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September 11, 2020 Advisory Board Meeting Summary Minutes

The FIC Advisory Board met via video-teleconference, at 12:00 p.m. EDT, Roger Glass, Chair, presiding.

PRESENT

  • ROGER GLASS, M.D., Ph.D., Fogarty International Center, Chair
  • GRETCHEN BIRBECK, M.D., M.P.H., University of Rochester Medical Center
  • ROBERT BOLLINGER, M.D., Johns Hopkins University School of Medicine
  • WALDEMAR A. CARLO, M.D., University of Alabama at Birmingham
  • MYRON S. COHEN, M.D., University of North Carolina at Chapel Hill
  • JAMES CURRAN, M.D., M.P.H., Emory University
  • JACOB A. GAYLE, Jr., Ph.D., Medtronic Foundation
  • GREGORY GERMINO, M.D., National Institutes of Diabetes and Digestive and Kidney Diseases; ex officio
  • VIKAS KAPIL, D.O., M.P.H., Centers for Disease Control and Prevention; ex officio
  • JOHN T. MONAHAN, J.D., Georgetown University
  • GBENGA OGEDEGBE, M.D., M.P.H., F.A.C.P., New York University
  • STEFFANIE STRATHDEE, Ph.D., University of California, San Diego
  • JUDITH N. WASSERHEIT, M.D., M.P.H., University of Washington
  • MICHELLE WILLIAMS, S.M., Sc.D., Harvard University
  • MARY WILSON, M.D., University of California, San Francisco

ALSO PRESENT

  • JOHN BALBUS, M.D., M.P.H., National Institute of Environmental Health Sciences (NIEHS)
  • BLYTHE BEECROFT, M.S., FIC
  • GWEN COLLMAN, Ph.D., NIEHS
  • CAROL DAHL, Ph.D., The Lemelson Foundation
  • ERIC GOOSBY, M.D., University of California, San Francisco
  • CHRISTINE JESSUP, Ph.D., FIC
  • CHANDY JOHN, M.D., Indiana University School of Medicine
  • FLORA KATZ, Ph.D., FIC
  • PETER KILMARX, M.D., FIC
  • JOSEPH KOLARS, M.D., University of Michigan Medical School
  • ARIANNE MALEKZADEH, M.A., FIC
  • AMIT MISTRY, Ph.D., FIC
  • VIVIAN PINN, M.D., FIC
  • LAURA POVLICH, Ph.D., FIC
  • ANN PUDERBAUGH, FIC
  • JOSHUA ROSENTHAL, Ph.D., FIC
  • CHRISTINE SIZEMORE, Ph.D., FIC
  • DAVID SPIRO, Ph.D., FIC
  • CECILE VIBOUD, Ph.D., FIC
  • KRISTEN WEYMOUTH, FIC, Executive Secretary
  • STEN VERMUND, M.D., Ph.D., Yale School of Public Health
  • RICK WOYCHIK, Ph.D., NIEHS

Director’s Update and Discussion of Current and Planned FIC Activities

Dr. Glass opened the meeting at 12:04 P.M. He welcomed new board members Drs. Eric Goosby, Carol Dahl, Sten Vermund, Karen Goraleski, and Chandy John. He announced that Drs. Waldemar Carlo, Gretchen Birbeck, Robert Bollinger, and John Monahan will be retiring from the board. There are five new institute directors: Dr. Rick Woychik for the National Institute of Environmental Health Sciences (NIEHS), Dr. Lindsey Criswell for the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), Dr. Michael Chiang for the National Eye Institute (NEI), Dr. Shannon Zenk for the National Institute of Nursing Research (NINR), and Dr. Rena D’Souza for the National Institute of Dental and Craniofacial Research (NIDCR).

After the May 2020 Fogarty meeting, NIH hosted 116 fellows planning to go out for a year of mentored research. There were 14 different institutes at NIH partnering on global public health matters. COVID-19 has caused many fellows to delay their visits while others are unable to travel, but hope remains that the program will be back on track next year. NIH has been working on solutions to fund programs of research during COVID. Some accommodations that have been made are the extension of the length of grants either through no-cost extensions or through some cost reimbursement.

COVID-19 has caused a boost in activity at the Fogarty Center through the World RePORT website. World RePORT is managed by Michael Cheetham. It has all of the international grants of NIH and 12 other funding agencies that are members of a group called HIROs, Heads of International Research Organizations. The website is useful for discovering where investments are going by institute and provides information on the foreign components of domestic grants. Dr. Francis Collins has rolled World RePORT into a new major data program called iSearch in the NIH Office of Portfolio Analysis.

The Penn Global Health Group had a meeting on China Cooperation for Biotechnology and Health Security. Among the attendees was George Gao, head of the China CDC. The Chinese have been a source for COVID information by publishing the data on the sequence for COVID online, plans to deal with low, high and medium risks, and a number of effective public health interventions.

Dr. Christine Sizemore gave an overview on activities of the Fogarty Division of International Relations (DIR). Two top focuses are the European Union General Data Protection Regulation (GDPR) and use of non-human primates in clinical trials especially for COVID vaccines. The European Union GDPR governs how personally identifiable information from clinical trials has to be transferred between countries. FIC can often help communicate and coordinate for NIH in receiving animals from other countries.

Dr. Peter Kilmarx gave an overview on what activities he has been covering as FIC Deputy Director. He was invited to speak at the Virtual World Ophthalmology Congress in June. In July he co-moderated a panel at the International Aids Conference with Linda-Gail Bekker from the Desmond Tutu HIV Centre. Fogarty staff created a pre-recorded session on overviews of different programs within the center. Dr. Kilmarx has built a Listserv with over 100 leaders on COVID-19 responses around the country. He organized an international webinar with Cecile Viboud to discuss metrics and targets on COVID-19 responses. The webinar included presenters from Singapore and CDC. FIC published an article in Annals of Global Health focused on reviewing investments and health research capacity strengthening.

Ann Puderbaugh gave an overview of FIC’s communications office. Fogarty’s website is seeing about 20% higher than normal activity and the subscriber base continues to grow for the funding news report and newsletter. They continue to collect stories about how the Fogarty community is responding to COVID-19.

Blythe Beecroft and Arianne Malekzadeh gave updates on projects from FIC’s Center for Global Health Studies. Ms. Beecroft presented on the center’s HIV/NCD project investigating how mathematical modeling can advance the future of integrated care for HIV and NCDs. There is a multi-agency multi LMIC project directed by the Center for Global Health Studies investigating how mathematical modeling can determine the burden of NCDs among people living with HIV specifically in Sub-Saharan Africa. Ms. Malekzadeh talked about a stigma discrimination research toolkit that is being developed; they have developed stigma reduction tools that can be adapted and applied across health conditions, populations, and contexts which include theories, models, and interventions. The goal is for the first iteration of the toolkit to be available later this year. Dr. Kupfer and Ms. Malekzadeh started a project on how to transfer health innovations from LMICs to low-income settings in the U.S.

Dr. David Spiro presented an overview on the Division for International Epidemiology and Population Studies. He discussed a biosafety/biosecurity training program in Pakistan by Dr. Zeba Rasmussen. Dr. Martha Nelson and Mike Worobey published an article in Science related to new methods that look at travel and predicting how the COVID-19 virus spread. Dr. Joshua Rosenthal updated the board on the HAPIN Trial. The trial is being conducted in India, Rwanda, Guatemala, and Peru. It has entered its fifth and final year of scheduled funding. The intervention of transitioning to clean cooking fuels has been successful with a very high adherence.

Drs. Laura Povlich and Amit Mistry gave an update on the Data Science for Health Discovery and Innovation in African (DS-I Africa) Symposium. DS-I Africa is a new NIH Common Fund program and aims to spur new health discoveries, catalyze innovation in healthcare and public health research on the continent through the application of data sciences. The first applications for two funding opportunities in the research hubs and research training programs will be reviewed by Fogarty’s Advisory Board next August. The virtual symposium was held over two weeks in August and was attended by government, NGO, and private sector partners. The majority of speakers were from Africa. They had a Partnership and Innovation Marketplace with more than 30 different organizations with their own Zoom room. The next steps are to put together an evaluation report, a writing project to put a series of papers together that form a baseline for the state of the field, and a series of the state of data science presentations.

Select Fogarty COVID-19 Research Activities

Dr. Cecile Viboud gave a presentation and update on COVID-19 modeling. The first update she presented was on the excess mortality of the COVID-19 pandemic in the U.S. Two peaks of the pandemic aligned with the epidemic in the Northeast and the second peak in the South. There is a substantial excess mortality rate in the 25 to 45 age group, but the timing of this impact is not particularly synchronous with the other causes of death. States in the South and in the Midwest tend to have a younger distribution of death under normal circumstances. The highest mortality impact still remains in the northeast that had the pandemic earlier.

The second update is related to combining projections from different models to support interventions around COVID-19. Estimating very small probabilities is difficult and so that is why it is important to gather data from multiple models. A project started in early May provided modelers with data from a rural Pennsylvania county on testing, shut down approaches, and morbidity in the population. The teams were asked to predict the trajectory of outbreaks for four different types of reopening interventions. The four types were: to keep the stay at home order in place for 6 months, reopen workplaces 2 weeks after the peak, reopen when cases are at 5% of peaks, or to just immediately reopen.

Advancing Global Environmental Health Research

Dr. Roger Glass introduced Dr. Rick Woychik, Director of the National Institute of Environmental Health Sciences (NIEHS). Dr. Christine Jessup highlighted some programs NIEHS and Fogarty are working on together. Fogarty, NIEHS, and the National Cancer Institute have formed a program around global, environmental, and occupational health. This work has focused on researching humanitarian crises, the implementation scientific networks and household air pollution networks, and reviewing activities around the global alliance for chronic diseases. The program supports multiple GEOHealth Hubs. The hubs are based in countries like Peru, Suriname, Ghana, Thailand, Indonesia, West Africa, and Bangladesh among others.

NIEHS has a budget of about $900 million which comes from the Health and Interior Committees in Congress. The primary focus of NIEHS is on the prevention of adverse health effects. They are studying many of the complicated exposures people are experiencing at home, work, school, and within our communities. Pollution is the largest environmental cause of disease and premature cause of death today; 92% of pollution related deaths occurred in LMICs.

NIEHS is focused on four categories of science which are exposure science, interindividual variability, solution driven science and training, and global and environmental health. The global health community is looking into exposome frameworks which study the environmental exposure through the totality of a person’s lifetime. NIEHS and other ICs have launched the Genes by the Environment Initiative to discover how individuals respond to the environment in different ways. NIEHS has developed center-based programs to find practical scientific solutions to hazardous substance exposure. The Institute since December 17, 2019 has 128 global environmental health and research programs with 184 country tags. Since September 2013 NIEHS was designated a WHO Collaborating Center for Environmental Health Sciences. NIEHS was redesignated a WHO Collaborating Center in 2017 until 2021.

Dr. Germino talked about how NIEHS and National Institute of Diabetes and Digestive and Kidney Diseases are partnering on a chronic kidney disease initiative for unknown diagnosis. Dr. Birbeck mentioned that NINDS has a new K recipient in Zambia looking at communities for heavy metal toxins related to things like Konzo. Dr. Williams asked for examples in the implementation science field. Dr. Collman mentioned the biggest partnership on implementation science is on indoor pollution issues. It is important for NIEHS to identify and understand intervention strategies that could help at the community and individual levels due to a lack of a regulatory framework to develop new programs in the future. Dr. Williams suggested that on the implementation side to integrate that into the training. Dr. Wasserheit mentioned the important NIEHS’ work on climate change related research and suggested expanding support for the design and implementation of interventions related to climate change research.

Closing Remarks:

Dr. Glass thanked the members, presenters, and staff for their time and participation. He thanked the staff for their commitment and competence during the last six months of teleworking. The next board meeting will be virtual and is scheduled for February 8-9, 2021.

There being no further business, Dr. Glass adjourned the meeting at 2:41 p.m.