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 March 26, 4:00 p.m. to 5:00 p.m. EDT for the closed session, and on March 27, 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. Maureen Lichtveld, Dean of the Graduate School of Public Health, Professor of Environmental and Occupational Health, Jonas Salk Chair in Population Health, University of Pittsburgh
- Dr. Robert Murphy, Executive Director, Institute for Global Health, John Philip Phair Professor of Infectious Diseases, Northwestern University
Ex Officio Members Present
- Dr. Mike Reid, Chief Science Officer, Bureau of Global Health Security, U.S. Department of State
- Dr. Jane Simoni, Director, Office of Behavioral and Social Sciences Research, National Institutes of Health
FIC Staff Present
- Kristen Weymouth, Executive Secretary; Office of the Director
- Steve Smith, Acting Deputy Director
- Dr. Carl Dieffenbach, Senior Advisor to the Director
- Dr. Laura Povlich, Program Director, Division of International Training and Research
- Dr. Cecile Viboud, Acting Director, Division of International Epidemiology and Population Studies
Also Present:
- Dr. Rebecca Bunnell, Principal Deputy/Assistant Secretary, Bureau of Global Health Security and Diplomacy, U.S. Department of State
- Dr. Geri R. Donenberg, Associate Director for AIDS Research; Director, Office of AIDS Research (OAR), NIH
- Dr. Robert Eisinger, Acting Director, Division of AIDS, National Institute of Allergy and Infectious Diseases (NIAID), NIH
Opening Remarks
Dr. Peter Kilmarx brought the open meeting to order and reviewed the agenda. He welcomed Steve Smith, Acting Deputy Director, and Dr. Carl Dieffenbach, Senior Advisor to the Director, joining Fogarty and thanked Dexter Collins, Executive Officer, for his ongoing support for Fogarty. Dr. Kilmarx noted he is currently serving in his second term as Acting Director and plans to retire at the end of May. A candidate for the next FIC Director has been selected and confirmed by the NIH Director and the Secretary for Health and Human Services (HHS) and an announcement should be forthcoming.
America First Global Health Strategy Implementation Update
Dr. Bunnell gave an update on the Bureau of Global Health Security and Diplomacy (GHSD) and the President's Emergency Plan for AIDS Relief (PEPFAR), as well as the State Department's new global health strategy. Along with PEPFAR, which GHSD has housed for some time, GHSD recently absorbed the rest of the global health foreign assistance portfolio from the U.S. Agency for International Development (USAID). This includes U.S. foreign assistance for tuberculosis (TB), malaria, maternal-child health, nutrition, neglected tropical diseases, and global health security. Dr. Bunnell highlighted the legacy of collaboration with Fogarty that has helped the State Department make progress in reducing infectious diseases globally over the past two decades.
In 2025 the State Department launched the America First Global Health Strategy (AFGHS), which presents a forward-leaning vision for U.S. leadership in global health. The strategy is anchored in building partner country health sovereignty and resilient health systems, and aims to transform how health foreign assistance is delivered. With three guiding pillars, the strategy will leverage the reciprocal benefits of global health work to keep Americans safer by a) preventing and detecting infectious disease threats before they reach the U.S.; b) strengthening bilateral relationships with key countries; and c) helping make America more prosperous by protecting the economy from financial repercussions of outbreaks and promoting American health innovation. Within the strategy there are four primary areas of work: 1) bilateral agreements, including memorandums of understanding (MOUs), with partner countries; 2) innovation, including funding reserved to promote and accelerate health innovations like lenacapavir; 3) performance incentives, which are embedded in agreements with countries and consist of additional funding for countries that meet or exceed MOU targets; and 4) funding for transition resilience.
Dr. Gebreyes noted that the AFGHS focuses on government-to-government relationships and asked about the role of long-term partners such as Fogarty or academic institutions. Dr. Bunnell said that everyone will have to re-examine their roles under the new paradigm, and this also presents new opportunities, such as capacity building for global health innovation platforms. Dr. Eisinger noted that NIAID's Division of AIDS has had longstanding and successful collaborations with PEPFAR, which NIAID will build on to advance their priority of developing new and better prevention, diagnosis, and treatments for HIV infection and coinfections.
Mr. Smith commented there has been a substantial shift not only from a U.S. policy perspective but also for the host countries, whose capacity has increased so much over time that they are now true partners rather than recipients. He asked whether NIH scientists and intramural laboratories would be able to use the materials shared through these new MOUs in their ongoing research. Dr. Bunnell said that the language around specimen sharing was added to the agreements with HHS and NIH in mind, though they are still developing the standard operating procedure (SOP).
Advancing the Mission: Future Directions for NIH HIV Research
The Office of AIDS Research (OAR) coordinates HIV/AIDS research across NIH to advance a comprehensive HIV research portfolio. HIV/AIDS funding is allocated separately within the NIH budget, and OAR coordinates the distribution of those funds across more than 20 ICs. In FY25, $3.29B in HIV/AIDS funding supported more than 3,800 awards across NIH. In addition to their role in coordination, which includes strategic plan development and regular portfolio reviews, OAR catalyzes and advances cutting-edge HIV science across ICs and scientific disciplines; convenes stakeholders and events to promote a coordinated federal response and advance the research agenda across sectors; and communicates the outcomes and benefits of HIV research to relevant audiences. Dr. Geri Donenberg highlighted the role of global health research in several HIV research milestones, including the Strategic Timing of Antiretroviral Treatment (START) trial, which established the benefits of early ART, Undetectable = Untransmittable (U=U), which proved the concept of treatment as prevention, and the development of long-acting injectable PrEP.
OAR is catalyzing several multidisciplinary, cross-cutting programs to address areas of need identified by stakeholders: HIV and women, looking at sex-specific factors to ensure equitable representation in research; HIV and aging, as those with HIV live longer and face increased comorbidities; advancing technology to accelerate discovery through new tools and approaches; leveraging pharmacies as community-based sites for people to access prevention, testing, and treatment; addressing co-occurring conditions seen in people with HIV including mental health, substance use, and chronic disease; and implementation science to translate research into real-world impact. To promote scientific transparency and public accountability, OAR created a Data Hub that allows users to explore the NIH HIV research portfolio and demonstrates alignment of HIV awards to the strategic plan.
NIH has invested in HIV implementation science over time, supported by several science networks and hubs, and OAR has recently acquired the Adolescent HIV Prevention and Treatment Implementation Science Alliance (AHISA) and NIH-PEPFAR Local Implementation Science Network (LISN) global networks. Despite this, implementation science research accounted for only 7.5% of HIV/AIDS funding at NIH in FY25. They now have opportunities to emphasize the importance of strengthening that investment, particularly given Director Jay Bhattacharya's commitment to supporting implementation science to eradicate HIV infection in the U.S. OAR has recently launched Advancing Research in Implementation Science to End HIV (ARISE), which is a multidisciplinary program that aims to accelerate implementation research to end the HIV epidemic and increase training and capacity building in implementation science. Program activities include new mechanisms to accelerate research, like challenge competitions, as well as workshops, seminars, and symposia to generate and exchange ideas between stakeholders. They also received approval for an implementation science highlighted topic, which is open for applications. Dr. Donenberg concluded her remarks by noting that many issues around global health research are not well recognized, but emphasizing the benefits of international research for the American taxpayer can help to push this agenda forward.
Dr. Beyrer noted all the networks were working on implementation science in some way, and the HIV Prevention Trials Network (HPTN) was thinking about how it could play a role in a TB vaccine research agenda. He asked if TB was on OAR's agenda as a co-occurring condition with HIV. Dr. Donenberg expressed enthusiasm for integrating implementation science into the networks, and for focusing on co-occurring conditions; the challenge was how best to integrate implementation science, and which questions to ask to make sure that people will use the products they develop. Dr. Chi asked if there might be flexibility to support multi-year training for LAUNCH trainees. Dr. Donenberg indicated this could be considered. OAR generally does not issue grants, but puts out calls for proposals and works with the ICs to put forward grants they would like to see funded, and early-career investigators are prioritized.
Dr. Lichtveld asked how they could encourage researchers to look at non-communicable diseases (NCDs) as co-occurring conditions with HIV from an implementation science perspective. Dr. Donenberg said that OAR is developing a highlighted topic in comorbidities and co-occurring conditions, and several ICs have expressed interest in signing on. Dr. Bunnell added that, while it is difficult for GHSD to engage directly with NCDs because of their specific congressional appropriations, there could be opportunities to leverage their HIV-focused initiatives. For example, some countries may be interested in a stored specimen bank, where researchers could also look at hemoglobin A1c or other markers of chronic conditions to feed into broader agendas. More generally, collaboration with NIH will be important in the early stages of rolling out GHSD initiatives to optimize their ability to answer critical implementation science questions.
Potential H5N1 Pandemic Flu
The Division of International Epidemiology and Population Studies (DIEPS) is Fogarty's in-house research group, focused on infectious disease modeling. Originally focused on flu, DIEPS has since expanded to cover respiratory viruses, improving surveillance approaches and seroepidemiology, and forecasting and scenario projects. Dr. Cecile Viboud presented DIEPS' recent projections for the future potential impact of an H5N1 influenza outbreak. While H5N1 has been an emerging threat since 1997, recent years have shown a change in circulation, particularly widespread infections in mammals. Although human cases and deaths from H5N1 have decreased in the U.S. in 2026, H5N1 is still detected on a weekly basis in wastewater, indicating that the threat remains.
In order to predict the impact of an H5N1 outbreak in the population, researchers looked at preexisting immunity by examining the history of influenza strain circulation during the last century. In the U.S., people born before 1957 who were exposed to viruses descended from the 1918 H1N1 influenza are thought to have strong immunity to H5N1, while those born between 1957 and 1977 were primed by different viruses, and cohorts born after 1977 have had co-circulation of different viruses. A study published in 2025 sampled random individuals in the population for antibodies that are cross-reactive with H5N1. Those born before 1957 had high antibody titers, which aligns with the fact that they were primed with early H1N1 viruses. Younger cohorts acquired gradual immunity to influenza and built up titers, while there was a gap in immunity for the cohort born between 1957 and 1977 who were primed by unrelated viruses.
Based on these findings, DIEPS used a population-level transmission model to look at the effect of preexisting immunity in a full-blown H5N1 pandemic. For today's population, compared to a regular seasonal outbreak of H1N1, in an H5N1 pandemic the age distribution of infection would shift towards children, while adults 65 and older would be impacted similarly in both scenarios. Over time, they observed a higher overall impact of H5N1 as the cohort born before 1957 ages out of the population, decreasing overall population immunity. In the 65 and older age group there was a large relative change in infection attack rate, but it was still lower than the rate among children, who have a greater number of contacts. Assuming that enough vaccine supply exists to vaccinate 50% of each age group during an H5N1 pandemic, an optimal vaccine strategy would target 6- to 12-year-olds, who have both low immunity and high contacts, or 19- to 44-year-olds. Vaccinating 6- to 12-year-olds provides indirect benefits and reduces infection across all age groups surrounding them, while vaccinating 19- to 44-year-olds has a similar impact on the total attack rate and provides more direct benefit to protect that particular cohort. If vaccine supply was limited to less than 50% of each age group, the 6- to 12-year-olds should receive priority. If the supply was big enough to vaccinate 75% of each age group, infection would nearly be eliminated. Dr. Viboud noted that DIEPS only looked at immunity from the hemagglutinin, where the data came from originally, but more data is emerging for the neuraminidase antibody, which will be important to study in the future.
Dr. Beyrer asked what the antigens were in the new Moderna mRNA influenza vaccine, and Dr. Viboud said that they would be similar to recent seasonal strains. There have also been some efforts to put multiple strains of flu into an mRNA vaccine, which is an interesting approach. Dr. Lichtveld asked if they were able to tailor the population-based approach to specific communities, or if it was U.S.-wide. Dr. Viboud said that it was very broad, because the underlying titer data is from a random sample of individuals. Dr. Lichtveld asked about prioritizing age groups with limited vaccine supplies. Dr. Viboud said that school-aged children are a good target because of the indirect effects on other age groups, though this is somewhat nuanced; if the vaccine solely affects the severity of disease, then vaccine strategies should prioritize the age group that is most at risk of dying.
Dr. Kilmarx asked if they were considering vaccine uptake and messaging in their models. Dr. Viboud agreed that messaging about indirect effects could be challenging, as people are generally more comfortable with directly protecting those who are frail. Dr. Kilmarx noted the variation in immunity in the middle-aged cohort and asked if there was any role for rapid testing to further identify who would be more susceptible to disease. Dr. Viboud agreed that this was a good thought and noted that antibody titers vary widely between individuals, along with immune response.
Acting Director's Update and Discussion of FIC Activities
Dr. Kilmarx provided updates on Fogarty's funding activities. FIC fully obligated its FY2025 budget. The government shutdown set the Center behind, including study section reviews, and the February Board meeting was postponed until March 26th. On February 3rd FIC received the FY26 budget of $95.162M, which is level funding, and Dr. Kilmarx thanked everyone who had advocated for Fogarty and its mission.
A request for information on the NIH-Wide Strategic Plan - FY 2027-2031 - represents an opportunity to provide feedback on the next Strategic Plan and its three priorities (research areas, research capacity, and research operations). The response date is May 16th, and there will be a public webinar on April 8th.
Dr. Kilmarx highlighted several messages from NIH. In a Director's Statement, NIH Director Dr. Bhattacharya laid out the core tenets of ICO funding policies: aligning with NIH and ICO missions and strategic priorities; prioritizing scientific merit, program relevance, and program balance; incorporating the breadth of the ICO's research portfolio; considering investigator career stage and sustainability of the biomedical research workforce; considering the total amount of NIH funding available to investigators; and aligning with availability of funds from the ICO. Peer review remains important as part of NIH's Unified Funding Strategy, and ICOs should consider scores and reviewer comments in the context of their and NIH's priorities, strategic plans, and budgets.
Due to the lapse of appropriations during the government shutdown, emergency modifications have been made to the NIH peer review process, and Dr. Kilmarx noted that the next FIC Board meeting will be delayed to late June. NIH is now required to use 50% of remaining competing research project grant (RPG) funds for multi-year funding for research grants, and this will be carried forward to FY26. NIH updated its policy on foreign subawards in May 2025. However, recipients were allowed to renegotiate foreign subawards involving human subjects as foreign administrative supplements. Dr. Kilmarx shared two blog posts he wrote for Global Health Matters. The first highlighted the rationale for NIH's engagement in international collaboration and its relevance to the Make America Healthy Again agenda, and the second discussed the concept of reciprocal innovation in global health partnerships. In addition to Global Health Matters, FIC continues to produce its Funding Newsletter for global health researchers, and the two newsletters combined had 333,000 subscribers in 2025, a marked increase from 2024. IC social media has been sunsetted and consolidated into central NIH accounts. NIH website consolidation is ongoing; IC funding information is centralized at grants.nih.gov, and to consolidate public health information into content area hubs. NIH is also moving to a single centralized communications office, which will be connected to ICs via representatives. Andrey Kuzmichev will be the representative for Fogarty.
Dr. Kilmarx attended the Prince Mahidol Award Conference in Bangkok, Thailand in January of 2026, where he presented on FIC's involvement in the Data Science and Innovation Africa program and met with CDC staff and the U.S. Ambassador. He also made several visits to universities and to Children's National Hospital and heard from multiple trainees and faculty that interest in global health had rebounded since COVID.
Dr. Laura Povlich reported on advances in Harnessing Data Science for Health Discovery and Innovation in Africa (DS-I Africa), a Common Fund program that Fogarty co-leads with NIBIB, NIMH, and NLM. DS-I Africa is a consortium of 38 awards across a variety of data science and health research and training fields. It supports collaborations across 22 African countries and 19 U.S. states and enables globally relevant research using African data, capacity, and infrastructure. The NIH Common Fund recently announced it will not be supporting a second stage of the program, and the focus now is on working with grantees to figure out next steps through dedicated support from other NIH ICs or funding partners such as Wellcome Trust. The final consortium meeting will take place in Mombasa, Kenya from May 15-21.
Dr. Kilmarx provided an update on the NIH Health and Extreme Weather (HEW) Initiative, which has recently expanded funding through notices of funding opportunity (NOFOs). In 2025 the program officially launched with its own webpage and strategic framework. The HEW Steering and Executive Committees have members from 12 participating ICs, while the working group has members from 30 ICs and Offices, including the NIH Office of the Director. Several ICOs, including Fogarty, have also signed on to a new NIH highlighted topic on HEW, which will be released soon. The Convene, Accelerate, Foster, and Expand (CAFE) Research Coordinating Center has built a community of practice, which it now supports via capacity building, resource development, and data management. There are also 21 exploratory P20 centers across the U.S., five of which have an international focus. Dr. Kilmarx shared one of the HEW Initiative studies, which analyzed data from almost 300,000 children across 36 LMICs to assess the effects of heatwaves on child feeding practices. They found that heatwaves significantly disrupted consumption of diverse foods and meal frequency, leading to overall inadequate diet quality. Future activities for the HEW program include a grantee meeting in April, another iteration of the HEW Scholars Program, and ongoing strategic visioning activities.
The next FIC Advisory Board meeting will be virtual and at the end of June with the date to be determined. The next in-person FIC Advisory Board meeting is September 10-11, 2026.
Dr. Gebreyes asked about Fogarty's collaborative activities, and whether it was possible to continue the work of DS-I Africa by partnering directly with foundations who were formerly contributing through the Common Fund. Dr. Povlich said that Fogarty typically doubles its budget each year with co-funding. While it is unlikely that a single foundation will take over and continue funding the DS-I Africa program, there are opportunities to leverage the priorities of groups like the Wellcome Trust who are interested in building off DS-I Africa. Dr. Beyrer thanked Dr. Kilmarx for his leadership at Fogarty and said that while this is a challenging time for international solidarity and collaboration, global health remains an example of why it is important.
Closing Remarks
Dr. Kilmarx thanked the Board members for their engagement in the meeting, and the Fogarty staff for all of their hard work in fulfilling Fogarty's mission, especially given the challenges of the past year. There being no further business, the meeting was adjourned at 12:31 p.m.