New goals set for global health research, training

As research discoveries and aid efforts have reduced deaths from HIV/AIDS, populations in the developing world are increasingly suffering from noncommunicable diseases such as heart disease, cancer, diabetes, and mental illness.

"It is critical that we leverage the existing HIV research and care delivery platform to build the capacity needed to stem the tide of these new disease epidemics," said Dr. Roger I. Glass, who leads Fogarty and serves as the NIH associate director for global health research. "We must focus our attention on these pressing problems, which also plague us in the United States, and discover new ways to prevent and treat them. Today, global health and local health are becoming one and the same and research anywhere can help people everywhere."

Fogarty plans to reinvigorate its efforts to train more developing-country scientists in these new areas of global health, where the field is moving and where the most interesting discoveries are yet to be made, according to the plan.

"Our concept of investing in training outstanding young investigators, both U.S. and foreign, and linking them early in their careers in research partnerships between their institutions has been a winning strategy that has had a major impact on the research enterprise for global engagement," said Glass.

Fogarty trainees have participated in research studies that have resulted in key discoveries to improve care and reduce the spread of HIV/AIDS. These include determining that populations in low-resource settings can adhere to complicated treatment regimens and that antiretroviral drugs and circumcision are effective at preventing disease transmission.

To capitalize on the upsurge of interest in global health on U.S. campuses, Fogarty intends to boost efforts to recruit investigators with diverse specialties including cardiology, oncology, bioengineering, neurology and mental health, and other topics that in the past were not considered in the realm of global health. To better address today's complex global health problems, the center will also support the development of multidisciplinary teams with skills not traditionally related to health, such as engineering, business, economics and law.

Another priority under the new plan is to intensify efforts to incorporate information and communication technology into the center's research and training programs.

"E-learning is a powerful way to enable physicians and medical personnel at all levels to gain access to the ever-expanding and changing knowledge base that can keep them up-to-date throughout their careers," Glass explained.

The ubiquity of cellphones in the developing world has created opportunities to adapt mobile applications to improve access to populations for research and provision of care. However, it will be critical that these projects are carefully monitored and evaluated to ensure they are effectively integrated into the practice of medicine, public health and research.

Implementation science remains a high priority for the center under the new plan, so that proven interventions are quickly adapted for use in low-resource settings and scaled up effectively. Increased efforts are needed to catalyze partnerships and improve communication between the scientific community and program implementers and decision-makers, so that science informs program and policy, and research is responsive to program and policy needs, according to the plan.

Fogarty's new strategic vision is intended to advance the global health research agenda by building on past and current Fogarty investments and successes in a way that responds to the changed landscape in global health. Specific goals and priorities are outlined in five main areas:

• building research capacity to meet current and future global health challenges • stimulating innovation in the development and evaluation of technologies to address global health problems • supporting research and research training in implementation science • advancing research on prevention and control of communicable and noncommunicable diseases and disabilities • forming partnerships to advance global health research and research capacity

"By taking science to where the problems are, and by supporting research and research training in areas where the burden of disease is greatest, Fogarty investments will continue to build the health research workforce of the future. This will ensure scientific methods are brought to bear on some of the world's most complex health problems, which are affecting populations both at home and abroad," Glass concluded.

Since it was founded in 1968, Fogarty has provided significant research training to more than 5,000 scientists worldwide. Today, the center funds some 400 research and training projects involving more than 100 U.S. and foreign universities for scientific collaborations on infectious diseases, chronic conditions, brain disorders, tobacco, biodiversity and natural products discovery, implementation science, mobile health and other topics.

The full text of Fogarty's strategic plan is available at: http://bit.ly/FogartySP