Sunday, November 1, 2009

Investing in Global Health

The Obama Administration has pledged $63 billion for the “Global Health Initiative” and is now moving ahead with projects. For example, a newly created high level Trans-NIH Global Health Research Working Group is the result of a two year effort to analyze global health research activities at NIH and to find better ways to coordinate efforts across NIH and throughout the government.

Participants in the working group will focus on three overarching issues such as improving data collection on NIH international activities, ensuring that clinical trials supported by NIH meet the highest possible standards no matter where they take place, and discuss the best ways for NIH to play a strategic role in global health activities.

One of the road blocks to having all the data is that foreign sites that receive direct awards from NIH are in the system but foreign components of domestic awards are not. This means that the database needs to be strengthened so that the funding gaps can be understood according to Dr. Sally Rockey, Acting Director of Extramural Research at NIH.

In another effort, NIH’s Fogarty International Center is going to award more than $9.23 million to eight global health informatics programs over the next five years. The Fogarty “Informatics Training for Global Health” program is in place to increase informatics expertise in low and middle income countries, to train scientists to design information systems, and to apply computer supported management and analysis to biomedical research.

The grants are being awarded to both new and ongoing informatics programs at various international sites:

• The University of Pittsburgh and Javeriana University in Bogota, Columbia will educate more individuals in health informatics with an emphasis on clinical research

• Oregon Health and Science University will combine their informatics and epidemiology program with the Italian Hospital in Buenos Aires, Argentina, to focus on clinical and translational research informatics

• The Andean Global Health Informatics Research and Training Center administered by the Cayetano Heredia University in Lima Peru, will have participation from the U.S. Naval Medical Research Center Detachment in Lima, University of Cauca in Colombia, Andia University of Simon Bolivar in Ecuador, and the University of Washington in Seattle.

• The University of Georgia, the Oswaldo Cruz Foundation Rene Rachou Research Institute, the Federal University of Minas Gerais in Belo Horizonte, Brazil, and the Oswaldo Cruz Institute in Rio de Janeiro, will expand into bioinformatics, epidemiology, and molecular evolution

• The University of California, San Diego will support the Biomedical Research Informatics for Global Health Training Program and help the South network to expand

• Vanderbilt University will support a new informatics training partnership with two leading research institutions in India, to include the National AIDS Research Institute in Pune, and the National Institute of Epidemiology in Chennai

• The University of KwaZulu-Natal in South Africa will develop research and training capacity in informatics through a Pan-African collaborative initiative involving institutions in Uganda, South Africa, and Zimbabwe

• The East African Center of Excellence in Health Informatics is going to be resource for improving health informatics and clinical research in sub-Saharan Africa

Technology is also playing an important role in the Fogarty Challenge Grants now available with Recovery Act funding. The goal is to study chronic diseases, climate change, emerging technologies, and the effect of cultural beliefs on health. “These grants will help support cutting edge research in priority areas and help scientists explore new ways to leverage emerging technologies to improve human health, “said Fogarty Director Dr. Roger I. Glass.

Funding for one project at the University of Alabama at Birmingham will focus on long distance communication and distance learning applications. The project will develop four courses which will be offered over a two year period to 150 study coordinators at various international sites. The approach will be to have internet-based classes, courses on CD-ROM, podcasts, and text messaging.

Another study will analyze how electronic protocols might improve adherence by healthcare providers and patients. The study to be carried out by Dr. Marc Mitchell of Harvard University and his team, have designed software that can guide providers through electronic protocols related to childhood illnesses.

According to Dr. Mitchell, the software can be operated on a PDA or cell phone and help providers avoid skipping steps or arriving at an inaccurate diagnosis. The study is going to be carried out in Tanzania Evangelical Lutheran Church clinics since they currently use paper based protocols to treat children.