Research and Training Opportunities inResearch and Training Opportunities in
Global HealthGlobal Health
Joel G. Breman, MD...
Research Funding PerspectivesResearch Funding Perspectives
Demographic and disease trends
Thinking research needs
Natio...
Research Funding PerspectivesResearch Funding Perspectives
Demographic and disease trends
Thinking research needs
Natio...
Presented at BioVisionAlexandria, 2006
Disease Control Priorities Project
2006 Publications www.dcp2.org
Disease Control Priorities Project (DCPP)Disease Control Priorities Project (DCPP)
Life Expectancy, 1550-2050Life Expectan...
GNI = gross national income per capita (US$); LE = life expectancy at birth (average male and female).GNI = gross national...
““The Bottom Billion”*The Bottom Billion”*
 Over a billion people live on less than $1 a dayOver a billion people live on...
Disease Control Priorities ProjectDisease Control Priorities Project
10 Best Buys for Health10 Best Buys for Health
1. Pre...
Disease Control Priorities ProjectDisease Control Priorities Project
10 Best Buys for Health (2)10 Best Buys for Health (2...
Research Funding PerspectivesResearch Funding Perspectives
Demographic and disease trends
Thinking research needs
Natio...
Research Needs: Disease Burden that Can or Cannot
be Averted with Existing Interventions
Not Avertable
Disease Burden:
Ave...
Research and Development Categories and Results
for Implementation
New basic understanding
• Fundamental research
• Epidem...
Research and Development Categories and Results
for Implementation
New and improved intervention methods
• Treatment algor...
NIH: Medical and Behavioral Research forNIH: Medical and Behavioral Research for
the Worldthe World
“Science in pursuit of...
Office of the DirectorOffice of the Director
National Institute
on Alcohol Abuse
and Alcoholism
National Institute
on Alco...
U.S. Balanced National Biomedical ResearchU.S. Balanced National Biomedical Research
Portfolio, FY2008Portfolio, FY2008
NI...
People: Countries Sending the Most Visiting Scientists to NIHPeople: Countries Sending the Most Visiting Scientists to NIH...
http://www.nlm.nih.gov/http://www.nlm.nih.gov/
International ResourceInternational Resource
 Free full-text archive
 315...
PubMed HitsPubMed Hits —— June, 2006June, 2006
6.5 M6.5 M
6.0 M6.0 MPortugal
1.1 M1.1 M
8.8 M8.8 M
18,69518,695
869,520869...
MedlinePlus Page ViewsMedlinePlus Page Views
December 2005December 2005
Research and ResearchResearch and Research
TrainingTraining
• ~$50 million in grant~$50 million in grant
awardsawards
• 2/...
Extramural Training Grants
• Institutional training grant to U.S. universities/research institutions
in response to a spec...
 AIDS International Training and Research Program (AITRP)
 International Bioethics Education and Career Development Awar...
 Informatics Training for Global Health
 Framework Programs for Global Health
 The NIH Pathway to Independence (PI) Awa...
• Fogarty International Research Collaboration Award (FIRCA)
• International Cooperative Biodiversity Groups (ICBG)
• Ecol...
• Systematic approach
• Long-term commitment
• Response to local priorities
• Long-term mentoring
• Mutual reinforcement o...
AIDS International Training and Research ProgramAIDS International Training and Research Program
First and oldest research...
International Cooperative Biodiversity Groups
Scientific and
Economic
Development
Drug
Discovery
Bioinventory and
Biodiver...
ICBG Accomplishments:ICBG Accomplishments:
ScienceScience
 275+ novel bioactive compounds discovered
 20 compounds for m...
ICBG Accomplishments:ICBG Accomplishments:
ConservationConservation
 Initiate/strengthen 12 biodiversity reservesInitiate...
Global Infectious DiseaseGlobal Infectious Disease
 Research training (laboratory,Research training (laboratory,
clinical...
Fogarty International Center GoalsFogarty International Center Goals
 Train the next generation of medical researchers,Tr...
2 FIRCAs: The Genetics of Hearing Loss
Mary-Claire King- University of Washington -Seattle
Moien Kanaan – Bethlehem Univ.,...
General Tips on GrantsmanshipGeneral Tips on Grantsmanship
 Read the solicitationRead the solicitation very carefullyvery...
Advocates for Global Health
Fogarty Ellison Scholars, 2006Fogarty Ellison Scholars, 2006
24 “pairs” of trainees going to 16 medical centers in the dev...
Global Burden of Disease (DALYS)Global Burden of Disease (DALYS)
19901990 20202020
Lower Respiratory InfectionLower Respir...
Pharmaceutical Research: Priority Areas, WHO (2004)Pharmaceutical Research: Priority Areas, WHO (2004)
PriorityPriority Co...
Epidemiological, Demographic, and Political Transitions
• Shift from acute to chronic diseases
• Aging populations
• Healt...
Mal AlimentationMal Alimentation (“bad food”) associated with(“bad food”) associated with
Economic Development, Longevity,...
GLOBAL EXAMPLES OF EMERGING AND RE-
EMERGING INFECTIOUS DISEASES (A.S. FAUCI)
GLOBAL EXAMPLES OF ENDURING
ENVIRONMENTAL DISASTERS
GLOBAL EXAMPLES OF PEDIATRIC AND
ADULT CANCERS
GLOBAL EXAMPLES OF GENETIC DISEASES
AND DISORDERS
National Institutes of Health Main CampusNational Institutes of Health Main Campus
Bethesda, Maryland, U.S.A.Bethesda, Mar...
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Research and Training Opportunities in Global Health

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  • More than 13 million children under age five (including stillbirths) die each year in developing countries.
    At least 70 percent of these deaths could be prevented.
    A mother’s chance of dying of pregnancy-related conditions is more than 200 times higher in the lowest-income countries than in the highest-income countries.
    Major childhood killers include measles, polio, whooping cough, and diphtheria. *It costs as little as US$2 to buy a new year of healthy life by expanding immunization coverage with standard child vaccines.
    Ensure access to family planning services to prevent high-risk pregnancies, unsafe abortion, and infant deaths.
    **Improving care of children under 28 days old (including resuscitation of newborns) is a highly cost-effective way to extend a life. It costs as little as US$10 for each year of healthy life gained.
    Main causes of death in the first 28 days of life: Premature birth, asphyxia, and infections.
    Reasons children under age 5 are most likely to die: pneumonia, diarrhea, tetanus, malaria, measles, whooping cough, HIV/AIDS, and malnutrition.
  • More than 13 million children under age five (including stillbirths) die each year in developing countries.
    At least 70 percent of these deaths could be prevented.
    A mother’s chance of dying of pregnancy-related conditions is more than 200 times higher in the lowest-income countries than in the highest-income countries.
    Major childhood killers include measles, polio, whooping cough, and diphtheria. *It costs as little as US$2 to buy a new year of healthy life by expanding immunization coverage with standard child vaccines.
    Ensure access to family planning services to prevent high-risk pregnancies, unsafe abortion, and infant deaths.
    **Improving care of children under 28 days old (including resuscitation of newborns) is a highly cost-effective way to extend a life. It costs as little as US$10 for each year of healthy life gained.
    Main causes of death in the first 28 days of life: Premature birth, asphyxia, and infections.
    Reasons children under age 5 are most likely to die: pneumonia, diarrhea, tetanus, malaria, measles, whooping cough, HIV/AIDS, and malnutrition.
  • [Animated, 1 click]
    There are two broad categories contained in the NIH Mission Statement.
    The first relates to biomedical research
    [Click] And the second, to the health of the nation – and, indeed, of all humanity, here at home and throughout the world
    These, then, are the main categories of our analysis.
    Note: The first picture (right) was provided by NIDCD. Dr. Mathew Kelley, Developmental Neuroscience Sect, NIDCD.
  • [Animation: 1 Click:
    NIH database website address dissolves in on click]
    [Updated 2/13/07 by Ed Sequeira and David Lipman]
  • 2006 
    FIC
    Research Projects
    R01
    63
    13
    $1,535,302
    20.6%
     
     
     
    R03
    178
    33
    $1,223,414
    18.5%
     
     
     
    R21
    8
    3
    $367,263
    37.5%
     
     
     
    U01
    5
    0
    $0
    0.0%
     
     
    Other Activities
    D43
    78
    39
    $6,330,574
    50.0%
     
     
     
    D71
    2
    2
    $103,937
    100.0%
     
     
     
    K01
    24
    1
    $113,399
    4.2%
     
     
     
    R25
    34
    16
    $1,750,346
    47.1%
     
     
     
    T90
    0
    0
    $125,000
    0.0%
     
     
     
    U13
    0
    0
    $25,000
    0.0%
     
    IC Total
     
     
    392
    107
    $11,574,235
    27.3%
  • 2006 
    FIC
    Research Projects
    R01
    63
    13
    $1,535,302
    20.6%
     
     
     
    R03
    178
    33
    $1,223,414
    18.5%
     
     
     
    R21
    8
    3
    $367,263
    37.5%
     
     
     
    U01
    5
    0
    $0
    0.0%
     
     
    Other Activities
    D43
    78
    39
    $6,330,574
    50.0%
     
     
     
    D71
    2
    2
    $103,937
    100.0%
     
     
     
    K01
    24
    1
    $113,399
    4.2%
     
     
     
    R25
    34
    16
    $1,750,346
    47.1%
     
     
     
    T90
    0
    0
    $125,000
    0.0%
     
     
     
    U13
    0
    0
    $25,000
    0.0%
     
    IC Total
     
     
    392
    107
    $11,574,235
    27.3%
  • 2006 
    FIC
    Research Projects
    R01
    63
    13
    $1,535,302
    20.6%
     
     
     
    R03
    178
    33
    $1,223,414
    18.5%
     
     
     
    R21
    8
    3
    $367,263
    37.5%
     
     
     
    U01
    5
    0
    $0
    0.0%
     
     
    Other Activities
    D43
    78
    39
    $6,330,574
    50.0%
     
     
     
    D71
    2
    2
    $103,937
    100.0%
     
     
     
    K01
    24
    1
    $113,399
    4.2%
     
     
     
    R25
    34
    16
    $1,750,346
    47.1%
     
     
     
    T90
    0
    0
    $125,000
    0.0%
     
     
     
    U13
    0
    0
    $25,000
    0.0%
     
    IC Total
     
     
    392
    107
    $11,574,235
    27.3%
  • The AIDS International Training and Research Program is the
    longest running training program at Fogarty and the one that
    serves as a model for the other 10+ Fogarty training programs.
    The AIDS program began in 1988 with awards to 10 universities,
    and is now in its 14th year with grants to 23 universities. In my
    handout, I have included a listing of these 23 programs with
    contact information for the program director at each one
    and the countries in which they are working.
    IH believes that a long-term commitment in decades, not years,
    is needed to build success.
  • Total FIC investment ICBG - 14 years - 24.4M. 112 Ms and PhDs
    Total FIC investment AITRP - 20 years $200M, 579 MS and PhDs
  • is a long collaboration between Shahin’s Palestinian and Israeli supervisors, Moien Kanaan of Bethlehem University in the West Bank and molecular geneticist Karen Avraham of Tel Aviv University. The project got going in 1996, after Avraham learned of Kanaan’s interest in the genetics of hearing loss. “We hit it off,” she recalls. It was a compelling project that drew them together: Palestinian communities suffer high rates of inherited deafness. “You have villages where 10% of the children are born profoundly
    deaf,” says Avraham. Together with their U.S. partner, geneticist Mary-Claire King of the University of Washington, Seattle, the scientists are tracking down genes involved in inherited deafness. To date, they have identified four genes and have collected data on 59 Israeli and 74 Palestinian families that, they hope, should help pin down further genes.
    Many Israeli scientists are open to collaboration with Palestinian and other Arab scientists. Take the joint graduate programme between Tel Aviv University and Bethlehem University involving geneticist Mary-Claire King at the University of Washington. This project is looking at the genetic origins of deafness, and the Middle East is ideal for such research, as rich pedigrees are available because marrying close relatives is unusually common. Moreover, Bethlehem researchers have spent time in King’s laboratory, bringing back new skills to Palestine. the three-way collaboration is an example of a successful effort to maintain such constructive contact. This is just one example of partnerships involving Israel, its neighbours and scientists in Europe or the United States. Israel is a research powerhouse that, given an eventual improvement of relations with its neighbours, could rejuvenate science and development in the region through collaboration and training.
  • Research and Training Opportunities in Global Health

    1. 1. Research and Training Opportunities inResearch and Training Opportunities in Global HealthGlobal Health Joel G. Breman, MD, DTPHJoel G. Breman, MD, DTPH Fogarty International CenterFogarty International Center U.S. National Institutes of HealthU.S. National Institutes of Health The Academy of Sciences for the Developing WorldThe Academy of Sciences for the Developing World BioVisionAlexandria 2008 ConferenceBioVisionAlexandria 2008 Conference Alexandria, EgyptAlexandria, Egypt April 11, 2008April 11, 2008
    2. 2. Research Funding PerspectivesResearch Funding Perspectives Demographic and disease trends Thinking research needs National Institutes of Health (NIH) Fogarty International Center, NIH, programs
    3. 3. Research Funding PerspectivesResearch Funding Perspectives Demographic and disease trends Thinking research needs National Institutes of Health (NIH) Fogarty International Center, NIH, programs
    4. 4. Presented at BioVisionAlexandria, 2006 Disease Control Priorities Project 2006 Publications www.dcp2.org
    5. 5. Disease Control Priorities Project (DCPP)Disease Control Priorities Project (DCPP) Life Expectancy, 1550-2050Life Expectancy, 1550-2050 Source: Disease Control Priorities Project, 2006 (http://www.ncbi.nlm.nih.gov/books/bookres.fcgi/dcp2/ch1.pdf) 35 45 55 65 75 85 1950- 1955 1960- 1965 1970- 1975 1980- 1985 1990- 1995 2000- 2005 High Income Countries Europe & Central Asia Middle East & North Africa Latin America & Caribbean East Asia & Pacific South Asia Sub-Saharan Africa
    6. 6. GNI = gross national income per capita (US$); LE = life expectancy at birth (average male and female).GNI = gross national income per capita (US$); LE = life expectancy at birth (average male and female). Tracheal and lungTracheal and lung cancercancer CerebrovascularCerebrovascular diseasesdiseases Diarrheal diseases ChronicChronic obstructiveobstructive pulmonarypulmonary diseasedisease UnipolarUnipolar depressivedepressive disordersdisorders Perinatal conditions UnipolarUnipolar depressivedepressive disordersdisorders 55 Alzheimer's andAlzheimer's and other dementiasother dementias Ischemic heartIschemic heart diseasedisease Lower respiratory infections Self-inflictedSelf-inflicted injuriesinjuries Ischemic heartIschemic heart diseasedisease Diarrheal diseases DiarrhealDiarrheal diseasesdiseases 44 UnipolarUnipolar depressivedepressive disordersdisorders Homicide andHomicide and violenceviolence Traffic accidents UnipolarUnipolar depressivedepressive disordersdisorders ChronicChronic obstructiveobstructive pulmonarypulmonary diseasedisease Lower respiratory infections IschemicIschemic heartheart diseasedisease 33 CerebrovascularCerebrovascular diseasesdiseases UnipolarUnipolar depressivedepressive disordersdisorders Perinatal conditions CerebrovascularCerebrovascular diseasesdiseases PerinatalPerinatal conditionsconditions MalariaLowerLower respiratoryrespiratory infectionsinfections 22 Ischemic heartIschemic heart diseasedisease PerinatalPerinatal conditionsconditions Ischemic heart disease Ischemic heartIschemic heart diseasedisease CerebrovascularCerebrovascular diseasesdiseases HIV/AIDSPerinatalPerinatal conditionsconditions 11 High–incomeHigh–income countriescountries (GNI: $26,500)(GNI: $26,500) LE:78LE:78 Latin AmericaLatin America and theand the CaribbeanCaribbean (GNI: $3,580)(GNI: $3,580) LE:71LE:71 Middle East and North Africa (GNI: $2,200) LE:68 Europe andEurope and Central AsiaCentral Asia (GNI: $1,970)(GNI: $1,970) LE:69LE:69 East Asia andEast Asia and the Pacificthe Pacific (GNI: $900)(GNI: $900) LE:69LE:69 Sub- Saharan Africa (GNI: $460) LE:46 South AsiaSouth Asia (GNI: $450)(GNI: $450) LE:63LE:63 RankRank Leading causes of Disability-Adjusted Life Years in Low/Middle-income and High-Income Countries, by World Bank Region, 2001 Sources: Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJL, eds in Global Burden of Disease and Risk Factors, 2006 1 World Development Indicators, 2003
    7. 7. ““The Bottom Billion”*The Bottom Billion”*  Over a billion people live on less than $1 a dayOver a billion people live on less than $1 a day  980 million people live in “trapped countries,” 58 nations980 million people live in “trapped countries,” 58 nations “clearly heading toward what might be described as a black“clearly heading toward what might be described as a black hole.”hole.”  70 percent of the bottom billion live in Africa; most of70 percent of the bottom billion live in Africa; most of the rest in Central Asiathe rest in Central Asia  Average life expectancy in the bottom billion is 50 yearsAverage life expectancy in the bottom billion is 50 years  Around one in seven children dies before the age of 5Around one in seven children dies before the age of 5  Nearly three-quarters of the people in the bottom billionNearly three-quarters of the people in the bottom billion have recently been through, or are still in the midst of, ahave recently been through, or are still in the midst of, a civil warcivil war * The Bottom Billion: Why the Poorest Countries Are Failing and What Can Be Done About It, by Paul Collier, Oxford University Press
    8. 8. Disease Control Priorities ProjectDisease Control Priorities Project 10 Best Buys for Health10 Best Buys for Health 1. Prevent neonatal mortality 2. Ensure healthier mothers and children 3. Promote good nutrition 4. Reduce cardiovascular disease deaths 5. Stop the AIDS pandemic
    9. 9. Disease Control Priorities ProjectDisease Control Priorities Project 10 Best Buys for Health (2)10 Best Buys for Health (2) 6.6. Stop the spread of tuberculosisStop the spread of tuberculosis 7.7. Control malariaControl malaria 8.8. Combat tobacco useCombat tobacco use 9.9. Reduce fatal and disabling injuriesReduce fatal and disabling injuries 10.10. Ensure equal access to high-quality careEnsure equal access to high-quality care
    10. 10. Research Funding PerspectivesResearch Funding Perspectives Demographic and disease trends Thinking research needs National Institutes of Health (NIH) Fogarty International Center, NIH, programs
    11. 11. Research Needs: Disease Burden that Can or Cannot be Averted with Existing Interventions Not Avertable Disease Burden: AvertableAlready averted coverage Biomedical research to identify new and improved interventions Increase effectiveness or reduce costs of existing interventions Broader implementation of cost-effective interventions; identify obstacles to expansion of coverage Research Needs: 100%
    12. 12. Research and Development Categories and Results for Implementation New basic understanding • Fundamental research • Epidemiology, risk factors, disease modeling New and improved tools • Drugs • Vaccines • Diagnostics • Devices • Vector control • Environmental modification • Behavioral, social, and economic change
    13. 13. Research and Development Categories and Results for Implementation New and improved intervention methods • Treatment algorithms and guidelines • Intervention packaging • Priority setting: costing and cost-effectiveness studies • Delivery: health systems and health services • New and improved policy instruments
    14. 14. NIH: Medical and Behavioral Research forNIH: Medical and Behavioral Research for the Worldthe World “Science in pursuit of fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to extend healthy life and reduce the burdens of illness and disability.” ...  Has research laboratories and recruits outstanding scientistsHas research laboratories and recruits outstanding scientists  Institutes/Centers created in response to public health needsInstitutes/Centers created in response to public health needs  Trainees join NIH and become leaders in US and worldTrainees join NIH and become leaders in US and world  117 grantees or trainees are Nobel Laureates (as of 2005)117 grantees or trainees are Nobel Laureates (as of 2005)
    15. 15. Office of the DirectorOffice of the Director 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 CenterClinical 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 National Institutes of Health
    16. 16. U.S. Balanced National Biomedical ResearchU.S. Balanced National Biomedical Research Portfolio, FY2008Portfolio, FY2008 NIH – $29 B Clinical Research Basic Research Translational Research Private Sector – $59 B Clinical Research Basic Research Translational Research
    17. 17. People: Countries Sending the Most Visiting Scientists to NIHPeople: Countries Sending the Most Visiting Scientists to NIH Average Number of Scientists=3,800/yrFiscal Year
    18. 18. http://www.nlm.nih.gov/http://www.nlm.nih.gov/ International ResourceInternational Resource  Free full-text archive  315 journals*  985,000 items*  Voluntary submissions - May 2, 2005 *As of 2/13/07 Visit NIH Databases at: http://www.ncbi.nlm.nih.gov/ Genomics, proteomics, metabolomics… Nanoscience Molecular biology Clinical trials networks Imaging & biomarker advances Information & communications technology “The speed of biomedical advance is accelerating – like Moore’s law “ Ray Kurzweil Why now? New Frontiers in Science Accelerating Discovery
    19. 19. PubMed HitsPubMed Hits —— June, 2006June, 2006 6.5 M6.5 M 6.0 M6.0 MPortugal 1.1 M1.1 M 8.8 M8.8 M 18,69518,695 869,520869,520 2.1 M2.1 M 21,48521,485 6,0686,068 8,5978,597 59,02359,023 3,9303,930 17,07917,079 41,04841,048 1.1 M1.1 M 72,55872,558 268,900268,900 Saudi Arabia 246,935246,935 Jordan 82,89882,898 U.K. 14.0 M14.0 M Germany 8.1 M8.1 M Hits/country 293 Million Hits in June, 2006
    20. 20. MedlinePlus Page ViewsMedlinePlus Page Views December 2005December 2005
    21. 21. Research and ResearchResearch and Research TrainingTraining • ~$50 million in grant~$50 million in grant awardsawards • 2/3 research training,2/3 research training, 1/3 research1/3 research • Awards range $10,000 –Awards range $10,000 – • $1 million$1 million • Low/middle incomeLow/middle income countriescountries • Research capacityResearch capacity developmentdevelopment http://www.fic.nih.gov/programs/index.htm
    22. 22. Extramural Training Grants • Institutional training grant to U.S. universities/research institutions in response to a specific request for applications (RFA) • Awardees are current NIH grant recipients with demonstrated research collaboration with foreign research institutions • Purpose – support training for research-capacity building for scientists from developing nations http://www.fic.nih.gov/programs/index.htm
    23. 23.  AIDS International Training and Research Program (AITRP)  International Bioethics Education and Career Development Award  International Clinical, Operational and Health Services Research Training Award for HIV/AIDS and Tuberculosis (ICOHRTA AIDS/TB)  ICOHRTA Non-communicable Diseases  ICOHRTA Malaria  Global Infectious Diseases Research Training Program Award (including TB and Malaria) (GID)  International Training and Research in Population and Health  International Training and Research in Environmental and Occupational Health  Fogarty International Collaborative Trauma and Injury Research Training (ICTIRT) FIC Training Capacity Building: 14 Programs http://www.fic.nih.gov/programs/index.htm
    24. 24.  Informatics Training for Global Health  Framework Programs for Global Health  The NIH Pathway to Independence (PI) Award (K99/R00)  Fogarty International Clinical Research Scholars Resource and Support Center (FICRS) (formally known as the FIC/Ellison Program)  International Scientist Research Development Award (IRSDA) FIC Training Capacity Building: 14 Programs http://www.fic.nih.gov/programs/index.htm
    25. 25. • Fogarty International Research Collaboration Award (FIRCA) • International Cooperative Biodiversity Groups (ICBG) • Ecology of Infectious Diseases (EID) • International Studies on Health and Economic Development (ISHED) • Int’l Tobacco and Health Research and Capacity Building Program • Global Research Initiative Program for New Foreign Investigators (GRIP) • Stigma and Global Health Research Program • Brain Disorders in the Developing World: Research Across the Lifespan Research Grants – 8 Programs http://www.fic.nih.gov/programs/index.htm
    26. 26. • Systematic approach • Long-term commitment • Response to local priorities • Long-term mentoring • Mutual reinforcement of investments in training and research • Institutional partnerships • Advanced In-country research training opportunities • Empowerment/mutual respect • Networking • Flexibility • Leverage Fogarty International Center Program Characteristics Fogarty International CenterFogarty International Center Major Research and Training Sites  Address health needs ofAddress health needs of developing countries withdeveloping countries with research supportresearch support  Build research capacity inBuild research capacity in developing countries- individualdeveloping countries- individual and institutional -throughand institutional -through research trainingresearch training
    27. 27. AIDS International Training and Research ProgramAIDS International Training and Research Program First and oldest research training program at FIC and the modelFirst and oldest research training program at FIC and the model for subsequent research training programsfor subsequent research training programs Johns Hopkins AITRP program: Nurse training session at Sassoon General Hospital , Pune, India.  Builds institutional capacityBuilds institutional capacity  Develops senior leaders  Authored 25% of HIV/AIDS papers in conferences AITRP Jeanne McDermott, Program Officer, FICJeanne McDermott, Program Officer, FIC mcdermoj@mail.nih.govmcdermoj@mail.nih.gov
    28. 28. International Cooperative Biodiversity Groups Scientific and Economic Development Drug Discovery Bioinventory and Biodiversity Conservation
    29. 29. ICBG Accomplishments:ICBG Accomplishments: ScienceScience  275+ novel bioactive compounds discovered  20 compounds for malaria, leishmaniasis, trypanosomiasis, tuberculosis, HIV, bacteria, cancer  Found new species of plants, fungi and insects  Publications in chemistry, biodiversity and policy Flora Katz, Program Officer, FICFlora Katz, Program Officer, FIC katzf@mail.nih.govkatzf@mail.nih.gov Josh Rosenthal, Program Officer, FICJosh Rosenthal, Program Officer, FIC rosenthj@mail.nih.govrosenthj@mail.nih.gov Madagascar Vietnam and Laos Panama Costa Rica Kyrgyzstan Kazakhstan Tajikistan Uzbekistan Papua New Guinea Fiji
    30. 30. ICBG Accomplishments:ICBG Accomplishments: ConservationConservation  Initiate/strengthen 12 biodiversity reservesInitiate/strengthen 12 biodiversity reserves  New/enhanced databases on biodiversity distributionNew/enhanced databases on biodiversity distribution  Leveraged investments from 50 companies,Leveraged investments from 50 companies, foundations, universities and governmentsfoundations, universities and governments  New models of intellectual property rights and benefit-New models of intellectual property rights and benefit- sharingsharing
    31. 31. Global Infectious DiseaseGlobal Infectious Disease  Research training (laboratory,Research training (laboratory, clinical, epidemiological or socialclinical, epidemiological or social science).science).  Relevant to developing countries.Relevant to developing countries.  35 programs in 25 countries35 programs in 25 countries Barbara Sina, Program Officer, FICBarbara Sina, Program Officer, FIC sinab@mail.nih.govsinab@mail.nih.gov Research Training ProgramResearch Training Program Ecology of Infectious DiseasesEcology of Infectious Diseases Research ProgramResearch Program  Past 30 years, changes in biodiversity coincided with the emergence and re-emergence of infectious diseases worldwide  8 projects, in 7th year. Josh Rosenthal, Program Officer, FICJosh Rosenthal, Program Officer, FIC rosenthj@ficod.fic.nih.govrosenthj@ficod.fic.nih.gov
    32. 32. Fogarty International Center GoalsFogarty International Center Goals  Train the next generation of medical researchers,Train the next generation of medical researchers, both US and foreign, in global healthboth US and foreign, in global health  Build/strengthen centers of research excellenceBuild/strengthen centers of research excellence abroad through collaborations and partnershipsabroad through collaborations and partnerships  Strengthen relations through health diplomacyStrengthen relations through health diplomacy  Reduce health disparities and inequalitiesReduce health disparities and inequalities  Increase America’s involvement in global healthIncrease America’s involvement in global health  Provide scientific leadership in global healthProvide scientific leadership in global health
    33. 33. 2 FIRCAs: The Genetics of Hearing Loss Mary-Claire King- University of Washington -Seattle Moien Kanaan – Bethlehem Univ., Palestine Karen Avraham- Tel Aviv Univ., Israel Linking within a grant: Fogarty Collaborative Small Grants (FIRCAs) Science for Peace
    34. 34. General Tips on GrantsmanshipGeneral Tips on Grantsmanship  Read the solicitationRead the solicitation very carefullyvery carefully  Call program officer to clarify eligibility, etc.Call program officer to clarify eligibility, etc.  Get copies of successful relevant grants fromGet copies of successful relevant grants from colleagues to modelcolleagues to model  Write for the peer reviewers, not for yourselfWrite for the peer reviewers, not for yourself http://artfiles.art.com/images/-/Null/Cliff-Jump-Note-Card-C11763337.jpeg The greatest risk in scienceThe greatest risk in science is to stop taking risks!is to stop taking risks! E. Zerhouni, 2007 Director, NIH
    35. 35. Advocates for Global Health
    36. 36. Fogarty Ellison Scholars, 2006Fogarty Ellison Scholars, 2006 24 “pairs” of trainees going to 16 medical centers in the developing world
    37. 37. Global Burden of Disease (DALYS)Global Burden of Disease (DALYS) 19901990 20202020 Lower Respiratory InfectionLower Respiratory Infection 11 Ischaemic heart diseaseIschaemic heart disease Diarrhoeal DiseaseDiarrhoeal Disease 22 DepressionDepression PerinatalPerinatal 33 Road Traffic AccidentsRoad Traffic Accidents DepressionDepression 44 CerebrovascularCerebrovascular Ischaemic Heart DiseaseIschaemic Heart Disease 55 COPDCOPD CerebrovascularCerebrovascular 66 Lower Respiratory InfectionLower Respiratory Infection TuberculosisTuberculosis 77 TuberculosisTuberculosis MeaslesMeasles 88 WarWar Road Traffic AccidentsRoad Traffic Accidents 99 Diarrhoeal DiseaseDiarrhoeal Disease Congenital DiseasesCongenital Diseases 1010 HIVHIV MalariaMalaria 1111 Perinatal DiseasePerinatal Disease COPDCOPD 1212 ViolenceViolence FallsFalls 1313 CongenitalCongenital Iron-deficiency anemiaIron-deficiency anemia 1414 Self-inflicted injurySelf-inflicted injury Protein calorie malnutritionProtein calorie malnutrition 1515 Bronchial and Lung CancerBronchial and Lung Cancer
    38. 38. Pharmaceutical Research: Priority Areas, WHO (2004)Pharmaceutical Research: Priority Areas, WHO (2004) PriorityPriority ConditionCondition 11 Infections/resistanceInfections/resistance 22 Pandemic influenzaPandemic influenza 33 Cardiovascular diseasesCardiovascular diseases 44 Diabetes (1 and 2)Diabetes (1 and 2) 55 CancerCancer 66 Acute strokeAcute stroke 77 HIV/AIDSHIV/AIDS 88 TuberculosisTuberculosis PriorityPriority ConditionCondition 99 Neglected diseases*Neglected diseases* 1010 MalariaMalaria 1111 Alzheimer’sAlzheimer’s 1212 OsteoarthritisOsteoarthritis 1313 COPDCOPD 1414 Alcohol disordersAlcohol disorders 1515 DepressionDepression 1616 Postpartum hemorrhagePostpartum hemorrhage *trypanasomiasis, Buruli ulcer, leishmaniasis, Chagas disease
    39. 39. Epidemiological, Demographic, and Political Transitions • Shift from acute to chronic diseases • Aging populations • Health disparities • Emerging and re-emerging diseases • Behavioral and psychological diseases • Biodefense
    40. 40. Mal AlimentationMal Alimentation (“bad food”) associated with(“bad food”) associated with Economic Development, Longevity, Sedentary SocietyEconomic Development, Longevity, Sedentary Society Source: http://en.wikipedia.org/wiki/BK_Stacker Photo credit: Mychal Stanley ''''''BK Stacker'''BK Stacker''' Serving sizeServing size 1 sandwich1 sandwich 311g311g EnergyEnergy 1000 cal1000 cal Energy from fatEnergy from fat 620 cal620 cal Total fatTotal fat 68g68g Saturated fatSaturated fat 30g30g CholesterolCholesterol 240mg240mg SodiumSodium 1800mg1800mg Dietary fiberDietary fiber 1g1g SugarsSugars 6g6g ProteinProtein 62g62g SourceSource www.BK.comwww.BK.com NotesNotes US % Daily ValueUS % Daily Value based on 2000based on 2000 calorie diet.calorie diet.
    41. 41. GLOBAL EXAMPLES OF EMERGING AND RE- EMERGING INFECTIOUS DISEASES (A.S. FAUCI)
    42. 42. GLOBAL EXAMPLES OF ENDURING ENVIRONMENTAL DISASTERS
    43. 43. GLOBAL EXAMPLES OF PEDIATRIC AND ADULT CANCERS
    44. 44. GLOBAL EXAMPLES OF GENETIC DISEASES AND DISORDERS
    45. 45. National Institutes of Health Main CampusNational Institutes of Health Main Campus Bethesda, Maryland, U.S.A.Bethesda, Maryland, U.S.A. jbreman@nih.gov

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