research capacity building programs of the fogarty international center, nih international affairs...

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


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


Program ObjectivesProgram Objectives


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


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


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:


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


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


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


Principles for Capacity Building and SustainabilityPrinciples for Capacity Building and Sustainability


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

http://www.nih.gov/fic






research capacity building programs of the fogarty international center, nih international affairs...

Documents

international awards1

support research

weeks research

foreign research awards50

international rt awards166

major training

months shortterm training

postdoctoral training