Fogarty Funding Concepts

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)