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  • Image: Nobel Prize (Chemistry)
  • 83% of NIH funding supports about 325,000 scientists and research staff in more than 3,000 institutions across the country and abroad 10% of funding supports more than 6,000 scientists conducting cutting-edge research on the NIH campus NIH provides trustworthy and timely health and science information to millions of people nationwide and throughout the world
  • Image: Nobel Prize (Chemistry)
  • Image: Nobel Prize (Chemistry)
  • NIH received 75,120 applications - CSR reviewed 52,788 ~ 70% ICs reviewed 20,437 applications; ~ 27% other agencies in DHHS (FDA, CDC, AHRQ) reviewed remainder ~ 3% Range across ICs: 13.2% -- 33.5% Roadmap: 10.1% Comp supps: $11.1 million Fiscal Year 2005: Reviewed Awarded Success New 35,874 6,739 18.1% Continuation 7,025 2,809 40.0% Supplement 170 51 30.0% _______________________________________ Totals 43,069 9,599 22.3 %
  • Research Grants (Activity codes of R, P, M, S, K, U, as well as G12, D42, DP1, DP2) consist of: Research Projects (R01 equivalents, Program projects, small grants, AREA and a few others) Research Centers Research Career SBIR/STTR Other Research Grants In FY 2006, there were 36,814 research projects (excluding SBIR/STTR) awarded for $14,853 million, out of a total 46,797 research grants ( $20,154 million). * Competing Continuation = An application that requires competitive peer review and institute/center action to continue beyond the current competitive segment.  Also known as a Renewal or Type 2. Non-Competing Continuation = A year of continued support for a funded grant.  Progress reports for continued support do not undergo peer review, but are administratively reviewed by the Institute/Center and receive an award based on prior award commitments.   Also known as a Type 5. NIH received 75,120 applications - CSR reviewed 52,788 ~ 70% ICs reviewed 20,437 applications; ~ 27% other agencies in DHHS (FDA, CDC, AHRQ) reviewed remainder ~ 3% Range across ICs: 13.2% -- 33.5% Roadmap: 10.1% Comp supps: $11.1 million Fiscal Year 2005: Reviewed Awarded Success New 35,874 6,739 18.1% Continuation 7,025 2,809 40.0% Supplement 170 51 30.0% _______________________________________ Totals 43,069 9,599 22.3 %
  • 27.3% $11,574,235 107 392     IC Total   0.0% $25,000 0 0 U13       0.0% $125,000 0 0 T90       47.1% $1,750,346 16 34 R25       4.2% $113,399 1 24 K01       100.0% $103,937 2 2 D71       50.0% $6,330,574 39 78 D43 Other Activities     0.0% $0 0 5 U01       37.5% $367,263 3 8 R21       18.5% $1,223,414 33 178 R03       20.6% $1,535,302 13 63 R01 Research Projects FIC 2006 
  • http://www.aamc.org/students/medstudents/overseasfellowship/start.htm
  • presentation

    1. 1. “ Science for Global Health: Fostering International Collaboration” University of Maryland at Baltimore James Herrington, Ph.D., M.P.H. Director Division of International Relations Fogarty International Center National Institutes of Health U.S. Department of Health and Human Services June 5, 2007
    2. 2. Outline <ul><li>Global Burden of Disease </li></ul><ul><li>Global Health Research </li></ul><ul><li>NIH Structure, Function </li></ul><ul><li>Extramural Grant Awards </li></ul><ul><li>NIH Investments in Intramural Researchers </li></ul><ul><li>Fogarty International Center </li></ul>
    3. 3. Global Burden of Disease, Reported Mortality by Cause, 2002 Source: World Health Report, 2004; Disease Control Priorities Project, 2006 Pop. ~ 6 billion Pop. ~ 672 million Communicable, Maternal, Perinatal, and Nutritional Conditions Non-Communicable Diseases Injuries
    4. 4. Global Burden of Disease, Reported Mortality by Cause, 2002 Source: World Health Report, 2004; Disease Control Priorities Project, 2006 Pop. ~ 880 million Pop. ~ 672 million Communicable, Maternal, Perinatal, and Nutritional Conditions Non-Communicable Diseases Injuries
    5. 5. Global Burden of Disease, Reported Mortality by Cause, Communicable Diseases , Africa Region, 2002 Source: World Health Report, 2004; Disease Control Priorities Project, 2006 Diphtheria Measles Pertussis Polio Tetanus
    6. 6. Mal Aria (“bad air”) associated with marshes; Female Anopheles mosquito taking blood meal
    7. 7. Global Burden of Disease, Reported Mortality by Cause, Communicable Diseases , European Region, 2002 Source: World Health Report, 2004; Disease Control Priorities Project, 2006 Diphtheria Measles Pertussis Polio Tetanus
    8. 8. Global Burden of Disease, Reported Mortality by Cause: Non-Communicable Diseases , European Region, 2002 Source: World Health Report, 2004; Disease Control Priorities Project, 2006
    9. 9. Mal Alimentation (“bad food”) associated with economic development, longevity, sedentary society Source: http://en.wikipedia.org/wiki/BK_Stacker Photo credit: Mychal Stanley US % Daily Value based on 2000 calorie diet. Notes www.BK.com Source 62g Protein 6g Sugars 1g Dietary fiber 1800mg Sodium 240mg Cholesterol 30g Saturated fat 68g Total fat 620 cal Energy from fat 1000 cal Energy 1 sandwich 311g Serving size ''' BK Stacker'''
    10. 10. Mal Comportment (“bad behavior”) associated with economic development, longevity, mobile society Source: Tobacco Free Initiative, World Health Organization
    11. 11. Mal Environment (“bad surroundings”) associated with economic stagnation/decline, low female literacy, agrarian society Photo: Grameen Shikka
    12. 12. Global Burden of Disease, Projected Mortality by Cause: Communicable (Group I) Diseases , World, 2002-2030 Source: Mathers, C.D. and Loncar, D. in http://medicine.plosjournals.org/archive/1549-1676/3/11/pdf/10.1371_journal.pmed.0030442-L.pdf
    13. 13. Global Burden of Disease, Projected Mortality by Cause: Non-Communicable (Group II) Diseases , World, 2002-2030 Source: Mathers, C.D. and Loncar, D. in http://medicine.plosjournals.org/archive/1549-1676/3/11/pdf/10.1371_journal.pmed.0030442-L.pdf
    14. 14. Global Burden of Disease, Projected Mortality by Cause: Trauma and Injury (Group III) , World, 2002-2030 Source: Mathers, C.D. and Loncar, D. in http://medicine.plosjournals.org/archive/1549-1676/3/11/pdf/10.1371_journal.pmed.0030442-L.pdf
    15. 15. Disease Control Priorities Project (DCPP) The 20 th Century Take Off in Human Health, Life Expectancy, 1550-2050 Source: Disease Control Priorities Project, 2006 ( http://www.ncbi.nlm.nih.gov/books/bookres.fcgi/dcp2/ch1.pdf )
    16. 16. Disease Control Priorities Project (DCPP) Levels and Changes in Life Expectancy, 1960-2002, by World Bank Region Source: Disease Control Priorities Project. Burden of Disease in China in 2001 ( http://www.dcp2.org/pubs/DCP/1/Table/1.1 )
    17. 17. Burden of Disease Attributable to Alcohol Among the 10 Leading Risk Factors for Disease In Developed and Developing Countries - % DALYs* Source: World Health Organization, 2002 *disability-adjusted life years (years of potential life lost due to death plus years of healthy life lost to disability) <ul><li>Alcohol/Tobacco </li></ul><ul><li>Blood pressure </li></ul><ul><li>Nutrition </li></ul>
    18. 18. Examples of Change in China: Adult Per Capita Alcohol Consumption by Development Status: 1960-2000 1 1 Adapted from Room et al. (2002). Alcohol and the Developing World: A Public Health Perspective [Summary]. Helsinki: Finnish Foundation of Alcohol Studies in collaboration with the WHO, p. 12. 2 Derived from World Health Organization Health Statistical Database: Apparent Alcohol Consumption. http://www3.who.int/whosis/ 0 1 2 3 4 5 6 7 1960 1965 1970 1975 1980 1985 1990 1995 2000 <ul><li>Developed countries </li></ul><ul><li>Former Soviet Union </li></ul><ul><li>China 2 </li></ul><ul><li>(1961-1999) </li></ul><ul><li>Developing countries </li></ul>Liters of Pure Alcohol Per Person 15+ Years
    19. 19. Epidemiological, Demographic, and Political Transitions <ul><li>Shift from Acute to Chronic Diseases </li></ul><ul><li>Aging Population </li></ul><ul><li>Health Disparities </li></ul><ul><li>Emerging and Re-emerging diseases </li></ul><ul><li>Behavioral and Mental Health diseases </li></ul><ul><li>Biodefense </li></ul>
    20. 20. 4.2% ($29.2 billion) of total FY 2007 HHS budget ($698 billion) in research Administration for Children and Families (ACF) Administration for Children and Families (ACF) Food and Drug Administration (FDA) Food and Drug Administration (FDA) Health Resources and Services Administration (HRSA) Health Resources and Services Administration (HRSA) Administration on Aging (AoA) Administration on Aging (AoA) Centers for Medicare and Medicaid Services (CMS) Centers for Medicare and Medicaid Services (CMS) Indian Health Service (IHS) Indian Health Service (IHS) Centers for Disease Control and Prevention (CDC) Centers for Disease Control and Prevention (CDC) Substance Abuse and Mental Health Services Administration (SAMHSA) Substance Abuse and Mental Health Services Administration (SAMHSA) Program Support Center (PSC) Program Support Center (PSC) Agency for Toxic Substances and Disease Registry (ATSDR) Agency for Toxic Substances and Disease Registry (ATSDR) Agency for Health Care Policy and Research (AHCPR) Agency for Health Care Policy and Research (AHCPR) National Institutes of Health (NIH) National Institutes of Health (NIH) Michael Leavitt Secretary of Health and Human Services Michael Leavitt Secretary of Health and Human Services
    21. 21. = Institutes and Centers that award grants Elias Zerhouni, M.D. Director, NIH Elias Zerhouni, M.D. Director, NIH National Institute on Alcohol Abuse and Alcoholism National Institute on Alcohol Abuse and Alcoholism National Institute of Arthritis and Musculoskeletal and Skin Diseases National Institute of Arthritis and Musculoskeletal and Skin Diseases National Cancer Institute National Cancer Institute National Institute of Diabetes and Digestive and Kidney Diseases National Institute of Diabetes and Digestive and Kidney Diseases National Institute of Dental and Craniofacial Research National Institute of Dental and Craniofacial Research National Institute on Drug Abuse National Institute on Drug Abuse National Institute of Environmental Health Sciences National Institute of Environmental Health Sciences National Institute on Aging National Institute on Aging National Institute of Child Health and Human Development National Institute of Child Health and Human Development National Institute on Deafness and Other Communication Disorders National Institute on Deafness and Other Communication Disorders National Eye Institute National Eye Institute National Human Genome Research Institute National Human Genome Research Institute National Heart, Lung, and Blood Institute National Heart, Lung, and Blood Institute National Institute of Mental Health National Institute of Mental Health National Institute of Neurological Disorders and Stroke National Institute of Neurological Disorders and Stroke National Institute of General Medical Sciences National Institute of General Medical Sciences National Institute of Nursing Research National Institute of Nursing Research National Library of Medicine National Library of Medicine Center for Information Technology Center for Information Technology Center for Scientific Review Center for Scientific Review National Center for Complementary and Alternative Medicine National Center for Complementary and Alternative Medicine National Institute of Allergy and Infectious Diseases National Institute of Allergy and Infectious Diseases National Center for Research Resources National Center for Research Resources Clinical Center Clinical Center National Center on Minority Health and Health Disparities National Center on Minority Health and Health Disparities National Institute of Biomedical Imaging and Bioengineering National Institute of Biomedical Imaging and Bioengineering Fogarty International Center Fogarty International Center
    22. 22. <ul><li>Mission </li></ul><ul><li>Address global health challenges through innovative and collaborative research and training programs </li></ul><ul><li>Support and advance the NIH mission through international partnerships </li></ul><ul><li>“Science for Global Health” </li></ul><ul><li>FY 2007 Appropriation $67 million </li></ul>
    23. 23. National Institutes of Health Main Campus Bethesda, Maryland, U.S.A.
    24. 24. NIH Mission <ul><li>Uncover New Knowledge That Leads To Better Health For Everyone By: </li></ul><ul><ul><li>Supporting peer-reviewed scientific research at universities, medical schools, hospitals, and research institutions throughout United States and overseas </li></ul></ul><ul><ul><li>Conducting research in its own laboratories </li></ul></ul><ul><ul><li>Training research investigators </li></ul></ul><ul><ul><li>Developing and disseminating credible health information based on scientific discovery </li></ul></ul>
    25. 25. Contemporary NIH <ul><li>NIH creates research laboratories and recruits outstanding scientists from universities and abroad </li></ul><ul><li>Institutes and Centers are created in response to public health needs, most with intramural programs </li></ul><ul><li>Many young trainees join NIH and go on to become leaders in science across the US and around the world </li></ul><ul><li>117 grantees or trainees are Nobel Laureates (as of 2005) </li></ul>
    26. 26. Appropriated NIH Budget, FY07, $29.2 Billion Spending Outside NIH $24.2 B Spending at NIH $4.9 B 83% of the total NIH budget supports about 212,000 Extramural Scientists and Research Personnel at 2,800 Institutions Nationwide. $818 million (~2.8%) of NIH budget is international research and research training awards Research Mgt & Support $1.1B 3.8% NLM, OD, etc. $1.0B 3.2% 6000 Intramural Scientists & Research Personnel $2.9B 10% Expenditure Amount %
    27. 27. Balanced National Biomedical Research Portfolio NIH - $29 B Clinical Research Basic Research Translational Research Private Sector - $59B Clinical Research Basic Research Translational Research
    28. 28. NIH – Extramural and Other Grant Awards, by Type <ul><li>Research Grant Programs (8 types) </li></ul><ul><li>New Investigators Program (2 types) </li></ul><ul><li>Multiple Principal Investigators (NEW in Feb 2007) </li></ul><ul><li>Research Supplemental Programs (1 type) </li></ul><ul><li>Ruth L. Kirschstein </li></ul><ul><ul><li>National Research Service Awards (NRSA) (8 types) </li></ul></ul><ul><li>Research Ethics and Training Grant Programs (2 types) </li></ul><ul><li>NIH Career Development (K) Awards (15 types) </li></ul><ul><li>Small Business Awards (1 type) </li></ul><ul><li>Other Programs (8 types) </li></ul>Source: http://grants2.nih.gov/grants/funding/funding_program.htm
    29. 29. NIH – Extramural Awards, by Type
    30. 30. NIH Research Training and Career Development Timetable Small Grant (R03) Research Project Grant (R01) Independent Scientist Award (K02) Approx. Stage of Research Training and Development NIH Pathway to Independence (PI) Award (K99/R00) Mentored Research Scientist Development Award (K01) Mentored Clinical Scientist Development Award (K08) Mentored Patient-Oriented RCDA (K23) Mentored Quantitative RCDA (K25) Exploratory/Development Grant (R21) Predoctoral Individual NRSA (F31) Predoctoral Individual MD/PhD NRSA (F30) Postdoctoral Institutional Training Grant (T32) Postdoctoral Individual NRSA (F32) Senior Scientist Award (K05 ) Mechanism of Support GRADUATE/ MEDICAL STUDENT POST DOCTORAL EARLY MIDDLE SENIOR CAREER Predoctoral Institutional Training Grant (T32) Midcareer Investigator Award in Patient-Oriented Research (K24)
    31. 31. NIH Extramural Grant Awards, Competitive and Non-Competitive, New and Continuations, FY 2006 <ul><li>46,797 research grants awarded ($20.2 billion) </li></ul><ul><ul><li>36,814 research project grants ($14.8 billion) </li></ul></ul><ul><li>73% of NIH extramural awards go to institutions of higher education </li></ul><ul><li>More than 75,000 grant applications received (all mechanisms) </li></ul>
    32. 32. NIH Intramural Program, Visiting Fellows and Guest Researchers, by E.U. Member/Candidate Countries, 2005 N=966 x average stipend cost $50,000/yr = $48.3 million
    33. 33. Rhode Island Congressman John Edward Fogarty
    34. 34. Congressman Melvin Laird (R-WI) 1967 <ul><li>The Committee “… has provided funds to plan a lasting memorial to a man who, for more than a quarter of a century, worked tirelessly for a healthy America, in a healthier world.” </li></ul>
    35. 35. <ul><li>Mission </li></ul><ul><li>Address global health challenges through innovative and collaborative research and training programs </li></ul><ul><li>Support and advance the NIH mission through international partnerships </li></ul><ul><li>“Science for Global Health” </li></ul><ul><li>FY 2007 Appropriation $67 million </li></ul>
    36. 36. FIC Organizational Structure
    37. 37. <ul><li>Dr. Glass was named Associate Director for International Research, NIH and Director of Fogarty International Center by NIH Director Elias A. Zerhouni, M.D., on March 31, 2006. </li></ul><ul><li>Harvard College in 1967 </li></ul><ul><li>Fulbright Fellowship, University of Buenos, 1967 </li></ul><ul><li>M.D. from Harvard Medical School </li></ul><ul><li>M.P.H. from the Harvard School of Public Health, 1972 </li></ul><ul><li>Medical officer assigned to the Environmental Hazards Branch Text CDC in 1977 </li></ul><ul><li>Ph.D. from the University of Goteborg, Sweden in 1983 and joined NIH Laboratory of Infectious Diseases to work on the molecular biology of rotavirus </li></ul><ul><li>1986 returned to the CDC to become Chief of the Viral Gastroenteritis Unit at the National Center for Infectious Diseases </li></ul>Roger Glass, M.D., Ph.D. Director, Fogarty International Center
    38. 38. <ul><li>Research and Research Training </li></ul><ul><li>~$50 million in grant awards </li></ul><ul><li>1/3 Research, 2/3 Research Training </li></ul><ul><li>Awards range $10,000 - $1 million </li></ul><ul><li>Low and Middle Income Countries </li></ul><ul><li>Research Capacity Development and Equity </li></ul>
    39. 39. <ul><li>Extramural Training Grants – 14 Programs </li></ul><ul><li>Extramural Research Grants – 8 Programs </li></ul><ul><li>International Training Grants for U.S. citizens </li></ul><ul><ul><ul><li>- Scientist Development Fellowship (Post-doc) </li></ul></ul></ul><ul><ul><ul><li>- Fogarty/Ellison Fellowship (Pre-doc/Pre-med) </li></ul></ul></ul>
    40. 40. <ul><li>Fogarty International Collaborative Trauma and Injury Research Training </li></ul><ul><li>International Clinical, Operational, and Health Services Research Training Awards for HIV/AIDS and Tuberculosis </li></ul><ul><li>International Maternal and Child Health Research Training </li></ul><ul><li>Fogarty-Ellison International Clinical Research Training </li></ul><ul><li>Informatics Training for Global Health </li></ul><ul><li>International Collaborative Genetics Research Training </li></ul><ul><li>International Clinical, Operational, and Health Services Research Training Awards </li></ul><ul><li>International Clinical, Operational, and Health Services Research Training Awards for Malaria </li></ul><ul><li>Global Infectious Diseases Research Training </li></ul><ul><li>International Research Ethics Education and Career Development </li></ul><ul><li>International Centers for Excellence in Research Clinical Research and Management Training </li></ul><ul><li>International Training Program in Environmental and Occupational Health </li></ul><ul><li>Global Research Training in Population Health </li></ul><ul><li>AIDS International Training and Research </li></ul><ul><li>Framework Programs for Global Health </li></ul><ul><li>International Research Scientist Development Awards </li></ul>
    41. 41. <ul><li>Flexible </li></ul><ul><li>Long-term commitment </li></ul><ul><li>Built on research collaborations </li></ul><ul><li>Re-entry support </li></ul><ul><li>Response to local needs </li></ul><ul><li>Empowerment </li></ul><ul><li>Networking </li></ul>Research Training Program Characteristics
    42. 42. <ul><li>Fogarty International Research Collaboration Award (FIRCA) </li></ul><ul><li>International Cooperative Biodiversity Groups (ICBG) </li></ul><ul><li>Ecology of Infectious Diseases (EID) </li></ul><ul><li>International Studies on Health and Economic Development (ISHED) </li></ul><ul><li>Int’l Tobacco and Health Research and Capacity Building Program </li></ul><ul><li>Global Research Initiative Program for New Foreign Investigators (GRIP) </li></ul><ul><li>Stigma and Global Health Research Program </li></ul><ul><li>Brain Disorders in the Developing World: Research Across the Lifespan </li></ul>Research Grants – 8 Programs
    43. 43. Extramural Training Grants <ul><li>Generally institutional training grant to U.S. universities and </li></ul><ul><li>non-profit research institutions in response to a specific </li></ul><ul><li>request for applications (RFA) </li></ul><ul><li>Awardees are generally current NIH grant recipients with </li></ul><ul><li>demonstrated research collaboration with foreign </li></ul><ul><li>research institutions </li></ul><ul><li>Purpose – support training for research-capacity building for </li></ul><ul><li>scientists from developing nations </li></ul>
    44. 44. Framework Programs for Global Health <ul><li>Provides support to educational institutions to develop trans-institutional programs in Global Health </li></ul><ul><li>Develops new multidisciplinary curricula in broad range of global health research areas </li></ul><ul><li>Develops administrative framework for a Global Health research program </li></ul><ul><li>Brings new investigators and students into the Global Health field </li></ul><ul><li>Applicants from U.S. or eligible low- and middle-income countries; multiple institutions may work together on a single project </li></ul>
    45. 45. Fogarty International Clinical Research Scholars Program (Pre-doc/Pre-med) <ul><li>Provides mentored clinical research training opportunities for 3 rd year U.S. medical and other health profession graduate students in NIH-funded research centers in developing countries; 25-30 per year. </li></ul><ul><li>Fellowship stipends approximately $18,000-$20,000 per year (adjusted to cost of living expenses at the foreign site) with an additional $6,000 per year for travel, insurance, and educational materials. </li></ul><ul><li>Builds clinical research capacity in developing countries by pairing a peer trainee from the developing country with a U.S. trainee. </li></ul><ul><li>Collaboration with Association of American Medical Colleges, Association of Schools of Public Health, National Institute of Allergy and Infectious Diseases , the National Institute of Dental and Craniofacial Research, and the National Institute on Drug Abuse , </li></ul><ul><li>http://www.aamc.org/students/medstudents/overseasfellowship/start.htm </li></ul>
    46. 46. Fellowship Sites <ul><li>Bangladesh </li></ul><ul><li>Botswana </li></ul><ul><li>Brazil </li></ul><ul><li>China </li></ul><ul><li>Haiti </li></ul><ul><li>India, Chennai </li></ul><ul><li>India, Vellore </li></ul><ul><li>Kenya </li></ul><ul><li>Mali </li></ul><ul><li>Peru, Lima, Johns Hopkins University </li></ul><ul><li>Peru, Lima, University of Washington </li></ul><ul><li>Russia </li></ul><ul><li>South Africa, Durban </li></ul><ul><li>South Africa, Pretoria </li></ul><ul><li>Tanzania </li></ul><ul><li>Thailand </li></ul><ul><li>Uganda </li></ul><ul><li>Zambia </li></ul>
    47. 47. Trainee Activities <ul><li>3-week orientation program at NIH (July) </li></ul><ul><li>Clinical research at designated site (10 months) </li></ul><ul><li>FIC/NIH clinical research training via distance learning and contact with FIC staff </li></ul><ul><li>Summary report of activities and research accomplishments at the end of the training year </li></ul><ul><li>After completion of the research year, the fellow presents results at the annual NIH meeting (March) </li></ul><ul><li>Alumni remain connected via continuing relationship with mentors and collaborators and through an FIC alumni tracking/program evaluation system </li></ul>
    48. 48. NIH Alumni Associations <ul><li>Brazil – University of California, Berkeley </li></ul><ul><li>Central and Eastern Europe – University of Iowa </li></ul><ul><li>China – University of California, Los Angeles </li></ul><ul><li>India – Brown University </li></ul><ul><li>Malawi – University of Illinois at Chicago </li></ul><ul><li>Mexico – Emory University </li></ul><ul><li>Russia – Yale University </li></ul><ul><li>South Africa – Columbia University </li></ul><ul><li>Thailand – University of California, Los Angeles </li></ul><ul><li>Uganda – Case Western Reserve University </li></ul>

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