US-Pakistan research collaborations improve health

June 2010 | Volume 9, Issue 3

Pakistan, the world's sixth most populous country, is one of the fastest growing economies in Asia. But one-third of its citizens live in poverty, unable to access quality health care and other basic amenities, contributing to an average life expectancy of only 65. Pakistan has one of the world’s highest child mortality rates and is one of only four countries that has not yet eliminated polio.

To address these and other health needs, Fogarty and several other NIH Institutes and Centers have formed productive research and research training collaborations with Quaid-i-Azam University in Islamabad; Aga Khan University in Karachi; and King Edward University and University of the Punjab, both in Lahore.

These ventures are making scientific discoveries to improve health, in addition to adding to the country’s research capacity by providing advanced training for Pakistani scientists. Funds from the U.S. State Department are helping to support several projects that are investigating genetic hearing loss, studying environmental toxins and occupational health issues (see the related article Traditional surma eye makeup poses lead risk) and supporting training to develop and implement ethical research practices.

Of the millions of yearly neonatal deaths and stillbirths, 98% of the burden is in Pakistan and other developing countries where home delivery is common. Eunice Kennedy Shriver National Institute of Child Health and Human Development is supporting a program that teaches Pakistan’s rural birth attendants about newborn resuscitation and routine infant care, significantly reducing deaths.

Respiratory infections cause about a quarter of deaths in Pakistani children under five. NIH-funded research is helping determine the role viruses play, advancing diagnostic capacity and informing an effective vaccine strategy.

Research projects like these require well-trained scientists. Pakistan had almost no formal training program in infectious diseases before a Fogarty initiative enrolled its first trainee in 2006. The project has helped Pakistan to recognize pediatric infectious diseases as a distinct sub-specialty, while also helping to establish a pediatric infectious diseases research laboratory.

Other NIH-supported collaborations are studying the genetics of stuttering and hearing loss among several large families in Pakistan, where intermarriage is common. This work, supported by the National Institute on Deafness and Other Communication Disorders and the National Human Genome Research Institute, may add to better understanding of the brain’s neural structure and functions that generate speech.

Mental retardation is also prevalent in Pakistan, where Fogarty-supported researchers have studied methods to better screen children for disabilities so they can receive special care earlier (see the related article International collaboration improves screening and care for mentally retarded). The scientists hope to implement their screening tool and educational outreach nationwide.

Another mental health issue in Pakistan is suicide, considered both a sin and a crime in this Muslim country. NIH-funded researchers studied risk factors and causes by reviewing hospital records and police reports, the only data available (see the related article Researchers find suicide and self-harm on the rise). Further support could be used to investigate effective interventions and provide training for emergency department staff.

Chronic kidney disease is a growing public health problem in Pakistan, where testing kidney function is a laborious procedure performed in health care facilities. Kidney disease often goes undiagnosed until dialysis is required or death occurs. A Fogarty grant is supporting the first population-based study using markers to detect the disease.

These and other NIH-supported research and research training collaborations between U.S. and Pakistani partners are strengthening the biomedical research enterprise in Pakistan, with the long-term goal of saving lives and improving health.

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Related World Regions / Countries

• South Asia