Fogarty Initiatives for Building Capacity in HIV/AIDS

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1 Fogarty Initiatives for Building Capacity in HIV/AIDS April 13, 2010 Michael P. Johnson, M.D., M.P.H Deputy Director Fogarty International Center

2 Global Health Transition in 21 st Century the unfinished agenda ; infectious diseases, maternal mortality, and child health the second agenda ; chronic diseases, e.g. cardiovascular disease, cancer, stroke, diabetes, mental illness the third agenda ; newer health risks caused by obesity, environmental hazards, injuries & accidents, climate change, addictions

3 Global Health Research at NIH Presented at new Trans-NIH GH Working Group NHLBI Centers of research in cardiovascular disease NIEHS Partnership in Science Translation with WHO NIAID Intramural/Extramural Cooperation to develop foreign capacity FIC Building a Global Cohort of Skilled Scientists NIDCD Special Foreign Populations with Genetic Basis of Deafness OAR Joint Funding with Foreign Partner NEI Tapping Private-Sector Tools and Capabilities NIAAA Accessing Extreme-Exposure Populations NCI Brokering Regional Collaboration w/ Shared Funding & Leadership NHGRI Using Community Engagement to Study Genetic Diversity NIA Mining Global Demographic Transitions for Scientific Opportunities

4 Global Health Leadership of Three NIH Directors

5 NIH Directors Global Health Meeting 60 global health leaders invited by NIH Director Fundamental science Population Science Sustaining investments Partnerships (USG, NGO, host government, equity, open access, informatics)

NIH Directors Global Health Meeting Sustaining Investments Continuum of NIH training grants (integral to research grants) Enhancement of global clinical trials capacity

6 NIH Directors Global Health Meeting Sustaining Investments Continuum of NIH training grants (integral to research grants) Enhancement of global clinical trials capacity Multi-disciplinary research and Implementation Science Institutional Strengthening (Ethics, ICT, Mgmt, Indirect cost rate) Research training for policy and other leadership

s of Health Office of Director National Cancer Institute National Eye Institute National Heart, Lung and Blood Institute National Human Genome Research Institute National Institute of Aging on

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

8 Fogarty Strategies for Long-Term Sustainability U.S. Institutions Foreign Institutions Long-term Institutional Research Training Commitments (AITRP, AITRP-like Award) (in context of funded research at foreign site, usually supported by NIH) FIC TOOLS Support for individuals and cross-cutting infrastructure Scholars/Fellows Program GRIP Program (re-entry grant) FIRCA Program Informatics Training Bioethics Training Frameworks Program Medical Education Partnership Initiative (MEPI)

9 Guiding Principles of FIC Programs Low- and middle-income country focus Training in independent & competitive research sites Locally-driven research agenda Long-term investment Partnership Leverage

10 Fogarty Intl Center Percent of NIH Budget 0.25% 99.75%

11 percent $ (millions) NIH Collaborative Activities Report FY 2009 % Collaborative Activities Total Obligations FIC NCCAM NIBIB NINR NIMH NHGRI NIDA NICHD NIDCR NIAMS NINDS NCMHD NIAAA NIEHS NHLBI NIA NIDDK NIAID NIDCD NEI NCI NIGMS NCRR NLM

12 Fogarty funded trainees degree by world bank region, Latin America & Caribbean Sub-Saharan Africa East Asia & Pacific South Asia Europe & Central Asia OECD & High Income Middle East & North Africa Bachelor's Professional Doctorate Postdoctoral position (>=3 months) Other non-degree training (>=3 months) Master's Research Doctorate Short-term training Other Other non-degree training includes certificate, diploma, sabbaticals

13 Sustainability FIC Trainees Return Home 92% 92% 85% 86% 92% 86% Fogarty CareerTrac Database

14 Newer Approaches to Global Health Research Multi-disciplinary teams; engineers, behavioral scientists, economists, policy experts, modelers, anthropologists Study complex aspects of diseases; multi-factorial etiologies, behavioral changes Address implementation science; study and correct the gap between what we know and what we do Sustainability; individual long-term training institutional capacitybuilding networks of excellence New types of partnerships; research and program, emerging economies, elevated host-country leadership role, across disease entities

15 Medical Education Partnership Initiative MEPI will provide support to strengthen the clinical and research capacity of medical educational institutions in Sub-Saharan Africa and thereby help to strengthen the human capacity for health. MEPI has three main objectives: Improve the quality of clinical education and clinical care; Enable graduating medical students to remain in their home country to practice, serve as faculty, and/or conduct research related to the implementation of PEPFAR and other public health priorities; Enhance the recruitment and retention of qualified academic faculty through partnerships and research opportunities. Funds awarded are not expected to solely fund research projects, although funds may be used to support building research capacity, research training, and increasing opportunities to participate in research or apply for research funding.

16 Medical Education Partnership Initiative Program Awards PEPFAR support excellence in clinical training and increased capacity of medical students and faculty to participate in and carry out locally-driven research (e.g. implementation science, clinical trials, health systems research) Office of AIDS Research (OAR) support for the research capacity building component to enhance research and training partnerships between U.S. and African academic institutions Office of Research on Women s Health support for professional training of women Linked Awards NIH Common Fund support for clinical and research training capacity in priority health areas related to and/or beyond HIV/AIDS Coordinating Center Evaluation and dissemination of innovative practices Participation of 17 NIH Institutes/Centers, CDC, HRSA, DOD, USAID

17 Medical Education Partnership Initiative Due: Postmarked by May 12, 2010 Eligibility: Programmatic and Linked Awards: Foreign Public/State Controlled and Private Institutions of Higher Education with medical schools based in a Sub-Saharan African country which receives PEPFAR support. Must be same PI. Must have successful Program award to get Linked Award. One Program application and up to two Linked applications per institution as prime. Coordinating Center Award: U.S. Public/State Controlled or Private Institution of Higher Education with a medical school. One per institution as prime or collaborating institution. Scoring: Investigator(s), Approach, Significance, Innovation, Environment

18 Medical Education Partnership Initiative Prime applicant is sub-saharan medical training institution, choosing partners in north Encouragement for locally-driven research and training agenda (applied, implementation and/or health systems-oriented) Synergy of research and clinical training Blending AIDS and non-communicable disease training and research Support for institutions and networks/partnerships Professional development of women Intellectual, financial, administrative bridges across USG

Obama administration support for global health May 6, 2009 Obama Seeks a Global Health Plan Broader Than Bush s AIDS Effort Global Health Initiative seven principles Woman- and girl-centered approach

19 Obama administration support for global health May 6, 2009 Obama Seeks a Global Health Plan Broader Than Bush s AIDS Effort Global Health Initiative seven principles Woman- and girl-centered approach Strategic coordination and integration Leverage multilateral organizations, partnerships and private sector Country ownership, country-led plans Health systems strengthening Metrics, monitoring and evaluation Promote research and innovation

20 Experiment in Networks Wellcome Trust African Institutions Initiative 7 awards made to consortia involving 70 institutions 5 year period starting August 2009 (renewable) 28m (~ $42m) in total

G8 Planning Meeting NIH, February 2010 Statement from 2009 Summit address gaps in knowledge about how to manage, organize, and delivery health care including by developing networks of researchers and

21 G8 Planning Meeting NIH, February 2010 Statement from 2009 Summit address gaps in knowledge about how to manage, organize, and delivery health care including by developing networks of researchers and by working with our African partners to establish a consortium of interdisciplinary centers of health innovation Commitment to explore partnerships Better integration of overseas development assistance and research funding Realize commitments; (Bamako Health Ministerial)

22 Infrastructure To Address Long-Term HIV/AIDS Burden Research, training, and service delivery are integral to health system, funding in any one should be balanced with funding to others Research capacity creates strong program and policy leadership; (1) research training integral to clinical, health management and policy training, and (2) can achieve greater synergy between academic institutions and public health/ministry Integrate Non-AIDS research and program support To achieve a primary host-country leadership and a locally-driven research agenda; (1) greater capacity for institutions and networks should be part of all interventions, and (2) create opportunities for multidisciplinary and applied/implementation-oriented work, with use of new technology

Planning, Priority Setting, and Budget Development for NIH AIDS Research

Planning, Priority Setting, and Budget Development for NIH AIDS Research Robert W. Eisinger, Ph.D. Office of AIDS Research s of Health Focus of Presentation Overview of OAR Priority Setting Process Budget