Concepts represent early planning stages for program announcements, request for applications, or solicitations for
Fogarty Advisory Board input. Clearance of a concept by Fogarty's Advisory Board does not guarantee it will become an initiative.
Updated May 13, 2019
HIV-associated Non-Communicable Diseases (NCDs) Research at Low- and Middle-Income Country (LMIC) Institutions
Purpose/Goals and Objectives: Support locally relevant research in critical areas of HIV-associated non-communicable diseases (NCDs) at Low- and Middle-Income Country (LMIC) Institutions to enhance research capacity and build a network of researchers both within and across LMICs to address this critical burden. Research may be proposed in the following broad categories: basic mechanistic studies, aging process, diagnostics, therapeutic interventions, behavioral studies, clinical studies, access and continuity of care, and implementation science.
Background/Rationale: NCDs are responsible for over 70% of deaths globally and 85% of these deaths occur in LMICs, where 15 million people aged 30 to 69 die prematurely. People living with HIV (PLWH) also have high rates of NCDs. Increasing uptake of antiretroviral therapy (ART) has led to decreased mortality rates due to HIV. Thus, PLWH on ART are developing non-HIV-related chronic conditions of aging similar to the uninfected population. Moreover, HIV-infected individuals stable on ART are at higher risk of non-communicable diseases, particularly hypertension, diabetes mellitus, renal disease, pulmonary disease, cardiovascular disease, cancer, bone abnormalities and liver failure. HIV infection itself also seems to be associated with an accelerated aging process. More research is needed to understand the relationships between PLWH and NCDs in order to design interventions aimed at decreasing the effects of such co-morbidities.
Prior FIC Initiatives: Global Noncommunicable Diseases and Injury Across the Lifespan: Exploratory Research (R21 Clinical Trials Optional)
3/56 awarded grants were directed to HIV associated NCD research.
FIC conducted two initiatives in this area with multiple stake holders over the last several years that resulted in papers captured in two major journal supplements:
Overview of the Proposed Program: Through this initiative we hope to stimulate new research on the interplay between HIV and development of NCDs in PLWH and uncovering to what extent HIV infection influences the pathogenic effects of comorbid conditions. We expect that the new research will fill gap areas via exploratory studies to understand the etiopathogenesis of NCDs in HIV-positive people for effective diagnosis, prevention, therapeutic interventions and integrated clinical care.
Applicants will also be asked to address the needs of collaborating LMIC institutions to develop capacity for carrying out research in this field. Research teams should contain an appropriate mix of disciplines to accomplish the proposed studies. Partnerships between HIV and NCD researchers are expected to form the interdisciplinary teams. The small research grant mechanism to initiate new ideas and to determine feasibility is aptly suited for exploratory studies of novel approaches to understand and reduce the long-term suffering from the comorbid disorders. Applicants should develop their studies in keepng with the NIH and OAR priorities for HIV research.
Relevance to FIC Strategic Plan: The proposed initiative supports several of FIC’s strategic goals. It builds research capacity through individuals, institutions, and networks to meet future and evolving global health challenges It stimulates innovation in the development and implementation of technologies and other locally relevant solutions to address global health problems (Goal 2). It advances research on prevention and control of the dual burden of communicable and noncommunicable diseases and disabilities (Goal 4). It builds and strengthens partnerships to advance global health research and research capacity (Goal 5).
Eligibility: US and LMIC investigators for work to be done in partnership at LMIC sites.
Hubs of Interdisciplinary Research and Training in Global Environmental and Occupational Health (GEOHealth)
Purpose: To support the development of institutions in low- and middle-income countries (LMICs) that serve as regional hubs for collaborative research, data management, training, curriculum and outreach material development, and policy support around high-priority local, national and regional environmental and occupational health threats; and to support a global network of hubs that serves as a platform for coordinated research and training activities in environmental and occupational health.
Background: The World Health Organization (WHO) estimates that in 2012, 12.6 million deaths globally, representing 23% of all deaths, were attributable to the environment, and that 22% of the global burden of disease is due to the environment (1). Meanwhile, more than two million workers around the world die each year due to occupational injury or illness, and 317 million people suffer from work related injuries, costing the global economy billions of dollars (2). The burden is highest in LMICs, particularly in Africa, Southeast Asia and the Western Pacific. Although LMICs suffer more from environmental and occupational hazards, in many cases, inadequate capacity exists to study and mitigate these problems.
The Global Environmental and Occupational Health (GEOHealth) Hub program originated from a reengineering of the Fogarty International Center’s (FIC’s) long-standing International Training and Research in Environmental and Occupational Health (ITREOH) program. The ITREOH program provided research training to nearly 200 scientists at 34 institutions in 43 countries. Because of this breadth, there was less investment in any one program or LMIC institution. The goal of the new GEOHealth program was to develop a handful of regional science hubs, based in LMICs, that would become internationally-recognized centers for environmental and occupational health research, ideally serving the multinational regions in which they reside (3).
In 2015, FIC funded seven
GEOHealth Hubs in partnership with the National Cancer Institute (NCI), the National Institute of Environmental Health Sciences (NIEHS), the National Institute for Occupational Safety and Health (NIOSH), and Canada's International Development Research Centre (IDRC). The Global Alliance for Clean Cookstoves also participates in the program by offering supplemental funding. The GEOHealth Hubs are supported by two linked cooperative agreement awards, with a research award to the LMIC institution and a research training award to the US institution. To date, the GEOHealth program has 1) supported research on air pollution, electronic waste, agricultural health, neurotoxicants, climate change and occupational health, 2) provided research training to over 100 LMIC trainees, often directly associated with the research supported through the linked LMIC GEOHealth research award, 3) supported new degree programs in environmental health at LMIC institutions, 4) supported cross-network research and training activities, and 5) engaged local stakeholders and decision and policy makers through workshops and outreach efforts.
Continued development of LMIC-based hubs that conduct high-quality research, that train a research workforce with cutting-edge skills to understand and interpret environmental and occupational health threats, and that provide a means of engagement with decision and policy makers is essential for addressing existing challenges and to be poised to address emerging global environmental and occupational health challenges.
Prior FIC Initiatives:
RFA-TW-14-001: Hubs of Interdisciplinary Research and Training in Global Environmental and Occupational Health (GEOHealth) - Research (U01)
RFA-TW-14-002: Hubs of Interdisciplinary Research and Training in Global Environmental and Occupational Health (GEOHealth) - Research Training (U2R)
Overview of the Proposed Program: The GEOHealth program will continue to support the development of LMIC-based hubs through funding announcements inviting new and renewal linked applications. The program will continue to support hubs as linked awards with coordinated management -- a research award to an LMIC institution linked to a research training award to a U.S. institution, with other collaborating U.S. and LMIC institutions as “spokes”. GEOHealth Hubs are expected to bring together multiple disciplines to advance the pace of scientific discovery, initially in one focal environmental or occupational health area.
Relevance to FIC Strategic Plan: The GEOHealth program supports the research capacity building of individuals, their institutions, and regional and global GEOHealth networks, fostering a sustainable platform to address priority needs in environmental and occupational health (Goal 1). The program supports activities that bring researchers and policy makers together to enhance uptake of evidence in policy and practice (Goal 3). The program focuses on the growing burden of noncommunicable diseases (Goal 4). The structure of the program fosters institutional research and training collaborations and benefits from several funding partnerships across the NIH, HHS, and internationally (Goal 5).
- Prüss-Ustün A, Wolf J, Corvalán C, Bos R and Neira M. 2016. Preventing disease through healthy environments: A global assessment of the burden of disease from environmental risks. World Health Organization. ISBN 978 92 4 156519 6.
https://www.who.int/quantifying_ehimpacts/publications/preventing-disease/en/ Accessed 7 February 2019.
- International Labor Organization. 2012. Estimating the Economic Costs of Occupational Injuries and Illnesses in Developing Countries: Essential Information for Decision-Makers. ISBN 978-92-2-127015-7.
http://www.ilo.org/wcmsp5/groups/public/---ed_protect/---protrav/---safework/documents/publication/wcms_207690.pdf. Accessed 7 February 2019.
- Rosenthal J, Jessup C, Felknor S, Humble M, Bader F, and Bridbord K. 2012. International Environmental and Occupational Health: From Individual Scientists to Networked Science Hubs. Am J Ind Med 55:1069-1077.
http://onlinelibrary.wiley.com/doi/10.1002/ajim.22130/pdf. Accessed 7 February 2019.
Mobile Health: Technology and Outcomes in Low- and Middle-Income Countries
Purpose: To encourage exploratory/developmental research applications that propose to study the development and validation of innovative new or emerging mobile health (mHealth) technology specifically suited for low- and middle-income countries (LMICs). The overall goal of the program is to catalyze innovation through multidisciplinary research that addresses global health problems, develop an evidence base for the use of mHealth technology to improve clinical and public health outcomes, and strengthen mHealth research capacity in LMICs.
In the context of this program, mHealth is the use of mobile and wireless devices (cellphones, tablets, etc.) to improve health outcomes, health care services and health research.
Background: The Fogarty International Center (FIC) developed
Mobile Health: Technology and Outcomes in LMICs in 2013 to address the need for an evidence base for mHealth interventions and tools in LMICs. The program has funded 55 applications with partner institutes at NIH and a remaining set of applications will be reviewed in March 2019. The grants funded so far have resulted in
numerous publications and new knowledge regarding mHealth for behavior change, diagnostic approaches, and more. This program continues to fill a gap in research funding since there are few initiatives at NIH and elsewhere that focus on early-stage mHealth research specifically in LMICs. However, challenges faced by current grantees and the evolving mHealth research landscape has led to some changes, which are outlined below in the Overview of the Proposed Program.
Prior FIC Initiative:PAR-18-242: Mobile Health: Technology and Outcomes in Low and Middle Income Countries
Overview of the Proposed Program:
- The revised Mobile Health program utilizes a phased innovation approach that provides two to five years of support.
- The first two years will support milestone driven exploratory studies and, if milestones are met and the project is approved to continue, up to three years of support will be provided for further validation studies.
Applicants should propose research on the development and validation of new or emerging technologies, platforms, systems, and analytics.
- Applicants are strongly encouraged to form multidisciplinary teams that are necessary for the study of innovative mHealth technology.
- Applications will be required to propose partnerships between at least one U.S. institution and one LMIC institution and must contain key personnel from both. The research plan should involve U.S. and LMIC investigators and include strategies for increasing mHealth research capacity at the LMIC institution.
Relevance to FIC Strategic Plan: By supporting the development and validation of new or emerging mHealth technology, this program directly addresses FIC’s strategic goal to stimulate innovation in the development and implementation of technologies and other locally relevant solutions to address global health problems. Additionally, the research proposed should build mHealth research capacity in LMICs, which supports FIC’s goal to build research capacity through individuals, institutions and networks to meet future and evolving global health challenges.
Global Infectious Disease (GID) Planning Grant (D71)
Purpose: To support applicants from low- and middle-income countries (LMICs) to strengthen research training skills and plan infectious disease research training program applications with their U.S. collaborators.
Background: The previous announcement provided a small amount of funding to a LMIC PI for one year to support a training needs assessment, meet with U.S. collaborators and faculty and prepare a D43 grant application. Evaluation of historical application data and recent feedback from GID grantees suggested many reasons that these awards resulted in few successful GID D43 grant applications. A revision of the Global Infectious Disease (GID) Planning Grant (D71) program announcement will include options for LMIC faculty strengthening, designing LMIC specific research training curriculum, and additional time and funding that should result in more successful applications and effective LMIC-based GID programs.
Prior FIC Initiative:PAR-17-058: Planning Grant for Global Infectious Disease Research Training Program (D71)
Overview of the Proposed Program:
- Up to 2 years of increased funding will be available.
- The announcement will continue direct LMIC support for advanced research training needs assessment, meeting with U.S. collaborators and faculty and preparation of a D43 grant application that focuses on training in an infectious disease research area of high priority to the LMIC.
- In addition, research training leadership skills training for the LMIC PI and faculty will be supported in areas such as grants writing, project management, conducting a needs assessment, mentorship, evaluation, responsible conduct of research, adult pedagogy and distance learning.
- LMIC applicants may also be supported to work with collaborators to design orientation and research training guidance materials and required advanced research training courses that do not exist at their institutions. Support will also be provided to pilot distance learning courses/modules.
Relevance to FIC Strategic Plan: The proposed program will support progress toward “Goal 1 Build research capacity through individuals, institutions and networks to meet future and evolving global health challenges.”
Fogarty HIV Research Training Program for Low-and Middle-Income Country Institutions (D43) and International Research Training Planning Grants (D71)
Purpose/Goals and Objectives: To support the training of LMIC researchers in critical areas of HIV/AIDS prevention, treatment, care and cure continuum; to enhance research capacity building efforts at the LMIC institution; to build a network of researchers both within and across LMICs to collaborate and share unique resources; and to develop the scientific strengths to find a global solution to end the AIDS epidemic.
Background/Rationale: The Fogarty HIV Research Training (HIVRT) Program originated from a consolidation of the AIDS International Training and Research Program (AITRP) and the International Clinical, Operations and Health Services Research Training Award for AIDS and TB Program (ICOHRTA-HIV/TB). These programs were designed to strengthen the capacity of institutions in LMICs to conduct HIV-related research on the evolving HIV epidemic in their country. Over the last 30 years, the training program has produced a generation of LMIC scientists who are leading the research efforts in their home countries. With success in the treatment options and prevention approaches, life expectancy in people living with HIV (PLWH) has increased. Simultaneously, about 2 million new infections per year continue to fuel the transmission of HIV. There is a disproportionate benefit of access to treatment and care across the various PLWH communities, and a disproportionate spread in the incidence of new infections across the various age groups at a global level. The increased longevity of PLWH has coincided with a plethora of age-related morbidities that are exacerbated in HIV infection. Increased reliance on drugs has underscored the importance of understanding the pharmacology of drug-drug interactions and nutritional requirements for effective treatment. These are just some of the reasons to continue training efforts and to maintain a research workforce in the LMIC that will be poised to take on new and emerging challenges.
Prior FIC Initiatives: The most recent predecessors for the currently proposed initiatives expired in August 2018. These are:
- Fogarty HIV Research Training Program for Low-and Middle-Income Country Institutions (D43 Clinical Trial Optional) -
- International Research Training Planning Grants (D71) -
Overview of the Proposed Program: The overall goal of this program is to continue the Fogarty mission of supporting and facilitating global health research partnerships between U.S. and LMIC institutions in training the next generation of LMIC scientists to combat HIV/AIDS. This program is designed to focus each individual training award on specific research capacity building at one or within a regional network of LMIC institutions. The D43 mechanism is for applications to support research training programs that are expected to develop and strengthen the scientific leadership and expertise needed for HIV-related research at LMIC institutions. Continued training in basic, clinical, translational, and epidemiological research is still needed to address emerging issues. While all areas of research of public health importance to the LMIC are welcome, emerging research areas that represent significant scientific gaps include: a) HIV and coinfections and comorbidities including non-communicable diseases (NCDs); b) behavioral and social sciences research including stigma and discrimination; c) understanding HIV positive key populations, at risk adolescents and young children; d) HIV associated disorders in the aging population including mental health and dementia; and e) research on implementation of effective public health measures to decrease transmission and incidence of new infections across the populations. The D71 mechanism will support planning for a D43 training grant for those looking to start new training programs.
Relevance to FIC Strategic Plan: The proposed initiatives support several of FIC’s strategic goals and serves as an important conduit to build the much-needed HIV/AIDS research workforce. It builds research capacity through individuals, institutions and networks to meet future and evolving global health challenges (Goal 1); supports research and research training in implementation science (Goal 3); and builds and strengthens partnerships to advance global health research and research capacity (Goal 5).
Infrastructure Development Training Programs for Critical HIV Research at Low-and Middle-Income Country (LMIC) Institutions (G11)
Purpose/Goals and Objectives: The overall goal is to enhance and sustain research capacity building efforts at the LMIC Institutions to address the HIV epidemic in their countries through supporting the training of LMIC researchers and administrators in critical infrastructure areas.
Background/Rationale: The Fogarty HIV Research Training Program is designed to strengthen the ability of institutions in LMICs to conduct HIV-related research on the evolving HIV/AIDS epidemics in their country. To accomplish this goal, it is necessary to provide training a) in research support areas necessary for the execution of research programs, b) in managing and maintaining grants and c) to be competitive for research funding.
Prior FIC Initiatives: The previous FOA, listed below, ended in August 2018.
Infrastructure Development Training Programs for Critical HIV Research at Low-and Middle-Income Country Institutions (G11) -
Overview of the Proposed Program: Research infrastructure training programs will maximize previous investments and further strengthen the LMIC institution's research capabilities by providing more accessible research infrastructure training opportunities to candidates in their own country and in other LMICs. The G11 mechanism will support applications from U.S. and LMIC institutions for infrastructure development training programs to achieve technical, administrative and financial management expertise required for one of several research infrastructure functions considered critical to a successful high-quality research environment. These are: a) research administration and management, b) research integrity oversight, c) ethical review of research for the protection of human subjects, d) laboratory animal welfare oversight, e) health sciences library and information services, f) information and communications technology systems (ICT) for research, g) biostatistics and data analysis, h) technology transfer and intellectual property protection, and i) any area not mentioned above that justifiably will contribute to enhancing Institutional services that can support research activities. The awards may be requested for a duration of up to 3 years. The budget can be up to $100,000 (total costs) per year.
Relevance to FIC Strategic Plan: The proposed initiative supports several of FIC’s strategic goals. It builds research capacity through individuals, institutions and networks to meet future and evolving global health challenges (Goal 1). It stimulates innovation in the development and implementation of technologies and other locally relevant solutions to address global health problems (Goal 2). It builds and strengthens partnerships to advance global health research and research capacity (Goal 5).
Emerging Global Leader Award
For the published request for applications, see the NIH Guide announcements: