & Leprosy Control, Chinese Academy of Medical Sciences Site: Nanjing, China • Oluwatoyin Fafowora, MD, MPH Heritability of juvenile glaucoma in a genetically diverse population. UCLA Jules Stein Eye Institute Site: Ibadan, Nigeria • Magaly Blas, MD, MPH, Ph. D Association between Human Papillomavirus and Human T-lymphotropic virus infection in Indigenous Women from the Peruvian Amazon Site: Universidad Peruana Cayetano Heredia, Lima, Peru

Examples of Fellows & Projects (cont. ) • Gerald Bloomfield, MD, MPH The prevalence of atherosclerosis among patients with heart failure Site: Moi University School of Medicine, Eldoret, Kenya • Thuy Le, MD A Randomized, Open-Label, Comparative Study of the Effectiveness of Itraconzole versus Amphotericin B in the Acute-Phase Treatment of Penicilliosis in HIVInfected Persons in Vietnam Site: Oxford University Clinical Research Unit, Vietnam • Richard van Zyl-Smit, MB Ch. B, MMed Do the constituents of tobacco smoke attenuate protective mycobactericidal host immune responses in the human lung? Site: University of Cape Town, South Africa

Fellows Program Applicant Eligibility • US Citizens/Permanent Residents OR • Citizens of any nation exclusive of high income countries as defined by the World Bank (www. worldbank. org/data/countryclass/classgroups. htm) • US Citizens/Permanent Residents • Applicants can be engaged in clinical or residency programs or in post-residency fellowships, in postdoctoral level training programs (post-docs) , or within 3 years of completion of their last major training • Can propose new sites • Non-US citizens • Must apply within 3 years of completing their last training (registrarship, residency, fellowship, or Ph. D) • Must work with sites on the pre-approved list • Must have at least one US-institution-based mentor included in the proposed research

Applications require the following: • Research Proposal • Career Statement • Biosketches of applicant & proposed mentors • Budget • Site Application (if proposing new site) • Letters of support from site Nigeria

Program Applications – Application forms are available on FICRS-F Support Center website in July • www. fogartyscholars. org/fellows – Applications are due by December 1, 2010 – Reissued annually

Fellows Selection Process Early January • External selection committee selects finalists Late January • Finalists are interviewed via phone by a separate interview committee March or April • Successful candidates are notified Cape Town, South Africa

Mechanisms of Support – Salary/Stipends • Salary level for US Fellows set at $45, 000 • Salary/stipend level of international fellow must be fair and equitable within country, and not exceed $45, 000 – Funds for travel, insurance (where applicable), and educational materials – Up to $15, 000 for research training costs (budgeted within application) – Each participating foreign site receives infrastructure support – Funds are made available via cost-reimbursable subcontract to performance site

Fogarty Fellow Facts – Each award last for a one year period (July-June) – Number of awards available per year are contingent upon funding from various NIH institutes. – There is no limit on applications or awards from any particular institution – Second year extensions sometimes available on a competitive basis, contingent upon on funding

India Kenya South Africa Mali China Photos in the Field- Fellows

Vanderbilt University, Institute for Global Health The FICRS-F Support Center is housed at the Vanderbilt University Institute for Global Health through a Training Grant from the Fogarty International Center.

For More Information… www. fogartyscholars. org Contact: Catherine Lem, MPH 615 -343 -3555 c. lem@vanderbilt. edu

International Research Scientist Development Award (IRSDA) • Purpose: To encourage top-tier U. S. postdoc biomedical and behavioral scientists to pursue careers in international health research, and to create international collaborations.

International Research Scientist Development Award (IRSDA) – U. S. postdoctoral, epidemiological/clinical and behavioral scientists committed to international health research – Four years support with at least 24 months at the foreign site – Grantees who obtain tenure track faculty positions may apply for 3 more years of support – $75, 000/year plus travel, health insurance, living allowance, $20, 000 research development support

International Research Scientist Development Award (IRSDA) • http: //www. fic. nih. gov/programs/training_grants/irsda. htm • Eligibility: – U. S. postdoctoral biomedical and behavioral scientists – Within 7 years of Ph. D. or M. D. – Two mentors with collaboration