Research Capacity Building Programs of Research Capacity Building Programs of
the Fogarty International Center, NIHthe Fogarty International Center, NIH
International Affairs CommitteeInternational Affairs CommitteeInfectious Diseases Society of AmericaInfectious Diseases Society of America
San Juan, Puerto RicoSan Juan, Puerto RicoJune 21, 2002 June 21, 2002
Joel G. Breman, M.D., D.T.P.H.Joel G. Breman, M.D., D.T.P.H.Senior Scientific AdvisorSenior Scientific Advisor
Fogarty International CenterFogarty International Center
MissionMission
To promote and support To promote and support
research and research training research and research training
internationally to reduce disparities internationally to reduce disparities
in global healthin global health
Fogarty International CenterFogarty International CenterScience for Global HealthScience for Global Health
0
20,000,000
40,000,000
60,000,000
80,000,000
100,000,000
120,000,000
140,000,000
1994 1995 1996 1997 1998 1999 2000
Visiting Program
Direct Foreign Research Awards
Foreign Components of Domestic Awards
Training Grants
NIH International Research ExpendituresNIH International Research ExpendituresD
olla
rs
Fiscal Years 1994 to 2000Fiscal Years 1994 to 2000
Training = $103 million (34%)
Research = $203 million (66%)
Fiscal Year 2000Fiscal Year 2000
NIH Overall Expenditures on NIH Overall Expenditures on Tropical Infectious DiseasesTropical Infectious Diseases
Tropical Medicine TotalMalariaTBDiarrheal DiseasesDengueChagas 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
60,000,000
900,000
$255,400,000
Other Programs:FIRCABiodiversityInformaticsEnviron & OccMCHCareer DevBioethicsOthers
Fogarty International CenterFogarty International CenterFunding for Infectious Diseases & Other ProgramsFunding for Infectious Diseases & Other Programs
Fiscal Year 2000: $35 millionFiscal Year 2000: $35 million
Malaria: 2%
AIDS: 38%
Emerging Inf Dis: 5%
Ecology Inf Dis: 4%
TB: 3%ABC/ICIDR: 3%
Bioterrorism: 1%
44%
Fogarty International CenterFogarty International Center Programs and Collaborating PartnersPrograms and Collaborating Partners
Fiscal Year 2000 FundingFiscal Year 2000 Funding
FIC NIA
NICHD
FIC CDC
NIEHS
Population and Health$1.8 million
Environmental and Occupational Health
$2.0 million
FIC CDC
NIAID
Emerging Infectious Diseases
$2.7 million
NIDCR
FIC NCCAM
NHLBI
Research Bioethics$1.4 million
NIAMS
FIC
NSF
Ecology of Infectious Diseases
$1.5 million
NIEHS
FIC NICHD
Maternal and Child Health$1.3 million
FIC NLM
Medical Informatics$1.4 million
FIC NIAAA
NIMHNHLBI
NCI
HRSA
NICHDOAR
NINR
NIDCR
AIDS InternationalTraining and Research
$15.1 million
NIDA
FIC USAID
Tuberculosis$1.5 million
NCMHD
FIC NCMHD
MIRT$5.5 million
FIC
USDANHLBI
NCI
NIMH
NSFNIDABiodiversity$3.9 million
NIAID NIAID
NIAID
NIAID
NIAID
NCMHD
Major Training and Research Sites
Fogarty International CenterFogarty International CenterScience for Global Health
Long-term trainingLong-term training* pre- and post-doctoral training in U.S. institutions * pre- and post-doctoral training in U.S. institutions (duration: minimum 9 months)(duration: minimum 9 months)
Short-term trainingShort-term training* focused workshops and technology transfer* focused workshops and technology transfer (duration: several days to several weeks) (duration: several days to several weeks)
Research performed preferentially in-countryResearch performed preferentially in-country
Fogarty International CenterFogarty International CenterScience for Global HealthScience for Global Health
Research Training MechanismsResearch Training Mechanisms
• 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 CenterFogarty International CenterScience for Global HealthScience for Global Health
Program ObjectivesProgram Objectives
Fogarty International CenterFogarty International CenterScience for Global HealthScience for Global Health
AITRP Accomplishments, Fiscal Years 1988-1998AITRP Accomplishments, Fiscal Years 1988-1998
Long-term training epidemiology and post-doctoral trainees
countries
In-country activities
courses
trainees
countries
654
59
264
16,624
30
1,027
84
451
29,804
inc
1,681
98
715
46,428
65
FY88-93 FY94-98 Total
• 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 CenterFogarty International CenterScience for Global HealthScience for Global Health
AITRP-Supported Achievements (examples)AITRP-Supported Achievements (examples)
• 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
Fogarty International CenterFogarty International CenterScience for Global HealthScience for Global Health
AITRP-Supported Achievements (examples) 2AITRP-Supported Achievements (examples) 2
International Clinical, International Clinical, Operational, and Health Operational, and Health
Services Research Training Services Research Training Award for AIDS/Tuberculosis Award for AIDS/Tuberculosis
(ICOHRTA - AIDS/TB)(ICOHRTA - AIDS/TB)
Emphasizes integration of therapy Emphasizes integration of therapy and care with prevention effortsand care with prevention efforts
Builds capacity to support the Builds capacity to support the integration of clinical, operational, integration of clinical, operational,
and health services researchand health services research
ICOHRTA - AIDS/TBICOHRTA - AIDS/TB
and
• 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
Fosters Major NIH International Fosters Major NIH International AIDS Research Efforts:AIDS Research Efforts:
ICOHRTA - AIDS/TBICOHRTA - AIDS/TB
Fosters Major USG and Other Fosters Major USG and Other International AIDS Research Efforts:International AIDS Research Efforts:• CDC Global AIDS Program
• USAID Rapid Response (LIFE) Initiative
• Bill & Melinda Gates Foundation
• amFAR
• 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
ICOHRTA - AIDS/TBICOHRTA - AIDS/TB
Fogarty International CenterFogarty International CenterCountries in Emerging Infectious Diseases Program, 2001Countries in Emerging Infectious Diseases Program, 2001
Mexico
Nicaragua
Ecuador
Chile
Brazil
Poland Czech Republic
China
Peru
Guatemala
Bolivia
Haiti
Kenya
Ethiopia
GhanaNew GuineaIndonesia
India
Malawi
Mali
Lithuania
Georgia
Belize
Venezuela
Philippines
Hungary
Pakistan
Russia
KazakhstanArmeniaLatvia
Paraguay
• U.S. principal investigators: 13
• Countries: 36– Americas: 12– Eastern Europe: 10– Asia: 8– Africa: 6
ITREID Collaborations
ITREID AccomplishmentsFY
1998 1999 2000 2001* Total
Pre/post-doctoral trainee years
48 100 93 74 315
In-country
-Courses 33 25 26 26 110
-Trainees 2589 1130 1473 1045 6237
-U.S. faculty participation
46 60 41 38 185
*2001, partial data: new countries are Bangladesh, Estonia, Rwanda, and Sri Lanka
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 AccomplishmentsITREID Accomplishments continuedcontinued
Bartonella bacilliformis
Corynebacterium diphtheriae
Leptospira
Mycobacterium tuberculosis, M. avium
Streptococcus pneumoniae
STDs (chlamydia, gonococci)
ITREID Pathogen FociITREID Pathogen Foci Bacterial DiseasesBacterial Diseases
Entamoeba histolytica
Leishmania
Plasmodium falciparum, P. vivax
Schistosoma hematobium
Trypanasomes
ITREID Pathogen FociITREID Pathogen Foci
Parasitic DiseasesParasitic Diseases
Dengue
“Diarrhea” and El Niño
Human papilloma virus
Rickettsia prowazakii and R. felis
ITREID Pathogen FociITREID Pathogen FociViral and Rickettsial DiseasesViral and Rickettsial Diseases
Long-term commitment Long-term commitment * National * National * Institutional * Institutional * Trainee * Trainee
Re-entry grants for traineesRe-entry grants for trainees Diversified program themesDiversified program themes Mentoring and networkingMentoring and networking Dual appointments for facultyDual appointments for faculty
Fogarty International CenterFogarty International CenterScience for Global HealthScience for Global Health
Principles for Capacity Building and SustainabilityPrinciples for Capacity Building and Sustainability
Global Health Research Global Health Research Initiative Program (GRIP)Initiative Program (GRIP)
Purpose: Combat “brain drain” –– re-entry grantsSupport 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, D43 programs)
Support Level: $50,000/year for up to 5 years for salary and research costs
• 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
Future and Focus of Future and Focus of FIC Research Training ProgramsFIC Research Training Programs
Long-term commitment Long-term commitment * National * National * Institutional * Institutional * Trainee * Trainee
Re-entry grants for traineesRe-entry grants for trainees Diversified program themesDiversified program themes Mentoring and networkingMentoring and networking Dual appointments for facultyDual appointments for faculty
Fogarty International CenterFogarty International CenterScience for Global HealthScience for Global Health
Principles for Capacity Building and SustainabilityPrinciples for Capacity Building and Sustainability
Fogarty International CenterFogarty International CenterScience for Global HealthScience for Global Health
Principles for Capacity Building and Sustainability (2)Principles for Capacity Building and Sustainability (2)
South-to-South collaborationSouth-to-South collaboration Sustained linkagesSustained linkages Contribution of resources from all partnersContribution of resources from all partners Leverage resources for added support Leverage resources for added support Connectivity via modern IT systemsConnectivity via modern IT systems Centers of excellence in home countriesCenters of excellence in home countries Mutual benefits known to allMutual benefits known to all
FIC Website: FIC Website: http://www.nih.gov/fic