Dr. Kilmarx, FIC Acting Director, presiding, the FIC Advisory Board met in building 16 on the NIH Campus in Bethesda Maryland and via videoconference on September 4, 3:00 p.m. to 5:00 p.m. EDT for the closed session, and on September 5, 9:00 a.m. to 12:30 p.m. for the open session.
Present
- Dr. Peter H. Kilmarx, Chair, Acting Director, Fogarty International Center
- Dr. Clement Adebamowo, Director, Cancer Epidemiology Division, Department of Epidemiology and Public Health, University of Maryland School of Medicine
- Dr. Chris Beyrer, Director, Duke Global Health Institute, Gary Hock Distinguished Professor in Global Health, Professor of Medicine, Research Professor of Global Health, Duke University
- Dr. Benjamin Chi, Vice Chair for Research and Innovation, Department of Obstetrics and Gynecology, Distinguished Professor, Global Women's Health, Interim Director, Center for Women's Health Research, Adjunct Professor, Epidemiology, University of North Carolina
- Dr. Wondwossen Gebreyes, Hazel C. Youngberg Distinguished Professor, Molecular Epidemiology, Executive Director, Global One Health Initiative, the Ohio State University
- Dr. Jennifer Kates, Senior Vice President and Director of Global Health & HIV Policy, KFF
- Dr. Robert Murphy, Executive Director, Institute for Global Health, John Philip Phair Professor of Infectious Diseases, Northwestern University
Ex Officio Members Present
- Dr. Satish Gopal, Director, Center for Global Health at the National Cancer Institute, National Institutes of Health
- Dr. Jane M. Simoni, Director, Office of Behavioral and Social Sciences Research, National Institutes of Health
Also Present
- Dr. Geetha Bansal, Program Officer, Division of International Training and Research (DITR), FIC
- Dr. Kevin Bardosh, Senior Science Strategist, Office of the Director, NIH
- Dr. Unja Hayes, Program Officer, DITR, FIC
- Dr. Marya Levintova, Program Officer, DITR, FIC
- Dr. Laura Povlich, Program Officer, DITR, FIC
- Sarah Scharf, Regional Program Director, Europe, Israel & Multilateral Organizations, Division of International Relations, FIC
- Dr. Barbara Sina, Acting Director, DITR, FIC
- Dr. David J. Spiro, Director, Division of International Epidemiology and Population Studies (DIEPS), FIC
- Dr. Cecile Viboud, Senior Scientist, DIEPS, FIC
- Kristen Weymouth, Executive Secretary, FIC Advisory Board
Update and Discussion of Current FIC Activities
Dr. Peter Kilmarx began by welcoming all participants to the meeting and delivering some updates.
NIH Director Dr. Jay Bhattacharya recently launched a new HIV strategy, with 12 points. Dr. Kilmarx noted its focus on training future biomedical scientists, improving oversight on NIH funds to foreign research institutions, and implementing advances in HIV/AIDS research. Dr. Bhattacharya is especially excited about the use of lenacapavir for HIV prophylaxis.
There is a new foreign research policy at NIH. All foreign research NIH funds must have a clear scientific reason for it being conducted in a foreign country rather than the United States. All research supported at international sites must have a direct potential to generate knowledge applicable to understanding, improving or protecting the health of Americans. There will also be a new NIH foreign subaward structure, that will include prime domestic awards with independent foreign awards that are linked to the prime, allowing NIH to track the project’s funds individually. NIH anticipates implementing the new award structure in the next fiscal year. NIH also has a goal to limit the number of NOFOs, or notices of funding opportunity, to empower investigator-driven projects, reduce the number of overly specific NOFOs, and cut administrative burden.
Dr. Kilmarx spoke of his recent travels for Fogarty. In June, he traveled to Seoul, South Korea, with Dr. Bhattacharya for the meeting of the Heads of International Research Organizations (HIROs). Last month, he went to the meeting of World Congress of Sexually Transmitted Infections and HIV Community in Montreal, Candana, putting together a symposium on STI research capacity strengthening in low- and middle-income countries (LMICs).
Dr. UnJa Hayes spoke of the global health fellows and scholars/LAUNCH program, a one-year mentored research program sponsored by seven consortia. Orientation brings the trainees together, allowing them to make connections across consortia, begin skills training, and engage in discussions related to global health research and career development. Trainees come from across the world and focus on a broad range of research topics. Dr. Hayes shared a few highlights, including the support of NIH leadership coming to speak to the trainees. LAUNCH is appreciative of the contributions of its partners, including Dr. Bhattcharya, who participated in a fireside chat with Dr. Kilmarx. During the Food Is Medicine session Dr. Drew Bremer, director of the Office of Nutrition Research, spoke of NIH's investment in improving health and reducing disease burden by improving the nutritional status of the American population.
Dr. Geetha Bansal highlighted a HIV research training network meeting that brought 240 participants from multiple different programs together for networking and knowledge-building. The first session was on contributions of research and training to help advance the health of Americans. The second and third sessions were on the relevance of building capacity in LMICs. The fourth session was on fair practices in international partnerships. The fifth session was with the OAR director regarding the current HIV/AIDS portfolio.
Dr. Laura Povlich mentioned the fifth annual consortium meeting for NIH's Harnessing Data Science for Health Discovery and Innovation in Africa (DS-I Africa) program, supported through the NIH Common Fund. It centered around partnerships, including with the Welcome Trust, who brought 75 grantees. It highlighted how the landscape is evolving in Africa and the roles of different sectors.
Dr. Cecile Viboud reviewed Fogarty's in-house research in the fields of modeling for pandemic preparedness, including the potentiality of an H5 pandemic. There may not be enough vaccine to vaccinate everyone in the event of a pandemic, so Dr. Viboud proposes vaccinating the 1-12 year-age cohort, which could bring large reductions in infection across the board. Older people have more immunity and fewer contacts, making vaccination less pressing.
Sarah Scharf went over the work of the Division of International Relations, the global office for FIC that but also serves NIH at the organizational and operational levels. NIH's partnership with the Research Council of Finland dates to 2020 with the goal of expanding and fostering biomedical and behavioral research collaboration between the United States and Finland. It encourages the submission of joint research grants. The Finnish agency is completely funding its side of the partnership. Topics must be of mutual interest and benefit to both agencies, and include AI for health, disease prevention, and potentially quantum sensing for biomedical applications, among others.
Dr. Barbara Sina presented on the continuation of the international bioethics training program, which promotes ethical conduct in NIH research in global settings. These programs support bioethics curriculums and degree programs to allow LMIC programs to have their own capacity to promote ethical conduct. Trainees learn how to lead ethical review of studies, teach responsible conduct to research, conduct research on critical ethical issues in clinical and public health research, and help sustain research oversight. The awards are for five years to support advanced degree training for multiple trainees.
Dr. Bansal presented a potential new infectious disease research training program, consolidating the HIV research training program and the Global Infectious Diseases research training program (GID). The new program comes out of the recent drive for NOFO consolidation. The awards for the program would support multiple trainees from LMIC institutions for up to five years of mentored advanced training. Focus areas include endemic life-threatening diseases, emerging infectious diseases, chronic infections associated with comorbid conditions, and relevant interventions for public health management.
Dr. Marya Levintova spoke of NIH's collection of information on inclusion of women and minorities in human subjects’ research. Every three years, NIH must provide a written report on human subjects to the NIH Director and Congress. The report was finished in the spring and approved in the closed meeting, until the requirements were changed to mandate approval in the open meeting. Dr. Levintova informed the open meeting of the report's completion and imminent publication.
State of Global Health, Dr. Jennifer Kates
Global health is entering a transition period following executive actions affecting USAID, the U.S. Agency for International Development, U.S. participation in international organizations, and proposed budget reductions. PEPFAR, the U.S. President's Emergency Plan for AIDS Relief, historically a cornerstone of U.S. global health leadership, is currently operating at reduced spending levels, though targeted waivers continue to support high-impact interventions such as prevention of mother-to-child transmission and PrEP for pregnant and breastfeeding women. Congressional appropriations have, in some cases, diverged from the Administration’s proposals, creating ongoing policy and legal deliberations.
The Administration is reassessing U.S. engagement in multilateral institutions, including the Global Fund and World Health Organization (WHO), with a focus on fiscal stewardship, accountability, and alignment with U.S. interests. While funding levels and strategies remain under review, the State Department has maintained engagement in targeted initiatives, such as expanding access to innovative HIV prevention tools (e.g., lenacapavir) in low- and middle-income countries.
This evolving landscape presents an opportunity to modernize and strategically refocus U.S. global health investments, prioritizing cost-effectiveness, measurable outcomes, innovation, and targeted interventions that protect both global health security and American interests. A deliberate, evidence-based transition can help sustain core public health gains, reduce risk of disease resurgence, and ensure continued leadership in areas critical to U.S. health security and economic stability.
Dr. Kilmarx concluded by asking Dr. Kates what gives her optimism about the state of global health. Dr. Kates said that there is an opportunity to be more thoughtful and specific about how to deliver effective interventions and think about U.S. support in a more targeted way. A scaling down of U.S. support will likely happen, but it can be done in a way that can minimize harm.
Aligning Global Health Research Priorities with U.S. Health Priorities in the MAHA Era
Dr. Spiro started off by thanking Dr. Kates for her remarks, before introducing the topic of Secretary Kennedy's Make America Healthy Again agenda. He then introduced Dr. Kevin Bardosh, Senior Science Strategist in the NIH Office of the Director, and Dr. Chris Beyrer, FIC Advisory Board member and Director of the Duke Global Health Institute.
Dr. Bardosh said there is an exceptional opportunity under current leadership, and seizing those points and running with them could do a lot of good to the field of global health.
The world is changing, Dr. Beyrer said, and global health will be dealing with a large amount of chronic disease issues in the coming decades as Africa's large youth population ages. The recent MAHA report was focused on childhood disease, zoning in on diet, nutrition, chemical exposures, behavior and sedentary lifestyle, and overmedicalization.
Dr. Beyrer spoke of a predicament in science around replication. Replicating studies will improve science going forward. Within this trajectory is also metascience: how can scientists make science better? He said that philanthropy and new wealth have become major drivers of science in recent years and asked how science can have a relationship with a product that can improve outcomes.
Dr. Beyrer began by acknowledging and thanking Dr. Kilmarx for his leadership. He said Fogarty has long been engaged in the work of health security, investing in partnerships, and building capacity so countries can move toward independence and country ownership. Investing in people and intellectual capacity, rather than brick and mortar, has helped lay the groundwork for research and the future.
Dr. Beyrer touted the faculty of the Global Mental Health Program. There is a need for their work, as there are currently 75 child and adolescent psychiatrists in all of Africa, and 50 of them are in one country, South Africa. He spoke of an issue around chemicals, which he thinks are understudied. There is a great deal of toxic chemical exposure due to illicit mining in places like the Amazon basin and the Congo. Historic drought in the Amazon has raised the level of chemicals in the groundwater, which coupled with extreme heat, has led to the emergence of the first new disease that can be associated with extreme heat chronic kidney disease of unknown origin, or CKDU. It is mostly seen in young men who work in subsistence agriculture in the Northern Cone of South America and Sri Lanka. In Sri Lanka, there is also kidney disease thought to be linked to agricultural chemicals.
Dr. Beyrer ended on a note of optimism. The results of two large lenacapavir efficacy trials have been "extraordinary," and the treatment has the potential to be a "game-changer."
Closing Remarks/Adjourn
Dr. Kilmarx thanked the board for its ongoing support and remarked on another great meeting before adjourning at 12:26 PM.