Research Capacity Building Programs of the Fogarty International
Research Capacity Building Programs of the Fogarty International Center, NIH International Affairs Committee Infectious Diseases Society of America San Juan, Puerto Rico June 21, 2002 Joel G. Breman, M. D. , D. T. P. H. Senior Scientific Advisor Fogarty International Center
Fogarty International Center Science for Global Health Mission To promote and support research and research training internationally to reduce disparities in global health
NIH International Research Expenditures Fiscal Year 2000 Dollars Fiscal Years 1994 to 2000 Research = $203 million (66%) Training = $103 million (34%)
NIH Overall Expenditures on Tropical Infectious Diseases Tropical Medicine Total Malaria TB Diarrheal Diseases Dengue Chagas Disease Pathogen sequencing (FY 01 -02) Multilateral Initiative on Malaria Overall $195, 548, 00 57, 833, 000 56, 039, 000 54, 578, 000 7, 060, 000 10, 119, 000 60, 000 900, 000 $255, 400, 000
Fogarty International Center Funding for Infectious Diseases & Other Programs Fiscal Year 2000: $35 million Other Programs: FIRCA Biodiversity Informatics Environ & Occ MCH Career Dev Bioethics Others AIDS: 38% 44% Bioterrorism: 1% Malaria: 2% ABC/ICIDR: 3% Emerging Inf Dis: 5% Ecology Inf Dis: 4% TB: 3%
Fogarty International Center Programs and Collaborating Partners Fiscal Year 2000 Funding NIA FIC Population and Health $1. 8 million FIC CDC Environmental and Occupational Health $2. 0 million NIEHS NICHD NCI FIC NIAID CDC FIC Emerging Infectious Diseases $2. 7 million NIDCR NIAMS NIAID FIC Research Bioethics $1. 4 million NIAID NCMHD NCCAM FIC NCI NHLBI NIAAA NIDCR Biodiversity $3. 9 million NIDA NHLBI NIMH FIC NICHD Maternal and Child Health $1. 3 million NSF Ecology of Infectious Diseases $1. 5 million AIDS International Training and Research $15. 1 million OAR NCMHD USDA NIEHS FIC NSF USAID Tuberculosis $1. 5 million NIAID FIC NIDA NICHD NINR NHLBI NLM Medical Informatics $1. 4 million NIAID HRSA NIMH FIC NCMHD MIRT $5. 5 million
Fogarty International Center Science for Global Health Major Training and Research Sites
Fogarty International Center Science for Global Health Research Training Mechanisms l Long-term training * pre- and post-doctoral training in U. S. institutions (duration: minimum 9 months) l Short-term training * focused workshops and technology transfer (duration: several days to several weeks) l Research performed preferentially in-country
Fogarty International Center Science for Global Health Program Objectives • Train leaders in science and public health • Establish centers of excellence in home countries • Promote long-term collaborations between U. S. and foreign institutions • Facilitate outstanding scientific research focused on problems of developing countries • Facilitate trainees assuming positions of responsibility, authority, and influence
Fogarty International Center Science for Global Health AITRP Accomplishments, Fiscal Years 1988 -1998 FY 88 -93 FY 94 -98 Total epidemiology and post-doctoral trainees 654 1, 027 1, 681 countries 59 84 98 264 451 715 16, 624 29, 804 46, 428 30 inc 65 Long-term training In-country activities courses trainees countries
Fogarty International Center Science for Global Health AITRP-Supported Achievements (examples) • China: Identified plasma donors at risk for HIV • Kenya: Uncircumcised males at risk for HIV 1 and genital ulcers • Uganda: Nevirapine injection to HIV-positive pregnant woman and neonates associated with 48% decrease in perinatal transmission • Uganda and Haiti: Prophylaxis with INH and rifampin reduced TB and AIDS in HIV-positive persons
Fogarty International Center Science for Global Health AITRP-Supported Achievements (examples) 2 • Vietnam: Subtype E (not Thai B) identified as main subtype among injection drug users and commercial sex workers • Georgia: Develop National AIDS Prevention Program and National Blood Safety Program
International Clinical, Operational, and Health Services Research Training Award for AIDS/Tuberculosis (ICOHRTA - AIDS/TB)
ICOHRTA - AIDS/TB Emphasizes integration of therapy and care with prevention efforts and Builds capacity to support the integration of clinical, operational, and health services research
ICOHRTA - AIDS/TB Fosters Major NIH International AIDS Research Efforts: • Prevention Trials Network • Vaccine Trials Network • Comprehensive International Program of Research on AIDS (CIPRA) • Popular Opinion Leaders • International Centers for Excellence in Research • Partnerships for HIV/AIDS Research in Africa
ICOHRTA - AIDS/TB Fosters Major USG and Other International AIDS Research Efforts: • CDC Global AIDS Program • USAID Rapid Response (LIFE) Initiative • Bill & Melinda Gates Foundation • am. FAR • Elizabeth Glaser Pediatric AIDS Foundation • Academic Alliance for AIDS Care and Prevention in Africa • Global AIDS, TB, and Malaria Fund • UNICEF, UNAIDS, and WHO AIDS and TB Programs
Fogarty International Center Countries in Emerging Infectious Diseases Program, 2001 Hungary Lithuania Russia Latvia Czech Republic Mexico Haiti Poland Mali Armenia Kazakhstan Georgia Ethiopia China Pakistan Belize Guatemala Nicaragua Ecuador Peru Bolivia Chile Ghana Kenya Venezuela Brazil Paraguay India Philippines Indonesia Malawi New Guinea
ITREID Collaborations • U. S. principal investigators: 13 • Countries: 36 – – Americas: 12 Eastern Europe: 10 Asia: 8 Africa: 6
ITREID Accomplishments FY 1998 Pre/post-doctoral 48 trainee years In-country -Courses 33 -Trainees 2589 -U. S. faculty 46 participation 1999 100 2001* Total 93 74 315 25 1130 60 26 1473 41 26 1045 38 110 6237 185 *2001, partial data: new countries are Bangladesh, Estonia, Rwanda, and Sri Lanka
ITREID Accomplishments continued Scientific Output and Awards, FY 2000 § Science progress – – Presentations, 104 Publications, 109 (submitted, accepted, published) § Awards – – FIRCA award received by trainee from Czech Republic to work on C. parvum (NY State Dept of Health) Best poster European Society of Virology, molecular epidemiology of hepatitis C in Czechoslovakia (UC Berkeley)
ITREID Pathogen Foci Bacterial Diseases Bartonella bacilliformis Corynebacterium diphtheriae Leptospira Mycobacterium tuberculosis, M. avium Streptococcus pneumoniae STDs (chlamydia, gonococci)
ITREID Pathogen Foci Parasitic Diseases Entamoeba histolytica Leishmania Plasmodium falciparum, P. vivax Schistosoma hematobium Trypanasomes
ITREID Pathogen Foci Viral and Rickettsial Diseases Dengue “Diarrhea” and El Niño Human papilloma virus Rickettsia prowazakii and R. felis
Fogarty International Center Science for Global Health Principles for Capacity Building and Sustainability l Long-term commitment * National * Institutional * Trainee l Re-entry grants for trainees l Diversified program themes l Mentoring and networking l Dual appointments for faculty
Global Health Research Initiative Program (GRIP) Purpose: Combat “brain drain” – re-entry grants Support the best science and the best scientists to work on global health challenges Eligibility: Young scientists from resource-poor nations completing NIH-supported training in U. S. after returning home (NIH, academic centers, D 43 programs) Support Level: $50, 000/year for up to 5 years for salary and research costs
Future and Focus of FIC Research Training Programs • In-country research, re-entry awards • Organization of scientific workshops by trainees • Promotion and tracking of trainees’ careers • Special attention to: – – Bioethics Good clinical practice involving human subjects
Fogarty International Center Science for Global Health Principles for Capacity Building and Sustainability l Long-term commitment * National * Institutional * Trainee l Re-entry grants for trainees l Diversified program themes l Mentoring and networking l Dual appointments for faculty
Fogarty International Center Science for Global Health Principles for Capacity Building and Sustainability (2) l South-to-South collaboration l Sustained linkages l Contribution of resources from all partners l Leverage resources for added support l Connectivity via modern IT systems l Centers of excellence in home countries l Mutual benefits known to all
FIC Website: http: //www. nih. gov/fic
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