NIH International Programs Flora N. Katz, Ph.D. Fogarty International Center, N.I.H.

National Institutes of Health Office of the Director National Institute on Aging National Institute on Alcohol Abuse and Alcoholism National Institute of Allergy and Infectious Diseases National Institute of Arthritis and Musculoskeletal and Skin Diseases National Cancer Institute National Institute of Child Health and Human Development National Institute on Deafness and Other Communication Disorders National Institute of Dental and Craniofacial Research National Institute of Diabetes and Digestive and Kidney Diseases National Institute on Drug Abuse National Institute of Environmental Health Sciences National Eye Institute National Institute of General Medical Sciences National Heart, Lung, and Blood Institute National Human Genome Research Institute National Institute of Mental Health National Institute of Neurological Disorders and Stroke National Institute of Nursing Research National Institute of Biomedical Imaging and Bioengineering National Center for Complementary and Alternative Medicine Fogarty International Center National Center for Research Resources National Library of Medicine National Center on Minority Health and Health Disparities Clinical Center Center for Information Technology Center for Scientific Review

Fogarty International Center, NIH Mission: Promote and support scientific research and training internationally to reduce disparities in global health. “Science for Global Health”

Fogarty International Center Programs 29 Programs in 91 countries: Training (16) Research (11) Fellowship (2) Most of our programs receive co-funding from other NIH Institutes and other USG agencies

Structure of Programs Most grants require collaborations between US or developed country investigators and investigators and institutions in low and middle income countries. Emphasis placed on interdisciplinary approaches not addressed adequately in current NIH global portfolio Many projects involve multiple foreign countries

Fogarty International Center International Research Scientist Career Development Maternal & Child Health Environment & Ecology Mental Health / Stigma Research Tobacco Prevention & Control Health & Economic Development Bioinformatics Bioethics Genetics Clinical / Operational / Health Services Research Promote Strategic Alliances Conduct Appropriate Research Create Collaborative International Research Networks Build International Research Capacity FIRCA Program Health Disparities Population & Demography Environmental & Occupational Health HIV / Malaria / TB & Other EIDs Biodiversity Platform — Mission Responsible Medical Reporting Demography & Other Social Sciences Student Program Health, Environment and Economic Development HeaBrain Disorders Vector Biology & Arbovirology Competing/In Development Program Expansions (illustrative examples) Current Programs (illustrative examples) Foundation

Communication, Mentoring, Program Management

Web-based Networking Collaboratories for Fogarty Training Programs NIMH Small Business Innovation Research Contracts To address the needs of international collaborations to share data, materials, meetings, and seminars Access portal to relevant information Videoconferencing capability

Barriers to connectivity-survey of grantees (JG Perpich, LLC) Slow connection speeds—several respondents routinely use modems at less than 56K Service charges on the internet service providers (ISPs) can be prohibitive (many of the laboratories are unable to use the government email or internet structure due to inefficiencies and have to pay for private ISPs)

Barriers Infrastructure can be unreliable—electricity, phone and internet connections come and go periodically Political/social issues—censorship of discussions about blood, plasma and HIV are real problems in some countries, especially China

Data Management, Flow, and Access

International Cooperative Biodiversity Groups Program Economic development Drug discovery Biodiversity conservation

New ICBG U01 Awards Uzbekistan/ Kyrgyzstan Papua New Guinea Vietnam/Laos Madagascar Panama

New Planning Grants Costa Rica Jamaica Jordan Fiji Samoa Madagascar Philippines

Vietnam-Laos ICBG Drug Discovery Program Research Institute on Medicinal Plants, Laos (Samples and information) Cuc-Phuong Park, Vietnam (Inventory, Sample Collection) National Institute for Science and Technology, Vietnam (Extractions, prescreens, chemistry) University of Illinois, Chicago (Bioassays, Chemistry, Literature and Database searches) BMS-oncology (cancer discovery and development) 19

Infrastructure is insufficient without training

International Training in Medical Informatics (1997-2003) Mission: Enhance Informatics capacity in developing countries through training 10 Programs in 11 countries Trained over 70 students, 40 to the level of MPH, MSc, or PhD. 100% of trainees that received US training returned to home countries

Examples of Projects Establishment of the first rural Medical Records System in Kenya at a primary care facility servicing an area with no electricity, telephones, or tap water Establishment of first postgraduate/degree Program in Medical Informatics in sub-Saharan Africa Distance learning project for MI in Brazil

Examples In addition to training, establishment (with help from NLM) of a wireless wide area network with internet link to connect the College of Medicine at the University of Malawi internally and with four international projects funded by NIH, the Wellcome Trust, the Gates Foundation, and the Malaria Project.

Informatics Training for Global Health (ITGH- 2004) Mission: To build capacity in informatics to support biomedical and behavioral research in developing country institutions and to develop regional training centers. Training must be integrated with ongoing research at foreign site. Enquires regarding more than 70 institutions Projects: Awards will be announced in May, 2004

More advanced applications?

Health, Environment, and Economic Development (HEED) Mission: To encourage developmental and exploratory research in developing countries on topics that combine the issues of health, environment, and economic development.

Use of GIS analysis-one example US-Brazil: How do land use/cover changes in frontier areas of Brazilian Amazonia impact human health? Integrate socio-demographic data and geo-referenced land use/cover data into a unified geo-referenced database.

FIC Website: http://www.fic.nih.gov