NIH programs build synergy, capacity in Africa

November / December 2013 | Volume 12, Issue 6

By Cathy Kristiansen

The NIH is increasing its investment in Africa, adding funds for genomics studies, related training and to build biorepositories and other scientific infrastructure. The Human Heredity and Health in Africa (H3Africa) initiative, launched by NIH and the Wellcome Trust in 2010, recently announced its second round of awards, bringing the total funding for the multiyear project to about $74 million.

H3Africa logo"Studying human diseases within populations with the greatest genetic variability and encouraging the contributions of our African colleagues should yield new insights about the role of genetics in health and disease," said Dr. Eric D. Green, director of the National Human Genome Research Institute (NHGRI), which helps coordinate NIH H3Africa grants.

There is growing synergy among participants in the genomics initiative and other NIH projects in the region. For instance the majority of H3Africa institutions are also engaged in the Medical Education Partnership Initiative (MEPI). Begun in 2010, MEPI is designed to strengthen medical education, improve faculty retention and build clinical and research capacity in Africa. The $135 million project - funded by NIH and the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) - is co-administered by Fogarty and the Health Resources and Services Administration (HRSA).

Both H3Africa and MEPI were cultivated by the NIH Common Fund, the crosscutting NIH program intended to catalyze high-impact ventures that are broadly relevant to improving health. The expanding network of African researchers involved in the endeavors includes a number of alumni of Fogarty's research training programs.

"We are increasingly seeing synergies build in African research, as targeted training programs supported by Fogarty and other funders produce a cadre of scientists with excellent skills and knowledge who can then contribute to cutting-edge research across Africa," said Fogarty Director Dr. Roger I. Glass.

For instance, Dr. Clement Adebamowo, an oncologist, epidemiologist and bioethicist at the Institute of Human Virology, Abuja, Nigeria, will manage a $4 million H3Africa grant to learn more about Africa's most common carcinoma - cervical cancer - as well as the vaginal microbiome and the human papilloma virus (HPV). Adebamowo's affiliation with Fogarty began in 2004, when he attended a bioethics training course. He then obtained a grant from Fogarty and NHGRI, which helped him launch a bioethics master's program in Nigeria, its first ever multidisciplinary degree, and establish his country's national health research ethics committee along with its formal code for research ethics.

"Fogarty's programs opened my eyes to what is possible in terms of developing a high-quality research career, even for someone located in a low-income country," Adebamowo recalled. "Fogarty also provided the opportunity to meet the scientists you would ordinarily only read about in books. This built our confidence and showed us the value of mentored training." As well as his position in Nigeria, Adebamowo is a professor of cancer epidemiology at the University of Maryland School of Medicine, Baltimore.

Another Nigerian, Dr. Christian Happi of Redeemer's University, will lead an H3Africa award to study pathogens that cause fevers in rural Africa. Febrile illnesses are a common cause of disability and death in tropical developing countries. Happi and his team from Nigeria, Senegal, Sierra Leone and the U.S. will use new sequencing technologies and microbial metagenomics - the study of microbial communities.

Happi began his research training at Harvard School of Public Health in 2003 under Fogarty's Global Infectious Disease (GID) Research Training Program. Five years later, he received his own Fogarty International Research Collaboration Award to investigate Plasmodium falciparum resistance to artemisinin-combination therapies in Nigeria. "Those grants provided enough resources to increase my specialized skills, my productivity, my visibility, and to make me more competitive," he said. "Becoming an independent investigator was a major turning point in my career."

A key component of the H3Africa initiative is to develop biorepositories, so that Africans can build and locally maintain a collection of biological specimens that will be made available to the entire research community. Dr. Moses Joloba of Makerere University in Uganda received one of the biorepository pilot study grants.

Joloba's history with Fogarty goes back to 1996, when he began studying for a master's then a postdoctoral degree in molecular biology, supported by Case Western University's Fogarty AIDS International Training and Research Program (AITRP) grant. "During these years, I received a lot of knowledge and technical skills in handling laboratory-related activities," Joloba noted. "I developed networks with more experienced scientists that have mentored me in my career."

He earned a large grant from NIH's National Institute of Allergy and Infectious Diseases (NIAID) and established a molecular biology laboratory at Makerere. He currently receives support from the International Implementation, Clinical, Operational and Health Services Research Training Award for AIDS and Tuberculosis (IICOHRTA-AIDS/TB) program, funded by Fogarty and NIH partners.

"I chose to be a scientist because I believed it could offer some solutions to key human health problems," he said. "The desire to use science to solve some of the human health issues has always motivated me."

Several participants in Nigeria's MEPI grant at the University of Ibadan worked behind the scenes to help two investigators - Drs. Mayowa Owolabi and Bruce Ovbiagele - prepare a successful proposal for an NIH H3Africa grant to study stroke, a major killer in Africa. After the pair participated in a MEPI grant writing workshop, their draft application was reviewed by Drs. Ogunniyi, Odaibo and Olaleye and was backed by letters of support, finally netting a $2.37 million grant.

"As H3Africa, MEPI and other NIH initiatives in Africa mature, they are building the framework and human capacity necessary so the region can take ownership of its research agenda and set priorities driven by local health needs," said Glass. "The strong foundation we are putting in place provides promising opportunities for additional funders."

H3Africa is funded by the Wellcome Trust and several NIH entities, primarily the NIH Common Fund, and also the National Human Genome Research Institute (NHGRI), National Institute of Allergy and Infectious Diseases (NIAID), National Institute of Neurological Disorders and Stroke (NINDS), National Institute of Child Health and Human Development (NICHD), NIH Office of AIDS Research (OAR), and NIH Office of Research on Women's Health (ORWH).

The Medical Education Partnership Initiative (MEPI) is funded by the Office of the Global AIDS Coordinator (OGAC) and NIH components including the NIH Common Fund, Office of AIDS Research (OAR), Office of Research on Women's Health (ORWH), National Heart, Lung and Blood Institute (NHLBI), National Human Genome Research Institute (NHGRI), National Institute of Mental Health (NIMH), National Institute of Neurological Disorders and Stroke (NINDS), and National Institute of Nursing Research (NINR).

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