Dr. Kathleen Neuzil, FIC Director, presiding, the FIC Advisory Board met in building 16 on the NIH Campus in Bethesda Maryland and via videoconference on September 5, 2:00 p.m. – 4:30 p.m. EDT, for the closed session, and on September 6, 9:00 a.m. – 2:45 p.m. EDT, for the open session.
Present
- Kathleen Neuzil, M.D., M.P.H., Director, FIC
- Clement Adebamowo, Ph.D., Professor, University of Maryland School of Medicine
- Ben Chi, M.D., M.Sc., Professor, Institute for Global Health and Infectious Diseases, University of North Carolina
- Wondwossen Gebreyes, M.D., Ohio State University
- Jennifer Kates, M.D., Kaiser Family Foundation
- Robert Murphy, M.D., Northwestern University
Ex Officio Members Present:
- Jeanne Marrazzo, M.D., M.P.H., National Institute of Allergy and Infectious Diseases (NIAID), NIH
- Gregory Germino, M.D., National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NIH
- Vikas Kapil, D.O., M.P.H., Center for Global Health, Centers for Disease Control and Prevention
FIC Staff Present:
- Kristen Weymouth, FIC Advisory Board Executive Secretary; Office of the Director, FIC
- Nalini Anand, J.D., M.P.H., Director, Division of International Science Policy, Planning and Evaluation; Director, Center for Global Health Studies, FIC
- Flora Katz, Ph.D., Director, Division of Training and Research, FIC
- Peter Kilmarx, M.D., Deputy Director, FIC
- Andrey Kuzmichev, Communications Director
- Amit Mistry, Ph.D., Senior Scientist, FIC
- Annette Rid, M.D., Ph.D., Bioethicist, FIC
- Christine Sizemore, Ph.D., Director, Division of International Relations, FIC
- David Spiro, Ph.D., Director of International Epidemiology and Population Studies, FIC
- Judy Coan-Stevens, Communications Office, FIC
Also Present
- Blyth Beecroft, Public Health Advisor, FIC
- Unja Hayes, Ph.D., Program Director, FIC
- Geetha Bansal, Ph.D., Program Director, FIC
- Marya Levintova, Ph.D., Program Director, FIC
- Barbara Sina, Ph.D., Deputy and Program Director, DITR, FIC
- John Schieffelin, M.D., PREVSL, Tulane University
- Troy Moon, M.D., M.P.H., PREVSL
- Moses Badio, PREVAIL
- Soka Moses, PREVAIL
- Cozie Gwaikolo, University of Liberia
- Patricia Hibberd, Boston University
- Sam Gebeh, Epidemiology Ph.D. Program, Boston University School of Public Health
- Bernice Dahn, University of Liberia
- Jeffrey Martin, M.D., Ph.D., Prevail
- Krysia Lindan, M.D., M.S., Prevail
- Keith Gray, PREVSL
- Jamie Nishi, Chief Executive Officer of the American Society of Tropical Medicine and Hygiene
Director's Update and Discussion of Current and Planned FIC Activities
Dr. Kathleen Neuzil, FIC Director, called the open meeting to order and reviewed the agenda.
She welcomed the new advisory board members Dr. Clement Adebamowo, Dr. Benjamin Chi, and Dr. Julie Parsonnet. She noted board member Dr. Chris Beyrer could not attend the meeting.
Dr. Neuzil reported attending the David E. Barmes Global Health Lecture which featured Ambassador Dr. John Nkengasong, U.S. Global AIDS Coordinator and Senior Bureau Official for Global Health Security and Diplomacy. Before his address, he spoke with NIH Director Monica Bertagnolli, Dr. Peter Kilmarx, and Dr. Neuzil on global AIDS achievements and future plans. Dr. Neuzil also attended side meetings with the National Institute of Allergy and Infectious Diseases (NIAID) and other sectors, such as PEPFAR, about future partnerships in implementation science. She detailed the activities of NIH's Division of International Relations in support of Fogarty and NIH,
which included opening scientific discussion between other countries and the World Health Organization (WHO), supplying NIH-relevant input to U.S. government treaties and negotiations, providing guidance on the establishment of international agreements, advising the NIH Office of the Director on policy implications, and overseeing collaborative research and training programs in the U.S. Embassy Science Fellows Program. Other big events included the WHO and NCI's launch of the WHO CC for Global Cancer Control and NIH Japan Society Promotion of Science's visit to FIC.
Dr. Neuzil spoke on the Global Health Fellows and Scholars LAUNCH Orientation that occurred in early July, which included speakers such as Drs. Jeanne Marrazzo, Francis Collins, and Anthony Fauci. Many FIC program network meetings were also held, some being the first in-person meetings since COVID-19. Dr. Neuzil described her trip to Nairobi for the 7th annual AFREHealth Symposium, in which the University of Nairobi was deeply involved. She attended the trainee workshop, which focused on HIV and mental health services. She commented on the President's Malaria Initiative. She expressed hope of pursuing further collaboration between organizations within and outside NIH to have the greatest impact on global health.
Dr. Peter Kilmarx, FIC Deputy Director, spoke on events he attended to promote training and collaboration. He gave a keynote address at the virtual Wayne State University Global Health Research Center summer workshop as well as the Global Virus Network 8th Short Course in Translational Virology. He attended the Global Ophthalmology Summit in Portland, Oregon in August. Not long after, he visited Brazil with Kevin Bialy, FIC's Regional Director for the Americas, and they met with Dailani Carrijo, HHS/OGA Public Health Specialist. Afterwards, they visited with key leading research institutions collaborating with the NIH, including the Brazilian Center for Research in Energy and Materials (CNPEM). They toured the only fourth generation synchrotron light sources in the Americas and met with Director General Dr. Antonio José Roque da Silva, who is helping put together Orion, Latin America's first BSL-4 laboratory, where they will connect to a particle accelerator to enhance medical imaging. He also paid a visit to Instituto Butantan, the largest producer of immunobiologicals and biopharmaceuticals in Brazil, where they were working on a dengue fever vaccine in a new cell-based vaccine factory. The institution also had an interactive science park and vaccine museum. Another highlight was visiting the Research Support Foundation of the State of São Paulo (FAPESP) and signing an MOU with the president, Dr. Marco Antonio Zago, dedicating additional resources to any NIH award with an investigator in São Paulo. FAPESP's research is funded by 1% of all state taxes, as described in the state's constitution. After the signing, Dr. Kilmarx attended a lecture at the 90th anniversary celebration of the School of Medicine of the University of São Paulo, meeting with its dean, Dr. Eloise Bonfá.
Dr. Amit Mistry, FIC, gave a briefing on future NIH activities within the Division of International Science Policy Planning and Evaluation (DISPPE), such as the Global Forum on Humanitarian Health Research. The goal of this activity is to bring together different groups of health practitioners and researchers within the humanitarian research space and build support outreach for scientists in lower income countries. Its focus will be on climate health and the nexus of humanitarian crises. The first webinar took place in late August 2024. Future webinars are planned for October 2024 and February 2025. An in-person meeting will be held in Nairobi in May 2025. Dr. Mistry acknowledged the role of collaborators in putting these events together, including ELRA of the U.K. and IEC in Canada.
Blythe Beecroft, FIC, gave an update on the NIH Working Group on Global Health Research Equity. The summary report for the RFI was finished, and five action groups were created from various partner ICs: Data Management, Sharing, and Capacity; Equitable Partnerships and Community Engage (EPACE); Funding Opportunities and Mechanisms (FOM); Maximizing Applications and Grants for Impact and Capacity (MAGIC); and Promoting Equity and Engagement in Review (PEER).
Dr. Andrey Kuzmichev, FIC’s Director of Communications, stated that Fogarty's communications office’s goal for 2024 has been to increase communication and interaction with younger generations of prospective trainees in the U.S. and abroad, successfully making progress in increased viewership, followership, and engagement with their social media and other online presences. The office plans to post about people and the lives they lead at the NIH in the near future. Dr. Kuzmichev spoke on plans to create YouTube content focusing on interviews of fellows and why they chose a career with NIH, advice from leaders in the field such as Dr. Anthony Fauci, training videos, and even communications trainings. He discussed mentorships in global health matters. The goal for the communications office is to use these different stages and platforms to promote Fogarty programs.
Dr. David Spiro, Director of FIC’s Division of International Epidemiology and Population Studies (DIEPS) introduced Dr. Sean Moore, a new research scientist in the division. Dr. Moore joined the division with experience in mathematical modeling of infectious disease dynamics, graduating from Oregon State University with a Ph.D. in zoology and a focus on disease ecology. He performed his postdoctoral research at the Center for Atmospheric Research citing the association between climate and vector-borne infectious diseases. He continued his work at John Hopkins Bloomberg School of Public Health, where he focused on epidemic diseases. He served as a research associate professor in the Department of Biological Sciences at the University of Notre Dame. He is interested in developing and applying data-driven statistical and mathematical modeling methods to explore the association between environmental conditions and infectious disease dynamics. Dr. Spiro congratulated him and welcomed him to the Fogarty team.
Dr. Spiro gave a brief update on select recent DIEPS publications, such as "Assessing population-level target product profiles of universal human influenza A vaccines" and "Scenario design for infectious disease projections: Integrating concepts from decision analysis and experimental data," both connected to the "SARS-CoV-2 correlates of protection from infection against variants of concern" publication. These articles dealt with statistics from the first cohort study (C-study) of respiratory disease incidents and immunological aspects in urban and rural areas in South Africa, and the further study of protection from infectious diseases such as forms of COVID. Dr. Spiro commented on the work of DIEPS summer interns.
Dr. Neuzil said FIC has begun their strategic planning process by taking advantage of network meetings to get input from stakeholders.
Dr. Neuzil acknowledged Dr. Flora Katz, Director of FIC’s Division of International Training and Research (DITR), who will retire in January 2025. She mentioned future trips to Africa for meetings of the Global Alliance of Chronic Disease and DSI Africa.
FIC Program Concepts and Reissues, Division of International Training and Research (DITR)
Global Brain and Nervous System Disorders Research Across the Lifespan, R01, R21
Dr. UnJa Hayes, Program Director, DITR, presented on the Global Brain and Nervous System Disorders Research Across the Lifespan (Global Brain Program). The program was created in 2003 to fill a gap in research and training as neurological and behavioral disorders continued to be a leading cause of death and disability in lower- or middle-income countries (LMICs). The goals of the program are to contribute to maintaining long term research in LMICs and to support research collaborations between LMICs and higher income countries such as the U.S. This would include the provision of equipment and supplies, mentorship programs, and needs/opportunity assessments. Research topics include neurodevelopmental effects of traumatic brain injury (TBI) in Latin America and the Caribbean, the risk for mental disorder in adolescents and young adults in Asia, and the influence of trauma of the nervous system in Eastern Europe. Dr. Hayes stated that the program is in line with FIC's strategic plan to strengthen research collaborations in LMICs, provide funding opportunities for the global neuroscience research Community, and gives NIH the opportunity to extend its global research footprint.
The program supports companion research application responses to R01 and R21 funding opportunities and is supported by eight IC partners. Dr. Hayes highlighted that the program emphasizes research collaboration, so applications are required to propose capacity-building activities that address the research needs of LMIC collaborator institutions. As demand rose in the past 20 years, the program averaged 80 application submissions annually with R21s at a stabilized rate and R01s having increased. Dr. Hayes stated that this is comparable to the success rate of all applications across the NIH for the same period of time. The Global Brain Program has been a sound, cost-effective Fogarty investment with continued NIH and IC support. The awarded research in the program has led to the publication of over 6,500 journal articles, strategic investments that meet the needs of collaborating LMICs, and the continued renewals of R01 awards. Dr. Hayes recommended that Fogarty continue to support the Global Brain Program.
Dr. Gregory Germino, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Deputy Director, asked what the success rate had been for the applications. Dr. Hayes responded that the rough percentages are 15% for R21s, and 14% for R01s.
Dr. Ben Chi, University of North Carolina, asked Dr. Hayes to expand on the capacity building requirement, whether there is a set allocation for funds, and what kinds of activities will be going on. Dr. Hayes said that the number of restrictions on what can be proposed is set to a minimum. The R21 application could be sued to conduct a needs assessment, and its function can range. There are awards that are developing training relevant to the research product, which include activities that support faculty development, ability to support findings, procurement of equipment, and so on.
Dr. Neuzil stated that she has been impressed with how committed the National Institute of Neurological Disorders and Stroke is to their partnership with FIC and global health. She added that the Global Neurosurgical Society had reached out about partnering with Fogarty, and that Dr. Hayes would be meeting with them.
Dr. Robert Murphy, Northwestern University, asked if any effort was being made to bring in more new programs. Dr. Katz stated that with the concerted effort that was made to establish these programs in countries that needed and lacked it, it is different to have the institutes do R01s for the FIC and that she would like to see that.
Dr. Germino said the problem started with there being no neuroscience development in LMICs and asked whether the program has matured enough to allow focus on new fields, or if it should continue to garner support as an underdeveloped opportunity. Dr. Katz answered that the need is still new, that the focus on mental health and the programs that relate to the field will still be a need and should be pursued.
Dr. Neuzil said she hoped for an output of strategic planning with a focus on partnership and coordination in NIH. It will take work, but there are cross opportunities at NIH that FIC would like to explore. Dr. Katz stated that other contributions are made by fellow ICs, and that they received over 30 million from co-funding alone.
Fogarty HIV Research Training Program, G11, D43
Dr. Geetha Bansal, Program Director, DITR, overseer of HIV-related training and research programs, presented on component adjustment in Fogarty HIV Research Training (HIVRT), a program that expired last August and is up for renewal. The HIVRT program was created when the AIDS International Training and Research Program (AITRP) and the International Clinical, Operational, and Health Services Research Training Award for AIDS and Tuberculosis (ICOHRTA/AIDS-TB) merged in 2013. The goal of AITRP (1988-2012) was to build and broaden basic biomedical, behavioral, and social science research capacity in relative LMIC institutes. ICOHRTA (2002-2011) consisted of two phases. The first was to build up planning grants, the second to take the successful grants and apply them to training programs. After the programs merged, the base goal was to develop research capacity at an institutional level in LMICs and support critical research infrastructure capacity needs. Two grant mechanisms used to accomplish this were the D43 international training grants and the G11 research infrastructure development grants, which will be reconfigured for the renewal.
The D43 grant's focus laid in strengthening the research capacity in one scientific discipline at LMIC institutions through long, medium, and short-term training. Trainees looking to move into HIV research areas had the opportunity to earn their Ph.D., masters, and postdoc degrees or train within the discipline as clinicians, nurses, and pharmacists. Even training in research methods and grant and manuscript writing was offered. The program has operated in 28 countries over the past 10 years. The topic areas within the most recent D43 grant portfolio all need to be focused on improving HIV. The success rate of the grant would more often be dependent on the money put into the research. The co-funding scenario has been steadily rising with new institutions joining in more recent years. The success rates of these trainings are monitored via career tracks. Over 800 trainees' careers are tracked using this method, though there are more unaccounted for.
Dr. Bansal introduced some additions and enhancements to the D43 program. The main focus will be on encouraging certain aspects of capacity building and having a place for trainees to go. Dr. Bansal addressed additional key scientific areas that have created gaps in HIV research training, such as accelerated aging, women's health, vaccine development, and social and behavioral sciences, that the program would focus on in the future. Increasing the number of LMIC PI written grants and having them discuss in the application how they will take care of their trainees post training was another goal she emphasized.
Dr. Germino asked what the level of interest in health system issues and chronic illness might be to PEPFAR, as those areas are not necessarily in their direct line of knowledge. Dr. Bansal explained
that since PEPFAR would have a say in which area they invest in, she wanted to keep the Notice of Funding Opportunity (NOFO) topics list broad.
Dr. Chi focused on the transition of U.S. PIs to LMIC PIs and asked what the role of the U.S. institute would be over time, and whether there was any prediction for a future scenario of no U.S. involvement. Dr. Bansal responded that the goal was not to get rid of U.S. PI involvement entirely, just encourage the LMIC PIs to take the lead in grant writing and working together. Dr. Chi commented that it is reasonable to have the U.S. involved from a funder's viewpoint.
Dr. Geetha presented on the G11 grant's background and future goals with the renewal. Its purpose is to build the support system at LMIC institutions to be able to conduct the research proposed in the D43. It will provide anything needed to be able to run a successful, competitive grant. The institutions this grant applies to need to have HIV research run throughout, enough to warrant HIV funds. PIs not already in HIV research have not been applying for the G11. The HIV component will be removed from the NOFO to open the application process up to other researchers who also need G11 programming at their institution. A decision has been made to focus more heavily on Research Administration and IRBs, the two awards that maintained a consistently high level of attention within institutions.
The focus of the restructured G11 is based on the need to support research capacity building, a direct link to HIVRT's overall goals and Fogarty's strategy planning. The G11 will be moved away from HIVRT and become a standalone program. It will be run like D43s with network meetings to connect those participating. It will start as an RFA and be given a trial run as a three-year grant. Part of the proposed infrastructure development program offered is to create a "coordinating center" model to provide the necessary training in understanding how to apply for the G11 grant, why an institution might need it, and how they can use it to their benefit by connecting local partners and countries that share time zones, language, cultural backgrounds, and legal parameters. This resource will most likely be online with an annual meeting. The focus areas will remain as previously profiled. The grant will no longer appear to be restricted to HIVRT, moving away from solo PIs or institutions to include a wider group, therefore enhancing networking ability through LMICs, maintaining sustainability whether trainees stay or relocate institutions, and being more cost-effective.
Dr. Chi asked if partners for the "coordinating center" model have been identified as of yet. Dr. Bansal answered that that will be written into the G11 renewal NOFO. A grantee from any country may participate.
Jamie Nishi, CEO of the American Society of Tropical Medicine and Hygiene (ASTMH), asked what more was needed to make sure there will be robust support and buy-in to have the funding for G11 and expand it over time. Dr. Bansal replied that HIVRT has not been able to acquire the funds to do so yet but hopes to soon. Dr. Katz remarked that if an institution is awarded the grant, the HIV research division will inadvertently benefit because the institution benefits as a whole. Dr. Chi concurred with his fellow board members and stated that the rehashing of this grant will produce positive outcomes.
Dr. Robert Murphy, Northwestern University, emphasized the importance of other components after research administration and spoke on other topics that could take precedent after the basics are covered by funding. Dr. Marrazzo noticed that NIAID's contribution to D43 funding is small and asked if this is because of another program already covering this. Dr. Bansal said there is leftover
funding from when AITRP was separately functional, but there isn’t any in HIVRT's current funding. Dr. Katz commented that Fogarty's relationship with NIAID is symbiotic.
Chronic, Non-Communicable Diseases and Disorders Across the Lifespan: Fogarty International Research Training Award (NCD-LIFESPAN), D43
Dr. Marya Levintova, Program Director, DITR, presented on the renewal of the Non-Communicable Diseases and Disorders Across the Lifespan (NCD-LIFESPAN) Fogarty International Research Training Award. She stated that NCDs continue to be predominant in LMICs, as two thirds of individuals die from an NCD, with five of ten of the leading NCD causes of death being heart disease, stroke, COPD, Alzheimer’s, and lung cancer. The need for research is plentiful, but the number of research training programs is low. The NCD-LIFESPAN program completed its three-year cycle in July 2024, and NIH is looking to renew the program. It is open to any applications for NCD topic except trauma and cancer, as those topics have separate well-established research training programs. The program's trajectory of grants has been varied, with a decrease in applications in 2022 and an increase in 2023. Dr. Levintova stated that Fogarty is responsible for funding two thirds of the program, with the rest funded by various other foundations and institutions at the NIH. Countries in Africa and South and East Asia had nearly 70% of funding consistently throughout the three-year cycle. In 2021, LMICs were encouraged to submit applications even without U.S. PIs, and as a result about one third of applicants were direct recipients. Publications were prolific throughout the period of the program, showing a breadth of different topics in global health matters such as refugee health and dental health.
Dr. Levintova stated why the program should be renewed, the most prevalent reason being the need for developing researchers that can successfully conduct NCD research in LMICs, and that the NCD-LIFESPAN is one of the sole funders of this need. There have also been NIH ICsthat have shown continued interest and support in recompeting the program. Evidence of the productivity of this program has been shown through the further funding of trainees within their field with NIH awards and other means and the advancing of trainees to leadership roles within the program. Dr. Levintova proposed a three-year PAR similar to the previous NOFO. This would continue to encourage primary recipient applications and the exclusion of trauma and cancer topics. The 18-month funding requirement for applicants to show credible research funding will be replaced by a requirement to submit a justification statement explaining how the applying trainees will be supported throughout their research training.
FIC spoke to the head of the program in Lebanon, Dr. Houlahan, about her experience with the program and a pathway forward for future successful trainees. She was unfamiliar with the process of the institute, which raises the question of how do specific institutions within NIH support research in the global space. Dr. Levintova, replied that DITR has organized forms of engagement to do just that.
Dr. Christine Sizemore, Director of FIC’s Division of International Relations, confirmed that the most common questions are generic ones on basic functions of NIH programs. Dr. Germino commented that he had heard that the NIH access point for grant information will be updated in late September. Dr. Sizemore added that the Fogarty home page includes a regularly updated section that provides general resources. Judy Cohen-Stevens, Fogarty Communications Office, confirmed that they post a weekly newsletter to go through all NIH grants available and will highlight the specifics of their availability.
Global Infectious Diseases Research Training Programs to Build Research Capacity in Liberia and Sierra Leone
Dr. Barbara Sina, DITR, brought the board up to date on three successful research programs in Liberia and Sierra Leone., The goal was to make tools and grants available to build research capacity in a low-capacity space, produce an entire environment and culture where research could occur. Past successful trainees of other programs led the forefront of research to success during the outbreaks of diseases such as Ebola in West Africa. NIAID invested during Ebola and previous epidemics through intramural programs, producing high functioning research capacity and physical facilities in Liberia, which allowed the start of clinical trials to aid in the fight against Ebola. In Sierra Leone, there was a long-time investment in Lassa fever labs. Guinea and Mali have collaborated with NIAID as well. Clearly Fogarty and NIH needed to operate similarly in countries with similar epidemics. In these countries, the University infrastructure is disorganized along with longstanding deficiencies in the sciences and math due to civil unrest. Much has been done to organize these infrastructures while the political and civil unrest persisted. In 2017, the renewal for the Mali GID award included Guinea, helping that country greatly. The grants became competitive with grants coming in from other countries, and in 2019 applications were transformed to operation agreements to further help them become collaborative with other programs. Post Ebola, a National Institute for Public Health was established in Liberia, and research capacity began to grow, developing new programs such as Cure Liberia and BRIDGE-U. NIAID played a large supporting role, organizing integral biweekly meetings to continue to share information.
Dr. Troy Moon, Tulane University, introduced himself and the group who worked within the Partnership for Research in Emerging Viral Infections-Sierra Leone (PREVSL). The program received a B71 planning grant that was converted into a U01 cooperative agreement with Vanderbilt University Medical Center and Tulane. The grant was awarded to Tulane and its partner College of Medicine and Allied Health Sciences (COMAHS) and Kenema Government Hospital (KGH), and the program is up for renewal. The goal of the program is to increase research capacity via three fundamental principles Dr. Moon described as pillars: human resources capacity via long-term trainees, institutional capacity, and field research site capacity.
In October and November of 2023, the University of Sierra Leone launched its first Ph.D. program, though it relied heavily on support from foreign partners, and has had support from the grant program in supplying some of its courses. The program supplies ancillary support that had not existed before within grant management and finance offices. A needs assessment was performed to determine what the grants administrations needed at each institution. From this, two grant programs were written collaboratively and put into practice in 2022. The first program was the Grants Administration International Network (GAIN) which was a virtual class held weekly to promote connectivity. It was followed by the second program, the Global Research Administration Practicum (GRASP), a three-week program that spanned from October 30 to November 18 in which the trainees put their learned skills to active use in an administration setting. At the same time, Sierra Leone launched the Research and Innovation Center at COMAHS that houses their Office of Grants Support. The program helped them establish a new financing system, training 12 staff members and transferring 8 years of projects into QuickBooks. Help was also provided to help the Research and Innovation Center establish its own REDCap administration site. Field research site
capacity was expanded at KGH by providing data management training within pediatric wards, training the clinical staff on how to conduct clinical research.
Dr. Jeffrey Martin, UCSF, presented on Training in Clinical and Epidemiological Research for Liberia (TRACER), a program that ran from 2019 to 2024 that used D71 and U2R grants and partnered with the University of Liberia. He asked for the renewal of these grants. TRACER's goal is to increase the number of Liberian leaders in the clinical and epidemiological research field. Dr. Martin stated that they found three scientists who were promising candidates and brought them into the program: Mr. Moses Badio, Dr. Cozie Gwaikolo, and Dr. Soka Moses. TRACER made available to them the same quality of formal education in research and resources used in UCSF's master’s program. Each trainee was mentored through the life cycles of several research projects. All three trainees completed the master’s program, submitted their manuscripts for publication, and participated in NIH grant submissions. Mr. Badio and Dr. Gwaikolo joined the Ph.D. program at UCSF and Dr. Moses was selected as the Scientific Director of PREVAIL.
Dr. Patricia Hibberd, Boston University, presented on the Boston University and University of Liberia Emerging and Epidemic Virus Research Program (BULEEVR), and FIC GIDR training program that ran from 2019 to 2024. The program started with a D71 planning grant in 2017 and 2018 with the goals of understanding the needs for training GID researchers in Liberia and to develop the initial training plan for a D43 grant. The program partners at the time consisted of Boston University School of Medicine and the New England Emerging Infectious Diseases Laboratory (NEIDL), University of Liberia and Dogliotti College of Medicine (UL CM), PREVAIL, And the National Public Health Institute of Liberia (NPHIL). The program got a D43 grant as they had wanted, and it was converted into a U2R. BULEEVR's overall goal was to train physicians and masters graduates to be the next generation of Liberian researchers with a focus on basic science and clinical and transitional research in order to address the challenges of emerging and prevalent epidemic infectious diseases in Liberia. Building the infrastructure of the program was a multi-institutional effort, with each partnership between the collaborating institutions growing stronger as they furthered the program.
Panel: Recommendations for Building Research Capacity in Low Research Resource Countries
Dr. Sina introduced Dr. Bernice Dahn, University of Liberia, who discussed how to build research capacity in LMICs. Dr. Dahn explained that the traditional approach to research training for LMICs has been to send their trainees to high income country (HIC) institutions to be trained, and have the trainees return to LMIC institutions to advance research and training there. The challenge with this approach is that the trainees do not always return to LMIC institutions, which is a loss in benefit. Even when they do, there is no system or not enough funding in place to support the continuance of their research. Dr. Dahn said LMIC institutions need to focus on creating quality programs and supportive forces in-country that could provide a larger, more long-lasting impact. Capacity building and grant management systems are in place in Liberia, which has helped establish a curriculum, but funding is still needed to build a larger faculty and faculty support, strengthen administration management, increase research resources, and seed future funding. If support could be provided to help with this gap, it will help build a stronger permanent research infrastructure, but it will take time.
Dr. John Schiefflin, Tulane University, stated that pursuing these solutions within Dr. Dahn's recommendations can be done incrementally throughout multiple five-year cycles of these programs. One contributing issue is that it is hard to find PIs in LMICs that meet the challenging R01 requirements, making it also hard to maintain consistent in-country PI leadership as Dr. Dahn recommended. As it is hard to compete for R01s right after graduation, Dr. Schiefflin said they would like to find a mechanism to help Ph.D. graduates gain more experience before applying for R01s. There is also the issue of replacing the trainees after they have moved on from the program, as there is no stable system to train in sustainable basics needed to run the program This also connects to maintaining grants management, as the infrastructure cannot use D43s. He stated that is was a major obstacle to find adequate facilities for trainees.
Dr. Jeffrey Martin, UCSF, argued that having one particular topic to focus research around is too restricting, and that FIC should be open to broadening the in-country training in order cover a vast field. He also suggested that the training be developmentally specific to each country. To become scientific partners in the future will take time. A more realistic long-term plan needs to be implemented on how the transition to in-country training would occur. Dr. Martin suggested creating a tiered competition He agreed with Dr. Schiefflin on needing more than five years to accomplish this and letting go of the need for already existing PIs, which narrows the candidate pool.
Discussion
Dr. Wondwoosen Gebreyes, Ohio State University, remarked that in terms of sustainability, resources, and participation of other institutes, the cooperation of the Liberian government could prove helpful. He asked the representatives of BULEEVR to elaborate more on the Liberian government's responsibility in this role change.
Dr. Dahn, University of Liberia, remarked that the government has asked them to submit a budget for the Ph.D. programs, which is around three million dollars. She said the government then factored this into their budget to be able to get some basics in place. Those who teach in-country and those who have full-time roles will be relied on to help establish their goals. The continued networking and funding of other institutes will bring more researchers in and help to expand the human resource capacity. Dr. Dahn stated that since the government does support some of what they do they would like the institutes to be able to build large programs.
Dr. Moon, Tulane University, said that in Liberia, a lot of work has been going into building a research environment and culture in Liberia through the retained faculty network and that as funding is provided and other opportunities are created, those resources can be put to use to establish a long-term sustainability without external support.
Dr. Soka Moses, BULEEVR graduate, commented that as part of the sustainability plan, they have been working to build in Liberia thanks to PREVAIL and NIH, they were able to have the laboratory information system be run by an in-country team. By 2025, they plan to build and transition to a data center with the procurement of services being ongoing, collaborating with the NIH to establish a platform to transition to their own data center so that trainees can use that facility.
Dr. Kilmarx stated that a key question for the board is whether this is something they should continue to support in just these few countries exclusively, or if these methods should be spread elsewhere.
Dr. Murphy commented that FIC and NIH can only do so much, and with USAID's help, much of these programs flourished in places like Mali and Nigeria, who received funding from PEPFAR. He wondered if there were other institutes that could contribute and collaborate as well.
Dr. Jennifer Kates, Kaiser Foundation, said that when she speaks with PEPFAR, one of the things that they try to work out is how they will create sustainable capacities in the programs and institutions they support. Since some institutions have successfully created a low investment model and plan to pursue those functions in the future, these plans should be presented to PEPFAR to see if they would like to invest in the program graduates' countries and elsewhere.
Dr. Chi said there was a reason these countries were picked and that their successes should be built on. Whether this model should be replicated elsewhere is a question of strategy, because the increase of research capacity is required in many places.
Jamie Nishi stated that one of Fogarty's comparative advantages is their investment in many institutions grants a unique view of where resources can have space for research capacity. Branching out pilot initiatives is a good thing, but the approach needs to be well planned as they will be stretching their resources further.
Dr. Soka reminded the board that the world is still at risk from epidemics such as EBD, and that the support received in Africa could benefit global world health in the fight against these diseases. He pointed out that once countries become more self-sustaining, the need for U.S. investment will no longer be as acute.
Closing Remarks and Adjournment
There being no further business to address, the meeting was adjourned at 2:44 p.m.