It is one of the most enduring axioms of comedy, politics and romance: "Timing is everything." So, too, it was everything when the Fogarty International Center launched its vaunted Framework Programs for Global Health in 2005.
The recent announcement of the third cohort of prestigious Fogarty Framework grants completes one cycle in the challenge of drawing disparate academic disciplines together in a program that has succeeded beyond its original intentions.
Telemedicine is a specialty of the University of Texas
Medical Branch, recipient of a Framework award.
With global health suddenly a sought-after field of study from the undergraduate to postdoctoral level, the program is building girders of support at 31 universities by nudging faculty, who might never have crossed the quad to meet one another, to create new multidisciplinary curricula.
As a result anthropologists and engineers, JDs and MBAs, physicians and communicators are collaborating on public health projects around the world.
"Campuses have seen a dramatic surge of interest in global health," says Fogarty Director Dr. Roger I. Glass. "These awards have enormous impact, despite their modest size," he says. "They provide the catalyst to transform global health programs by leveraging and enhancing existing resources, fostering innovative research collaborations and creating new foreign research training opportunities."
Program director Dr. Flora Katz explains, "Our money was to be used to allow faculty to devote time and creativity," leaving the universities to do what they do best--teach the curriculum.
Framework is the epitome of Fogarty's mission to build capacity not only in low- and middle-income countries but among U.S. researchers and foreign scientists who come to America for training. "We want to create a pipeline of young scientists who go into global health," says Katz.
Beyond serving the student demand, Framework has resulted in an informal network of global health programs in the United States and in three foreign sites in Peru, Mexico and China. "It was meant to be catalytic, and it was. It was transformative at a time money was coming into the field."
Recipients call the program indispensable to their university's efforts to win more money from other sources and to provide students clamoring for global health training with foreign research experience.
Johns Hopkins, the oldest and largest U.S. university addressing global health issues, used its Framework grant not only to pull together faculty from a number of schools and departments on two different campuses but to develop courses for undergraduates.
The program, which combines curricula from the schools of medicine, nursing and public health, also awards travel grants to both graduates and undergraduates on a competitive basis, with matching funds raised by the university's Center for Global Health.
When Hopkins received its Framework grant three years ago, public health had become the No. 1 major among Arts & Sciences undergraduates. "The timing was perfect," says Center director Dr. Thomas C. Quinn. "It's one of the best grant mechanisms that Fogarty has ever launched for American universities," he said, noting that in contrast to other programs shared among NIH institutes and centers, "This one really has Fogarty's name written all over it."
Principle investigator Dr. James Tielsch says Hopkins also used the grant to establish undergraduate courses at a nearby public university campus. "If we want to build a constituency for global health issues in the United States, then we have to increase awareness among the educated population," he said.
The University of Virginia used part of its Framework grant to develop 12 new courses across the campus. One of them, "Financing a Sustainable Future," teamed a professor of commerce and infectious diseases professor who went to Tanzania with a group of students from a variety of disciplines. They looked into establishing a business there for the production of HIV testing kits, which are prohibitively expensive to import. Working closely with Tanzanian students, the group created a business plan to build a factory and formed a foundation to raise seed money.
Program co-directors Dr. Rebecca Dillingham and Dr. Richard Guerrant stress that the Framework program not only advances global health research, it also directly benefits individual students and faculty.
International collaboration literally bore fruit in one case, Dillingham recounts. As a result of coursework on urban agriculture in foreign countries, students presented their findings to the city council and established a consortium to reduce the costs of locally grown food for all residents of Charlottesville.
As for faculty, Guerrant said, "Just applying for (an award) has transformed our institutions. It really is breaking us out of our silos for our own good."
The University of California, San Diego's Dr. Steffanie Strathdee notes that her Framework site is the closest U.S. city to a developing country, sharing a border with Tijuana, Mexico. The proximity offers a unique opportunity for her students to get practical experience with global health issues, particularly the cross-boundary spread of narcotics and sexually transmitted infections.
But the larger part of the San Diego Framework is the creation of a joint doctoral program between UCSD and San Diego State University, schools that had difficult, but eventually surmountable, institutional hurdles to clear. "Global health is so popular as a field that students heard about it through the grapevine and were applying before the ink was even dry on the announcement," Strathdee said.
She is also working with others in California to create a university system-wide global health program involving all 10 UC campuses.
Tufts University created a global health concentration in the MPH program, bringing together not only the medical, veterinary and engineering schools but the renowned nutrition and diplomacy schools. It quickly became the most popular concentration, says program director Dr. Jeffrey K. Griffiths.
Tufts has partnerships with universities in Tanzania, Uganda and Kenya and uses an electronic library and other information technology to co-develop curricula. "We're building capacity to share content and share discussion", says Griffiths. "Faculty have to change the way they're teaching, and students push the faculty to start using electronic means to get content up on the Internet."
In eastern Africa, where there is a dearth of research, "We sort of turned something on its head. We've been working on a network of like-minded people to create educational networks that can become research networks." He credits students for "cementing the relationships between institutions."
Planning is under way for a successor to the Framework program, and Fogarty's Katz says, "We don't want to lose the momentum these programs have generated on their own campuses."