Fogarty Funding Concepts

Renewal Concept: Chronic, Non-Communicable Diseases and Disorders Across the Lifespan Research Training Award (NCD-LIFESPAN; D43)

Purpose/Goals & Objectives: To sustainably strengthen the NCD research capacity of low- and middle-income (LMIC) institution(s), and to train in-country experts to develop and conduct research on NCDs across the lifespan, with the long-range goal for capacity to identify, develop and implement evidence-based interventions relevant to their countries. LMICs are defined by the World Bank Classification system as low, lower-middle, and upper-middle income countries.

Background/Rationale: Globally, non-communicable diseases kill more than 41 million people each year with approximately 75% of these deaths occurring in LMICs, where they also contribute significantly to these countries' overall burden of disease. The Global Burden of Disease study estimated that in 2019, NCDs and injuries accounted for 64% of disability-adjusted life years (DALYs). A large proportion of deaths and chronic illness due to NCDs are caused by cardiovascular disease, cancer, chronic respiratory diseases, and diabetes, although other conditions, including hepatic, digestive, neurological, mental and behavioral, hematological, endocrine, renal, musculoskeletal, skin and oral diseases, and genetic disorders as well as injuries also contribute to overall morbidity and mortality, and may be of particular interest in certain populations or regions. The care and treatment of NCDs strain existing health care systems and lead to lost economic productivity.

Prior/Current Related FIC Initiatives: FIC has implemented three programs to promote research training in NCDs over the past 20 years: International Clinical, Operational and, Health Services Research Training Award program (ICOHRTA); Millennium Promise Research Training Awards for Non-communicable Diseases and Disorders (NCoD); and the Chronic NCD Research Training Award for Diseases and Disorders across the Lifespan (NCD-Lifespan). The NCD-Lifespan research training program received its last set of applications in July 2024. Overall, 95 grants have been funded through the NCD-Lifespan D43 from 2011- 2023, providing medium to long term training to well over 470 scientists across all continents, along with short term specialized training.

Overview of Proposed Program: The primary focus of the proposed continuation of the NCD-Lifespan D43 program is on sustainable strengthening of capacity of LMIC institutions and investigators to conduct research on NCDs through the education and career development of individual researchers and key personnel. Sustainable NCD research capacity is known to require a critical mass of scientists and health research professionals with in-depth scientific expertise and complementary leadership skills that enable them to conduct independent, internationally recognized NCD research relevant to the health priorities of their country.

The long-range goal is to provide a solid foundation in LMICs for development and implementation of evidence-based interventions relevant to NCD's across the lifespan. While evidence may exist upon which to base research for interventions and implementation strategies, often the evidence base is not well developed or not relevant to the given country or culture. Therefore, training across the spectrum of research disciplines is encouraged as needed, from basic biomedical, behavioral and social science to clinical and applied sciences, including translational and implementation science that emphasizes the resources, context and needs of multiple stakeholders in local settings.

New research training programs are expected to focus on developing capacity in a single LMIC institution unless other prior collaborations provide a foundation for a more expansive research training program or network. While many programs will be collaborations with US institutions, an LMIC institution will be eligible to submit without a US partner. Furthermore, an LMIC institution will be eligible to apply alone or in a partnership with another LMIC.

Previously established collaborative research training programs (renewals) with US institution as primary, are strongly encouraged by their third renewal to shift leadership to the LMIC institution(s) and expand or network for research training and capacity building with other institutions within the LMIC and region.

Relevance to FIC Strategic Plan: This program is responsive to the following Fogarty strategic plan goals:

• Goal 1: Build research capacity through individuals, institutions and network
• Goal 4: Support research and research training in implementation science
• Goal 5: Advance research on prevention and control of the dual burden of communicable and non-communicable diseases and disabilities

Concept: Fogarty HIV Research Training Program for Low-and Middle-Income Country Institutions (D43)

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-AIDS/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 36 years, the training program has produced a generation of LMIC scientists who are leading the research efforts in their home countries. With continuing 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 predecessor for the currently proposed initiative expired in August 2024 (PAR-22-151: Fogarty HIV Research Training Program for Low-and Middle-Income Country Institutions (D43 Clinical Trial Optional) (nih.gov).

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 by training multi-disciplinary cadres of individuals at the pre-doctoral, doctoral and post-doctoral levels, medical and other health care professionals. 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 as a consequence of effective anti-retroviral therapies (ART) and PLWH living longer healthier lives. While all areas of research of public health importance to the LMIC are welcome, emerging research areas that represent significant scientific gaps include:

1. HIV and coinfections and comorbidities including non-communicable diseases (NCDs); 
2. behavioral and social sciences research including stigma and discrimination;
3. understanding HIV transmission dynamics in key populations, at risk adolescents and young children;
4. health effects on perinatally infected populations;
   
   
5. HIV associated disorders in the aging population including mental health and dementia; 
6. research on implementation of effective public health measures to decrease transmission and incidence of new infections across the populations; and
7. research on HIV reservoir and HIV cure.

Relevance to FIC Strategic Plan: The proposed initiative supports several of FIC's strategic goals and serves as an important conduit to build the much-needed HIV research workforce. 

• Goal 1: Build research capacity through individuals, institutions and networks
• Goal 3: Supports research and research training in implementation science
• Goal 5: Advance research on prevention and control of the dual burden of communicable and non-communicable diseases and disabilities

Renewal Concept: Global Brain and Nervous System Disorders Research across the Lifespan

Purpose: To catalyze innovative and collaborative research in neuroscience at low- and middle-income country (LMIC) institutions that could benefit from the collective strengths of the collaborating institutions (and research networks) to strengthen research capacity in neuroscience research.  

Background: The Global Brain program was established to address the disproportionate burden of neurological and behavioral disorders across the lifespan in low- and middle-income countries (LMICs). This program catalyzes neuroscience research and further establishes neuroscience expertise in LMICs by providing a way in which LMIC and US investigators with shared interests in nervous system disorders can establish research collaborations and engage in research capacity strengthening activities. Purposely minimizing limitations on the type of neuroscience research this program supports, the global research community is able to propose flexible and creative approaches to context-sensitive challenges that reflect the interests and needs of the collaborating scientists, institutions and countries. Additionally, the unique emphasis in this research program on research capacity building allows awardees to address a broad range of research needs at collaborating LMIC institutions. To harness the breadth of projects, populations, diseases and disorders, and geographic areas, the Global Brain program hosts an annual networking meeting to foster a community of practice that shares successes, challenges, scientific advances and approaches. Since the inception of the program in 2003, 199 R21s and 123 R01s have been awarded to support research in 71 LMICs. The reach of this program is due largely to the robust participation of NIH Institutes, Centers, and Offices as partners. For every $1 invested in the program by FIC, co-sponsoring ICs and partners have invested more than $11, multiplying the scientific and capacity building reach of this program. In recognition of the program's 10^th anniversary, FIC funded an evaluation of the Global Brain program's performance that later was followed by the publication a Nature supplement (2015) of articles on challenges and opportunities in neuroscience research and capacity building in LMICs written by Global Brain grantees. Now in its third decade, the expectation is that the investments in the research programs at LMIC institutions will lead to more research projects led by LMIC researchers as well as the development of more research collaborations.   

Prior FIC Initiative: Continuation of PAR-22-097: Global Brain and Nervous System Disorders Research Across the Lifespan (R01 Clinical Trials Optional) and PAR-22-098: Global Brain and Nervous System Disorders Research Across the Lifespan (R21 Clinical Trial Optional)

Overview of the Proposed Program:

• The Global Brain program provides funding to conduct innovative collaborative research at low- and middle-income country (LMIC) institutions on nervous system function, diseases and disorders that align with their national health priorities.
• The program uses two companion funding opportunities to provide research support for two (R21) or up to five (R01) years. Because R01 applications are only awarded by participating ICs other than FIC, R01 applications must propose research projects that are relevant to the mission of those ICs.
• The collaborative research programs expect to contribute to the long-term building and strengthening of sustainable neuroscience research capacity in LMICs by strengthening the research environment and capacity of individuals and institutions in LMICs related to the proposed research areas.
• Types of research applicable to the Global Brain program span the full range of health-related research topics, populations, and methodologies that can serve as a foundation for the development of innovative diagnostics, treatments, prevention and implementation strategies; research networking; and evidence-based policy beyond the specific research project.
  

 
Relevance to FIC Strategic Plan:  This program is responsive to the following Fogarty strategic plan goals:

• Goal 1: Build research capacity through individuals, institutions and network
• Goal 4: Support research and research training in implementation science
• Goal 5: Advance research on prevention and control of the dual burden of communicable and non-communicable diseases and disabilities

Concept: Research Administration Development Award for Low-and Middle-Income Country Institutions

Purpose/Goals and Objectives: To support the training of LMIC researchers, technical personnel and administrators in critical function areas that are expected to enhance and sustain research capacity building efforts at the LMIC Institutions.

Background/Rationale: The Fogarty HIV Research Training Program is designed to strengthen the human capacity to contribute to the ability of institutions in LMICs to conduct HIV-related research on the evolving HIV-related epidemics in their country. To accomplish these goals at a current and at a sustained level, it is necessary to provide training in research support areas in support of the research programs and maintenance of grants, and to assist LMIC institutions to compete independently for research funding. Training programs to support research infrastructure will maximize previous investments, further strengthen the LMIC institution's research capabilities, and potentially provide more accessible research infrastructure training opportunities to others at Institutions in their own country and in other LMICs.

A portfolio analysis suggested that our previous efforts for infrastructure development training resulted in several smaller grants to investigators that were not able to reach the broader Institutional communities. In addition, there was a demonstrated need for more widely accessible training on research administration including pre- and post- award grants management, oversight of research integrity and establishing institutional review boards for human subjects' protection.

Prior FIC Initiatives: The previous Notice of Funding Opportunity (NOFO) expired in August 2024. (PAR-22-153: Infrastructure Development Training Programs for Critical HIV Research at Low-and Middle-Income Country Institutions (G11 Clinical Trials Not Allowed) (nih.gov)

Overview of the Proposed Program: The G11 mechanism will support applications from U.S. and LMIC institutions, alone or as partners, for infrastructure development training programs for administrative personnel at LMIC institutions 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. In addition to research administration and ethical oversight, these may include: 

1. laboratory animal welfare oversight, 
2. health sciences library and information services, 
3. information and communications technology systems (ICT) for research,
4. biostatistics and data analysis,
   
5. technology transfer and intellectual property protection, and
6. any area not mentioned here but which will contribute to enhancing Institutional services that can support research activities.

The program will offer cohort-based online training with both didactic and breakout group practicum components to individuals from multiple institutions in the region who have been nominated by their institution, increasing equitable access to training and fostering regional Communities of Practice in research infrastructure support. The proposed program will support one large grant or three to four regional grants to address the needs in different regions to address differences in time zones, language, cultural learning preferences, legal and policy environment, and other considerations. The goal is to improve oversight of FIC grant awards and compliance with NIH funding policies and Federal research funding requirements.

Relevance to FIC Strategic Plan: The proposed initiative supports several of FIC's strategic goals.

• Goal 1: Build research capacity through individuals, institutions and network/li>
• Goal 2: It stimulates innovation in the development and implementation of technologies and other locally relevant solutions to address global health problems.
• Goal 5: Advance research on prevention and control of the dual burden of communicable and non-communicable diseases and disabilities

Concept: Global Alliance for Chronic Diseases Program Supporting Implementation Research in Low- and Middle-Income Countries and Tribal Nations (R01 Clinical Trial Optional, R61/R33 Clinical Trial Required)

Purpose: Continue NIH participation, with FIC leadership, in the Global Alliance for Chronic Diseases (GACD) partnership of international funding agencies by supporting meritorious awards across NIH’s IC funding priority areas through three new funding opportunities FY2026-2028. While FIC will not fund awards directly, FIC will lead/manage these trans-NIH efforts toward using implementation science (IS) research to address non-communicable diseases (NCDs) and represent NIH within the GACD Strategy Board.

Background/Program Overview: NCDs account for 60% of deaths globally. Importantly, this global burden is felt even more deeply in low- and middle-income countries (LMICs), and low-resource settings of high-income countries (HICs), such as within tribal nations—even though NCD risk factor burden is often lower in LMICs, mortality rate is much higher due in part to the lack of access to quality, integrated health services and the poor availability of early interventions and effective NCD prevention programs. While NCDs account for the greatest loss of disability-adjusted life years (DALYs) around the world, they are relatively ignored and under-resourced, especially in LMICs where the burden is rising at the fastest rates throughout the world. In response to this major concern, the Global Alliance for Chronic Diseases (GACD) was formed in 2010 as a partnership of 15 health research funding agencies around the world to coordinate funding for research and research training on NCDs in LMICs and among tribal nation communities of HICs. GACD supports research and intervention scaling to address the burden of NCDs practically, effectively, contextually, and sustainably. Specifically, GACD supports IS research which examines what works, for whom and under what circumstances, and how interventions can be adapted and scaled up in ways that are accessible and equitable. Projects funded through the GACD program are encouraged to work toward both location-specific and globally transferrable lessons across low- and high- income countries.

Since 2011, the GACD has awarded over $375 million in IS research grants focused on preventing and managing NCDs in low-resource contexts. GACD has now supported over 1,300 researchers at over 250 institutions in 80+ countries through investment in 182 funded research projects to-date. The GACD Secretariat coordinates the development of aligned funding announcements each year to address global health issues associated with chronic, non-communicable diseases; as such, funding announcement focus areas have included both targeted opportunities for specific NCDs as well as cross-cutting opportunities (please see “Prior/Current Related FIC Initiatives” for more information). All research projects that are part of GACD research programs receive their funding from the GACD Associate Member organizations that are participating in each respective program. Together the GACD Associate Members aim to foster collaboration and coordination of research programs by agreeing on joint research priorities and funding world-class research.

Associate Members issue joint calls for proposals on a regular basis on topics in our strategic focus areas. As a founding GACD Associate Member, NIH has now supported 37 awards across these NCD domains and proposes continuation of GACD partnership for cross-cutting, trans-NIH funding over the coming years. While FIC does not directly fund these awards, FIC staff manage this trans-NIH initiative on behalf of the partner NIH Institutes and Centers (ICs) that sign on to yearly funding announcements based on their strategic goals and alignment with the call focus. FIC Advisory Board clearance is utilized by many, but not all, partner ICs for their required concept clearance process, which substantially benefits the cohesiveness and funding scope of this trans-NIH program, especially as the GACD program has transitioned to cross-cutting funding opportunities. This program aims to launch yearly Notices of Funding Opportunity (NOFOs) through the R01 Clinical Trial Optional and R61/R33 Clinical Trial Required PAR mechanisms for inviting applications for the following funding areas during FY2026-2028:

• FY2026: Funding opportunities focused on IS research addressing strategies for equitable transformation of health systems to reduce the prevalence and impact of NCDs in LMICs and underserved populations in high-income countries (HICs). These funding opportunities will invite applications that address the broader health system, defined as the organizations, people and actions, whose primary intent is to promote, restore or maintain health and prevent disease. This includes efforts to influence determinants of health as well as more direct health-improving activities.
• FY2027: Funding opportunities focused on IS research around strategies leveraging settings and sectors beyond the health system, to tackle the growing burden of NCDs in LMICs and underserved populations in HICs. These funding opportunities will invite applications that utilize implementation strategies around prevention, screening, and management of NCDs involving additional sectors to pursue improved health.

FY2028: Funding opportunities focused on IS research on interventions targeting children and young people to tackle the increasing burden of NCDs in LMICs and underserved populations in HICs. These funding opportunities will invite applications that utilize implementation strategies around prevention, screening, and management of NCDs, centered on the critical life stages from early childhood to young adulthood (age 1-24 ). Additionally, this funding opportunity will strategically serve to scale up efforts associated with the GACD’s 2021 funding opportunity entitled, “Implementation Research to Reduce Noncommunicable Disease (NCD) Burden in Low- and Middle-Income Countries (LMICs) and Tribal Nations During Critical Life Stages and Key Transition Periods.”

In October 2023, the GACD brought together a group of international experts to guide the selection of these future topics for funding opportunities, focused on implementation science around strategies to tackle the increasing global burden of NCDs. Members had expertise in NCDs, IS, working with underserved communities in LMICs and policymaking. The group met over two days in London, and discussed wide ranging topics relevant to NCDs, from the growing field of artificial intelligence in health, to the impact of gender on health. The group developed a report, scoping out this series of three future funding opportunity topics, in line with the current GACD strategy to take a holistic, rather than disease focused approach, to tackle NCDs in LMICs and among underserved populations experiencing health disparities, such as First Nation Populations, in HICs. This report, along with its funding opportunity topic recommendations, was then approved by the GACD Strategy Board (represented by the FIC Director and Deputy Director), the GACD Board of Trustees, and will be further implemented by the GACD Program Subcommittee (represented by FIC Program staff).

The GACD and all Associate Member Funding Agencies are committed to supporting research undertaken through genuine partnership among high and low/middle-income country academics, policymakers, local authorities, and community groups. Where possible, it is encouraged that research questions be driven by local stakeholders and other intended beneficiaries of the research project. While all GACD member funding agencies have agreed to the general scope and topic of the three calls, individual agencies decide on a year-by-year basis if they will participate in a call cycle and may adjust certain specific requirements of the call to fit their own research strategy. As such, NIH will launch its own NOFOs for each of the three proposed funding topics, but in close alignment with the broad funding call launched by the GACD Secretariat.

Prior/Current Related FIC Initiatives: NIH is a founding member of the GACD. As such, FIC and participating NIH ICs have funded applications through each of the last nine funding NOFOs. To-date, 37 R01-equivalent research projects have been funded through NIH partner ICs (brief descriptions of funded GACD projects, including those supported by the NIH, can be found here: https://www.gacd.org/research-projects). Prior and current funding opportunities have focused on hypertension, lung diseases, diabetes, mental health, cancer, hypertension/diabetes intervention scale-up, taking a life-course approach to NCD prevention and management, leveraging the city environment for tackling NCDs where global populations are growing fastest, and scaling proven approaches to management of multiple long-term conditions (multimorbidities) for more holistic healthcare.

Under the GACD partnership, Associate Member agencies agree on a general research topic area. FIC staff (in partnership with IC representatives) translate this topic to meet IC and agency priorities. Funded investigators from all GACD agencies participate in annual network meetings, collaborate on projects, and synthesize findings from their work for the global community. The most recent annual report of the GACD can be found here: https://www.gacd.org/our-impact/annual-reports. To date, NHLBI, NINDS, NIMH, NIDA, NIEHS, NCI, NICHD, NIA, NIMHD, and NEI have participated in funding projects. FIC coordinates the partnership on behalf of the agency. The FIC Director represents NIH on the GACD Strategic Advisory Board and FIC program staff represent NIH on the GACD Program Subcommittee.

Relevance to FIC Strategic Plan: Partnership with GACD and funding of GACD-related awards is aligned with all five FIC Strategic Goals and nearly all Strategic Priorities:

• Goal 1: Build research capacity through INDIVIDUALS, INSTITUTIONS and NETWORKS to meet future and evolving global health challenges:
  • Support training of INDIVIDUALS to build future research leaders in the U.S. and low- and middle-income countries (LMICs).
  • Promote research NETWORKS.
  • Stimulate linkages among disciplines to address complex global health problems.
• Goal 2: Stimulate innovation in the development and implementation of technologies and other locally relevant solutions to address global health problems:
  • Support the enhanced use of information and communication technologies to facilitate and improve health research education.
  • Encourage innovation in the development and implementation of mobile and other technologies, systems, and policies to address global health problems.
• Goal 3: Support research and research training in implementation science:
  • Expand investment in research and research training in implementation science across programs.
  • Catalyze interaction between researchers, policymakers and program implementers to promote uptake of evidence into global health policy and practice.
• Goal 4: Advance research on prevention and control of the dual burden of communicable and noncommunicable diseases and disabilities:
  • Support research and research training in clinical, behavioral and population sciences.
  • Identify ways to leverage investments in communicable diseases, including HIV, to better address the dual burden of disease.
• Goal 5: Build and strengthen partnerships to advance global health research and research capacity:
  • Engage and support the NIH Institutes and Centers to advance their research agendas for global health.
  • Forge partnerships at home and abroad to leverage complementary interests and strengths.

Concept: Global Infectious Disease Research Training Program (D43)

Purpose: The Global Infectious Disease Research Training program will support collaborative LMIC-US research training programs that are innovatively designed to build sustainable infectious disease research capacity at an institution in an endemic LMIC. Sustainable infectious disease research capacity is known to require a critical mass of scientists and health research professionals with in-depth scientific expertise and complementary leadership skills that enable the institution to conduct independent, internationally recognized infectious disease research relevant to the health priorities of their country. The objectives of the Global Infectious Disease Research Training program are:

• To develop research training opportunities and professional development activities for a cadre of LMIC scientists and health research professionals to strengthen the capacity to conduct independent, sustainable infectious disease research at a LMIC institution.
• To provide mentored training-related infectious disease research experience that is directly relevant to the health priorities of the LMIC.
• To strengthen the capabilities of trainees at LMIC institutions to lead, manage and train others in infectious disease research.

Background: Infectious diseases continue to impose a tremendous health burden in resource-poor countries throughout the world, claiming millions of lives annually and inflicting severe morbidity that results in significant losses in economic productivity and social progress. Attempts to control infectious diseases endemic to low- and middle-income countries (LMICs) suffer due to an incomplete understanding of the pathogens, disease manifestations and transmission mechanisms, inadequate preventive measures and interventions, and insufficient health services and disease control efforts. A major barrier to improved, evidence-based treatment and control of infectious diseases in LMICs is the low capacity to conduct locally relevant infectious disease research.

Overview of the Program: Awards will support up to 5 years of mentored advanced research training (postdoctoral, degree & non-degree) for multiple trainees within a LMIC-US collaboration ($250,000/year/award). Each program should provide LMIC trainees with rigorous research training, i.e., relevant advanced coursework, mentored research experience and appropriate technical and professional skills development. Programs may focus on:

• Major endemic or life-threatening emerging infectious diseases
• Neglected tropical disease
• Infections and microbiomes associated with non-communicable disease conditions of public health importance or
• Infections that frequently occur as co-infections in HIV infected individuals.

NIH Partners: NIAID

Relevance to FIC Strategic Plan:

• Goal 1: Build research capacity through individuals, institutions and networks to meet future and evolving global health challenges
• Goal 3: Support research and research training in implementation science
• Goal 5: Build and strengthen partnerships to advance global health research and research capacity

Renewal Concept: Emerging Global Leader Award

Purpose: To support the career development of early-career Low- and Middle-Income Country (LMIC) scientists under the guidance of U.S. and LMIC mentors, leading to independent research careers at LMIC institutions.

Background: Opportunities for scientists in LMICs to establish independent global health research careers are critical to building a robust global health workforce, but the mentored research experiences that foster research independence can be difficult to obtain. The Emerging Global Leader Award is a mentored career development award that provides support for LMIC scientists to conduct mentored research and career development activities. It is modeled after Fogarty International Center (FIC)'s longstanding International Research Scientist Development Award (IRSDA; K01) program, which has been instrumental in launching successful independent global health research careers of U.S. scientists, but foreign applicants are not eligible for NIH K01 awards. The Emerging Global Leader Award complements the IRSDA program and other FIC-supported programs that target earlier points in the career pipeline. The robust participation of NIH Institutes, Centers, and Offices (ICOs) as partners indicates that the Emerging Global Leader Award program is filling an important gap across the NIH by supporting LMIC scientists. Since its inception in 2016, the program has supported 77 awards in 19 LMICs, covering a wide range of research topics, with 43% of awards receiving co-funds from other ICOs. The expectation is that through this sustained period of research and career development, LMIC scientists will launch research careers at their LMIC institutions and become competitive for independent and collaborative research support. Indeed, 18% of all K43 PIs have successfully competed as PI on NIH research and research training grants awarded by several ICs.

Prior FIC Initiative: Continuation of PAR-21-251: Emerging Global Leader Award (K43 Independent Clinical Trial Required) Emerging Global Leader Award (K43) and PAR-21-252: Emerging Global Leader Award (K43 Independent Clinical Trial Not Allowed)
 
Overview of the Proposed Program:

• The Emerging Global Leader Award provides three to five years of salary support and research support to an early career research scientist from an LMIC for an intensive, mentored research career development experience.
• The candidate must hold a junior faculty or junior research scientist position at an LMIC academic or research institution.
• The candidate may not have been the PI (including MPI) of an R01 or R01-equivalent award from any funding entity or a career development award equivalent to the NIH K awards.
• During the award period, recipients are expected to increase their capabilities in advanced research methodology, analysis and data management, research administrative skills, responsible conduct of research, scientific presentation, and manuscript and grant writing.
• Applicants should propose critically needed career development activities and research projects highly relevant to the health priorities of their country. These activities should propel awardees to become competitive PIs for new research funding and lead to an independently funded research career at the LMIC institution. The research activities should take place primarily in the LMIC.
• The broader goals of the program are to ensure a career pathway for promising LMIC scientists, to strengthen the intellectual capacity for global health research at foreign institutions, and to foster long-term international research collaborations.

Relevance to FIC Strategic Plan: By supporting early-career LMIC scientists as they transition to independent global health research careers at their home institutions, the Emerging Global Leader Award program fills an important career development need, and it supports all of FIC's strategic goals.  The program builds global health research capacity and invests in LMIC institutions; stimulates the development of locally relevant solutions, supports research in implementation science, advances research on the dual burden of communicable and non-communicable diseases, and  strengthens international research collaborations to advance global health research.
 

Integrating Mental Health Care into Health Care Systems in Low- and Middle-Income Countries (R01 Clinical Trial Optional)

Purpose: : This Funding Opportunity Announcement (FOA) from NIMH (Notice of Intent to Publish a Funding Opportunity Announcement for Integrating Mental Health Care into Health Care Systems in Low- and Middle-Income Countries (R01 Clinical Trial Optional)) will support implementation research focused on developing, optimizing, and testing innovative theory-based strategies to integrate mental and physical health care within health care systems in low-and middle-income countries (LMICs). This FOA is expected to contribute to the long-term goals of strengthening the research capacity in LMICs and enhancing the potential for multidirectional knowledge and the exchange of research advancements with the US and other High-Income countries (HIC). FIC is considering signing on to the FOA as a Partner, with a focus on health disparities in mental health care access and outcomes.

Background: The interaction between mental illness and other chronic diseases is complex, including biological, psychosocial, environmental, and economic factors. Managing these conditions requires a comprehensive approach, integrating mental health treatment into the primary care setting.

Globally, patients that suffer from mental, neurological and substance use disorders are often overlooked by the primary healthcare system, with more than 75% of these patients not receiving the necessary treatments. Furthermore, individuals with mental illness often present with comorbidities that have lower treatment adherence, poorer clinical outcomes, and a higher risk of disability and mortality.  Understanding the potential mechanisms and interactions could help identify more efficacious strategies, interventions, and models of care to simultaneously address mental and co-occurring chronic illnesses. There is a need for research studies that examine the optimal structure and implementation strategies necessary to scale up and sustain integration of mental health services into the primary health care systems in LMICs.

Overview of the Proposed Program:

• Pending additional appropriations to FIC.
• Funding mechanism – R01.
• Up to 5 years of funding.
• Foreign applicants are eligible.
• Projects must be carried out in an LMIC.
• Includes a research capacity requirement.
• Potential focus areas (not limited to):
• Identify and implement an optimal integration model to ensure scalability and sustainability.
• Identify the necessary core elements of integrated mental health care models (e.g., routine screening, training/hiring case manager and consulting, disease registry) to enable the model’s implementation, scale-up, and sustainability.
• Develop and test implementation strategies and innovative health technologies to improve health system-, patient-, and family-level outcomes and ensure the quality of integration.
• Develop and test models and strategies for training, supervising, and supporting providers, including identifying the optimal functions, roles, and composition of integrated care teams to deliver integrated care with fidelity and high quality.
• Test mechanisms of actions/ target mediators of implementation strategies for overcoming barriers to the adoption, adaptation, integration, scale-up, and sustainability of integrated care models.
• Develop and test models and strategies for linking integrated care with other community-based services.
• Develop and test behavioral economic strategies, financing models (payment mechanisms), and health policies that influence the success of scaling up and sustaining the provision of integrated care; by including an integrated care model on the universal health system and a cost-effective bundle of service.
• Determine how an integrated care model can best engage local communities to enhance service user participation (e.g., demand and utilization).
• Examine the independent and complementary or synergistic effects on the mental and physical health outcome of integrated care models with multilevel interventions targeting modifiable conditions (e.g., the structure of the health system, health policies, and other social drivers of mental illness).
• Test strategies that target health system arrangements, such as incentives, regulations, and policies, which may facilitate or deter the availability (supply), accessibility, scalability, and sustainability of integrated care model and test relevant approaches to measure and extract existing data regarding these arrangements.

Current NIH Partners: NIMH and NCI

Relevance to FIC Strategic Plan: 

• Goal 1: Build research capacity through individuals, institutions and networks to meet future and evolving global health challenges
• Goal 3: Support research and research training in implementation science
• Goal 5: Build and strengthen partnerships to advance global health research and research capacity

Addressing Health Disparities in Low- And Middle-Income Countries

Purpose: To identify, characterize, and reduce health disparities (HD) in low- and middle-income countries (LMICs) and to build a diverse biomedical global health research workforce in the US and LMICs to address HDs.

Background: Health Disparities are a major obstacle to health and to access to quality care in LMICs and in the US.  Health disparities are preventable differences in health status and outcomes that adversely affect certain populations. Research on health disparities examines the influence of environment, social determinants, and other underlying mechanisms leading to differences in health outcomes. Disparity populations may include race and ethnic minorities, persons of low socioeconomic status, underserved rural residents, and sexual and gender minorities, among others.  In alignment with FIC’s vision to “reduce the burden of disease, promote health, and extend longevity for all people”, this proposal focuses specifically on obstacles and feasible interventions to reduce HD.  The scope of the proposed HD initiative is broad and includes more inclusive access to and affordability of care; technological solutions to reach all populations; healthy environments and environmental justice; the social determinants of health; elimination of health system, cultural, and systemic barriers to care; reduction of stigma; inclusion of under-represented minorities in clinical research,  biorepository materials, and genomic databases (and dependent risk algorithms and standard of care recommendations), among others.  We also include the importance of a diverse global health research workforce to study and address these disparities.

Overview of Proposed Program: FIC already funds a modest portfolio of grants that address HD within our research, fellowship, and research training programs, although it has not been specifically targeted. We propose to issue a Notice of Special Interest (NOSI) to invite submission of applications on HD to any of our programs. The applications will be reviewed with other applications to each program but awards would be funded through an annual set aside with the goal of increasing the number of awards in HD.  Given the nature of HD, rooted in both individual and population behaviors and biological, social, and physical factors (see: National Institute on Minority Health and Health Disparities Research Framework), we would welcome multidisciplinary approaches and inclusion of non-traditional partners, as appropriate.  HD grantees and trainees from all our programs will be invited to attend annual joint network meetings and workshops to help foster, define, and facilitate a global health HD community.

Relevance to FIC Strategic Plan:

• Goal 1: Build research capacity through individuals, institutions and networks to meet future and evolving global health challenges
• Goal 2: Stimulate innovation in the development and implementation of technologies and other locally relevant solutions to address global health problems
• Goal 4: Advance research on prevention and control of the dual burden of communicable and noncommunicable diseases and disabilities
• Goal 5: Build and strengthen partnerships to advance global health research and research capacity

Ecology and Evolution of Infectious Diseases (EEID) Program

For the published funding opportunity announcement, see the program solitication on the  National Science Foundation website: Ecology and Evolution of Infectious Diseases (EEID) program solicitation (NSF 21-609) . Also see the notice of particpationin the NIH Guide: Notice of NIH Participation in the Ecology and Evolution of Infectious Diseases Program.

Fogarty Global Health Training Program

For the published funding opportunity announcement, see the NIH Guide: Launching Future Leaders in Global Health (LAUNCH) Research Training Program (D43 Clinical Trial Optional)

Interventions for Stigma Reduction to Improve HIV/AIDS Prevention, Treatment and Care in Low- and Middle- Income Countries

For the published funding opportunity announcement, see the NIH Guide: Interventions for Stigma Reduction to Improve HIV/AIDS Prevention, Treatment and Care in Low- and Middle- Income Countries (R01 - Clinical Trial Optional)