Field Note

Fogarty Seeds Research Grants To Help Developing Countries

Sharon H. Hrynkow, PhD
Deputy Director, Fogarty International Center
Gerald T. Keusch, MD
Director, Fogarty International Center and
Associate Director for International Research, National Institutes of Health

It started 15 years ago when the Fogarty International Center (FIC) introduced what would become the enormously successful AIDS International Training and Research Program (AITRP).

AITRP, and many of the FIC research and research training programs that followed, focus on seeding developing countries with homegrown research scientists and health professionals who are trained at U.S. institutions through FIC-supported programs.

Since AITRP's 1988 introduction, and the introduction of more than a dozen newer FIC research and training programs on other global health areas, the vast majority of FIC trainees have returned to their home countries, where many have become internationally renowned leaders in science and medicine. Crispus Kiyonga, M.D., the former Ugandan Minister of Health, was an FIC trainee. Dr. Kiyonga received advanced training through an FIC program at John Hopkins University, and was recently tapped to chair the Global Fund to Fight AIDS, Tuberculosis and Malaria Working Group.

FIC partners with nearly every NIH institute, center and office to develop and implement global health programs. Those NIH partners include the National Institute of Allergy and Infectious Diseases; the National Heart, Lung, and Blood Institute; the National Cancer Institute; the National Institute of Mental Health; the National Institute on Drug Abuse; the National Institute of Child Health and Human Development; and the offices of AIDS Research, Behavioral and Social Sciences Research, and Research on Women's Health.

FIC's mission is to promote and support scientific discovery internationally and mobilize resources to reduce disparities in global health. Founded at NIH in 1968 to honor Rhode Island Congressman John E. Fogarty, the center devotes the major part of its resources to research and research training in developing countries where the burden of disease is greatest and the resources are most limited.

FIC's 34-year history of supporting international medical research collaborations began with programs that provided training funds to individuals. AITRP was the first FIC program to award international training grants to U.S. institutions instead of to individual U.S. or foreign scientists. Through partnerships between these U.S. institutions and their foreign counterparts, critical research is conducted while training the next generation of researchers. FIC supports collaborative research and research training projects at more than 120 institutions throughout the United States and in more than 100 foreign countries.

Building on this foundation, FIC recently unveiled the International Clinical, Operational, and Health Services Research Training Award for AIDS and Tuberculosis (ICOHRTA AIDS-TB), to address new challenges. As its name implies, ICOHRTA AIDS-TB's goal is to strengthen research systems in developing countries for support of clinical, operational and health services research, including clinical trials of drugs, other interventions, and prevention strategies that can ultimately be incorporated into local health care systems.

ICOHRTA represents a new generation of FIC grants in that it integrates clinical, operational and health services research training across the spectrum in HIV/AIDS and tuberculosis research.

With its first-generation research training programs, including AITRP, the model is that FIC awards grants to U.S. institutions to support projects that encourage collaboration with foreign scientists in research topics that include HIV/AIDS and other infectious diseases, population growth, maternal and child health, bioinformatics and biodiversity. By and large, FIC provides support for behavioral, clinical, and epidemiological research and research training, as well as laboratory-based research and related research training. Through FIC's programs, health professionals and researchers from developing nations have tended to come to a U.S. institution for didactic training and, to the greatest extent possible, complete practical work in their home country.

ICOHRTA AIDS-TB, on the other hand, places the primary initiative and operation of the program with developing country institutions. Under the ICOHRTA AIDS-TB program, funding will be awarded jointly to the developing-country institution and the U.S. institution. The change is subtle but profound.

By putting more responsibility in the hands of qualified developing country scientists and institutions, FIC fosters growth and independence. Allowing the developing-country scientists to propose research and research training programs and to identify the U.S. institutions with which they wish to work means that the research programs are more relevant to local health needs and the training is a more meaningful experience. With this new approach, the center of gravity is moving more toward the developing country, which is now assuming more responsibility for carrying out the research and managing the research training of young scientists.

To be considered for an ICOHRTA AIDS-TB grant, an applicant must go through a two-step proposal process. The first step, the planning grant process, is currently under way. A planning grant gives the developing-country institution the monetary resources needed to reach out to a university or other research institution in the United States or elsewhere to form a partnership. Once contact is established, the two entities can design a long-term, linked training program proposal. Only after a planning grant is approved can a foreign institution become eligible for a full ICOHRTA AIDS-TB grant, which will provide approximately $250,000 to the foreign partner and the same to the U.S. partner.

FIC's ICOHRTA programs will build much-needed capacity in developing countries to translate research advances into health care and treatment. The ICOHRTA AIDS-TB program and its predecessor ICOHRTA program that focuses on mental health, drug abuse, and aging-related conditions are part of a strategy to help build institutional research capacity in centers of excellence that can successfully compete for research funding anywhere in the global scientific marketplace.

FIC's approach is long-term - even decades long - to build needed capacity in the developing world and to sustain it. The ICOHRTA programs will not necessarily bear fruit tomorrow, but they will be extremely valuable in the years to come as low- and middle-income countries address local - as well as global - health challenges.

More information about FIC, including announcements of FIC initiatives and opportunities and a full list of programs and contacts, is available on the Center's web site at http://www.nih.gov/fic

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