• Global Health Matters

February 2007 Volume 5, Issue 1
Global Health Matters
F o g a r t y I n t e r n a t i o n a l C e n t e r ( N I H / H H S )
“ S c i e n c e f o r G l o b a l H e a l t h ”
Fogarty Framework Programs in Global Health
INSIDE THIS ISSUE:
World-renowned research “Framework Programs for A repeated theme
Letter from the Director 2 scientists and educators from Global Health”. throughout the meeting
all corners of the globe—U.S., was the catalytic value of
Latin America, Africa, China, The Programs link Schools bringing all these strands
Fogarty Ellison Fellows 3 and Russia—gathered on the from diverse disciplines on a together as a truly trans-
Share NIH campus on November 30 single or on multiple campus Program. The flip
and December 1, 2006, to campuses—such as Schools of side, however, was the
Foreign Tracking System 5 participate in the first Public Health and Medicine repeated theme of the
international networking with Schools of Engineering, challenges—administrative
meeting for the FIC Law, Business, International and cultural—of working
Malaria Progress and 5 Relations, Communications, across traditional
Perspective and others—to create joint boundaries within the
activities, curricula and institutions.
FIC Strategic Plan 6 educational opportunities in
Global Health. In a series of short
presentations, panel
Across the Center 7
In many cases, the process of discussions and break out
preparing an application was working groups
Bioethics Training Pro- 7 the first time some members of participants discussed the
gram in Egypt the global health community various models they are
at a university learned of each using to create global
Dr. Flora Katz, Program Director, other’s work. health programs.
Framework, FIC and
Dr. Warren Johnson, Cornell University
CONTINUED ON PAGE 4
International Health Research Activities Report
Under the direction of Dr. Karen Hofman, Director of Fo-
Overview of Scope and Timeframe garty’s Division of Advanced Studies and Policy Analysis,
planning has begun for publication of a new biennial,
For New Publication trans-NIH report on investment in international health research
and research training.
The Fogarty International Center, with the support of the NIH "Polls indicate that the American public wants to address
Director, is coordinating an effort which will enable NIH to global health disparities and believe that health research
take stock of the extent of our current extramural investments should be top priority for international spending," said Dr.
in global health—the International Health Research Activities Hofman. "Internal and external stakeholders are clamoring for
Report. It is hoped the report will be of use to a broad range of information on NIH investments abroad and this is an opportu-
audiences, including policy-makers, researchers and national nity to provide them and the US Congress with what they
governments. need".
CONTINUED ON PAGE 4
 Volume 5, Issue 1 Page 2
LETTER FROM THE DIRECTOR
It is a critical time in this country’s history—and overwhelming issues: the disparities in health within countries and be-
in the state of the world, where, in the broadest tween countries and the whole vexed issue of health systems.
sense, we in health have a great deal to offer.
Therefore, it was a tremendous privilege to wel- As we know, the world faces enormous environmental threats to health,
come Dr. Barry Bloom, the Dean of the Har- whether it is water shortages and air pollution in China, or rising tempera-
vard School of Public Health, to the NIH cam- ture and the inevitable spread of vector-born and other diseases. People
pus to address us on the mission of global health around the world are displaced by war, famine and civil and political un-
at the 2006 David E. Barmes Global Health rest. There are almost forty million displaced refugees and a slew of failed
Lecture. states since 1955, where parts of the country or governments can not con-
trol the security of their population.
“The challenge in global health is simple. A
billion of the 6.2 billion people alive enjoy a long The unfinished agenda of infectious diseases will never be finished—in
and healthy life. Our challenge is to help the Sub-Saharan Africa communicable diseases represent two-thirds of all the
other five billion to live longer, healthier lives,” deaths there--and more than a third in Asia. This represents major health
Dr. Roger I. Glass as Dr. Bloom stated. “The global public health problems. The data is imposing in terms of the burdens of infectious dis-
paradigm—and it is a paradigm—can be summa- eases, the cumulative deaths from AIDS—the fact that TB is a coconspira-
rized in three simple statements. The first is to tor with AIDS and kills vast numbers of people. Beyond AIDS, there is
define the problem, the second is to identify the risks and the third is to the recurrent issue of emerging infections. The Institute of Medicine
design interventions to prevent the disease or the problem.” (IOM) has documented thirty-two new infections that have either infected
humans for the first time, or recurred in humans when they were thought
A true leader in global health, Dr. Bloom has been on the advisory boards to be eradicated.
of the International Vaccine Institute and WHO. He’s has worked with
the Gates Foundation and with almost every major group that has advised Another major agenda in global health is the epidemic of chronic disease.
on global health. He has been, and continues to be, a “lifeguard” for Fo- When children do not die at the age of five because we can protect them,
garty. In 1996, he worked with us to create group of articulate recommen- to some extent, against infectious diseases, they will live to develop
dations that changed the direction of Fogarty, for the past decade. He chronic diseases. There will be a boom of aging and a rapid increase in
returned, in 2003, to provide a reorientation on that plan and those recom- chronic diseases--in countries that can’t even control most of their commu-
mendations still guide us today. nicable diseases.
Dr. Bloom’s visit was timely. The Harvard School of Public Health—like A quote that has rung salient with me was in an interview Dr. Bloom did
Fogarty—is going through a strategic planning process. Under Dr. in Nature. When he was asked what could be done to improve global
Bloom’s guidance, they put together a framework of multidisciplinary health in the world, his comment was that the most important thing the
global health areas that we all recognize as important. These include the US could do in global health would be to create one hundred times more
unfinished agenda of communicable disease, the coming epidemic of collaborations with scientists and universities in developing countries—a
chronic disease, the unnecessary epidemic of injuries and violence and two clear mission and a direction for all of us at Fogarty and NIH!
Upcoming Program Announcements and Requests for Applications
Program Contact Receipt Date Eligibility
Brain Disorders in the De- Kathleen Michels, PhD Non-AIDS: U.S. & foreign institutions; at least 2 investigators (1 from institution in
veloping World (BRAIN) mickelsk@mail.nih.gov May 16 high-income country and 1 from institution in low- to middle-income
AIDS-related: country) must collaborate on application as PI & Co-Investigator; PI may
August 23 be from low- to middle-income country or from U.S. or other high-
income country institution.
Fogarty Int’l Research Col- Kathleen Michels, PhD May 21 PI of U.S. based NIH-sponsored research project grant that will be active
laboration Award—Basic mickelsk@mail.nih.gov for at least 1 year beyond submission date of application, in collaboration
Biomedical (FIRCA-BB) with partner institutions in low- to middle-income countries
FIC/Ellison Clinical Re- Aron Primack, MD July through De- Students at U.S. medical, osteopathic, dental and nursing schools who
search Training Fellowship primacka@mail.nih.gov cember completed basic science courses and 1 year of clinical clerkship; students
(ELLISON) in doctoral public health programs who completed coursework and
passed qualifying exams prior to beginning of fellowship
Aids International Training Jeanne McDermott, PhD December 21 U.S. (or pre-approved non—U.S.) nonprofit, public or private institutions
and Research Program mcdermoj@mail.nih.gov with HIV/AIDS and HIV related research collaborations with low—to
(AITRP) middle—income country institutions
Volume 5, Issue 1 Page 3
Fogarty Ellison Fellows Share
The Ellison Medical Foundation offers a unique opportunity for
highly motivated U.S. medical and doctoral students to experi-
ence mentored research training at top-ranked NIH-funded "Brazil was steaming hot,
violent, crime ridden, over
research centers in Bangladesh, Botswana, Brazil, China, Haiti,
run with tropical diseases
India, Kenya, Mali, Peru, Russia, South Africa, Tanzania,
and my research was a ton of
Thailand, Uganda and Zambia. work. Despite that, and
maybe because of it, the
Into it’s fourth year, this highly regarded and successful pro- Fogarty Ellison Fellowship
gram is inspiring the next generation of U.S. global health re- was by far the most
searches, as Dr. Roger I. Glass, Director, FIC, has stated. important thing I did in
Here, Ellison Fellows share personal insights and photos. medical school. The
memories and experience
will last a lifetime."
“Everything is going well here in Salvador.
Peter "Buzz" Marcovici
The research is great - I'm running my own
clinical trial…I have a publication coming
out soon in American Journal of Tropical
Medicine and Hygiene. Not my research-- Favelas, Brazil
too early for that, but a tribute to the field
workers who keep things running out at “After an extraordinary year as a Fogarty Ellison Fellow, I can say with confidence
rural clinics. It's titled "Committed that the year has been a real “eye opener” for me. I through the program found that
Technician Making a Difference in Corte one of the most rewarding experiences personally was the impact we had on Bot-
de Pedra, Brazil.” (Brazil, Salvador) swana...” Raabya Rossenkhan
Tracey Newlove
“So amongst all the fanciful sights and sounds as
well as expansive beaches and wondrous wildlife,
Tanzania to me will continue to be about the beauty
of its people and children like Rosie who deserve a
better chance to live life to the fullest. My journey
begins anew, with the knowledge that through hard
work and great perseverance a difference can be
made to help those most in need.” Jeffrey Blander
“These skills can’t be learned in a book, and
for better or worse, they must be lived
Paul Drain, Dar se Salaam, Tanzania through day by day. All the best international Chennai, India
health researchers have lived through the joy,
“..this experience in Tanzania has solidi- and sometimes the frustration, of personally As result of the Fogarty/Ellison fellowship
fied my interests in infectious disease working abroad (Brazil, Salvador)” (Chennai, India), I now have an avid
medicine and global health” Paul Drain Aron Unger interest in global health.” Sonia Singh
“I am attaching the photo of the World AIDS Day 2006 event that I planned in Nanjing, China”
“This image was on the front page of Xiandai Kuaibao, a Nanjing Attached to each pair of slippers is a small note with an HIV/AIDS
newspaper that reported on the events. The event was hectic and fact or a short story of someone with HIV in China. Passersby were
swarming with people. In the photo, I am the Chinese American free to walk around the slippers and read the notes.” Susan Wong
woman in a dark blue coat and red hat (top right corner).
Before us is an installation piece that we set up in a large public square
in central Nanjing. There are 65 pairs of Chinese slippers laid out in a
ribbon and represent the 65 wan or 650,000 people in China believed
to be infected with HIV (statistics are from the 2006 reports issued by
UNAIDS, WHO and China Ministry of Health).
The 14 red slippers represent the 14 wan or 140,000 people who have
been tested and know that they are infected. The 50 blue slippers rep-
resent the 50 wan or 150,000 people who are infected but do not know
that are infected because they have yet to be tested. And the 1 pair of
child size orange slippers represent the 1 wan or 10,000 children in-
fected with HIV.
Volume 5, Issue 1 Page 4
Fogarty Framework Programs in Global Health
CONTINUED FROM PAGE 1 developing country participants; global Korn from the Association of American
health conferences and seminar series; and Medical Colleges. Dr. Nils Daulaire,
the design of new concentrations and President of the Global Health Council,
degrees in global health for students— made a presentation on the work of and
from undergraduate through professional resources available from that
level—were discussed. organization.
The new programs have already The Frameworks Program is co-sponsored
attracted considerable student and faculty by the Fogarty International Center with
interest and enthusiasm, with fully and the National Cancer Institute, the National
oversubscribed courses and activities. Center on Minority Health and Health
Disparities, and the National Institute on
Dr. Kathy Michels, FIC, and Richard Mollica, Deafness and Other Communication
Massachusetts General Hospital Disorders. There are currently nineteen full
framework programs and seven planning
grants. Representatives from every
The models presented used a variety of program attended the meeting. Web
approaches in parallel including: address: http://www.fic.nih.gov/
multidisciplinary courses and seminars; programs/training_grants/framework/
hands on experiential opportunities with
international partners; competitive faculty
grants to support new course
development; and carrying out Dr. Xu Quan, Fudan University, China, and Dr. Peggy
networking and groundwork for new Bentely, University of North Carolina, Chapel Hill
collaborations for global health research.
The use of virtual co-laboratories to Several guests also participated in the
prepare and deliver courses jointly with network meeting: Drs. Mark Weiss,
faculty and students in other countries Linda Lopez, and Rita Tuetonico from
was talked about. Hosting joint US-- the National Science Foundation; Dr.
foreign degree programs in other countries Harrison Spencer from the Association of
to make them more affordable for Schools of Public Health and Dr. David Dr. Ephata Kaaya, Muhimbili University, Tanzania
and Dr. Jeffrey Griffiths, Tufts University
International Health Research Activities Report
CONTINUED FROM PAGE 1
In consultation with the scientific community, external However, to ensure that data uncertainties and report limitations
stakeholder groups, and IC international representatives, are clearly communicated to the public, definitions and
DASPA has developed a scope and timeframe for the report. methodologies will be made available electronically.
The first volume is scheduled for release in June 2007. It will Depending on the outcomes of the 2007 report, classes of
focus on extramural international research and training research and research training reported in future years may be
investments made in fiscal years 2004 and 2005. In part, due to expanded upon.
production time constraints, the plan excludes intramural
research from the analysis; however, this may be considered for The first report is to be 75 to 100 pages in length; it will be
inclusion in the next report, scheduled for release in 2009. published in print and electronic media, to facilitate access by
individuals and institutions around the globe.
Given the importance of equitable, collaborative partnerships in
advancing international health research and improving health The report will rely heavily on informational graphs and tables,
outcomes throughout the world, only research projects that with limited narrative. Data will be aggregated along multiple
involve a foreign component will be included for now. dimensions, including country and region of investment, disease
code, and IC.
By excluding certain classes of research, the project (as
designed) will result in an underestimate of the ICs’ total global This report represents a resurrection of the “Annual Report of
health research spending, which Research!America defines as International Activities” that Fogarty published from the 1970s
health sciences research of relevance to low and middle income through 2000.
countries.
Volume 5, Issue 1 Page 5
“Defining and Defeating the Intolerable Burden of Malaria:
Progress and Perspectives”
Upcoming supplement to the accurately? Have the strategies
American Journal of Tropical and interventions used de- This collection of 40 plus pa- The editors of the malaria sup-
Medicine and Hygiene creased the toll? What are the pers, many of which were pre- plement are Joel Breman of the
new scientific and control ini- sented at a symposium at the Fogarty International Center
What is malaria and what con- tiatives to combat malaria and 4th Multilateral Initiative on (FIC), U.S. National Institutes
tribution does this disease define its decrease? Malaria (MIM) Pan African of Health; Martin Alilio of the
make to overall and childhood Conference held in November Global Health, Population and
deaths? How are co-morbidity Authorities on these topics 2005 in Yaoundé, Cameroon, Nutrition Department, Acad-
(malaria associated with other from malarious countries, the will complement and go be- emy for Educational Develop-
diseases) and co-mortality con- GMP, and research and control yond companion supplements ment, U.S.; Nicholas White of
sidered? organizations will address clini- to the American Journal of Tropi- the Mahidol University, Thai-
cal issues; epidemiology; con- cal Medicine and Hygiene on the land and Welcome Research
Most importantly, have coun- trol; evaluation; drugs; vectors; malaria burden published in Unit, Oxford University, U.K.;
tries, the Global Malaria Pro- genetics; immunology and 2004 (v.71, No.2, Suppl;pp1- and Cherice Holloway of the
gram (GMP), and other initia- vaccines; and international 282) and 2001 (v.64, No.1-2 Fogarty International Center
tives defined these burdens cooperation. Suppl;pp1-106). (FIC), U.S. National Institutes
Foreign Tracking System Reaches All Corners of the Globe
Fogarty’s Division of International Rela- international research portfolio growing on Audiences for the new report will range
tions (DIR), working with the US Depart- a yearly basis, the need for NIH to report from internal use within the NIH, foreign
ment of State, has successfully extended on its foreign collaborative activity has governments, and the US Congress.
the use of the Foreign Tracking System never been greater.
(FTS) out to seventy percent of all US The FTS, in future years, could also be
Embassies worldwide. As a database, FTS allows users—for the used as a model for other HHS agencies to
track and report their own international
This number encompasses nearly all coun- FIC will address the public’s growing research portfolios.
tries where NIH has a substantial research interest in the NIH international portfo-
investment—124 countries use FTS— lio by using the FTS data to assist in the DIR’s Kevin Bialy, Acting International
opposed to 30 countries only three months creation of the new International Program Officer for South America, has
ago. DIR anticipates that all US Embassies Health Research Activities Report. The been conducting training sessions across
worldwide will be using the system in early Report (featured in this issue of GHM) the NIH campus to introduce some of the
2007. will detail the on-going NIH invest- ways in which ICs can report on their in-
ments at foreign sites worldwide. ternational activities as well as the im-
Embassy staff can log-on to the web-based provements of the FTS over previous for-
system, review a project, and clear directly eign policy clearance mechanisms.
through the FTS. Feedback from Embas- first time—to track all NIH--funded extra-
sies using the system has been overwhelm- mural research conducted in foreign coun-
The next steps in making the FTS more
ingly positive, allowing them to review tries across ICs.
useful for ICs and non-NIH users in an
NIH research projects, from a foreign pol- The International Health Research Activi- “FTS 2.0” is to incorporate changes rec-
icy perspective, within days— or even ties Report (formally known as the An- ommended by the ICs and US Department
hours. The review time is a marked im- nual Report of International Activities), of State over the past two years.
provement over the previous cable-based was last published in FY 2000, and was
“1820” system, which would take weeks or largely halted due to the decentralized
nature and variable format of data avail- Further versions of the FTS will contain
months for ICs to obtain an embassy con-
able from the 27 ICs. reporting mechanisms that will provide a
currence.
full summary of NIH foreign activity in a
country with one button reports, interac-
While it is clear that the level of NIH inter- With all ICs now submitting data into the tive training modules, and refined key-
national research has been rapidly increas- FTS, and the ability to verify foreign fund- word searches for NIH disease research
ing over the past decade, NIH’s ability to ing amounts in real-time, FIC has solved within a specific country.
report those international collaborations, the problem of how to accumulate this
until now, has been difficult because there information, accurately, in one place from
was no central repository for the aggre- all ICs.
gated international NIH data. With NIH’s
Volume 5, Issue 1 Page 6
FIC Strategic Plan—Global Perspectives
“How will we train the next and identified gaps in global health health included stakeholders from
generation of US and foreign research. the World Health Organization
investigators in Global Health?” (WHO), Centers for Disease
On the international front, two
Control and Prevention (CDC),
“What can Fogarty do to stimulate Strategic Planning sessions were
Global Health Research in the US other NIH ICs and FIC-supported
held at Forum 10 of the Global
and abroad?” PIs.
Forum for Health Research in
Cairo Egypt in November 2006,
“What is the role of “Implementation
attended by Dr. Karen Hofman and There, Dr. Glass, provided
Science” in accelerating the
application of Global Health Dr. Linda Kupfer. impressions of “Fogarty from the
research findings?” Field,” and a perspective on
“Fogarty: past, present and future.”
Representatives from 16 countries,
The new FIC Strategic Plan will 13 of them developing countries,
address these and other questions, attended Fogarty’s sessions Dr. Kupfer, the organizing force
and guide the Center activities in including: South Africa, Cameroon, behind the Strategic Planning
the next five years. The Strategic Tanzania, Philippines, India, Meeting, offered the Stakeholders a
Planning process for Fogarty began Nepal, Pakistan, China, Colombia, view of the Plan “from the starting
in earnest in August of this year just Mexico, Ecuador, Lebanon, Egypt, gate to the finish” and a summary
a few months after Dr. Roger I. United Kingdom, United States and of recurrent themes—taken from
Glass came onboard as the New Zealand. previous meetings and conferences.
Director. Dr. Glass took up the
reins to put Strategic Planning
To gain additional input, Fogarty These included the need for US
process “on a fast track”.
asked for comments to specific researchers and students to be
question posed on our website. Our exposed to Global Health research
website generated 82 responses, early in their training in order to
43% of which were from 12 develop an interest in the field; the
developing countries. Fifty-four of need for long term support of
the respondents to the website were training programs for developing
from academic institutions, 11 were country scientists to build
FIC trainees, 38 were FIC developing country research
awardees. capacity; and that the field of
“Implementation Science” deserves
a place in the FIC portfolio.
Dr. Kupfer discussed Strategic
Planning with IC International
Representatives at a recent meeting At the end of the meeting, Dr.
and with PIs and Co-PIs from the Glass asked for suggestions
Dr. Roger I. Glass asked stakeholders for Fogarty Framework Program for regarding FIC’s brand. A vote from
suggestions regarding FIC branding Global Health at their network the stakeholders determined that
meeting. She received many “Science Anywhere Helps People
There were initially two internal thoughtful suggestions and Everywhere” was a winning entry.
Fogarty retreats in August and comments.
September 2006. Next, Strategic The Plan will be launched in July
Planning was discussed with the Finally, in December, FIC 2007.
FIC Advisory Board. In parallel, a convened a Strategic Planning
consultant analyzed the FIC Stakeholder Conference held on the
portfolio, examined the current NIH campus in Bethesda, MD.
landscape of global health research Attendees knowledgeable in Global
Volume 5, Issue 1 Page 7
Across the Center
Global Health Lecture Global Health Publications
Dr. Barry Bloom, Dean of the As profiled in the April 2006, edition of Global Health
Harvard School for Public Matters, a trio of books from The Disease Control Priority
Health, a world-class immunolo- Project (DCPP) were launched at a global health conference
gist with a passionate commit- in Beijing, China. The books were published December 2006.
ment to understanding and com-
bating global infectious diseas