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Q&A: Christine Sizemore, PhD: A pragmatic perspective on global health
July/August 2025 | Volume 24 Number 4
Photo courtesy of Christine Sizemore
Christine Sizemore
Christine Sizemore, PhD, retired from her position as the director of
Fogarty's Division of International Relations (DIR) on April 30. Her career began in the biopharmaceutical industry, where she worked in drug discovery and development. Prior to joining Fogarty in 2018, she spent 18 years at the
National Institute of Allergy and Infectious Diseases (NIAID) as chief of the Tuberculosis, Leprosy and Other Mycobacterial Diseases section. Sizemore received her master’s degree in Biology and her Ph.D. in Bacterial Genetics from the Friedrich Alexander Universität in Erlangen, Germany.
Why did you become a scientist?
Even as a little kid I was more of a nature person than a people person, so I had an interest in biology from the start. My sister became a medical technologist, working in bacteriology, so that became interesting to me as well. I studied general biology up until my master's, then I specialized and got my PhD in bacterial genetics. Becoming a scientist, actually a biologist, was always the only thing I could ever imagine doing.
You began your career in industry. Tell us about that.
In Germany, I began doing applied laboratory research during my master's degree program, and I quickly realized that I wasn't that interested in fundamental research, so I focused both my thesis and PhD dissertation on applied science. I'm very practical, very pragmatic, so applied science made sense to me. When I came to the U.S., I thought I’d do a postdoc, but lasted exactly six weeks! I immediately began looking for a job in the biotech sector and landed my first position with a small drug discovery company in Tucson, Arizona. I lived and worked there, focusing on metabolic diseases and anti-infectives, from 1992 until 1996.
Next, I moved to the east coast to work at DuPont Pharmaceutical Company reviving their antimicrobial discovery program. I had the privilege of leading the team and expanding into preclinical models and animal studies for anti-infectives.
So I started in academia with basic science, moved through various translational areas, and then moved all the way up to clinical studies while working in pharmaceutical companies. Then, I took all that I'd learned in academia and industry and began working for the government in 2000.
What was your first job at NIH?
I started as a program officer in the tuberculosis (TB) program at the National Institute of Allergy and Infectious Diseases (NIAID) in 2000. It was an opportunity to work on a much larger scale and on the full spectrum of research and product development for TB and other mycobacterial diseases. Along with being practical, I like seeing and making connections and figuring out strategy to fill gaps in knowledge in the most straightforward and practical way. The job fit me to a T.
At first, there were just two of us, but once we began to strategically grow the program and more program officers and medical officers joined the team, we became a Section within the Division of Microbiology and Infectious Diseases, and I was named Section Chief. I remained in that role until I became the director of DIR in 2018.
What did you accomplish at DIR?
When you’re a manager, there are jobs that you would like to do because they interest you, and then there are the jobs you should do because they aren't already taken by someone else and need to be done. Initially, I thought that I'd work with international organizations on developing partnerships, but I could see that Fogarty’s regional program directors were experts in their regions. So I focused more on NIH internally:
How is international research at NIH coordinated? Are we at the table where we should? Do we have workflows and processes that make sense? How do you coordinate DIR’s internal-facing work to complement the regional program offices’ external-facing work? Are we working in the best interest of NIH and the Institutes and Centers?
My vision for DIR was to go beyond the existing services we provided at NIH and fully realize the purpose and potential of an international office at NIH. I wanted to make Fogarty more visible for what it does beyond its scientific mission and provide critical input into NIH operations through the insight we in DIR were able to gain. DIR works on behalf of all of NIH and so has a much broader perspective than an individual Institute or Center—it has a real global view, in essence and in the context of NIH as a government organization. I also put effort into standardizing and smoothing the processes of the regional program officers in order to facilitate their work and to help remove challenges and obstacles. I hope I was able to implement this vision reasonably well during my time at Fogarty.
Do Americans benefit from NIH-funded research in low- and middle- income countries (LMICs)?
When I was at NIAID, I worked a lot with LMICs, because TB is a disease of poverty. I learned very quickly that the way scientists from lower resource countries think and the way they approach challenges is more pragmatic and often more outcome oriented. What we call “neglected diseases” are very real for them and any solutions they can develop will have real impact for their communities. They see interventions or programs that work at the local level as worthwhile, even if they do not scale globally. This has been a challenge for some very innovative projects criticized for not being “global enough” despite making a huge difference for local communities.
This practical thinking is a great complement to the science that is conducted in richer countries where doing research is not uncommon.
If we want to crack the hard nuts in research, then the two sides must work together—the pragmatists and the technologists. Collaborations between low- and high- income countries give investigators a lot of technological access, including large data centers and large infrastructure, all of which are necessary to holistically tackle a problem. But when it comes to direct patient outcomes and impact, you need to start with the pragmatism of LMIC researchers who have the experience and insights into what is needed to make prevention, diagnosis or cure a reality.
What do you tell global health researchers?
We would do well by communicating outside a narrowly-focused cluster of like-minded individuals. For example, try to explain the relevance of your scientific work to your non-scientific neighbors and take their questions seriously. If you can’t answer,
Why does that matter? in a way that resonates with them, then more introspection may be needed.
To really understand a disease and what it means, you need to go to where it is. My first trip to Africa showed me what it means to have TB as a patient, as a community and what TB means for healthcare providers—what infrastructure is available, what it takes to get your drugs and finish months’ worth of treatment, and what nurses, doctors, community health workers and families do to help patients. That immediately puts a different perspective on the utility of a fancy, sensitive diagnostic machine vs. a low tech, easy to use, fast diagnostic test.
After that trip, I never thought about my job in the same way again.
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Updated August 20, 2025
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