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Advancing Science for Global Health
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Gates Foundation grant launches nutrition study

March / April 2009 | Volume 8, Issue 2

The Foundation for the National Institutes of Health (FNIH) and Fogarty have launched a five-year study to investigate the linkages between malnutrition and intestinal infections and their effects on children in the developing world.

An estimated 20 million children under 5 are severely malnourished, leaving them more vulnerable to illness and early death, according to the World Health Organization.

The Interactions of Malnutrition and Enteric Infections: Consequences for Child Health and Development (MAL-ED) project is funded by a grant of nearly $30 million from the Bill and Melinda Gates Foundation to the FNIH.

Photo: Children sit at a long table eating from bowls
Photo by Alejandro Lipszyc, World Bank

Poor nutrition may be linked to intestinal
infections in children like these, who are
eating free school lunch in Una, Brazil.

Poor nutrition in early childhood may lead to cognitive defects and poor physical development, may increase susceptibility to and severity of infections and may diminish the effectiveness of childhood vaccines.

At the same time, infections causing diarrhea can damage the intestines, impair nutrient absorption and harm the immune system.

"We anticipate that this research network will make critical discoveries that will help us save the lives of those most at risk - the world's youngest and poorest children," said Dr. Tachi Yamada, president of the Gates Foundation's global health program.

FNIH Chairman Dr. Charles A. Sanders said, "With the establishment of this remarkable partnership, we hope to shed light on critical questions such as which organisms or infections disrupt growth and development, as well as identify the time in early life when those factors have the greatest impact on morbidity and mortality."

"The interactions between diarrheal diseases and malnutrition seem to produce a vicious cycle that has devastating developmental consequences for the world's poorest children," said Fogarty Director Dr. Roger I. Glass. "We have much to learn about this relationship and expect that the robust and expanding network that we are establishing will provide us with a wealth of useful information."

FNIH and Fogarty are coordinating the research effort, which will be conducted in collaboration with other partners, including universities in the United States and institutions in the developing world.

These partnerships will establish a network of urban and rural sites in Asia, Africa and South America. Sites were chosen on the basis of their diversity of exposure to intestinal disease-causing organisms, prevalence of disease, investigator experience and local scientific capacity.

In addition, the genetic diversity of the human populations involved in the network will enable investigators to study the host factors responsible for differential susceptibility to infectious agents and malnutrition.

These associated genomic studies will be supported by Gates Foundation awards to the University of Virginia and to Washington University, St. Louis.

The network will be coordinated by Dr. Michael Gottlieb of FNIH and Dr. Mark Miller of Fogarty.

Its network's main objectives are to create a standardized and harmonized set of epidemiological tools to accurately study the links between intestinal infections and gut physiology as risk factors for malnutrition across a number of diverse sites in the developing world.

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