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Promoting Global Health Research and Training to Reduce Disparities

The Fogarty International Center supports scientific research and training worldwide to reduce disparities in global health. They focus on infectious diseases in low-income countries and chronic non-communicable diseases in high-income countries.

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Promoting Global Health Research and Training to Reduce Disparities

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  1. Fogarty International Center Infectious Diseases Programs and Perspectives of theFogarty International Center, National Institutes of Health Joel G. Breman, M.D., D.T.P.H Program Director, International Training and Research Program in Emerging Infectious Diseases Deputy Director, Division of International Training and ResearchFogarty International Center National Institutes of HealthE-mail: jbreman@nih.gov Web site: www.nih.gov/fic International Affairs Committee, IDSAJanuary 29, 2001

  2. The FIC Mission “To promote and support scientific research and training internationally to reduce disparities in global health.” Fogarty InternationalCenter

  3. Fogarty InternationalCenter Causes of Death Differ with State of Development • In the high-income countries, chronic non-communicable diseases are the major cause of death • In the low-income countries, infectious diseases account for ¾ of the mortality in the under 5-year-old group and up to half the mortality in adults • As countries develop, there is a shift from communicable to non-communicable disease burdens

  4. National Institutes of HealthInternational Research Expenditures 1994 to 1999 Direct Foreign Research Grants $100,000,000 $90,000,000 and Contracts $80,000,000 Foreign Components of $70,000,000 $60,000,000 Domestic Grants and Contracts Amount $50,000,000 $40,000,000 Training Grants $30,000,000 $20,000,000 Visiting Program $10,000,000 $- 1994 1995 1996 1997 1998 1999 Fiscal Year

  5. FogartyInternational Center Research-Policy Interfaces Other ChronicDiseases Nutrition Responsible Medical Reporting International Research Scientist Career Development Maternal & Child Health Tobacco Prevention & Control Strategic Alliances Environment and Ecology Health & Economic Development Biodiversity Environmental & Occupational Health Medical Informatics HIV & Emerging Infectious Diseases Population & Demography Genetics Bioethics Medical Informatics Clinical/Operational Research Build International Research Capacity Create Collaborative International Research Networks Promote FIC In-house Research FUTURE NEW INITIATIVES CURRENT PROGRAMS FOUNDATION PLATFORM — MISSION

  6. Fogarty International CenterExtramural Programs

  7. FIC Population and Health $1.2 million NIA NICHD NCI FIC NIAID Biodiversity $3.6 million NIDA NIMH NHLBI USDA NSF NIAID FIC Tuberculosis $1.2 million NICHD Fogarty International Center Program Initiatives and Collaborating Partners Fiscal Year 2000 Funding FIC OD FIC Emerging Infectious Diseases $2.8 million Environmental and Occupational Health $2.0 million NIDCR NIAID CDC NICHD NCI FIC NIAID AITRP $12.8 million NIDA NIMH NIDCR FIC Medical Informatics $.6 million MIRT $2.7 million NLM NIAID FIC ORMH

  8. Fogarty InternationalCenter FIC Research Training Mechanisms • Long-term training* pre- and post-doctoral training in U.S. institutions (duration: minimum 9 months) • Short-term training* focused workshops and technology transfer (duration: several days to several weeks) • Research performed preferentially in-country

  9. “Where We Are Now” Countries in FIC Infectious Diseases Programs, 2000 Hungary Lithuania Russia Latvia Armenia Kazakhstan Czech Republic Poland Georgia China Ethiopia Mali Pakistan Mexico Haiti Belize India Philippines Guatemala Kenya Nicaragua Ghana New Guinea Indonesia Ecuador Venezuela Peru Malawi Brazil Bolivia Chile

  10. Fogarty InternationalCenter Sustainability in FIC Programs Principles • Commitment * National * Institutional * Trainee • Re-entry grants for trainees • Diversified program themes • Contribution of resources from all partners

  11. Fogarty InternationalCenter Sustainability in FIC Programs Principles (continued) • Sustained linkages • Leveraged resources • Dual appointments for faculty • Connectivity via modern IT systems • Centers of excellence in home countries • Mutual benefits known to all

  12. Research, Training and Support Needs According to Understanding of Diseases andEfficacy of Interventions High Training High Efficacy of Control Methods Research Needs Low Low Some Moderate High Research Support Needs

  13. Research, Training and Support Needs According to Understanding of Diseases andEfficacy of Interventions High High Training Efficacy of Control Methods DengueMalaria HIV/AIDSTuberculosisEbola/Marburg InfluenzaCancersAlzheimer’s SmallpoxGuinea wormPoliomyelitisH. influenzae type BMeaslesTetanus Research Needs Low Low Some Moderate High Research Support Needs

  14. Global Health =U.S. Self Interest • The U.S. population is a mosaic of minority populations of origin in other countries (often with high disease burden). It is sometimes more feasible to identify risk factors in countries of origin • Reducing disease transmission in endemic areas will reduce likelihood that U.S. travelers will acquire illness • Global eradication of smallpox, polio, and potentially measles has benefits to the U.S. — elimination of diseases and savings on vaccines Fogarty InternationalCenter

  15. Fogarty International Center For More Information E-mail: jbreman@nih.gov www.nih.gov/fic www.nih.gov

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