Science for Global Health: Fostering International Collaboration Norka Ruiz Bravo,PhD Special Advisor to the Director National Institutes of Health U.S. Department of Health and Human Services IANAS Science Funding Workshop July 2009

Outline Global Burden of Disease Biomedical Research Portfolio NIH Structure, Function Fogarty International Center

Communicable, Maternal, Perinatal, and Nutritional Conditions Non-Communicable Diseases Injuries Source: World Health Report, 2008; Disease Control Priorities Project, 2006 Pop. ~ 6 billionPop. ~ 874 million Global Burden of Disease, Reported Mortality by Cause, 2004

Source: World Health Report, 2008; Disease Control Priorities Project, 2006 Global Burden of Disease, Reported Mortality by Cause, Non-Communicable Diseases, Region of the Americas, 2004

Balanced National Biomedical Research Portfolio NIH - $30 B Clinical Research Basic Research Translational Research Private Sector - $60B Clinical Research Basic Research Translational Research

NIH Extramural Grants (FY 2008) Supports > 150,000 PIs & Key Personnel About 83% of NIH budget Awards issued to > 3,000 institutions in > 100 countries Clinical, Basic, & Translational Research

National Institutes of Health, Bethesda, Maryland, Research Campus

National Institutes of Health: The Steward of Biomedical and Behavioral Research for the Nation MISSION Science in pursuit of fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to extend healthy life and reduce the burdens of illness and disability. METHODS  Supporting peer-reviewed scientific research at universities, medical schools, hospitals, and research institutions throughout United States and overseas  Conducting research in its own laboratories  Training research investigators  Developing and disseminating credible health information based on scientific discovery

= Institutes and Centers that award grants

NIH Budget 84% Outside NIH > 3,000 Organizations Worldwide 16% Inside NIH $2.9 B Intramural Research (10%) $1.2 B Staff & Buildings (4%) $0.6 B Other (2%) Total FY 2009 Budget: $30.4 Billion

NIH – Extramural and Other Grant Awards, by Type Research Grant Programs New Investigators Program Multiple Principal Investigators Research Supplement Programs Ruth L. Kirschstein National Research Service Awards (NRSA) Research Ethics and Training Grant Programs NIH Career Development (K) Awards Small Business Awards Other Programs Source:

Mission Address global health challenges through innovative and collaborative research and training programs Support and advance the NIH mission through international partnerships “Science for Global Health” FY 2009 Appropriation $68.7 million

~$50 million in grant awards 1/3 Research, 2/3 Research Training Awards range $10,000 - $1 million Low and Middle Income Countries Research Capacity Development and Sustainability Research and Research Training

Fogarty International Research Collaboration Award (FIRCA) International Cooperative Biodiversity Groups (ICBG) Ecology of Infectious Diseases (EID) International Studies on Health and Economic Development (ISHED) Int’l Tobacco and Health Research and Capacity Building Program Global Research Initiative Program for New Foreign Investigators (GRIP) Stigma and Global Health Research Program Brain Disorders in the Developing World: Research Across the Lifespan Extramural Research Grants – 8 Programs

Fogarty International Collaborative Trauma and Injury Research Training International Clinical, Operational, and Health Services Research Training Awards for HIV/AIDS and Tuberculosis International Maternal and Child Health Research Training Fogarty International Clinical Scholars Research Training Informatics Training for Global Health International Collaborative Genetics Research Training International Clinical, Operational, and Health Services Research Training Awards for Malaria Global Infectious Diseases Research Training International Research Ethics Education and Career Development International Centers for Excellence in Clinical Research and Management Training International Training Program in Environmental and Occupational Health Global Research Training in Population Health AIDS International Training and Research Framework Programs for Global Health Extramural Training Grants – 14 Programs

Bridge the training gap for clinical, operational and health services research in order to:  Strengthen capacity to conduct clinical, operational, and health services research to measure incidence and prevalence of non-communicable disorders and diseases; characterize disease burdens; and devise, evaluate and implement practical and affordable therapeutic or preventive interventions;  Help LMICs apply current knowledge and new discoveries to clinical and public health practice; and  Support programs at research institutions to both train researchers and to communicate and disseminate knowledge in support of evidence-based policies.  $2.5 million awarded to 12 institutions ($150k each in new awards and $200k each in competing renewals) under previous PA issued in FY 2006  New Program Announcement anticipated  IC Partners: NCCAM, NIA, NIDA, NIDCR, NIMH, NINDS and OD/OD/Office of Dietary Supplements International Clinical, Operational, and Health Services Research Training Awards (ICOHRTA) Chronic Diseases: Goals and Objectives

ICOHRTA Chronic Diseases: Current Foreign Research and Training Sites Peru Argentina Brazil Czech Republic Poland Turkey Ukraine Bangladesh China India Vietnam Thailand

Evidence-based health care Maternal & child health and nutrition Suicide prevention and mental health Nutrition-related chronic disease prevention Finances and mental health Smoking cessation and substance abuse Oral health Mental health, developmental disabilities and behavioral disorders Community-based interventions to prevent drug use and HIV transmission Source: ICOHRTA Chronic: Current Research Training Areas

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