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Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
Tropical Disease Research in Panama: Historical Perspectives and ...
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  • 1. Tropical Diseases Research in Panama:Tropical Diseases Research in Panama: Historical Perspectives and CurrentHistorical Perspectives and Current OpportunitiesOpportunities Joel G. Breman, M.D., D.T.P.H.Joel G. Breman, M.D., D.T.P.H. Fogarty International CenterFogarty International Center National Institutes of HealthNational Institutes of Health Bethesda, Maryland, USABethesda, Maryland, USA Workshop to Establish the Santiago CenterWorkshop to Establish the Santiago Center for Geographic Medicine and Emergingfor Geographic Medicine and Emerging Tropical DiseaseTropical Disease Santiago, PanamaSantiago, Panama 6–7 December 20026–7 December 2002
  • 2. 40 Years of Tropical Medicine Research40 Years of Tropical Medicine Research A History of the Gorgas Memorial Institute ofA History of the Gorgas Memorial Institute of Tropical and Preventive Medicine, Inc. andTropical and Preventive Medicine, Inc. and the Gorgas Memorial Laboratorythe Gorgas Memorial Laboratory Willard H. Wright, D.V.M., M.S., Ph.D.Willard H. Wright, D.V.M., M.S., Ph.D. Washington, 1970Washington, 1970 Reese Press, Baltimore, MarylandReese Press, Baltimore, Maryland
  • 3. The Gorgas Memorial Laboratory, 1928-1968 Six Epochs 1928 – 1934 (political will)1928 – 1934 (political will)  Founded by Dr. Belisario Porras, President, Republic ofFounded by Dr. Belisario Porras, President, Republic of PanamaPanama - Land- Land - Building- Building - U.S. Congress support- U.S. Congress support 1934 – 1943 (scientific expertise)1934 – 1943 (scientific expertise)  StaffingStaffing - Protozologist (C.M. Johnson)- Protozologist (C.M. Johnson) - Helminthologist (A.O. Foster)- Helminthologist (A.O. Foster) - Entomologist (C.E. Rozeboom)- Entomologist (C.E. Rozeboom) 1943 – 1949 (scientific priorities)1943 – 1949 (scientific priorities)  Insect repellents, insecticidesInsect repellents, insecticides - U.S. Army Corps of Engineers- U.S. Army Corps of Engineers
  • 4. The Gorgas Memorial Laboratory,The Gorgas Memorial Laboratory, 1928-1968 (2)1928-1968 (2) 1949 – 1956 (public health priorities)1949 – 1956 (public health priorities)  Yellow Fever (Santo Tomás, Hospital)Yellow Fever (Santo Tomás, Hospital)  Yellow Fever Service of PanamaYellow Fever Service of Panama 1956 – 1960 (resource increase)1956 – 1960 (resource increase)  $150,000 from U.S. Congress (tripled budget)$150,000 from U.S. Congress (tripled budget)  NIAID grant, leishmanasisNIAID grant, leishmanasis 1960 – 1968 (resource increase)1960 – 1968 (resource increase)  $500,000 from U.S. Congress for infrastructure$500,000 from U.S. Congress for infrastructure  InsectaryInsectary  Grants and giftsGrants and gifts
  • 5. The Gorgas Memorial Laboratory, 1928-1968The Gorgas Memorial Laboratory, 1928-1968 Types of ResearchTypes of Research  Core activitiesCore activities - Epidemiology- Epidemiology - Treatment- Treatment - Control- Control - Laboratory work in support of field- Laboratory work in support of field activitiesactivities
  • 6. The Gorgas Memorial Laboratory, 1928-1968The Gorgas Memorial Laboratory, 1928-1968 Types of Research (2)Types of Research (2)  Major themesMajor themes - Malaria- Malaria - Yellow fever- Yellow fever - Other arboviral infections- Other arboviral infections - Chagas disease- Chagas disease - Leishmaniasis- Leishmaniasis - Equine trypanasomiasis- Equine trypanasomiasis - Residual insecticides- Residual insecticides
  • 7. The Gorgas Memorial Laboratory, 1928-1968The Gorgas Memorial Laboratory, 1928-1968 Types of Research (3)Types of Research (3) -- Helminithic and protozoalHelminithic and protozoal infectionsinfections - Diarrheal diseases- Diarrheal diseases - Reservoir hosts- Reservoir hosts - Immunology- Immunology - Other: herpetology, insect genetics- Other: herpetology, insect genetics ((Drosophila)Drosophila)
  • 8. Short- and Long-Term Research TrendsShort- and Long-Term Research Trends  Short-termShort-term -- Equine trypanosomiasis, 1930-1946 (H.S.Equine trypanosomiasis, 1930-1946 (H.S. Eakins), retirement; horses used lessEakins), retirement; horses used less - Equine helminthiasis, 1934-1939 (A.O. Foster)Equine helminthiasis, 1934-1939 (A.O. Foster) - Cattle trypanasomiasis, 1940-1943 (warCattle trypanasomiasis, 1940-1943 (war priorities)priorities) - Intestinal helminths, 1930 (intermittent, E.C.Intestinal helminths, 1930 (intermittent, E.C. Faust)Faust) - Tropical climatology, 1941Tropical climatology, 1941 - Tuberculosis, BCG vaccination, 1949-1951- Tuberculosis, BCG vaccination, 1949-1951 (taken over by Servicio(taken over by Servicio CooperativoCooperativo Interamericano de Salud Publica)Interamericano de Salud Publica)
  • 9. Long Term ProjectsLong Term Projects  Malaria, 1929 (H.C. Clark, C.M.Malaria, 1929 (H.C. Clark, C.M. Johnson)Johnson)  Chagas disease, 1931 (C.M.Chagas disease, 1931 (C.M. Johnson)Johnson)  Leishmaniasis, 1944 (M. Hertig, A.Leishmaniasis, 1944 (M. Hertig, A. Herrer)Herrer)  Insect taxonomy, 1929 (D.P. Curry)Insect taxonomy, 1929 (D.P. Curry)  Santa Rosa Field Station, 1931 andSanta Rosa Field Station, 1931 and Chagres River Villages (DDT use)Chagres River Villages (DDT use)
  • 10. How Research Projects ChosenHow Research Projects Chosen -Incidence, prevalence, epidemicsIncidence, prevalence, epidemics -Available staffAvailable staff -Outside scientific collaborationOutside scientific collaboration -ResourcesResources -SerendipitySerendipity
  • 11. Major AchievementsMajor Achievements Malaria, began in 1929Malaria, began in 1929  Drug treatmentDrug treatment -- Quinine studies, 1931Quinine studies, 1931 - Atebrin/plasmochin, 1935- Atebrin/plasmochin, 1935 - Quinine/plasmochin, 1935- Quinine/plasmochin, 1935 - DDT house spraying, 1945 (continued to 1977)- DDT house spraying, 1945 (continued to 1977) - Chloroquine/paludrine weekly, 1947- Chloroquine/paludrine weekly, 1947 Parasite rates droppedParasite rates dropped 26.5 %26.5 %  0.7 % (CQ)0.7 % (CQ) 34.8 %34.8 %  1.5% (P)1.5% (P) - Pyrimethamine/primaquine + DDT, 1960- Pyrimethamine/primaquine + DDT, 1960 (La Repressa and Mendoza villages) eliminated(La Repressa and Mendoza villages) eliminated disease after 2 months!disease after 2 months! Maintained 2 yearsMaintained 2 years But 53 cases detected from 1962 - 1964But 53 cases detected from 1962 - 1964
  • 12.  Primate malariaPrimate malaria - P. brasilianum,- P. brasilianum, attempt transmission to humanattempt transmission to human volunteers, 1930volunteers, 1930 - Immunity and- Immunity and P. falciparumP. falciparum, 1931, 1931 - Human malaria to monkeys, 1966- Human malaria to monkeys, 1966 Aotus trivirgatusAotus trivirgatus andand P. vivaxP. vivax, 1967, 1967 AotusAotus (night monkey)(night monkey) AtelesAteles (spider monkey)(spider monkey) SaquinusSaquinus (marmoset)(marmoset) CebusCebus  Transmission withTransmission with Anopheles albimanusAnopheles albimanus  DDT resistance detected after 8 years of use, lateDDT resistance detected after 8 years of use, late 1960s1960s Malaria (con’t)Malaria (con’t)
  • 13. AmericanAmerican Trypanasomiasis (T. cruzi)Trypanasomiasis (T. cruzi) Chagas Disease, began 1931Chagas Disease, began 1931  DiagnosisDiagnosis  PrevalencePrevalence  ManifestationsManifestations  TreatmentTreatment  EpidemiologyEpidemiology  HostsHosts  Vectors and ecologyVectors and ecology 3.8 % positive of 1,251 tested by CF test, 19633.8 % positive of 1,251 tested by CF test, 1963 40,000 cases, 196640,000 cases, 1966
  • 14. Surveys, 1967Surveys, 1967 NumberNumber % Pos% Pos Blood bankBlood bank 6,2536,253 2.02.0 OutpatientsOutpatients 1,2941,294 11.411.4 SurveysSurveys 399399 12.512.5 • Studies in SantoStudies in Santo TomTomááss HospitalHospital Arrythmias (RBBB, LBBB, A/V block)Arrythmias (RBBB, LBBB, A/V block) Ventricular and atrial enlargementVentricular and atrial enlargement Ventricular aneurysmsVentricular aneurysms • TreatmentTreatment 8 aminoquinolines8 aminoquinolines Chagas Disease (2)Chagas Disease (2)
  • 15.  Parasitology and EcologyParasitology and Ecology - T.cruzi- T.cruzi found in 33 animal species; dogs,found in 33 animal species; dogs, rats, positiverats, positive - T. rangeli- T. rangeli found to cross-reactfound to cross-react  Entomology and EcologyEntomology and Ecology - Rhodnius pallescens- Rhodnius pallescens efficient, butefficient, but R.R. prolixusprolixus (not native) could not be infected(not native) could not be infected with local isolates.with local isolates. - Other triatomes identified, but- Other triatomes identified, but R.R. pallescenspallescens found in native houses offound in native houses of 3,203. 32.1% infected with3,203. 32.1% infected with T. cruziT. cruzi andand 4.1% - 8.1% with4.1% - 8.1% with T. rangeliT. rangeli (non-(non- pathogenic, 1960s)pathogenic, 1960s) Chagas Disease (3)Chagas Disease (3)
  • 16. Leishmaniasis, 1944Leishmaniasis, 1944  EpidemiologyEpidemiology  TreatmentTreatment  Vectors and ecologyVectors and ecology  FindingsFindings -- Forest disease, disappears when forests clearedForest disease, disappears when forests cleared -- Pyrimethamine, 90% curePyrimethamine, 90% cure -- Geographic strain differencesGeographic strain differences -- Natural infection in wild caughtNatural infection in wild caught Phlebotomines,Phlebotomines, infection rate 8.1%infection rate 8.1% -- Animal model studies; tried rats, mice, hamsters,Animal model studies; tried rats, mice, hamsters, kinkajou, olingo, porcupine, marmosetkinkajou, olingo, porcupine, marmoset Succeeded with spiny ratSucceeded with spiny rat
  • 17. Helminths, 1930Helminths, 1930  Ascaris lumbricoidesAscaris lumbricoides, “common”, 80% prevalence, “common”, 80% prevalence  Necator americanusNecator americanus, “common”, 80% prevalence, “common”, 80% prevalence  Trichuris trichiuraTrichuris trichiura, 1.0% - 21.0%, pos., 1.0% - 21.0%, pos.  Strongyloides stercoralisStrongyloides stercoralis, 20% pos. of 1,663 in, 20% pos. of 1,663 in SantaSanta TomTomááss Hospital with 10.5% of those positiveHospital with 10.5% of those positive having symptomshaving symptoms  Mansonella ozzardiMansonella ozzardi, 9.9% of 244, 9.9% of 244  Capillaria hepaticaCapillaria hepatica in 8% of 194 stoolsin 8% of 194 stools  First report ofFirst report of Echinococcus oligarthrusEchinococcus oligarthrus from fatalfrom fatal case; seen in puma, jaguar, jaguarundi, agouticase; seen in puma, jaguar, jaguarundi, agouti  Trichinella spiralis;Trichinella spiralis; EEE,EEE, IlhéusIlhéus virus, Jap Bvirus, Jap B encephelitis, ended fatally in animalsencephelitis, ended fatally in animals
  • 18. Rickettsial and Viral DiseasesRickettsial and Viral Diseases  RickettsialRickettsial  Q fever, first report in Panama, 1946Q fever, first report in Panama, 1946  Murine typhus, first report, 1947Murine typhus, first report, 1947  RMSF, first report, 1951RMSF, first report, 1951  VirusesViruses  Mosquito vectors of yellow fever, first description in Panama andMosquito vectors of yellow fever, first description in Panama and Central America, 1949Central America, 1949  Vector ecology and transmission studies, 1949Vector ecology and transmission studies, 1949  SLE, first recovery and identification of human patients, 1957SLE, first recovery and identification of human patients, 1957  IlhéusIlhéus virus, first isolation, 1958virus, first isolation, 1958  Changuinola, first isolation, 1960Changuinola, first isolation, 1960  New arboviruses discovered, Madrid, Ossa, Patois, Zegla, 1961New arboviruses discovered, Madrid, Ossa, Patois, Zegla, 1961  Wyeomia subgroup, first isolated from human, 1963Wyeomia subgroup, first isolated from human, 1963  Bussuquara, first isolation from human, 1964Bussuquara, first isolation from human, 1964  IlhéusIlhéus virus, first case of encephalitis, 1964virus, first case of encephalitis, 1964  SLE foundSLE found DeinoceritesDeinocerites (crab-hole mosquitoes) as host, 1964(crab-hole mosquitoes) as host, 1964  Vesicular Stomatitis Virus, isolation from humans, sentinelVesicular Stomatitis Virus, isolation from humans, sentinel monkeys, 1968monkeys, 1968
  • 19.  EntomologyEntomology - Dermatobia hominis- Dermatobia hominis (human botfly), lifecycle(human botfly), lifecycle in man, 1929in man, 1929 - An. albimanus- An. albimanus, first laboratory colony in, first laboratory colony in Central America, 1935Central America, 1935 - DDT for- DDT for PhlebotominePhlebotomine control, 1944control, 1944 - DDT for- DDT for SimuliumSimulium control, 1945control, 1945 - DDT for- DDT for CulicoidesCulicoides sandflies, 1945sandflies, 1945 - Trombiculidae- Trombiculidae (chigger mites), habits and(chigger mites), habits and ecology, 1945ecology, 1945 - Inventory of ticks and biting insects, 1966- Inventory of ticks and biting insects, 1966  MiscellaneousMiscellaneous - Inventory of poisonous snakes and incidence- Inventory of poisonous snakes and incidence of snake bites, 1930-1954of snake bites, 1930-1954
  • 20. Papers Published by the Gorgas MemorialPapers Published by the Gorgas Memorial Laboratory, 1930-1969Laboratory, 1930-1969 PapersPapers MeanMean 1930-19341930-1934 6969 1414 1935-19391935-1939 114114 2323 1940-1944*1940-1944* 5858 1212 1945-1949*1945-1949* 6161 1212 1950-19541950-1954 6969 1414 1954-19591954-1959 5353 1111 1960-19641960-1964 7777 1515 1965-19691965-1969 130130 2626 1930-19691930-1969 630630 1616 * 1943-1945 = 12 papers* 1943-1945 = 12 papers
  • 21. Major Topics in Publications by the GorgasMajor Topics in Publications by the Gorgas Memorial Laboratory, 1930-1969Memorial Laboratory, 1930-1969  Malaria, 60 papersMalaria, 60 papers  Birds, 54Birds, 54  CulicidaeCulicidae, 51, 51  PhlebotomusPhlebotomus, 49, 49  TabanidaeTabanidae, 47, 47  Animals, wild, 40Animals, wild, 40  Monkey diseases, 36Monkey diseases, 36  AnophelesAnopheles, 35, 35  Laboratory infection, 35Laboratory infection, 35  Yellow fever, 26Yellow fever, 26  Laboratory techniques, 23Laboratory techniques, 23
  • 22. Middle America Research Unit, NationalMiddle America Research Unit, National Institute of Allergy and Infectious Diseases,Institute of Allergy and Infectious Diseases, Canal Zone (1958-1972)*Canal Zone (1958-1972)* Focus on arthropod virologyFocus on arthropod virology  Discovery of Machupo virus (BolivianDiscovery of Machupo virus (Bolivian hemorrhagic fever)hemorrhagic fever) - Uncovered biology and ecology of virus, and- Uncovered biology and ecology of virus, and rodent reservoir leading to building arenavirusrodent reservoir leading to building arenavirus familyfamily  Venezuelan Equine Encephalitis virus, discoveryVenezuelan Equine Encephalitis virus, discovery of antigenic and equine virulence variants; liveof antigenic and equine virulence variants; live virus vaccine (TC-83) for lab workersvirus vaccine (TC-83) for lab workers  Vesicular stomatitus virus; first clearVesicular stomatitus virus; first clear demonstration of transovarial transmission of andemonstration of transovarial transmission of an arbovirusarbovirus * Provided by Karl M. Johnson, MD, Director, MARU, 1964-1972* Provided by Karl M. Johnson, MD, Director, MARU, 1964-1972
  • 23. ““Every advantage in the past isEvery advantage in the past is judged in the light of the futurejudged in the light of the future issue”issue” DemosthenesDemosthenes
  • 24. Recent National Institutes of Health andRecent National Institutes of Health and Government of Panama CollaborationsGovernment of Panama Collaborations  National Cancer Institute, 1993-2001National Cancer Institute, 1993-2001 -- Human retroviruses: epidemiological surveyHuman retroviruses: epidemiological survey at Hospitalat Hospital SantoSanto TomTomáás ands and Research Triangle ParkResearch Triangle Park InstituteInstitute -- Establishment of cancer information center atEstablishment of cancer information center at Instituto de Nacionale de Oncologie,Instituto de Nacionale de Oncologie, ManaguaManagua  National Institute on Drug Abuse, 1997-1999National Institute on Drug Abuse, 1997-1999 -- Drug involvement among Latin Americans,Drug involvement among Latin Americans, Departamento de Farmacodependencias andDepartamento de Farmacodependencias and Johns Hopkins UniversityJohns Hopkins University
  • 25. Recent National Institutes of Health andRecent National Institutes of Health and Government of Panama Collaborations (2)Government of Panama Collaborations (2)  National Institute on Deafness and OtherNational Institute on Deafness and Other Communicable Disorders, 1997-2002Communicable Disorders, 1997-2002 -- Neural basis of complex-sound processingNeural basis of complex-sound processing -- National de Recursos Naturales RenovablesNational de Recursos Naturales Renovables and Washington Universityand Washington University  Pan American FellowshipPan American Fellowship -- PAHO/WHO partners with NIHPAHO/WHO partners with NIH -- One year postdoctoral training in the NIHOne year postdoctoral training in the NIH intramural laboratoriesintramural laboratories -- Focus on Caribbean, Central America andFocus on Caribbean, Central America and Andean countriesAndean countries -- Regional public health issues are priorityRegional public health issues are priority
  • 26. Recent National Institutes of Health andRecent National Institutes of Health and Government of Panama Collaborations (3)Government of Panama Collaborations (3)  Fogarty International CenterFogarty International Center -- International Cooperative Biodiversity Group, 1995-1998:International Cooperative Biodiversity Group, 1995-1998: Bioprospecting to discover new drugs for malaria and otherBioprospecting to discover new drugs for malaria and other infectious diseases.infectious diseases. Smithsonian Tropical ResearchSmithsonian Tropical Research Institute, University of Panama, Gorgas MemorialInstitute, University of Panama, Gorgas Memorial Institute for Health ResearchInstitute for Health Research, G.W. Hansen’s Disease, G.W. Hansen’s Disease Center (Louisiana), Walter Reed Army Institute of Research,Center (Louisiana), Walter Reed Army Institute of Research, Nature Foundation of PanamaNature Foundation of Panama, Novartis,, Novartis, ConservationConservation InternationalInternational -- Fogarty International Research Collaborative AwardsFogarty International Research Collaborative Awards Bioprospecting in the Panamanian rainforest, 1995-1998Bioprospecting in the Panamanian rainforest, 1995-1998 Fundacion Para La Conservacion de Los RecursosFundacion Para La Conservacion de Los Recursos andand the University of Utahthe University of Utah -- Studies ofStudies of Toxoplasma bradyzoiteToxoplasma bradyzoite (1999-2002)(1999-2002) Gorgas Memorial Institute for Health ResearchGorgas Memorial Institute for Health Research andand Stanford UniversityStanford University
  • 27. Mission:Mission: To promote and support research and training internationally to reduce disparities in global health Fogarty International CenterFogarty International Center Science for Global HealthScience for Global Health
  • 28. FogartyFogarty International CenterInternational Center Environment and Ecology Strategic Alliances Tobacco Prevention & Control Maternal & Child Health Health & Economic Development International Research Scientist Career Development Responsible Medical Reporting Research-Policy Interfaces Nutrition Other Chronic Diseases Promote FIC In-house Research Create Collaborative International Research Networks Build International Research Capacity Medical Informatics BioethicsGenetics Clinical/Operational Research HIV & Emerging Infectious Diseases Medical Informatics Environmental & Occupational Health BiodiversityPopulation & Demography FUTUREFUTURE NEW INITIATIVESNEW INITIATIVES CURRENT PROGRAMSCURRENT PROGRAMS PLATFORMPLATFORM —— MISSIONMISSION FOUNDATIONFOUNDATION
  • 29.  Extramural Training GrantsExtramural Training Grants —— 12 Programs12 Programs  Research GrantsResearch Grants —— 5 Programs5 Programs  International Training Grants for U.S. citizensInternational Training Grants for U.S. citizens * Minority International Research Training Grant (MIRT)* Minority International Research Training Grant (MIRT) * Scientist Development fellowship (post-doc)* Scientist Development fellowship (post-doc) * Foreign-funded fellowship (Japan)* Foreign-funded fellowship (Japan) Fogarty International CenterFogarty International Center Division of International Training and ResearchDivision of International Training and Research
  • 30.  HIV/AIDSHIV/AIDS  Building Capacity in Support of ICIDR sitesBuilding Capacity in Support of ICIDR sites  Emerging Infectious DiseasesEmerging Infectious Diseases  Environmental and Occupational HealthEnvironmental and Occupational Health  FIC-NLM Medical InformaticsFIC-NLM Medical Informatics  Maternal and Child HealthMaternal and Child Health  Population and HealthPopulation and Health  TuberculosisTuberculosis  Research BioethicsResearch Bioethics  MalariaMalaria  Clinical, Operational, and Health Services ResearchClinical, Operational, and Health Services Research  Tobacco and Health ResearchTobacco and Health Research Fogarty International CenterFogarty International Center Training Grants for Developing CountriesTraining Grants for Developing Countries
  • 31. • Masters and Doctoral DegreesMasters and Doctoral Degrees * Tuition, Stipends, Travel, Related Expenses* Tuition, Stipends, Travel, Related Expenses • Post-doctoral FellowshipsPost-doctoral Fellowships * Tuition, Stipends, Travel, Related Expenses* Tuition, Stipends, Travel, Related Expenses • Short Courses (in U.S. or In-country)Short Courses (in U.S. or In-country) * Tuition, Travel, Per diem* Tuition, Travel, Per diem • Training-related In-country research grants, Re-entryTraining-related In-country research grants, Re-entry grantsgrants • Limited salary, Administrative support for U.S. universityLimited salary, Administrative support for U.S. university Fogarty International CenterFogarty International Center Support Available Through Training GrantsSupport Available Through Training Grants
  • 32. • Ecology of Infectious DiseasesEcology of Infectious Diseases • Fogarty International Research Collaboration AwardFogarty International Research Collaboration Award (FIRCA)(FIRCA) • HIV-AIDS and Related Illnesses Collaboration AwardHIV-AIDS and Related Illnesses Collaboration Award (AIDS-FIRCA)(AIDS-FIRCA) • International Cooperative Biodiversity Groups (ICBG)International Cooperative Biodiversity Groups (ICBG) • International Studies on Health and EconomicInternational Studies on Health and Economic DevelopmentDevelopment • Proposed Global Health Research Initiative ProgramProposed Global Health Research Initiative Program (GRIP) for New Foreign Investigators(GRIP) for New Foreign Investigators • International Tobacco and Health Research and CapacityInternational Tobacco and Health Research and Capacity Fogarty International CenterFogarty International Center Research GrantsResearch Grants — 7 Programs— 7 Programs
  • 33.  A systematic approachA systematic approach  Stability and Long-termStability and Long-term CommitmentCommitment  Response to LocalResponse to Local Needs and PrioritiesNeeds and Priorities  Mutual ReinforcementMutual Reinforcement of Investments inof Investments in Training and ResearchTraining and Research  Individual and InstitutionalIndividual and Institutional PartnershipsPartnerships  Long-term mentoringLong-term mentoring  Advanced In-countryAdvanced In-country Research (re-entry grants)Research (re-entry grants)  Empowerment and mutualEmpowerment and mutual respectrespect  NetworkingNetworking  FlexibilityFlexibility  LeverageLeverage Fogarty International CenterFogarty International Center Program CharacteristicsProgram Characteristics
  • 34. • Generally institutional training grant to U.S.Generally institutional training grant to U.S. universities and non-profit research institutionsuniversities and non-profit research institutions in response to a specific request forin response to a specific request for applications (RFA)applications (RFA) • Awardees are generally current NIH grantAwardees are generally current NIH grant recipients with demonstrated researchrecipients with demonstrated research collaboration with foreign research institutionscollaboration with foreign research institutions • PurposePurpose —— support training for research-support training for research- capacity building for scientists from developingcapacity building for scientists from developing nationsnations Fogarty International CenterFogarty International Center Extramural Training GrantsExtramural Training Grants
  • 35. Sustainability in FIC ProgramsSustainability in FIC Programs  CommitmentCommitment * National* National * Institutional* Institutional * Trainee* Trainee  Re-entry grants for traineesRe-entry grants for trainees  Diversified program themesDiversified program themes  Contribution of resources from allContribution of resources from all partnerspartners PrinciplesPrinciples Fogarty International Center
  • 36. Sustainability in FIC ProgramsSustainability in FIC Programs  Sustained linkagesSustained linkages  Leveraged resourcesLeveraged resources  Dual appointments for facultyDual appointments for faculty  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 PrinciplesPrinciples (continued)(continued) Fogarty International Center
  • 37. Fogarty International CenterFogarty International Center On the HorizonOn the Horizon  Brain Disorders in the Developing WorldBrain Disorders in the Developing World  Trauma and InjuryTrauma and Injury  Health, Environment, and EconomicHealth, Environment, and Economic DevelopmentDevelopment
  • 38. NavigatingNavigating Your WayYour Way
  • 39. FIC Website:FIC Website: http://http://www.nih.gov/ficwww.nih.gov/fic
  • 40. Priorities: Emerging infectious diseases, HIV/AIDS, malaria, tuberculosis, arboviral diseases, population, environment, tobacco-related illness, mental health, economics, ecology, genetics, ethics, stigma… Fogarty International CenterFogarty International Center Science for Global HealthScience for Global Health Priority areas are driven by disease burden and scientific opportunity. Priorities are set through background work, consultations internally and externally (especially Third World), international conferences, coalition formation, national and international organizations.
  • 41. Research, Training and Support NeedsResearch, Training and Support Needs According to Understanding of DiseasesAccording to Understanding of Diseases andand Efficacy of InterventionsEfficacy of Interventions Research Needs Efficacy of Control Methods High High Training Some HighModerate Research Support Needs Low Low
  • 42. Research, Training and Support NeedsResearch, Training and Support Needs According to Understanding of DiseasesAccording to Understanding of Diseases andand Efficacy of InterventionsEfficacy of Interventions Research Needs Efficacy of Control Methods High High Smallpox Guinea worm Poliomyelitis H. influenzae type B Measles Tetanus Training Some HighModerate Research Support Needs Low Low Dengue Malaria HIV/AIDS Tuberculosis Ebola/Marbur g Influenza Cancers Alzheimer’s

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