The FIC Advisory Board met via videoconference on June 7, 2022. Dr. Roger Glass presided as Chair.
Present
- Roger I. Glass, M.D., Ph.D., Director, Fogarty International Center, Chair
- Carol Dahl, Ph.D., Lemelson Foundation
- Wondwossen Gebreyes, M.D., The Ohio State University
- Gregory Germino, M.D., National Institute of Diabetes and Digestive and Kidney Diseases (ex-officio)
- Karen Goraleski, MSW, American Society of Tropical Medicine and Hygiene
- Chandy John, M.D., Indiana University School of Medicine
- Steffanie Strathdee, Ph.D., University of California San Diego School of Medicine
- Sten Vermund, M.D., Ph.D., Yale University School of Medicine
- Judith N. Wasserheit, M.D., MPH, Harvard T.H. Chan School of Public Health
Also Present
- Peter Kilmarx, M.D., Deputy Director, FIC
- Kristen Weymouth, Executive Secretary, FIC Advisory Board
- Geetha Bansal, Ph.D., FIC
- Otis Brawley, M.D., Johns Hopkins University
- Patricia Brennan, Ph.D., National Library of Medicine, NIH
- Judy Coan-Stevens, FIC
- Dexter Collins, MPA, FIC
- Francis Collins, M.D., Ph.D., NIH
- Ronald Galiwango, Ph.D., Makerere University
- Maureen Lichtveld, M.D., University of Pittsburgh School of Public Health
- Robert Murphy, M.D., Northwestern University Feinberg School of Medicine
- Nicola Mulder, Ph.D., University of Cape Town
- Vivian Pinn, M.D., FIC
- Laura Povlich, Ph.D., FIC
- Michelle Skelton, Ph.D., University of Cape Town
- David Spiro, Ph.D., Director, FIC
- Bruce Tromberg, Ph.D., National Institute of Biomedical Imaging and Bioengineering, NIH
- Nidia Trovao, Ph.D., FIC
- Susan Vorkoper, MPH, MSW, FIC
Director's Update and Discussion of Current and Planned FIC Activities
Dr. Glass opened the meeting at 12:02 p.m. Dr. Glass recognized the passing of John Porter, who represented Chicago's northern suburbs for two decades in Congress, helped increase funding for biomedical research and was a major supporter of FIC. Fogarty has recently issued two announcements, a Notice of Special Interest (NOSI) on climate change and a Request for Information about promoting equity in global health research. Dr. John Nkengasong, a former Fogarty grantee, has been confirmed by the Senate to head the President’s Emergency Plan for AIDS Relief (PEPFAR) Initiative on AIDS prevention, care and research.
Dr. Kilmarx spoke about his recent trip to Uganda. The anchor event was the INTEREST meeting, the premier scientific conference for HIV in Africa. Fogarty grantees and trainees were strongly represented among the organizers, speakers, and participants. Uganda was ranked tenth among countries worldwide in terms of the number of NIH collaborations, the highest of any low-income country.
Ms. Vorkoper, Center for Global Health Studies (CGHS), discussed the Adolescent HIV Implementation Science Alliance (AHISA), a group of implementation science researchers and their in-country partners in sub-Saharan Africa. She thanked the Office of AIDS Research for granting additional funding extending the life of AHISA for another two years. The alliance had launched two new subgroups, one focused on sustainability, the other on implementation frameworks and models developed in the Global South for use there. It continued to host regular webinars and was slated to publish a special supplement on implementation science and adolescent HIV in AIDS and Behavior in the fall.
Ms. Judy Coan-Stevens, acting director of FIC’s office of communications, introduced her team members. Focusing on a holistic communication framework, the office makes extensive use of digital and print messaging to highlight the global health research work of FIC and NIH. They update the FIC website constantly, ensuring that it is easily readable on all devices. They maintain two regular newsletters and issued ad hoc news alerts via email and text messages to over 126,000 subscribers. FIC had 15,000 followers on Twitter and maintained a robust presence on Facebook and LinkedIn. There is also an array of printed fact sheets, books, and brochures for events. Anniversaries have been a great opportunity to amplify Fogarty's accomplishments. The following year will be the Global Health Fellows and Scholars' 20th anniversary, which the Office of Communications will support across its media.
Harnessing Data Science for Health Discovery and Innovation in Africa (DS-I Africa)
NIH Common Fund Program Overview
Dr. Laura Povlich, Division of International Training and Research (DITR), gave an overview of the program. Fogarty co-leads the DS-I Africa NIH Common Fund (CF) Program with NIBIB, NLM, and NIMH and many other NIH Institutes, Centers, and Offices (ICOs) participate in the working group. DS-I Africa aims to spur new health discoveries and catalyze innovation in health care, public health, and health research on the continent through the application of data science. Sub-goals include catalyzing new collaborations and exploring the state of the field for health data science in Africa, advancing health data science research there, and supporting new African and global partnerships for innovation and enhanced impact of the research that was funded. Four funding opportunities were released in September 2020, totaling around $75 million over five years. Awardees and their collaborators spanned 19 countries across the continent as well as the United States. These awards were possible largely thanks to generous co-funding from 12 different ICOs. A kickoff meeting was held in November 2021. Awardees were paired with individual research hubs, and many of the consortium activities had moved forward through the formation of the steering committee and working groups.
Two new funding opportunities for DS-I Africa included a research education opportunity (UE5) and a partnership for innovation project (U01). A webinar is scheduled for July 6, and initial applications are due September 28.
DS-I Africa Coordinating Center and Open Data Science Platform Updates
Dr. Skelton, University of Cape Town, explained that the coordinating center strove to build a cohesive and productive interdisciplinary network that would facilitate data science-driven innovation and solutions to complex health challenges. It supports the various projects, working group activities, and the steering committee. Its aims include fostering communications within the organization, supporting cross-consortium activities, overseeing consortium resources and databases, working on policies and guidelines, coordinating training within the group, and monitoring and evaluation. The center is developing a website that it hoped to launch this month. It has a Twitter account and is exploring what other social media platforms would work well. ActiveCollab is a team science tool with basic workspaces for the different projects. Anyone in the organization could access one of the workspaces and retrieve information. The tool also serves as an archive and a centralized emailing mechanism. Working groups include the Training and Education Working Group and the Data Management and Sharing Working Group. The center has onboarded 120 members so far. The more data it receives, the better it is able to make stronger predictions, more informed decisions and look for hidden opportunities. A key component of what the center would like to achieve is fostering partnerships with external organizations.
Dr. Mulder, University of Cape Town, presented on the Open Data Science Platform. Its aim was to build a flexible, scalable platform that enables the bringing together of data and apply science techniques to the various data sets. The platform has seven partners in Africa, three in the U.S., and one in the U.K. Metadata came in that described big data sets, and for each set a data model would be built. The next step would be working on ways to harmonize data to the models, thus enabling people to come into the platform and be able to search for particular data elements. Users would bring in their data sets and store them in the compartment they planned to use. The tool suite works off the standard APIs of the Global Alliance for Genomics and Health (GA4GH) and the Dockstore. The platform includes the commercial clouds, such as AWS, Azure, and GCP, but there were a number of people, particularly African researchers, who preferred to use local computer platforms. It was therefore necessary to have a flexible, scalable system that was completely agnostic. Centers in Mali, South Africa, and Uganda have set up infrastructure for those without cloud credits. The platform also has a help desk, user support, SOPs, and training materials.
The team hopes to expand the platform to include other tools and serve other consortia. They have discussed the possibility of a workspace with the H3Africa Consortium. Dr. Mulder said her team is trying to have a single interface where a user could access all the DS-I Africa data sets after choosing a platform. The first project up and running was the SARS-HIV Pandemic Preparedness Project.
Dr. Galiwango, Makerere University, talked about his experience as an early career researcher in data science in Africa and how that related to DS-I Africa and other Fogarty funded programs.
Dr. Glass thanked Dr. Francis Collins, former NIH Director when this CF program was given the green light, for joining the meeting and asked him to say a few words. Dr. Collins noted that NIH was the largest supporter of global health research in the world. NIH and the Bill & Melinda Gates Foundation (BMGF) comprise well over 50 percent of the resources going into this effort. There are about a dozen working groups jointly populated by NIH and BMGF staff focused on issues like HIV, HPV, maternal and child health, point-of-care diagnostics and others. Sub-Saharan Africa represents a major opportunity to build research capacity and sustainability, thus providing investigators with a sense of reassurance and the infrastructure necessary to do bold, satisfying research. NIH is trying to shift from a colonial model to one where Africans define how research pertaining to their continent should be done, or in Dr. Collins' words, from donorship to ownership.
Dr. Brennan, NLM Director, appreciated the forward thinking that had gone into these projects, as well as the emphasis on training and peer support and the use of innovative technologies. She asked about challenges and solutions regarding cross-country data harmonization, integration of technologies for in-field data acquisition, and the strategy for engaging citizens of the countries where projects were being implemented.
Dr. Tromberg, NIBIB Director, was struck by the fact that the creation of new programs brought about the opportunity to overcome the technical, operational, and policy barriers the U.S. had built up. He noted that the U.S. had struggled to reconcile imaging data and point-of-care technologies with genomic and clinical data and asked the team how fast they anticipated moving on this issue. He also expressed curiosity about the interoperability of the databases.
Dr. Mulder acknowledged that data harmonization is a big challenge. A lot of time had been invested in resolving this issue, including workshops, literature reviews, text mining, and machine learning, and her team was starting to tease apart how to do it. In terms of technologies, the team is still determining where each data set was coming from. A lot of the data had already been collected, so recruitment was not as much of a factor, but the team would be making more of an effort to engage the community. Machine learning techniques were being developed to break down imaging data, and it was largely a question of finding the best technique and ultimately developing new ones. Dr. Tromberg pointed to NIH's Medical Imaging and Data Resource Center (MIDRC) program, a national program for imaging data, as something that might be helpful in that regard. He added that multiple algorithms were being developed with extensive harmonization activities.
Dr. Murphy commented that NIH and NIBIB's opening up the RADx program to South Africa created a huge opportunity to examine point-of-care technologies. Integrating the data would be a challenge but will benefit everyone.
Dr. Vermund asked about DS-I Africa with respect to electronic medical records availability in Africa. Dr. Mulder said South Africa did not have a national EMR, and many African countries were still using paper records, so getting everything digitized would be a massive challenge. Privacy issues are also a major concern.
Dr. John noted that AMPATH had been a leader in implementing EMR in clinical settings throughout western Kenya and had been the basis for implementing a number of programs. He added that one of the challenges for African science was bringing data science, bioinformatics, and biostatistics to Africa and having the work done on the continent.
Dr. Lichtveld expressed interest in the issue of combining primary and secondary data in low- and middle-income countries (LMICs), the public-facing part of the data platform, and the integration of data in the digital platform.
Dr. Gebreyes asked about multi-sectoral engagement in African countries beyond the academic and health sectors. Dr. Povlich said that one of the requirements for the research hubs was that applicants had to come in with a non-academic partner for their research, and many had multiple non-academic partners.
Dr. Mulder said that on the primary and secondary data, the team is still at the point of building data models and seeing what different sets were there. Integrating the spatial data was also still in its early phases. The platform itself would be quite technical and scientific, but hopefully they would be accessible enough so that the public could see what projects were being worked on.
Dr. Germino asked if the investigators had to be at the hubs and whether access would be restricted primarily to African investigators. Dr. Mulder said her team was building everything to be as scalable and flexible as possible, with access to anyone within the consult team. Other projects are coming in that were not originally part of the consortium.
Dr. Wasserheit asked about challenges in bringing the various data streams together. Dr. Mulder said her team had not tried to tackle that yet, but they certainly recognize that it was important.
Dr. Dahl expressed interest in the development of tools for research and for implementation of learnings that came out of it. She asked if there was a way to identify needs for new tools and technologies and whether the opportunity existed for more and deeper capacity building. Dr. Povlich said each of the research hub awards required at least one solution-oriented research project. The research hubs would also be supporting pilot projects each year. Dr. Dahl commented that researchers at the downstream end often lacked a way to effectively communicate their needs. Dr. Tromberg echoed those concerns.
Dr. John asked how this big initiative could help support biostatistics capacity building in African countries. Dr. Mulder assured him that biostatistics would be part of the curriculum, and that the team was building all the foundational skills as well as specific skills related to specific areas.
Dr. Glass thanked the presenters, partners, and the Board members for the insightful discussion and looks forward to the exciting things to come for this trans-NIH program.
Select Fogarty Staff Activities
Dr. Trovao, Division of International Epidemiology and Population Studies (DIEPS), discussed Fogarty's work on the transmission dynamics of SARS-CoV-2. There are currently more than 11 million SARS-CoV-2 sequences available in public and semi-public genetic databases, but there were many countries in Africa and Asia for which there were no sequences available, so the genetic diversity and transmission dynamics in LMICs were largely unknown. Through trainings and collaborative efforts with participants, Fogarty was able to generate SARS-CoV-2 genomic data to supplement the pool in genetic databases. In its capacity-building initiatives, Fogarty trained scientists to be able to use computational biology approaches to analyze their own data. In collaboration with NIH Pakistan and Aga Khan University, FIC was able to successfully implement Oxford nanopore technologies in the country for sequencing.
Each workshop was tailored to provide the best learning experiences conducive to acquiring knowledge and implementation of genomic surveillance and epidemiology. The second level workshop consisted of genomic epidemiology training for public health labs plus strategies for study design for appropriate implementation of surveillance. The trans-genomic epidemiology workshop covered more sophisticated Bayesian statistics and computational models to estimate when and where variants emerged and the route and extent of transmission. Thus far, FIC had trained more than 400 participants in over 52 institutes and 23 countries on everything from study design to sequencing and phylogenetic analysis.
Dr. Glass asked how many sequences a country should be doing and if it was possible to do too many. Dr. Trovao said the U.S. was currently doing enough to track the emergence of new variants, but the numbers currently produced by LMICs were definitely too little.
Dr. Glass reminded the board of several upcoming network meetings, including one on non-communicable diseases in June, one on the HIV research training program in July, and one to be announced on HIV-NCD. The orientation for the fellows and scholars program is scheduled from July 11 to 15. AFREhealth, a spinoff of the MEPI program, would take place in Harare in August. The fellows and scholars program will celebrate its 20th anniversary the following April in conjunction with the CUGH meeting in Washington. The next board meeting is September 8-9 and will be held virtually.
Program Concept, DITR
Prevention and Treatment through a Comprehensive Care Continuum for HIV-Affected Adolescents in Resource-Constrained Settings (PATC3H-IN) (NICHD)
Dr. Bansal presented the board with a request for FIC participation in an NICHD program to build implementation science networks for HIV-affected adolescents in LMICs. NICHD had already approved the project and the question before the board was whether to approve FIC co-funding for the training and capacity building aspects. NICHD had made two Funding Opportunity Announcements. The first one, covering the UG1 phase, was for the development of a clinical research center. The second would fund the Coordination, Translation, and Advanced Methods Analytics Center (CTAMAC).
Drs. Lichtveld, Goraleski, Wasserheit, Germino, and John all expressed support for the project. Dr. Glass thanked the Board for their support to move forward.
Closing Remarks
Dr. Glass commented that when he started at FIC, its focus was mostly on infectious diseases with limited NIH partners but now almost all of the institutes are involved in Fogarty’s activities. He credited Dr. Collins for helping to raise Fogarty's profile.
There being no further business, Dr. Glass adjourned the meeting at 2:40 p.m.