The FIC Advisory Board met in Building 16 at the NIH Campus, 9000 Rockville Pike, Bethesda, Maryland, at 9:00 a.m. EDT, Steven Schiff, Director, presiding.
Present
- Dr. Steven Schiff, Chair, Director, Fogarty International Center
- Dr. Chris Beyrer, Duke University
- Dr. Benjamin Chi, University of North Carolina
- Dr. Maureen Lichtveld, University of Pittsburgh School of Public Health
- Dr. Robert Murphy, Northwestern University
Ex Officio Members Present
- Dr. Gregory Germino, Deputy Director, National Institute of Diabetes and Digestive and Kidney Diseases
- Dr. Satish Gopal, Director, Center for Global Health at the National Cancer Institute
FIC Staff Present
- Kristen Weymouth, Executive Secretary; Office of the Director
- Steve Smith, Acting Deputy Director
- Dr. Laura Povlich, Program Director, Division of International Training and Research
- Dr. Christine Jessup, Program Officer, Division of International Training and Research
Also Present
- Ms. Luciana Blanco, GEOhealth Trainee, Universidad Peruana Cayetano Heredia
- Dr. William Checkley, GEOhealth PI, Johns Hopkins University
- Mr. Diego Fano, GEOhealth Trainee, Universidad Peruana Cayetano Heredia
- Dr. Stella Hartinger, GEOhealth PI, Universidad Peruana Cayetano Heredia
- Ms. Angela Rozo, GEOhealth Training Program Administrator, Emory University
- Dr. Kyle Steenland, GEOhealth PI, Emory University
- Dr. Joseph Zunt, University of Washington
Director's Update and Discussion of FIC Activities
Dr. Steven Schiff brought the open meeting to order and reviewed the agenda. He recognized the service of departing advisory board members Otis Brawley, Wondwossen Gebreyes, Jen Kates, Maureen Lichtveld, and Rob Murphy. Staffing changes at FIC included the upcoming retirement of Acting Deputy Director of Fogarty, Steven Smith. He announced multiple leadership transitions across NIH institutes, including new directors in nursing, genomics, child health, and the National Library of Medicine. Dr. Schiff described planned meetings with incoming leaders and provided context on how these roles intersect with Fogarty’s priorities, such as integrating genomics and strengthening population-level research.
Beginning December 5, South African scientists will no longer be eligible for research training and career development grants from Fogarty due to South Africa’s status as an upper-middle income country. Ongoing trainings will be able to continue. The temporary moratorium on funding research in South Africa has been lifted, and the crucial relationships between NIH and South Africa will be maintained, given the country's unique contributions to global health.
Fogarty will soon begin utilizing the PF5 mechanism to work with international partners.
New NIH policies have been announced that are responsive to an Executive Order on high-risk research which could potentially be dangerous, including high-risk gain of function research and international research of concern. Dr. Schiff described recent adjustments that include clauses from the new policy in Notices of Award, underscoring the importance of providing appropriate safeguards for international research.
Dr. Laura Povlich reminded the board about current requests for information, including mechanisms for early-stage clinical trial investigators, changes to NIH peer review shifting from impact scores to categorical binning, updates to biosafety policies, and guidelines for sharing clinical study summary data with trial participants.
Fogarty is on track to spend its FY26 budget and is expecting to end the year having issued ~500 Notices of Awards. NIH will be funded by a continuing resolution through December 11. The DS-I Africa Program, an NIH Common Fund program harnessing data science for health discovery and innovation in Africa, held its sixth and final consortium meeting in May. The program is working with grantees to ensure they get the most out of their awards and have the greatest impact possible. DS-I Africa will present a closeout presentation to the NIH Council of Councils early in 2027.
At the Heads of International Research Organizations (HIROs) meeting, NIH Director Jay Bhattacharya reaffirmed the agency will continue to fund high-impact international research with safeguards in place. One area of concern discussed during the meeting was the need to update biosafety standards, which is an issue that has been receiving increased attention and one that Dr. Bhattacharya is highly involved in addressing.
At the July Orientation of the Launching Future Leaders in Global Health (LAUNCH) Research Training Program (LAUNCH), Dr. Schiff emphasized the importance of projects demonstrating generalizability beyond local contexts. Dr. Schiff recounted discussions with fellows and mentors and explained ongoing efforts to strengthen program review structures and ensure relevance to NIH priorities. He highlighted NIH’s broader shift toward supporting early-stage investigators, noting Fogarty makes substantial contributions. He proposed developing internal lists to quantify Fogarty’s support of early-stage investigators in order to demonstrate the current level of support.
Dr. Schiff discussed his recent trip to Uganda on a project to control and prevent mortality in neonates and disability from preventable diseases. He briefly highlighted the real-time analytics capability the Uganda team uses, which may be able to be easily modified to serve as an Ebola detection system. They are currently working with CDC, NIH, and the Ministry of Health in Uganda on rolling this out in high-risk border districts of Uganda, and incident response management leaders in the Democratic Republic of the Congo are also interested in using the tool.
Dr. Schiff is looking to rebuild FIC's Division of Epidemiology in a way that will provide a service to investigators and to NIH, expanding the use of AI and hybrid AI systems to guide control of outbreaks and endemic disease.
Comparing the distribution of drought and vegetation indices in Central Africa with brain and spinal infections, as well as midline cardiac malformations, has shown a high degree of correlation. The findings may help move towards being able to do population genomics that can inform not just the risk of disease, but also how to customize treatment and improve outcomes across populations.
Fogarty is actively trying to create new programs in partnership with CDC and has the full support of the directors of NIH and CDC. Fogarty has been involved in the Ebola response, with Dr. Schiff serving as liaison from NIH to CDC on their efforts. Steven Smith noted the importance of Fogarty's decades-long approach to capacity building. Fogarty trainees are involved in all aspects of the Ebola response and Ebola research studies. It is critical to communicate the impacts of the Center’s work, including mitigating the risks to the United States.
Global Environmental and Occupational Health (GEOHealth) Session
GEOHealth Program Background and Session Introduction
Dr. Christine Jessup provided a brief overview of the history of the program, which supports collaborative research between U.S. investigators and investigators in low- and middle-income countries (LMICs) to address environmental health challenges and enable strong research partnerships. The program began in 2012 with a focus on building regional science hubs based in LMICs and supporting their transition to become internationally recognized centers. The hubs serve as regional centers for collaborative research, data management, research training, and development of curricula and outreach material, as well as providing data to inform interventions in-country and around the world. Fogarty has been contributing a third of the program's $4.2 million annual budget, while its partners both co-fund the program and contribute intellectually. The GEOHealth hubs are supported by U01 research cooperative agreement awards to LMIC institutions and U2R awards to U.S. institutions to support the research training needed to conduct the research. The hubs receive a budget of $600,000 per year. To date, GEOHealth has supported ten hubs over two cycles, focusing on a variety of topics. Air pollution has been the most prominent topic; others have included mining, agricultural development, pesticide exposure, heat events, dust storms, and water scarcity/quality. The hubs have produced 241 publications, 66% of which include at least one LMIC PI, and more than half include a GEOHealth trainee as an author. Dr. Jessup invited several of the program's partners to speak about their involvement in GEOHealth and how it aligns with their organizations' priorities.
GEOHealth Hub Peru: A Decade of Environmental Health Infrastructure
Dr. Stella Hartinger presented on a decade's worth of work in environmental health research in Peru. Since 2015, their research has focused on four priority areas: household air pollution, ambient air pollution, diarrheal disease and climate, and arsenic contamination. The first phase of the program yielded 39 peer-reviewed publications and linked three countries. She discussed four studies from the first phase of work, including investigating whether providing LPG stoves reduced household air pollutant exposure and improved cardiopulmonary outcomes compared to open biomass cooking fires in a high-altitude village, a time series study connecting ambient PM2.5 to cardiorespiratory visits and mortality in Lima, an analysis of rotavirus vaccination and piped water access on childhood diarrhea at a national level, and identifying adverse associations between arsenic levels in drinking water with birth outcomes in a mining community. The overall goal of the hub for phase two is to build capacity around ambient air pollution research in Peru, as well as to study the association between ambient air pollution and cardiovascular/respiratory conditions, respiratory infections, and Alzheimer’s disease. Dr. Hartinger discussed Aim 1 of the hub's current work, estimating the short- and long-term effects of ambient air pollution on Alzheimer's disease and cardiorespiratory disease in Peru, along with the work on building a sensor network in urban and rural areas that was necessary for the project. In addition to working with universities and 35 health institutions in various regions of Peru, they partnered with 90 primary schools to host the sensors and interpret the data. The program has partnered with national and municipal government organizations to calibrate and maintain the equipment.
Field Calibration of a National Low-Cost PM2.5 Sensor Network in Peru
Luciana Blanco discussed the low-cost sensors used by the hub and the opportunity they provide to expand air quality monitoring in Peru. Given the limitations of the sensors, the study set out to develop and validate a local calibration model by comparing 12 multiple linear regressions and selecting the one with the best performance. For the analysis, they used 72 weeks of data per site. The model selected includes the interaction between temperature and relative humidity. Before correction, sensors overestimate PM2.5 in humid environments, but using the local calibration model their mean variance approaches zero at coastal and Amazonian sites. High Andean sites with low humidity will require a different calibration equation, and they are waiting on data from three such sites to conduct the second part of their analysis.
Pollution, Mites, and Asthma in Peru: From Exposure to Mitigation
Dr. William Checkley discussed some of the findings from cycles 1 and 2, focusing primarily on air pollution, allergenic exposures, and asthma in Peru. They collected data from all public hospitals in Lima and used Emory's high-resolution air pollution spatiotemporal model to create exposure-response curves. The team is also working on a life-cycle assessment to understand the inventory of the vehicular fleet in Lima and its contribution to air pollution. These two models will be combined to help develop mitigation strategies that will reduce traffic-related air pollution and lead to improvements in respiratory health. The program is also using its observations to better understand the role of allergenic exposures in Peru, specifically focusing on the high level of mite exposure its role in asthma control. The goal is to replicate the success of cycle 1 and to connect evidence of lung health across scales. With the infrastructure of the GEOHealth hub, they were able to assemble a prospective cohort of children with persistent asthma. This cohort has undergone detailed phenotyping to determine the specific IgE response to a variety of household allergens and exposures. The next step will be combining this information with data from the sensor network to identify potential interventions.
Environmental Hazards in Children with Persistent Asthma in Lima
Diego Fano discussed work underway as part of supplemental funding to better understand the effect of extreme weather phenomena on airborne allergen exposures. They conducted a prospective cohort study to evaluate how various environmental exposures, such as PM2.5, temperature change, and airborne allergens, may be affecting children with persistent asthma in two urban communities in Lima. A cohort of 112 children with persistent asthma were visited every three months over the course of one year. Lung function tests were performed before and after administration of bronchodilators, and indoor environmental exposure was assessed by collecting dust samples, which will be analyzed to collect information about the concentration of different airborne allergens. They also measured PM2.5, temperature, and relative humidity from the children's bedrooms. The team will soon begin a pilot intervention to improve indoor environmental quality in homes and assess how this improves these children's lives.
Dr. Checkley noted that this cohort is fairly unique. They are finding very high levels of sensitization to house dust mites and storage mites, but no sensitizations to any food allergens and very low levels of sensitizations to other common allergens that relate to asthma. Much of what they are seeing in Peru with asthma and allergen exposures can be directly translated to poor urban communities in the United States.
Case Control Study of Dementia and Air Pollution in Lima
Dr. Kyle Steenland presented on a study of subjects that have lived in Lima for at least ten years and had either Alzheimer's disease or frontotemporal dementia, with a clinical dementia rating of 0.5 to 2.0. The exposure variable used was a ten-year period average exposure across the residents assigned by municipal district. This is a population-weighted average for each district, and is derived from the model described earlier with one-kilometer resolution that has been validated against ground monitors. To date they interviewed 225 Alzheimer's, 91 frontotemporal dementia, and 31 mild cognitive impairment cases and used 326 controls with normal cognition. An interim preliminary data analysis showed an increase of PM2.5 was associated with a slight elevation of MCI, while patients with frontotemporal dementia had an elevation of 37%. Surprisingly, Alzheimer's was about the same as the controls and therefore not elevated, while most previous studies of Alzheimer’s disease and PM2.5 have shown a correlation. This finding may change as they continue diving into the data and getting more cases and controls. These were also corrected for comorbidities, smoking, and years of schooling, but they were not very strong predictors, possibly because the cases and controls used were similar in socioeconomic status.
A Ten-Year Program of Research Training in Environmental Health
Angelo Rozo discussed the intersection of research and training within the GEOHealth model. Training is embedded into all of the studies presented. The GEOHealth hub in Peru has trained 371 individuals with 560 training encounters through a four-tier training structure, from introductory courses to two doctoral programs. They have worked to strengthen curricula at local academic institutions by creating courses and self-sustaining research training opportunities that are now part of those institutions. Nearly 50 percent of the trainees worked in governmental institutions and strengthened their understanding of environmental and occupational health research and data analysis, with some coauthoring research papers. These trainees are part of the organizations that help with the translation of science into evidence-based prevention and intervention approaches to protect health. Trainees come from Peru, Bolivia, and Ecuador, which helps expand the regional network of researchers interested in environmental health. Returns on investment in LMICs should be measured more broadly than simple financial returns. In addition to building capacity in a region with few financial resources, their trainees are awarded grants from their country and internationally, generating money for the area and helping to create a sustainable network of environmental health researchers.
Discussion
Dr. Schiff asked if it makes sense to talk about eliminating PM2.5 and mites at a high level or if there are particular pollutants or mite species that are the major contributors to disease. Dr. Checkley said mite exposure used to be highly prevalent and because other allergens for asthma are not present in Lima, there is an opportunity to better understand the associated effects. They are now collaborating with a group of allergists to test across the different types of mites. They have also found that air pollution may play an important role as an adjuvant for allergens, especially in houses closer to roadways. The closer to a major road the house is, the greater the sensitization to dust mites. They hope to find simple, effective household interventions to reduce exposure and improve asthma outcomes.
Dr. Zunt asked if they have looked at subpopulations of people who experience elevated effects from PM2.5 particles and also have microvascular disease or APOE. Dr. Steenland said they had not, but APOE would be a good covariable to look into. They have also not yet looked specifically at vulnerable groups within Lima, but many studies from the U.S. show higher rates of Alzheimer's disease in the Medicare population from the same amount of PM2.5 as the non-Medicare population.
Dr. Chi asked about collaboration between hubs. Dr. Checkley said air pollution is a common theme across hubs, and they have shared protocols and ideas with other hubs. Dr. Schiff asked if NIH could play a role in centralizing data from the hubs and serve as a repository of lesson learned. Dr. Steenland thought centralizing PurpleAir sensor data collected from hubs would be valuable, since it is becoming increasingly common in more countries. Dr. Hartinger agreed and said that an institution like NIH sharing and communicating the value of PurpleAir data could lead other countries to leverage it, even with its limitations.
Maureen Lichtveld briefly discussed the Caribbean Consortium for Environmental and Occupational Health, one of the first round GEOHealth hubs. They have produced 54 publications, all but two of which were from early-stage investigators. 14 PhDs have come out of the program, all of whom were LAUNCH fellows, covering topics such as anemia, agricultural exposure and pesticides, TB, and HIV. The program maximized the use of dried blood spots and contributed 14,000 biospecimens to NIH's Human Health Exposure Analysis Resource database along with data from 80 different questionnaires.
Program Concepts, DITR
GEOHealth
Dr. Jessup presented the program concept for the renewal of the GEOHealth Program, proposing the continuation of the program with minimal changes. Fogarty recognizes that building capacity in a given area requires more than five or ten years, and there are opportunities to enhance what the program has already built without significant restructuring. Dr. Jessup briefly reviewed some of the program features and its background. They plan to pursue the current partnerships and will explore engaging new funding partners at the NIH and beyond. They will be making some adjustments to ensure the program is aligned with current administration requirements and NIH priorities. Dr. Jessup highlighted how the program addresses most of the aims of Fogarty's current strategic plan and noted that this is a team effort with project scientists engaging in the management and implementation of the awards.
Dr. Schiff suggested exploring strategies for extracting more granular information that would be more applicable to U.S. research in comparable conditions.
Dr. Beyrer noted GEOHealth Hub planned to partner with CDC's National Institute for Occupational Safety and Health (NIOSH) and asked how formal a relationship they envisioned. Dr. Jessup said NIOSH was an excellent partner in the first round of GEOHealth but they currently are not. She was not sure what a future collaboration would look like. Dr. Schiff said that it is an ideal time to bring NIOSH back into the program and it would be a powerful component of the proposal. Members discussed other potential NIH partners, particularly NICHD to look across the lifespan and enhancing existing partnership with NIEHS to strengthen connections with environmental health studies in the U.S. Harmonization across partners should be established before work begins, and NIH can enforce standards of data collection and deposition.
Dr. Germino suggested prioritizing cross-hub communication and collaboration.
Emerging Global Leader Award
Dr. Jessup presented the renewal concept for Fogarty's Emerging Global Leader Award, the only NIH K award for LMIC investigators at LMIC institutions. The award prepares investigators for independent research in global health, strengthens capacity at LMIC institutions, and fosters sustained international collaborations. The award provides protected time for investigators to engage in research projects and to engage in career development activities. The expectation is that these individuals will become research leaders at their home institutions and strengthen global health research capacity. The program is currently supported through two funding
announcements that will expire after the next deadline in December. They are proposing a continuation of the program with no significant changes. The programs reflects a broad and growing partnership across the NIH, with 12 ICOs on currently active funding announcements, many of which have provided co-funding over the years. Applicants can propose research in any area supported by NIH and relevant to the LMIC where they work. The program has
supported 120 awardees to date in 22 different LMICs. The research supported through the program has covered a wide range of biomedical and behavioral science fields, including maternity care, sickle cell disease, and mental health. 21% of awardees have become PIs on subsequent NIH grants. With increased interest in the program, the number of applications continues to grow, doubling over the ten years of its existence. The target audience for this award is junior faculty at LMICs institutions.
Dr. Schiff asked if the eligibility criteria were kept intentionally vague. Dr. Jessup said it is meant to be somewhat open because there are a number of different pathways to faculty positions in LMICs. Most NIH K awards require a PhD, but this does not, as long as the individual has research experience and an early career research position at their institution.
Dr. Beyrer commented that NIDA is looking to increase their international engagement and has received funding increases for overdose research, which is a major global health problem. He also commented on the importance of providing support to the recipients to manage NIH funding, which are not easy to administer. Sending new recipients to others in their region with experience in administering them has proven effective and cheap.
Dr. Gopal said that another proxy for career development would be age, which would be a good way to track who is getting these awards and if they are reaching the target audience. Dr. Jessup said they do not currently have an analysis by age. They rely heavily on the justifications the applicants submit, but are willing to look into other options.
Dr. Zunt thought it would be great if the program could include a requirement for all the LMIC trainees to come to the U.S. for training or to provide mentoring, similar to the recent change to LAUNCH. Dr. Jessup said many of the K43 mentees do come to the U.S. for training and thought that encouraging them to mentor the next generation was a good idea.
Dr. Schiff said that recent ideas to ensure trainees successfully develop into independent, self-sustaining investigators have been shared internationally. The number of fully trained physician-scientists in the U.S. has been plummeting due to the amount of time required, and this is an even bigger problem in LMICs. He wondered how better linkages across these programs could help support efforts to address the issue. Dr. Germino asked if they bring together K awardee cohorts for sessions on topics like grant writing, running a lab, or work-life balance. Dr. Jessup said they have not yet done this due to the wide range of biomedical research areas. There may
be a role for convening virtually to share overarching early career challenges and provide support.
Dr. Beyrer noted the soft power aspect of international alumni, which has proven beneficial over
the years.
Closing Remarks and Adjournment
Dr. Schiff thanked the presenters for their participation. There being no further business, the meeting was adjourned at 12:35 p.m.