The FIC Advisory Board met via Videoconference, at 9:00 a.m. EST, Dr. Peter Kilmarx, Acting Director, presiding.
Present
Board Members
- Peter Kilmarx, M.D., Chair, FIC
- Carol Dahl, Ph.D., Former Executive Director, Lemelson Foundation
- Wondwossen Gebreyes, M.D., Ohio State University
- Karen Goraleski, M.S.W., American Society of Tropical Medicine and Hygiene
- Chandy John, M.D., Indiana University School of Medicine
- Jennifer Kates, Ph.D., Kaiser Family Foundation
- Maureen Lichtveld, M.D., University of Pittsburgh
- Robert Murphy, M.D., Northwestern University
- Sten Vermund, M.D., Ph.D., Yale School of Medicine
- Judith N. Wasserheit, University of Washington
Ex Officio Members
- Gregory Germino, M.D., Deputy Director, National Institute of Diabetes and Digestive and Kidney Diseases, NIH
- Vikas Kapil, D.O., M.P.H., Center for Global Health, Centers for Disease Control and Prevention
FIC Staff
- Kristen Weymouth, Executive Secretary
- Nalini Anand, J.D., M.P.H, Director, Division of International Science Policy; Director, Center for Global Health Studies, FIC
- Blythe Beecroft, M.S., Center for Global Health Studies, FIC
- Judy Coan-Stevens, Acting Communications Director, FIC
- Flora Katz, Ph.D., Director, Division of Training and Research, FIC
- Amit Mistry, Ph.D., Senior Scientist, FIC
- Bradley Newsome, Ph.D., Program Officer, FIC
- Christine Sizemore, Ph.D., Director, Division of International Relations, FIC
- David Spiro, Ph.D., Director, Division of International Epidemiology and Population Studies, FIC
- Rachel Sturke, Ph.D., M.P.H., M.I.A., Acting Deputy Director, FIC
- Kaiyuan Sun, Ph.D., Postdoctoral Fellow, FIC
- Susan Vorkoper, M.P.H, M.S.W., FIC
Also present
- Linda-gail Bekker, Ph.d., Deputy Director, Desmond Tutu Hiv Centre, Institute of Infectious Disease and Molecular Medicine, University of Cape Town
- Kelechi Chima, Itest Youth and Rhodes Scholar-Elect
- David Franz, Ph.D., National Science Advisory Board for Biosecurity
- Julie Gerberding, M.D., M.P.H., Foundation for the National Institutes of Health
- Brya Grenfell, Ph.D., Princeton University
- Lee Hall, Ph.D., National Institute of Allergy and Infectious Diseases
- Michael Mbizvo, D.Phil., M.Phil., Zambia Country Director
- Eleanor Namusoke-Magongo, M.D., Ministry of Health, Uganda
- Nadia Sam-Agudu, M.D., University of Maryland, Baltimore; Institute of Human Virology
- Joseph Tucker, M.D., Ph.D., A.M., University of North Carolina, Chapel Hill
Director's Update and Discussion of Current and Planned FIC Activities
Dr. Peter Kilmarx called the open session to order and provided an update on recent activities related to the Fogarty International Center. He announced that Advisory Board member Michelle Williams is stepping down as Dean of the Harvard T.H. Chan School of Public Health. The U.S. Global AIDS Coordinator, Ambassador Dr. John Nkengasong, will be named as the first head of the Bureau of Global Health Security and Diplomacy. In December of 2022, Secretary of State Antony Blinken notified Congress of plans to establish the Bureau to address the growing national security challenges presented by global health crises. FIC supported training for Dr. Nkengasong with Dr. Art Reingold at the University of California Berkeley. Dr. Kilmarx also announced that Sir Jeremy Farrar will be stepping down as Wellcome Director this month to take the position of the World Health Organization (WHO) Science Division's Chief Scientist. He was preceded in this role by a former FIC trainee, Dr. Soumya Swaminathan.
Dr. Lee Riley passed away in October of 2022 at age 73. Dr. Riley was a pioneer in global health and the Director of the Global Health Equity Scholars Program at UC Berkeley School of Public Health, which is part of the consortium in Fogarty's Global Health Fellows & Scholars/LAUNCH program. Dr. Ford von Reyn, Director of the DarDar International Programs at Dartmouth Geisel School of Medicine, was awarded an honorary Doctor of Science degree from Muhimbili University of Health and Allied Sciences. With over 20 years of FIC funding, the DarDar Program has trained 18 Tanzanian colleagues. Dr.
Folasade Ogunsola, a MEPI Junior Faculty Principal Investigator and founding member of the Nigerian Society for Infection Control, was recently named Vice Chancellor of the University of Lagos. Dr. Bryan Grenfell, a co-founder of Fogarty's Research and Policy for Infectious Disease Dynamics (RAPIDD) modeling program, was awarded the 2022 Kyoto Prize in Basic Sciences for his research in phylodynamics. Three Fogarty grantees were elected to the National Academy of Medicine in 2022: Dr. Marleen Temmerman, Dr. Gagandeep "Cherry" Kang, and Dr. Wafaie Fawzi.
Former DIEPS Fogarty scientist Dr. Rebecca Grais was named Executive Director of the Pasteur Network, which brings together 33 institutions worldwide to improve human health through biomedical research, public health activities, training, and innovation. Drs. Salim and Quarraisha Abdool Karim, who led Fogarty's Columbia University HIV training and research program for over 20 years, received the Hideyo Noguchi Africa Prize for their impact on HIV and HIV/TB co-infection treatment and for serving as scientific leaders in the COVID-19 response in Africa. Dr. Kilmarx also announced that Dr. Roger Glass, FIC Senior Scientist Emeritus and most recent FIC Director, was awarded the Consortium of Universities in Global Health (CUGH) Lifetime Achievement Award in Global Health.
Dr. Annette Rid has joined Fogarty as a bioethicist, jointly appointed with the Department of Bioethics in the NIH Clinical Center. She will be engaged with projects in the Division of Science Policy, Planning and Evaluation, the International Bioethics Training Programs, and with Fogarty overall. Since the last FIC meeting, Fogarty sponsored a symposium on Building Research Capacity in Low- and Middle-Income Countries (LMICs) and Pandemic Preparedness. Dr. Kilmarx also co-chaired the third annual meeting of a working group on the ESSENCE Mechanism for Review of Investments in Research Capacity Strengthening in LMICs.
The 9th Annual NIH-Bill & Melinda Gates Foundation Consultative Workshop was held in December 2022, with major collaborative projects on the agenda, including novel potent broadly-neutralizing monoclonal antibodies against HIV, single-dose protection of licensed HPV vaccines, a novel TB vaccine, and gene-based cures for HIV and sickle cell disease (SCD). Also in December, Ukraine Minister of Health Dr. Viktor Liashko visited the NIH Clinical Center and met with NIH ICO leadership to discuss opportunities for research and development partnership. Dr. Kilmarx and FIC also represented NIH at the HHS-hosted roundtable on health equity and health systems strengthening at the 2022 U.S.-Africa Leaders Summit. Dr. Kilmarx also joined Dr. George Mensah and Dr. Francis Collins to participate in a roundtable on SCD hosted by the Embassy of the Republic of Tanzania. In January 2023, Dr. Kilmarx participated virtually in the 2nd Mexico-United States Symposium on Vision Health, which convened researchers from the U.S., Mexico, and Central America focused on diabetic eye diseases. On February 1, 2023, a delegation from Brazil's Oswaldo Cruz Foundation (Fiocruz) visited NIH to discuss interest in expanding research collaboration, including on health impacts of climate change.
Dr. Christine Sizemore next presented updates from the Division of International Relations. Recently, the division has supported collaborations between NIH leadership and the Korea National Institute of Health, the Sao Paulo Research Foundation, the Indonesian Ministry of Health, and the Academy of Finland. Dr. Kilmarx presented updates from the Center for Global Health Studies (CGHS), including three FIC Advisory Board members (Judy Wasserheit, Maureen Lichtveld, and Chandy John) who have joined the CGHS Subcommittee. Ms. Blythe Beecroft spoke about FIC's efforts in the Promoting Equity in Global Health Research initiative. Fogarty formed the NIH-Wide Working Group on Promoting Equity in Global Health Research with 7 other ICs, and they are currently in the process of analyzing responses to their request for information, which was open to the public from May 20 to August 1, 2022. The final report will be available to the public in March of 2023.
Dr. Amit Mistry spoke about a writing project related to the Common Fund Program on Data Science and Innovation in Africa. The activity supports a collection of scientific papers to serve as a benchmark of the current state of data science for health in Africa. Fifteen writing teams have been assembled, comprised of experts across Africa representing a range of disciplines. Ms. Susan Vorkoper shared information from the Learning from Global Food and Nutrition Insecurity webinar series, which was held in November 2022. The series represented robust research in a global setting and highlighted opportunities to learn about effective strategies and innovative interventions outside the U.S. Ms. Vorkoper is working with Frontiers in Public Health to develop a supplemental series, which is currently accepting manuscripts.
Dr. Brad Newsome presented information about FIC's work with the Global Alliance for Chronic Diseases (GACD), which specifically addresses chronic non-communicable diseases (NCDs). GACD has advanced the use of implementation science to address NCD prevention and mitigation in low and middle income countries (LMIC) and among tribal populations, with eight funding goals launched in the last 12 years.
These funding goals have focused on topics such as hypertension, diabetes, lung diseases, mental health, and primary and secondary prevention of cancer. The current funding opportunity, Implementation Research on NCD Risk Factors among LMIC and Tribal Populations Living in City Environments, is heavily aligned with the ongoing trans-NIH focus on climate and health.
Dr. Josh Rosenthal served as the co-chair for the NIH Steering Committee on Climate Change and Health. Over the past year the committee has developed a strategic framework, published a series of FOAs and NOSIs, started a health and climate data integration project funded by HHS, and issued a series of community engagement awards using the Community Engagement Alliance (CEAL) Against COVID-19 Disparities and Alliance for Community Engagement on Climate and Health (ACE-CH) mechanisms. The Executive Committee also drafted and published a paper in the Lancet and held at least eight webinars, established a Research Coordinating Center, launched an intramural research program, and awarded and onboarded eight NIH Climate Scholars, among other activities.
Dr. Kaiyuan Sun presented an update on COVID-19 in China. After abandoning its longstanding "zero COVID" policy in December 2022, China has experienced a swift epidemic wave, though it is difficult to assess the extent of the spread because the existing reporting system in China was overwhelmed by the large number of infections in a short period of time. In January 2023, the China CDC published a retrospective report on the epidemic wave, and Dr. Sun presented key findings from that report. The data suggests that the epidemic peaked in late December 2022 and was largely over by the end of January 2023. This is roughly in agreement with dynamic modeling projections that NIH conducted in early 2022. While the zero COVID policy was successful in controlling the ancestral strain of the virus, when variants emerged, the policy began to cause increased interruptions to daily life due to city-wide lockdowns, and analysis indicates that it is no longer feasible to sustain the policy in the Omicron era without costly lockdowns.
In terms of future activities, Dr. Kilmarx announced that FIC will participate in the State University of New York-University of the West Indies (SUNY-UWI) Health Research Consortium Conference in March, the CUGH 14th Global Health Conference in April, and the INTEREST Conference in May. He also shared reflections about Fogarty as it celebrates its 55th year. The Center has seen a 9.5% increase in budget for the fiscal year and is heavily involved with the recent $40 million appropriation to NIEHS for climate change and health research. They continue to maintain focus on capacity strengthening in LMICs and pandemic preparedness, planetary health, implementation science, and data science, while also promoting equity, addressing health disparities, and engaging underrepresented minorities. Dr. Gebreyes asked how Fogarty's bilateral funding impacts work in other countries and whether it came at the cost of other partnerships. Dr. Kilmarx said that many of the funding programs are with individual ICOs and that Fogarty does not earmark resources for specific countries. Dr. Sizemore added that they differentiated between bilateral funding programs that are NIH-wide and those focused on Fogarty.
Dr. Greg Germino, Deputy Director, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), and ex officio Board member, then delivered some remarks. He noted that one of his Institute's challenges is figuring out where there are opportunities for NIDDK to engage more in the global space. NIDDK is about to kick off a new health equity effort which will initially be internally-focused, but going forward they will be thinking about how to expand that to a global scale. Dr. Kilmarx commented that there was great potential for bidirectional learning in health disparities research. Dr. Wasserheit asked how FIC is approaching the strategic planning process given that their budget is the smallest at NIH, and noting that partnerships with other ICs are critically important. Dr. Kilmarx said FIC is focused on helping to ensure the success of the next Director and examining the Institute's strengths, weaknesses, opportunities, and threats. This process will include exploring new ways of partnering with other ICs and interacting with the Board without completely redesigning the way that Fogarty operates. Dr. Wasserheit noted that there is increased interest in interfacing with non-health sectors when it comes to pandemic preparedness and asked if Fogarty was thinking about that on the research side. Dr. Kilmarx said that part of the answer will be in the work around implementation science. Fogarty's primary interest is in the implementation of equity policies and health services, and it will become important to interact with non-health sectors in the course of that research.
Dr. John noted that there has not been a lot of movement around the issue of communication and messaging to the public and asked if Fogarty is working on that arena. Dr. Kilmarx said that FIC does not have a specific FOA addressing science or health communication, but it is incorporated into some of their programs and it is an important area to address moving forward. FIC encourages grantees to interact with U.S. embassies when they are abroad and to talk to local communities about their research. Dr. Sturke added that there is a Common Fund trans-NIH working group centered on health communications. Dr. Jennifer Kates introduced herself as a new board member.
Adolescent HIV Prevention and Treatment Implementation Science Alliance (AHISA)
Dr. Linda-Gail Bekker, Deputy Director of the Desmond Tutu HIV Centre at the University of Cape Town, gave some opening remarks and an overview of the Alliance achievements. Since its inception in 2017, AHISA's researchers, program implementers, and policymakers have honed their implementation science skills, shared challenges and successes, and advanced research to address adolescent HIV. They have made significant contributions to sustainable solutions to address HIV among adolescents, developed local alliances to address challenges specific to individual countries and regions, and published a series of peer-reviewed manuscripts and articles that have been collated for dissemination in 2023. Dr. Bekker thanked Dr. Sturke, Dr. Kilmarx, and Ms. Vorkoper for their leadership.
Dr. Sturke and Ms. Vorkoper gave an overview of the AHISA Network. AHISA originated in Fogarty's strategic plan, with the goal of enhancing the effective use of evidence and helping to overcome implementation challenges related to prevention, screening, and treatment of HIV among adolescents (ages 10 to 24) in Sub-Saharan Africa. AHISA is an overarching network intended to create a platform for bidirectional learning between policymakers, program implementers, and NIH-funded researchers. It is comprised of 26 teams from 11 countries; each team is composed of an NIH-funded implementation science researcher and their in-country counterparts. The Alliance is operationalized through annual meetings, action groups, conference presentations and attendance, and youth engagement. It has a focus on capacity-building via training for AHISA members; engagement of experts; HIV, Infectious Disease, and Global Health Implementation Research Institute (HIGH IRI) scholars; support of collaborative team efforts; and distributed capacity-building across local alliances. Dr. Sturke gave several examples of AHISA outcomes to date, including seminal publications and resources, research funding, and capacity built through successful research grant applications and other funding organizations. The teams have been able to leverage the AHISA platform to enable dialogue among local stakeholders and strengthen the link between evidence generation and the users of evidence.
AHISA also supports six local alliances to respond to local contextual implementation issues and meet specific needs of each region. Across the local alliances, AHISA's goal is to expand implementation of successful interventions focused on improving each step along the adolescent HIV continuum of prevention and care, by building networks of researchers, program implementers, and policymakers, building implementation science capacity, identifying evidence-based interventions to support response strategies, and enhancing translation of evidence into policy and practice.
Ms. Vorkoper introduced several participants from AHISA: Michael Mbizvo from Population Council in Zambia; Eleanor Magongo from the Ministry of Health AIDS Control Program in Uganda; and Nadia Sam- Agudu from the Institute of Human Virology in Nigeria and the University of Maryland School of Medicine in Baltimore. All three shared details of their work with the AHISA Network.
Dr. Mbizvo spoke about the Zambia Adolescents HIV Implementation Science Alliance, ZAHISA, which engages young people and other stakeholders to promote implementation science research, with a particular focus on young women and girls. They convene young people in youth advisory panels (YAPs) to elicit information and opinions and share promising interventions.
Dr. Magongo presented information about the Uganda Adolescent HIV Care and Treatment Implementation Science Alliance, U-AHISA. U-AHISA's stakeholders include the Uganda AIDS Commission, line ministries, researchers and academics, organizations working with adolescents living with HIV, and HIV-positive adolescents, their peers, and their networks. They are currently conducting decentralized implementation science training and have formed regional alliances at Jinja and Masaka Regional Referral Hospitals, with plans to decentralize to additional hospitals in the future.
Dr. Sam-Agudu spoke about the Central and West Africa Implementation Science Alliance, CAWISA, which involves five countries: The Gambia, Ghana, Nigeria, Cameroon, and the Democratic Republic of the Congo. Their goals are to facilitate the generation of local evidence led by local scientists to solve West and Central Africa's (WCA's) most pressing public health problems, and to provide mentorship to postdoctoral early researchers in WCA to achieve independent investigator-ship. In Year 1 of its AHISA funding, CAWISA established the alliance and created a regionally-tailored implementation science career development toolkit (ScholarIS). In Year 2, they conducted systematic reviews of program and implementation research data on adolescent and youth HIV and generated COVID-19 data relating to women and children in WCA. Currently, their goal is to continue to pull scholars into implementation science grants to advance CAWISA's goals, to continue and fund collaborative IS projects that emerge from training sessions, and continue scholar mentoring.
Dr. Joseph Tucker, University of North Carolina, Chapel Hill, touched on AHISA's long-term impact on national leadership, the importance of regionalization, enduring the COVID-19 pandemic, and the need for sustained funding, all of which are key to sustainability of the network. National in-country leadership makes it more likely that people trained through the networks will be able to translate findings into action, and regionalization increases local relevance. COVID provided a sort of test for the networks, all of which were able to stay strong. And AHISA as a network serves as a springboard for new collaborations and funding streams.
Dr. Wasserheit commended AHISA on their efforts to bring together policymakers, researchers, and implementers, which is the core of implementation science. She added that she was struck by their emphasis on sustainability and applying IS frameworks that grew out of high-income countries in LMICs. She asked what lessons have been learned about the changes that need to be made across geography and across age groups, whether AHISA is comparing findings across countries and which of those findings are most prominent, and what lessons they have identified for thinking about IS alliances in other areas that are high priorities for Fogarty. Dr. Mbizvo said that ZAHISA has learned that they cannot provide care in isolation, and in order to avoid missed opportunities they provide an integrated approach to respond to multiple needs of young people, which also helps with the stigma around HIV. There is a distinction between age groups, but they communicate very often, which is where the community voices and spaces play a role. He added that ZAHISA has seen a distinction between rural and urban populations of young people, and programmatic approaches have to be different for each group in order to resonate with their needs. Dr. Sam-Agudu said that, over time, CAWISA learned to include mentors in the IS training opportunities that were provided to scholars in order to augment their existing knowledge about research and trials. They also learned that they could not implement a standard CAWISA agenda in each country, and they agreed that while adolescent HIV was an important focus, CAWISA's work should not be limited to that condition.
Ms. Vorkoper noted that AHISA's longevity has meant that they have built deep-seated collaborations. This has taken a significant time commitment to manage, which means that it is not necessarily scalable. Dr. Bekker said that one of AHISA's strengths has been its ability to cultivate a sense of ownership and co-creation amongst the various regions and alliances that are involved. This has contributed to AHISA's longevity and holds promise for expansion into other priorities. Dr. Sturke asked for reflections on how to disseminate learning beyond the scientific publication space in order to speak to policymakers and program implementers more effectively. Dr. Kates said that it was important to identify which policymakers they want to reach, and then think about how to communicate with them and what information they need to hear. Dr. Mbizvo said that ZAHISA was able to get buy-in from the Ministry of Health, which nominated three people from the directorate to serve on the Technical Advisory Committee. ZAHISA has used simple, policy-targeted language to communicate ideas with the Ministry, which then came back with suggestions that informed the network's research.
Dr. John noted that research studies can drive change in implementation and cited the example of hydroxyurea for treating children with sickle cell disease in Africa, and the children's reluctance to continue treatment once they reach adolescence. He asked the AHISA speakers for concrete examples of what has worked in the adolescent HIV population and how that could be extrapolated to other
diseases. Dr. Sam-Agudu said that whenever CAWISA launches a project, they make sure to start out with people who are connected to ministries of health. In Nigeria, the Nigeria Implementation Science Alliance holds workshops and webinars that involve local and foreign policymakers, patient group representatives, clinicians, researchers, and heads of major health agencies. Recently, she was asked to present on IS at the West African Health Organization (WAHO), which provided an opportunity to leverage WAHO's connection to its parent organization, the Economic Community of West African States (ECOWAS). Dr. Mbizvo added that when young people see that other young people are living with the same conditions and have a forum to engage in discussions, they are then inspired to serve as agents of change in their own communities. Dr. Magongo added that, in Uganda, it has been very helpful to bring researchers and programmers into the same space to foster mutual understanding and collaboration. Mr. Kelichi Chima spoke about his involvement with AHISA, including joining an ethics working group,
co-authoring a research manuscript, and helping to organize a global conference. He noted that his experience with AHISA has been one of empowerment and mutual trust and has inspired him to become a driver of change in the HIV landscape among youth in Nigeria. He expressed his desire to see more young people receiving support and mentorship to contribute to impactful research, and more support for youth leadership within AHISA networks.
Update from FNIH Director Dr. Julie Gerberding
Dr. Gerberding gave updates about the Foundation for the National Institutes of Health (FNIH's) work and opportunities to expand its role. FNIH was established by Congress as a nonprofit organization to help the NIH achieve its mission. In addition to raising funds, FNIH fosters large scientific collaborations, otherwise known as team science, and supports scientists who do outstanding work through awards such as the Trailblazer Award and the Lurie Prize. To date, they have raised $1.4 billion in private funds, 90% of which is spent directly on supporting programs. Since its inception, FNIH has supported over 600 programs in 120 areas and has achieved high Charity Navigator scores, which helps them to maintain credibility as a productive and efficient organization.
Through FNIH's platform programs, teams of investigators come together from multiple sectors to concentrate on specific activities that may span multiple therapeutic areas. Of the platform programs' many components, Dr. Gerberding highlighted FNIH's ability to raise money from the private sector and to manage complex projects. She gave several examples of these projects: Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV), which recruited more than 20 partners and enrolled over 21,000 patients into trials in a coordinated research response to speed COVID treatment and vaccine options; the Accelerating Medicines Partnership (AMP), which began in 2014 to convene partners and share information in a pre-competitive space, elucidate pathways and potential targets for drug development, and work with the FDA and others to shorten the time between discovery of potential targets and development of new treatments; and the Biomarkers Consortium, which is a cross- sector effort to validate and qualify biomarkers and other drug development tools to accelerate the development of new therapeutics and health technologies. FNIH is also the locus of several Bill and Melinda Gates Foundation Grand Challenges in the areas of HIV, TB, malaria, and maternal and children's health.
Dr. Gerberding concluded her presentation by speaking about the value of collaboration. The challenges that FNIH addresses are complex and require a wide assortment of partnerships. FNIH will soon launch a campaign to raise money for the purpose of accelerating the implementation of programs; FNIH can jumpstart projects using funds that they raise and work on a faster timeline than NIH, which is constrained by a fiscal year budget. FNIH is also looking at ways to improve their own internal processes, using the trust it has built with its partners as a foundation for process improvements. Dr. Gerberding said that the invitation to collaborate with FNIH is an invitation to think about how their model could be relevant more broadly in global health issues, to invite new partners to become involved, and to explore opportunities to engage organizations and people who are trying to build infrastructure and capacity for global health.
Dr. Murphy asked if FNIH was interested in diagnostics in LMICs. Dr. Gerberding said that diagnostics are a big component of many AMP programs, but not as it relates to LMICs, where there is an unmet need. Many companies have foundations and are interested in global work, and there could be an opportunity to work with those foundations on this topic. Dr. John noted that there are several promising biomarkers for malaria and asked how people who are interested in the global health space could become part of the conversation about biomarkers for diseases that are prevalent in LMICs. Dr.
Gerberding said that when it comes to an area that is new territory for FNIH, like this topic, they start with a summit or forum on the issue and bring experts together to discuss the current state of the science, unmet needs, and who should be at the table to address those needs. She added that they would be interested in following up on the subject of malaria biomarkers.
Dr. Dahl said that in her work with the Grand Challenges in Global Health program with the Bill and Melinda Gates Foundation, one of FNIH's most important contributions was bringing together an international community to discuss the topic of genetically-modified mosquitos. She asked if Dr.
Gerberding saw a role for FNIH in fostering forward-thinking discussions about the downstream implications of new innovations. Dr. Gerberding commented that ecologic and sociologic considerations blend into the trust in science and health information, and the expertise that is needed to approach testing interventions is very complicated. One of FNIH's skills is in convening and creating connections between different people and places. Dr. Gebreyes asked if Dr. Gerberding saw a role for FNIH to play in the One Health Initiative. Dr. Gerberding said that she had championed One Health in her work with sequential spillovers at the CDC. She noted that they needed to be thinking about how to predict spillover hotspots more accurately and preempt them more effectively. NIH, FDA, CDC, and the Department of Agriculture all have One Health activities and FNIH is interested in collaborations on this topic.
Dr. Kilmarx asked about FNIH's interactions with the Advanced Research Projects Agency for Health (ARPA-H). Dr. Gerberding said that FNIH does work with ARPA-H, but they try not to create an either/or dynamic; ARPA-H, NIH, and FNIH all have their own strengths and need to think collaboratively. Dr.
Wasserheit asked whether FNIH has engaged in any efforts to counter disinformation and the anti- science movement. Dr. Gerberding noted that she had an upcoming meeting with Dr. Collins to discuss the issue of trust in science, and she will be participating in an upcoming coalition of organizations to correct misinformation and combat disinformation, which is currently in its very early stages. Dr.
Wasserheit asked if that coalition will be global as well as domestic in focus. Dr. Gerberding said that while the current members are primarily U.S. organizations, they are looking to link up with global partners in the future. Dr. Kilmarx noted that Fogarty would be interested in participating in the initiative and could assist with work in the global space.
Division of International Epidemiology and Population Studies (DIEPS) Evaluation Readout and Updates
Dr. Kilmarx introduced the review chairperson, Dr. Bryan Grenfell, and Dr. David Spiro, the Director of DIEPS. Dr. Spiro gave an overview of DIEPS, which is Fogarty's in-house program for conducting research in epidemiology and mathematical modeling of diseases, genomic evolution, implementation sciences, and population studies. Its secondary goal is to build capacity in LMICs through training and collaborative research. DIEPS' areas of focus include public health preparedness, household air pollution, climate change, childhood development, biorisk management, and international capacity- building. The divisions run a number of different programs, including the Multinational Influenza Seasonal Mortality Study, the Household Air Pollution Intervention Network (HAPIN), the COVID-19 Scenario Modeling Hub, and the Pakistan Biorisk Management project.
Dr. Spiro introduced the sections within DIEPS: Computational Epidemiology and Modeling of Infectious Diseases, which focuses on digital surveillance and big data approaches, epidemiology and disease burden of respiratory viruses, forecasting and scenario projections, and training and capacity-building in outbreak analytics; Genomic Epidemiology and Evolution of Pathogens, which looks at evolutionary and computational virology and bacterial molecular evolution; Household Air Pollution Implementation Science, which is currently moving into climate change and health; and Population Studies and Biorisk Management Capacity-Building in Pakistan, which runs the Water, Sanitation, Health and Hygiene Interventions Project (WSHHI) and Biorisk Management-Capacity Building in Pakistan (BRM) program.
Similar to the NIH Intramural Research Program, Fogarty has regular evaluations with external reviewers to assess their status and make recommendations about the future of DIEPS. Dr. Grenfell gave an overview of the recent evaluation of DIEPS in November 2022. The reviewers generated reports on the individual programs within the division, as well as overall summaries of the division as a whole. Overall, the current trajectories of DIEPS justify its excellent reputation in research, training, and outreach.
The committee found that the Computational Epidemiology and Modeling of Infectious Diseases group generates a body of innovative work, technical developments, and external network-building on important questions in infectious disease dynamics and global health. The committee recommended that the group focus on expanding its core and leveraging resources and expertise with NIH, extending its remit in various directions, such as One Health, and training efforts, such as an expanded sabbatical scheme for LMICs. The committee found that the Genomic Epidemiology and Evolution of Pathogens group has been successful in networking within and outside NIH, fundraising, and driving successful pathogen genomics training in LMICs. It recommended that the group develop a strategic plan to focus and further accelerate impact, increase networking, and expand its remit to areas such as further integrating with the modeling group to address pathogen phylodynamics.
For Household Air Pollution Implementation Science, the committee found that the group's Clean Cooking Implementation Science Network and its Household Air Pollution Intervention Network have been significant, and the IS component is the most promising for sustained impact. The committee recommended that more core funding would be appropriate given the expanding size of the problems the group is considering, and that expanded training opportunities could be powerful, particularly in the climate and health field. The committee noted that the Population Studies and Biorisk Management Capacity Building in Pakistan group is distinct from other programs in its focus on mentoring, leader development, and personal engagement. The combination of long-term involvement and regular communication makes their approach particularly powerful, and could serve as a foundation for more research-related work. The reviewers recommended involving more young researchers from the U.S. in the current network of interactions and noted that it was important to scale out this model to other LMICs and show similar long-term success.
Overall, the reviewers commented on how well DIEPS fits into FIC's mission and strategy in terms of global training and mentoring. They also noted a need to garner further financial and intellectual resources by increasing network building, especially within NIH, and that an increase in DIEPS core funding could still further increase its impact.
Dr. Spiro invited members of the evaluation panel to make comments. Dr. Gebreyes said that DIEPS was equipped to position itself as the One Health division of FIC. He also noted the importance of strategic plans, especially in strategizing synergistic activities to make impactful and efficient connections. Dr.
Wasserheit noted that DIEPS is a mix of intramural and extramural activities. It would be valuable to engage in strategic discussions with FIC leadership about the niche for an intramural hybrid program in helping to achieve the Center's objectives. Dr. David Franz commented that, after working with the previous generation of researchers in Pakistan, he was glad to see DIEPS' group continuing to foster the next generation. He praised group leader Dr. Zeba Rasmussen for her work in keeping the team engaged over the long-term. Dr. Lee Hall added that DIEPS is a platform that has demonstrated its worth and needs to be built upon, and he agreed that it would be worthwhile to develop a strategic plan to focus those efforts.
Dr. Kilmarx asked Dr. Franz about lessons learned from his research in Pakistan and whether those could be applied to other countries. Dr. Franz said that the tools that Dr. Rasmussen and her team have developed are applicable everywhere, and the biggest lesson from his research was the importance of people, building human relationships, and having the cooperation of leadership to manage programs.
Dr. Wasserheit suggested that there could be opportunities for collaboration between work related to pandemic diseases at NIAID and the group in Pakistan in the context of biosecurity.
Dr. Kilmarx asked for participants' comments about articulating NIH's role in the area of biorisk and biosafety. Dr. Vikas Kapil noted that research does not happen in a vacuum; it involves various supporting and enabling mechanisms, and it is appropriate for NIH to be engaged in areas like biosafety in substantive ways. Another participant added that this dovetails with FIC's capacity building role; in addition to building scientific capacity, it is important to build an environment where people treat biosafety seriously. Dr. Spiro said that they worked with the CDC to hold a training course in Pakistan that taught genomic epidemiology to labs that were involved in the COVID response. In general, DIEPS tries to work with other global teams and agencies to standardize their genomic epidemiology training as much as possible.
Adjourn
Dr. Kilmarx thanked participants for a successful meeting. There being no further business, the meeting was adjourned at 2:00 p.m.