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This NIH program is crucial to global health — and its future is in danger
Co-authored with Madhukar Pai, MD, a Canada Research Chair in Epidemiology and Global Health at McGill University in Montreal.
A little-noticed cut in President Trump’s proposed “budget blueprint to make American great again” would eliminate the Fogarty International Center, which is part of the National Institutes of Health. That would be a big mistake for the United States and the rest of the world.
The center, named after John E. Fogarty, a Republican representative from Rhode Island and longtime advocate for international health research, was created in 1968. Since then it has initiated and sustained research around the globe aimed at fighting polio, tuberculosis, AIDS and other infectious diseases, as well as focusing on global environmental health, bioethics, noncommunicable diseases and more. Through more than 400 research and training projects, the center has trained well over 5,000 scientists worldwide and involved more than 100 American universities. This is an incredible global footprint, by any metric.
We have a strong allegiance to, and memories of, the Fogarty. One of us (Arthur Reingold) was a program director for the center. The other (Madhukar Pai) was a Fogarty-funded international scholar. We have seen its impact on entire countries, on individuals and on us.
Here’s one example of the center’s work to improve global health. In response to the growing HIV/AIDS pandemic in 1998, which was disproportionately affecting the world’s poorest countries, the Fogarty Center started the AIDS International Training and Research Program. It aimed to address the devastatingly inadequate research capacity of the developing countries that were worst hit by this rapidly growing epidemic, along with tuberculosis and other opportunistic infections.
Through a competitive process, the NIH initially awarded six grants to U.S. academic centers to work closely with academic and public health partners in the worst-affected countries. Their mission was to provide highly focused research training and build research capacity in those countries. Today there are dozens of such programs. They benefit academic institutions, researchers, foreign and domestic trainees, and patients in many countries. The AIDS International Training and Research Program has provided significant research training to more than 2,000 individuals from more than 100 countries.
The training provided by these programs has supported many of the pivotal studies of HIV/AIDS prevention, control, and treatment strategies that have since become the cornerstone of highly successful interventions that have helped stem the tide of the global pandemics of HIV/AIDS, tuberculosis, and related conditions. Fogarty-funded research provided the underpinning to the highly successful US President’s Emergency Plan for AIDS Relief (PEPFAR) program initiated by President George W. Bush.
The result has been the prevention of countless HIV infections and HIV/AIDS-related deaths in dozens of countries around the world, as well as the training of thousands of health researchers and the strengthening of scores of foreign and US academic institutions.
Based on this model, the Fogarty International Center initiated equally successful collaborative research training initiatives focused on emerging infectious diseases, environmental and occupational illnesses, reproductive health, and noncommunicable diseases, among others.
I (Arthur Reingold) had the extraordinary good fortune to have served as the director of a Fogarty-funded program at the University of California, Berkeley. It worked in close partnership with the University of California, San Francisco; the health departments of the state of California and the city and county of San Francisco; and numerous foreign academic institutions.
For almost 30 years, our program trained hundreds of gifted physicians, nurses, pharmacists, dentists, and biomedical researchers from countries as diverse as Brazil, Peru, China, India, Vietnam, Thailand, Uganda, Zimbabwe, Ivory Coast, Kenya, the Democratic Republic of Congo and Sudan. More than 95 percent of those who came to the U.S. for training returned home afterward and either continued to work in the same region or worked for international health organizations such as the World Health Organization, UNICEF, or the U.S. Centers for Disease Control and Prevention.
Trainees from the Berkeley program have gone on to become directors of the national HIV/AIDS programs in their respective countries; senior officials at the Joint United Nations Program on HIV/AIDS (UNAIDS) and the Pan American Health Organization; influential researchers at the CDC; the inaugural director of the newly created Africa CDC; and numerous deans and professors at leading academic institutions around the world.
The Fogarty Center also benefitted U.S. scientists and institutions. It taught numerous American trainees from across the