NIAID Global Research: 


Improving Health in a Changing World
 

NIAID

National Institute of Allergy and Infectious Diseases
 

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 

National Institutes of Health 
CONTENTS 

2 Foreword 

4 About NIAID 

6 NIAID’s International Involvement: 

Taking the Lead To Improve Global Health Research 

8 Confronting the Global AIDS Pandemic 

 

 

 

10 Responding to Emerging and Re-Emerging Threats 

10 Tuberculosis 

12 Malaria 

14 Influenza 

16 Calling Attention to Neglected Tropical Diseases 

17 Improving Understanding of the Immune System 

18 Funding Opportunities for Foreign Scientists 

and Institutions 

20 Training Opportunities for Foreign Scientists 

21 NIAID Contact 
 

 

National Institute of Allergy and Infectious Diseases
 

NIAID Global Research: 


Improving Health in a Changing World
 

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 

National Institutes of Health 

National Institute of Allergy and Infectious Diseases 

NIH Publication No. 11-6433 

February 2011 
NIAID I FOREWORD 

Foreword 

Although infectious diseases have always affected 

humankind, increasingly we have come to appreciate how infections that emerge even in remote 

parts of the globe can spread quickly to affect 

health, security, and economic stability throughout the entire world. While medical science and 

public health campaigns have greatly reduced or 

eliminated certain diseases such as polio and smallpox, other diseases such as influenza and emerging 

forms of drug-resistant tuberculosis remind us that 

the struggle against infectious diseases continues. 

In this regard, continuing vigilance and an ongoing 

commitment to biomedical research is required for 

the development of appropriate tools for diagnosis, 

treatment, and prevention of emerging threats. 

The recognition of HIV/AIDS approximately 

30 years ago signaled the beginning of a new era 

in global health. Although first diagnosed in the 

United States, HIV/AIDS soon was found in populations throughout the world—with the highest 

infection rates in developing countries. Today, an 

estimated 33 million people are infected with HIV. 

Of these, more than 90 percent live in low- and 

middle-income countries. 

As governments, nongovernmental organizations, 

and philanthropic entities have responded to the 

HIV/AIDS crisis, attention also has begun to focus 

on many other devastating diseases that afflict 

people in poorer nations, often in tandem with 

HIV/AIDS. For example, tuberculosis killed 

approximately 1.7 million people in 2009, 380,000 

of whom also were infected with HIV. An estimated 225 million cases of malaria occurred in 2009, 

resulting in more than 780,000 deaths. Parasitic 

diseases such as schistosomiasis, leishmaniasis, 

trypanosomiasis, and filariasis, while rare or 

eliminated in many wealthier nations, continue to 

cause severe illness, disability, and death each year 

among millions of people worldwide. 

Recently, the world again experienced the direct 

impact of a rapidly spreading, emerging infectious 

disease when the pandemic 2009 H1N1 influenza 

virus infected people in more than 214 countries 

and territories. A concerted global public health 

response resulted in the development and distribution of safe and effective vaccines that protected 

millions of people. Furthermore, in the past year, 

outbreaks of cholera, dengue fever, polio, plague, 

and meningococcal disease have occurred in many 

parts of the world, particularly where public health 

systems do not have adequate resources to deliver 

preventive and medical services. Finally, the danger 

of a sustained outbreak of H5N1 influenza (bird 

flu) among humans still remains. 

To meet such challenges, NIAID has for more 

than six decades supported research to better 

understand, treat, and prevent infectious diseases 

of global health importance. We have been 

privileged to enjoy the generous support of the 

American people, Congress, and presidential 

administrations. Of note, President Obama 

recently launched the Global Health Initiative 

(GHI), which recognizes that public health is an 

essential component of international economic 

and social stability. The GHI gives particular 

attention to the welfare of women and girls, and 

its prevention and care strategies rely in part on 

knowledge derived from research supported by the 

National Institutes of Health (NIH). Several GHI 

target areas—HIV/AIDS, tuberculosis, malaria, 

and neglected tropical diseases—are key foci of the 

NIAID research program. 

2 
 

Anthony S. Fauci, M.D. 

NIAID and our sister agencies at NIH contribute 

to the GHI through continuing support of research 

that provides the knowledge and tools needed to 

make real improvements in disease prevention, control, and treatment. Much has been accomplished 

in recent months. In one important study, NIAIDsupported investigators demonstrated that a daily 

dose of an oral antiretroviral drug approved to 

treat HIV infection could reduce the risk of HIV 

acquisition among men who have sex with men. In 

other HIV prevention research, scientists sponsored 

by the U.S. Agency for International Development 

found that women using a vaginal microbicide gel 

containing an antiretroviral drug were less likely to 

become infected with HIV than women receiving a 

placebo gel. Both of these studies used the extensive research and training infrastructure established 

by NIAID. 

These and similar studies are possible when governments and academic institutions work with 

research organizations such as NIAID to enhance 

and sustain local laboratory and clinical research 

capacity. Many countries now recognize biomedical and infectious disease research as an engine 

of economic growth and improved public health. 

Therefore, they are increasingly investing in the 

hiring and training of local workers and collaborating with NIAID and other scientific organizations. 

NIAID remains deeply committed to supporting 

international research partnerships that are mutually beneficial and scientifically productive. For 

example, in 2009, representatives from NIAID and 

China’s Henan Provincial Bureau of Health signed 

an implementation arrangement to foster research 

on tuberculosis, including clinical research on new 

treatments for multidrug-resistant tuberculosis. 

NIAID also recently established the International 

Centers of Excellence for Malaria Research program 

to expand basic and clinical research capacity in 

malaria-endemic areas. NIAID views international 

research and partnerships as fundamental to its 

mandate and essential for global efforts to manage, 

control, and eliminate infectious diseases. In 

addition to infectious disease challenges, NIAIDsupported investigators continue to pursue research 

opportunities to reduce the global burden of 

immune-mediated diseases, including autoimmune 

disorders and allergy and asthma. 

We celebrate our successes, while acknowledging 

the enormous challenges that lie ahead. Global 

health research is a priority for NIAID, and we are 

confident that our sustained cooperative efforts 

will continue to help improve the health of citizens 

throughout the world. 

Anthony S. Fauci, M.D. 

Director 

National Institute of Allergy 

and Infectious Diseases 

NIAID I IMPROVING HEALTH IN A CHANGING WORLD 

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About NIAID
 

The National Institute of Allergy and Infectious Diseases 

(NIAID) is one of the 27 institutes and centers that constitute 

the National Institutes of Health (NIH), an agency of the U.S. 

Department of Health and Human Services (HHS). NIAID is one 

of the largest institutes at NIH, with an operating budget of 

approximately $4.5 billion in fiscal year 2010. More than 

11 percent of the NIAID operating budget supports international 

research and training, and NIAID is one of the few NIH institutes 

to have an Associate Director for International Research Affairs 

to facilitate international activities. 

As with other large NIH institutes, most of the NIAID budget 

supports biomedical research at academic and research institutions outside NIAID through grants, contracts, and cooperative 

agreements (called extramural research). The remaining budget 

funds research within NIAID’s own laboratories (called intramural 

research) and supports administrative functions. 

NIAID Extramural Research 

Extramural research is managed by the following NIAID divisions: 

•	 Division of Acquired Immunodeficiency Syndrome— 

supports research aimed at improving basic understanding, 

prevention, and treatment of HIV/AIDS and its complications 

and co-infections. 

•	 Division of Allergy, Immunology, and Transplantation— 

supports research on basic immunology and the etiology, 

treatment, and prevention of immune-mediated conditions, 

including autoimmune diseases; asthma and allergic diseases; 

and the rejection of transplanted organs, tissues, and cells. 

•	 Division of Microbiology and Infectious Diseases— 

supports research to control and prevent diseases caused by 

virtually all human infectious agents except HIV; major priorities include emerging and re-emerging infectious diseases 

and biodefense. 

•	 Division of Extramural Activities—serves NIAID and its 

extramural research community by overseeing policy and 

management for grants and contracts, managing NIAID’s 

research training and international programs, and conducting 

initial peer review of grant applications. 

NIAID I ABOUT NIAID 

4 

NIAID supported biomedical research 

in more than 100 countries during 

fiscal year 2010. 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

NIAID Intramural Research 

Most NIAID intramural laboratories are located on the 

NIH campus in Bethesda, Maryland, and in nearby 

Rockville, Maryland. NIAID also has a large research campus in Hamilton, Montana, known as the Rocky Mountain 

Laboratories, and research collaborations at sites in Mali, 

Uganda, India, and many other countries. 

The NIAID intramural program includes the following divisions: 

•	 Division of Intramural Research—conducts basic and clinical research in a wide range of disciplines related to immunology, allergy, and infectious diseases. Its global activities 

include HIV, malaria, and dengue vaccine development; 

research to develop better therapies for tuberculosis; and 

lab and field research on neglected tropical diseases, such 

as filariasis and leishmaniasis. 

•	 Dale and Betty Bumpers Vaccine Research Center— 

conducts research that facilitates the development of effective 

vaccines for human disease. Its global activities include studies on HIV, Ebola and Marburg viruses, and avian influenza. 

•	 Division of Clinical Research—facilitates the efficient 

performance of NIAID clinical research programs in the 

United States and abroad. Its global activities include support for research projects in Mali, Mexico, South Africa, and 

Southeast Asia. 

NIAID Office of Global Research 

The Office of Global Research (OGR), within the NIAID Office 

of the Director, facilitates and coordinates international activities and collaborative research programs. OGR works closely 

with other NIH institutes and centers such as the Fogarty 

International Center and with other offices and agencies of 

HHS, including the Office of Global Health Affairs within the 

Office of the Secretary, the Centers for Disease Control and 

Prevention, and the Food and Drug Administration. OGR also 

collaborates with other U.S. government agencies, such as 

the Department of State and the Agency for International 

Development, and with numerous foreign government agencies. 

Online Resources 

NIAID Organization 

www.niaid.nih.gov/about/organization 

NIAID Director’s Page 

www.niaid.nih.gov/about/directors 

NIAID Global Research 

www.niaid.nih.gov/topics/globalresearch 

Office of Global Research 

www.niaid.nih.gov/about/organization/odoffices/omo/ogr 

Division of Acquired Immunodeficiency Syndrome 

www.niaid.nih.gov/about/organization/daids 

Division of Allergy, Immunology, and Transplantation 

www.niaid.nih.gov/about/organization/dait 

Division of Clinical Research 

www.niaid.nih.gov/about/organization/dcr 

Division of Extramural Activities 

www.niaid.nih.gov/about/organization/dea 

Division of Intramural Research 

www.niaid.nih.gov/about/organization/dir 

Division of Microbiology and Infectious Diseases 

www.niaid.nih.gov/about/organization/dmid 

Vaccine Research Center 

www.niaid.nih.gov/about/organization/vrc 

NIAID I IMPROVING HEALTH IN A CHANGING WORLD 

5 
NIAID I INTERNATIONAL INVOLVEMENT 

NIAID’s International Involvement: 

Taking the Lead To Improve Global Health Research
 

I

ssues related to global health have captured 

the attention of world leaders, philanthropists, 

policy makers, academia, and the general public. Developed nations have realized that disease 

outbreaks in distant countries can have worldwide 

social, economic, and political ramifications. 

This heightened awareness has presented a welcome opportunity for those in biomedical research 

and public health to emphasize international collaboration and promote new and existing global 

health programs. 

NIAID has embraced its leadership role in global 

health with innovative scientific research programs that seek to not only advance knowledge of 

ever-changing pathogens, but also help translate 

new scientific discoveries into medical tools that 

improve diagnosis, prevention, and treatment of 

infectious diseases. 

NIAID accomplishes its mission by fostering 

collaborations between domestic and international scientists and by supporting development 

of research capacity in regions with high burdens 

of disease. Through partnerships with academia, 

private industry, philanthropic organizations, and 

other research-supporting agencies, NIAID helps 

guide and enhance medical research that improves 

the quality of human life around the world. 

6 
ICER Program Fosters Research Collaborations in Developing Countries 

The NIAID International Centers for Excellence in Research (ICER) 

program was launched in 2002 to develop and sustain research 

programs in resource-poor countries through partnerships with 

local scientists. NIAID has developed core programs at the ICER 

sites—currently located in Mali, Uganda, and India—and, over 

time, has facilitated the expansion of research capacity by training 

young scientists, improving laboratory and clinical infrastructure, 

and enhancing information technology capabilities. 

The ICER program builds on experience gained from NIAID’s longstanding malaria research collaboration with scientists in Mali. 

Initially, the collaboration focused on the genetics of malaria mosquitoes, but it has expanded significantly over the years. 

Today, Malian researchers collaborate with NIAID scientists on 

multiple projects, including studies on mosquito vectors, malaria 

drug resistance, and candidate malaria vaccines; research on 

neglected tropical diseases such as filariasis and leishmaniasis; 

and immunologic and microbiologic studies of patients co-infected 

with HIV and tuberculosis. NIAID and Malian colleagues have 

recently initiated research programs on relapsing fever and 

Lassa fever. 

The ICER site in Uganda, which includes a state-of-the-art field 

laboratory in the Rakai District and facilities at Makerere University 

in Kampala and the Uganda Virus Research Institute in Entebbe, 

conducts basic and clinical research on HIV and sexually transmitted infections, including studies on viral pathogenesis, transmission 

kinetics, treatment, and prevention. The ICER site in India, located 

at the Tuberculosis Research Centre in Chennai, conducts collaborative studies on filariasis and, more recently, on tuberculosisfilarial and HIV-filarial co-infections. 

NIAID I IMPROVING HEALTH IN A CHANGING WORLD 

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THROUGH PARTNERSHIPS WITH ACADEMIA, PRIVATE 

INDUSTRy, PHILANTHROPIC ORGANIzATIONS, AND 

OTHER RESEARCH -SUPPORTING AGENCIES, NIAID 

HELPS GUIDE AND ENHANCE MEDICAL RESEARCH 

THAT IMPROVES THE qUALITy OF HUMAN LIFE 

AROUND THE WORLD. 
Confronting the Global AIDS Pandemic
 

S

ince its recognition in 1981, AIDS has 

claimed approximately 30 million lives, the 

majority of them in the developing world. 

While extraordinary scientific, medical, and 

public health accomplishments have been made 

in the battle against HIV/AIDS, major challenges 

remain, especially in the delivery of therapies and 

prevention tools to the resource-poor countries that 

need them the most. 

NIAID played an important role in the design 

and early implementation of the President’s 

Emergency Plan for AIDS Relief and continues 

to serve as a scientific partner for that program. 

NIAID has led much of the research that supports 

the program, engaging scientists from all parts of 

the world and many U.S. biomedical and public 

health research institutions. 

NIAID’s investment in HIV/AIDS research has 

generated promising findings in preventing and 

treating HIV/AIDS and in advancing scientific 

understanding of the disease. In 2010, a study 

cosponsored by NIAID and the Bill & Melinda 

Gates Foundation and conducted at 11 sites in 

Brazil, Ecuador, Peru, South Africa, Thailand, and 

the United States found that a daily dose of an 

oral antiretroviral drug approved to treat HIV 

infection reduced the risk of HIV acquisition 

among men who have sex with men by 44 percent. 

The study, known as iPrEx, found even higher 

rates of effectiveness, up to 73 percent, among 

study participants who adhered most closely to the 

daily drug regimen. This landmark finding 

followed closely on the heels of another breakthrough international study, CAPRISA 004, which 

found that the use of a microbicide gel containing 

a 1 percent concentration of the antiretroviral drug 

tenofovir resulted in 39 percent fewer HIV infections 

compared with a placebo gel. NIAID was among 

the organizations that provided substantial support 

and resources to establish the infrastructure and 

training for the Centre for the AIDS Programme 

of Research in South Africa, which conducted the 

study. Ongoing and future clinical trials will build 

on these study results with the goal of bringing a 

safe and effective microbicide to the general public. 

Conducting AIDS research in international settings 

allows NIAID-supported scientists to study the disease under a variety of environmental and social 

conditions. For example, the NIAID-funded HIV 

Prevention Trials Network (HPTN) comprises more 

than 20 clinical sites in the United States, Africa, 

Asia, and South America. HPTN evaluates the 

effectiveness of multiple HIV prevention strategies— 

from the use of antiretroviral therapy to prevent 

HIV and other sexually transmitted infections to 

community education and counseling—in different 

populations to better understand and ultimately 

control the spread of HIV on a global scale. 

8 NIAID I CONFRONTING THE GLOBAL AIDS PANDEMIC 

 

 

 

 

 

 

 

 

 
 

Clinical Trials Network Evaluates Microbicides To Reduce Spread of HIV 

Women and girls account for half of all people living with HIV, 

according to UNAIDS estimates. In 2009, HIV/AIDS was the 

leading cause of disease and death among women between the 

ages of 15 and 44. Globally, the vast majority of women with 

HIV/AIDS became infected through heterosexual intercourse, 

frequently in settings where refusing to have sex or insisting on 

condom use is not an option because of cultural factors, lack of 

financial independence, and even the threat of violence. 

In response to these and other issues, NIAID established the 

Microbicide Trials Network (MTN) in 2006 to develop and evaluate products that could be applied topically by women to prevent infection with HIV and other sexually transmitted agents. 

Safe and effective microbicides would give women the ability 

to protect themselves when negotiating with sexual partners is 

difficult or impossible. 

The MTN conducts its multicenter studies at sites in Malawi, 

South Africa, Uganda, zambia, zimbabwe, India, and the United 

States. Its international trials include the Vaginal and Oral 

Interventions to Control the Epidemic (VOICE) study, which 

compares the safety and effectiveness of a microbicide to preexposure prophylaxis (PrEP), another experimental approach to 

HIV prevention. PrEP involves administering antiretroviral drugs 

to uninfected people who are at high risk of HIV infection. Like 

microbicides, PrEP is viewed as a potential HIV prevention method that women can use independently and proactively. VOICE 

will evaluate these experimental approaches in 5,000 women at 

sites in South Africa, Uganda, zambia, and zimbabwe. 

The MTN is structured to allow for active representation and 

participation by community stakeholders in every stage of clinical study development and implementation. In addition to including a community representative on its executive committee, the 

MTN has established a Community Working Group (CWG), comprising one Community Advisory Board member and one community educator from each site. The CWG aims to ensure the 

successful conduct of studies through community and researcher 

partnerships and to build capacity within local communities for 

providing input into the planning and conduct of MTN trials. 

As part of its effort to be more responsive to the needs and 

perspectives of local communities, the MTN also has adopted 

the Regional Physician Model, a successful component of the 

Bill & Melinda Gates Foundation-funded Partners in Prevention. 

Regional physicians are the MTN’s local ambassadors in Africa, 

providing support to clinical sites and educating local providers 

and community groups about microbicide research, MTN-specific 

trials, and safety measures designed to protect all trial participants. 

WOMEN AND GIRLS ACCOUNT FOR HALF OF 

ALL PEOPLE LIVING WITH HIV, ACCORDING 

TO UNAIDS ESTIMATES. 

NIAID I IMPROVING HEALTH IN A CHANGING WORLD 

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Responding to Emerging and Re-Emerging Threats
 

S

cientists have made extraordinary progress 

toward containing or nearly eliminating 

many infectious diseases, such as diphtheria, 

tetanus, polio, and measles. Despite these 

advances, the world still faces numerous threats 

from new microbes that emerge naturally and from 

familiar pathogens that re emerge with enhanced 

properties or in unusual settings. Tuberculosis, 

including drug resistant forms, and influenza viruses 

with pandemic potential are of particular concern. 

NIAID research programs combating these threats 

emphasize collaborations with domestic and inter 

national partners to improve knowledge; stimulate 

the pipeline of new drugs, diagnostics, and preven 

tive measures; and enhance existing research infra 

structure to effectively confront outbreaks where 

they occur. 

Tuberculosis 

In 2009, an estimated 9.4 million new cases of 

tuberculosis (TB) were reported worldwide, and 

an estimated 1.7 million people died of the disease. 

Antiquated techniques for diagnosing TB, complex 

drug regimens, an increase in the prevalence of 

multidrug-resistant (MDR) and extensively drugresistant (XDR) strains of Mycobacterium tuberculosis, and the interplay between TB and HIV/AIDS 

continue to present major challenges to effective 

TB control. 

NIAID TB research programs include domestic 

and international efforts to develop new tools and 

strategies to help control TB. NIAID is leading and 

sponsoring research activities to create a founda 

tion of knowledge for the discovery of new diag 

nostics, drugs, and vaccines for drug-resistant and 

drug-sensitive TB. Many of these programs are pro 

viding critical information to advance our scientific 

understanding of TB. 

NIAID I RESPONDING TO EMERGING AND RE-EMERGING THREATS 

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For example, a recent clinical study of a TB 

diagnostic that was developed through a publicprivate partnership with NIAID support showed 

that the test provides highly accurate and much 

more rapid results than what is possible with cur 

rent TB diagnostics. In the study of 1,730 patients 

with suspected drug-sensitive or MDR pulmonary 

TB, the Cepheid Xpert MTB/RIF TB test success 

fully identified 98 percent of all confirmed TB cases 

and 98 percent of patients with rifampin-resistant 

bacteria in less than 2 hours. These results were 

achieved directly from patient samples without the 

need to first culture or visualize the bacteria. NIAID 

continues to support expansion of this technology 

to detect other resistance markers for XDR TB. 

Other diagnostic tests initially supported through 

NIAID small-business grants are now being con 

sidered for rollout in countries with high burdens 

of TB. To further improve the pipeline of new TB 

diagnostics, NIAID recently established the TB 

Clinical Diagnostics Research Consortium (CDRC), 

which will assist in the clinical evaluation of earlystage TB diagnostic tests and with strategies in 

countries where TB is a public health concern. 

NIAID also supports preclinical and clinical devel 

opment of promising new TB drugs. SQ109, an 

anti-TB drug candidate initially identified through 

a partnership between NIAID intramural laborato 

ries and the biopharmaceutical company Sequella, 

currently is being evaluated in early-stage clinical 

trials through NIAID extramural support. Other 

drug candidates and new combinations such as 

PA-824 and fluoroquinolone antibiotics have been 

supported through NIAID’s preclinical development 

resources and animal model services. 

U.S.-South Korean Collaboration Seeks To 

Advance TB Care 

In 2003, NIAID scientists and clinical researchers at South 

Korea’s National Masan Tuberculosis Hospital joined forces 

to develop potential new drug regimens for effective TB 

treatment and to identify new rapid means of diagnosing 

drug resistance. The hospital is the national referral center 

for TB treatment failures in South Korea and has one of the 

largest numbers of in-patient MDR TB cases in the world. 

The United States and South Korean researchers have 

conducted numerous research studies and have more than 

800 patients participating in clinical trials. Trials of existing 

drugs in patients with highly drug-resistant TB are ongoing 

using PET/CT imaging technologies. In addition, researchers 

are collecting information about rates and causes of MDR 

and XDR TB in two groups of patients: those who are having 

an initial episode of active TB and those who have recurrent TB. Investigators also are studying the human and M. 

tuberculosis genomes to further understand the relationship 

between the expression of specific bacterial and human 

genes and the acquisition and development of XDR TB infection. More than 10 manuscripts describing these studies 

were published in 2010. 

Other scientists have been drawn to collaborate with the 

successful South Korean center. For example, a consortium 

of five groups with funding from the Bill & Melinda Gates 

Foundation is attempting to define correlates of response to 

TB therapy that may prove useful in determining the point 

at which cessation of drug therapy does not pose a risk 

of disease reactivation. Additionally, NIAID scientists and 

researchers from the University of Cape Town, South Africa, 

with funding from the Wellcome Trust, are using advanced 

imaging techniques to attempt to understand the development and containment of latent TB disease using paired 

clinical studies in South Africa and South Korea. 

IN 2009, AN ESTIMATED 9.4 MILLION NEW CASES 

OF TB WERE REPORTED WORLDWIDE, AND AN 

ESTIMATED 1.7 MILLION PEOPLE DIED OF 

THE DISEASE. 

NIAID I IMPROVING HEALTH IN A CHANGING WORLD 

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12 NIAID I MALARIA 

 

 

 

 

 

Malaria
 

Malaria continues to pose an enormous 

global health burden, particularly in 

countries in tropical and subtropical 

regions. The World Health Organization 

(WHO) estimates that in 2009 there were 225 

million cases of malaria worldwide. That same 

year, more than 780,000 people, mostly young 

children in Africa, died from the disease. 

NIAID has a longstanding commitment to 

malaria research and supports global efforts to 

reduce death and suffering from the disease. 

NIAID works closely with organizations such as 

the U.S. Agency for International Development, 

WHO, the European Malaria Vaccine Initiative, 

the Program for Appropriate Technology in 

Health Malaria Vaccine Initiative, the Wellcome 

Trust, and the Bill & Melinda Gates Foundation. 

Additionally, NIAID has joined with the NIH 

Fogarty International Center, the National Library 

of Medicine, and other institutions to form the 

Multilateral Initiative on Malaria, whose mission 

is to enhance worldwide research on malaria by 

facilitating multinational cooperation and by 

supporting the career development and research 

efforts of African scientists working in malariaendemic areas. 

Such collaborations have yielded notable successes. 

For example, NIAID-supported scientists have 

sequenced the genomes of the malaria parasites 

Plasmodium falciparum and Plasmodium vivax 

as well as Anopheles gambiae, the mosquito species that is the primary vector of malaria in Africa. 

These and similar studies promise to reveal potential new targets for drug and vaccine development. 

In Malawi, NIAID-funded research has suggested 

that chloroquine, the once-standard medication 

for preventing and treating malaria, may again be 

effective in that country, thanks to the reduced 

prevalence of the genetic mutation responsible for 

parasitic resistance to the drug. This finding may 
 

eventually lead to low-cost chloroquine being 

reintroduced in parts of Africa for use in combination with other drugs. NIAID also supports discovery and development of new antimalarial drugs, 

through investigator-initiated research and collaborations with public-private partnerships. For 

example, NIAID recently funded the preclinical 

development of the drug AQ-13, which may be 

effective against chloroquine-resistant parasites. 

This drug is now progressing through clinical trials. 

Finally, NIAID remains committed to developing 

safe and effective vaccines for malaria. Several vaccine candidates that target different lifecycle stages 

of the malaria parasite are in development, including those designed to either destroy parasites in the 

bloodstream or inhibit parasites from infecting red 

blood cells. NIAID supports clinical trials of these 

and other vaccine candidates in malaria-endemic 

countries. 

NIAID I IMPROVING HEALTH IN A CHANGING WORLD 

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IN 2009, MORE THAN 780,000 PEOPLE, 

MOSTLy yOUNG CHILDREN IN AFRICA, 

DIED FROM MALARIA. 

NIAID-Funded Centers Seek To Enhance 

Malaria Control 

Malaria has been eliminated from many parts of the globe, 

yet approximately half of the world’s population remains at 

risk of contracting the disease. In July 2010, NIAID awarded 

funds to establish the International Centers of Excellence 

for Malaria Research (ICEMR), which form a network of 

independent research institutions in malaria-endemic regions 

of Africa, Asia, the Pacific Islands, and Latin America. 

These regions include some of the focus countries of the 

President’s Malaria Initiative, an effort that since 2005 has 

worked to fight malaria in the regions most affected by 

the disease. 

The ICEMR program is based on the need for sustainable, 

multidisciplinary strategies to control malaria. The centers 

will integrate clinical and field approaches with laboratorybased immunologic, molecular, and genomic methods. They 

will adapt their research to changes in malaria epidemiology 

and emerging research needs as well as to opportunities 

within the specific regions. Findings are expected to help 

inform how new interventions and control strategies are 

designed and evaluated in the future. 

The ICEMR program will support malaria research in more 

than 20 countries and will provide the knowledge, tools, and 

evidence-based strategies to support researchers working 

in a variety of settings, especially within governments and 

healthcare institutions. The program is expected to bring 

critical infrastructure to malaria-endemic regions and help 

build the needed training and research capacity to combat 

malaria around the world. 
14 NIAID I INFLUENzA 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Influenza
 

S

easonal influenza, caused by viruses that 

vary slightly from year to year, is a classic 

example of a re-emerging infectious disease. 

Influenza viruses also can undergo more 

dramatic genetic changes to cause outbreaks in 

humans who have no immunity or only limited 

pre-existing immunity. If these viruses spread from 

person to person, they can cause a pandemic, such 

as the 2009 H1N1 influenza pandemic, which is 

estimated to have killed more than 18,000 people 

worldwide. 

NIAID supports a broad portfolio of influenza 

research, including studies that inform the development of vaccines, diagnostics, and therapeutics 

against both seasonal and pandemic influenza. For 

example, NIAID clinical trials provided information 

that became the foundation for the U.S. 2009 H1N1 

immunization program that protected millions of 

people during the H1N1 pandemic. NIAID trial 

data offered key scientific evidence essential for 

public health decision making, including determining 

optimal dosage and number of doses for individuals 

in different age brackets and for specific high-risk 

groups such as pregnant women. 

NIAID also helped initiate and conduct pediatric studies of the antiviral drug oseltamivir that 

provided critical data to the U.S. Food and Drug 

Administration for an Emergency Use Authorization 

of the drug against H1N1. This authorization 

allowed oseltamivir to be prescribed for the treatment of 2009 H1N1 influenza in children less than 

1 year of age, providing treatment for those who 

were infected and protecting others by preventing 

the spread of disease. These data also were shared 

with international regulatory agencies and used to 

support the use of oseltamivir in infants around the 

world. The data gathered and experience gained 

from successfully responding to a pandemic will be 

invaluable for subsequent influenza research and for 

future pandemic preparedness efforts. 

The South East Asia Infectious Disease Clinical 

Research Network (SEAICRN), cosupported by 

NIAID and the Wellcome Trust, brings together 

hospitals and institutions in Indonesia, Thailand, 

the United Kingdom, the United States, and 

Vietnam to advance scientific knowledge and 

clinical management of influenza and other infectious diseases. SEAICRN studies aim to improve 

patient care and help inform public health policy 
 

 

 

 

 

 

 

 

 

 

on the treatment of influenza and other emerging 

infectious diseases. The network also works with 

national ministries of health and other authorities 

to facilitate the sharing of samples of influenza 

viruses for research purposes. 

NIAID-funded research projects and repositories 

are providing researchers around the world with 

vital data to help improve the understanding of 

how influenza viruses evolve, spread, and cause 

disease. For example, the NIAID Influenza Genome 

Sequencing Project helps scientists identify sequences in the influenza genome that could be potential 

targets for vaccines or therapies. To date, more than 

6,000 complete influenza virus genomes have been 

sequenced and made available in the public domain. 

NIAID I IMPROVING HEALTH IN A CHANGING WORLD 

15 

THE EXPERIENCE GAINED FROM SUCCESSFULLy 

RESPONDING TO A PANDEMIC WILL BE INVALUABLE 

FOR FUTURE INFLUENzA RESEARCH. 

Centers Expand Global Reach of Influenza 

Research and Surveillance 

In 2007, NIAID established the Centers of Excellence for 

Influenza Research and Surveillance (CEIRS) to expand its 

worldwide influenza surveillance program and bolster influenza research in key areas, including understanding how the 

virus causes disease and how the immune system responds 

to infection with the virus. The goal of the CEIRS program is 

to provide essential information for the development of public health strategies crucial to both lessening the impact of 

seasonal influenza and responding to a pandemic. 

Following the 2009 H1N1 influenza outbreak, the CEIRS 

sites quickly began work with the virus. Within 4 months, 

several important findings had been generated, providing 

essential information and basic characterization of the 

virus. The basic research performed by CEIRS investigators 

helped explain how a new influenza virus emerged; its 

pathogenicity, transmissibility, and susceptibility to antiviral 

agents; and what to expect during recurrences of pandemic 

virus circulation. 

Current activities of the CEIRS program seek to expand the 

NIAID influenza virus surveillance program, both internationally and domestically, and to conduct research on the 

prevalence of avian influenza; how influenza viruses evolve, 

adapt, and are transmitted; and the immunological factors 

that influence the course of influenza infection. Some sites 

will continually monitor international and domestic cases of 

animal and human influenza to rapidly detect and characterize viruses that may have pandemic potential and to develop 

pandemic vaccine candidates. These activities help lay the 

groundwork for new and improved control measures for 

emerging and re-emerging influenza viruses. 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Calling Attention to Neglected Tropical Diseases
 

NIAID I CALLING ATTENTION TO NEGLECTED TROPICAL DISEASES 

16 

T

hough of low prevalence in most of the 

United States, tropical diseases such as dengue 

fever, lymphatic filariasis, leishmaniasis, and 

schistosomiasis take a tremendous toll on 

global health. According to recent estimates, more 

than 1 billion people—one-sixth of the world’s 

population—suffer from at least one neglected 

tropical disease (NTD). These diseases tend to 

thrive among impoverished populations in developing regions of the world, where water quality, sanitation, and access to health care are substandard. 

NIAID supports a robust program of research 

devoted to better understanding, preventing, and 

treating NTDs. Studies conducted and supported 

by NIAID have led to important new discoveries 

about the microbes that cause these diseases, the 

identification of targets for potential new drugs 

and vaccines, and the development of strategies for 

controlling the vectors that transmit NTD-causing 

agents to humans. For example, NIAID-supported 

investigators have sequenced the genomes of 

Trypanosoma brucei, Trypanosoma cruzi, and 

Leishmania major, the parasites that cause the 

diseases African sleeping sickness, Chagas’ disease, 

and leishmaniasis, respectively. Researchers also 

have sequenced the genome of Aedes aegypti, the 

mosquito species that transmits dengue and yellow 

fever. Currently, NIAID investigators are working 

on sequencing the genomes of two other important 

NTD vectors: the tsetse fly, which transmits 

T. brucei to humans, and the freshwater snail 

Biomphalaria glabrata, which transmits a parasite 

that causes schistosomiasis. 

This new genetic information promises to help 

researchers design better ways to diagnose, treat, 

and prevent NTDs. The genome of A. aegypti 

is particularly important because the mosquito 

has become increasingly resistant to insecticides. 

Researchers hope that studies of the sequence will 

help them develop new methods of controlling the 

mosquito, such as genetically altering the species so 

that it is resistant to agents that cause disease. 

Through its Partnerships with Public-Private Partnerships program and Tropical Disease Research 

Units, NIAID is actively supporting the discovery 

and development of treatments for parasitic tropical 

diseases. For example, researchers in these programs 

are developing a low-cost treatment for visceral 

leishmaniasis, the most severe form of the disease, 

and identifying new drugs for African sleeping sickness and Chagas’ disease. One drug, called K777, 

has recently completed early testing to evaluate its 

effect on T. cruzi, the Chagas’ disease parasite. K777 

was found to be effective against the parasite in vitro 

and in vivo and is now moving into preclinical studies to further assess its safety and efficacy. 

Recently, scientists supported in part by NIAID 

identified cellular components in mosquitoes and 

in humans that dengue viruses use to multiply 

inside both hosts. Their findings could lead to the 

development of drugs that would inhibit one or 

more of these components, thus limiting infection 

and the development of dengue fever. The search 

for anti-dengue therapies is vital, as no specific 

drugs or vaccines are available to fight dengue 

infection, which afflicts up to 50 million people 

worldwide each year. 

TROPICAL DISEASES SUCH AS 

DENGUE FEVER AND LEISHMANIASIS 

TAKE A TREMENDOUS TOLL 

ON GLOBAL HEALTH. 
Improving Understanding of the Immune System
 

B

asic immunology is the foundation for 

much of the research being conducted on 

HIV/AIDS, malaria, tuberculosis, and other 

global infectious diseases. NIAID supports a wide variety of research projects on the 

immunology underlying infection and vaccination 

outcomes. For example, the Population Genetics 

Analysis Program is an international effort to identify genetic differences among individuals within 

a given population and relate these differences to 

disease severity or vaccine efficacy and adverse 

events. Diseases of interest among these investigators include cholera, typhoid, smallpox, anthrax, 

tuberculosis, and influenza. 

Immunology also is vital in the fight against 

transplant rejection, autoimmune and allergic 

diseases, asthma, and other disorders of the 

immune system that cause chronic disease and 

disability on a global scale. NIAID supports and 

conducts basic and clinical immunology research 

to advance understanding of the mechanisms that 

underlie immune system disorders and to develop 

new strategies to detect, prevent, and treat them. 

For example, the NIAID Immune Tolerance 

Network, an international collaboration of more 

than 80 researchers, is making steady progress 

toward reducing the need for costly and potentially 

risky immunosuppressive drugs that are the current 

standard of care for many autoimmune disorders 

and for preventing rejection of transplanted organs 

and tissues. To date, more than 20 kidney and liver 

transplant recipients are surviving without immunosuppressive drugs, some for as long as 4 years. 

NIAID also supports clinical trials in food allergy, 

including studies aimed at preventing the development of allergies to particular foods and reversing 

established allergies to milk, eggs, peanuts, and others. For instance, an Immune Tolerance Network 

study of children in the United Kingdom is exploring whether early-life exposure to peanuts will 

prevent the emergence of peanut allergy. Children 

enter the study between the ages of 4 and 10 months 

and, until they are 5 years old, they either avoid 

peanuts completely or eat a peanut snack three 

times a week. At the close of the study, children 

will be assessed for the occurrence of allergic disorders, including allergies to peanut and other foods, 

by clinical history and an oral peanut challenge. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NIAID I IMPROVING HEALTH IN A CHANGING WORLD 

17 
 

 

 

 

 

 

 

 

 

 

 

 

18 NIAID I FUNDING OPPORTUNITIES FOR FOREIGN SCIENTISTS AND INSTITUTIONS 

Funding Opportunities for Foreign Scientists 


and Institutions
 

NIAID funds biomedical research through various mechanisms 

such as grants, cooperative agreements, and contracts. 

Grants 

Grants are used to foster creative scientific research with minimal NIAID involvement. Cooperative agreements are types of 

grants NIAID uses to fund projects in which substantial NIAID 

scientific or programmatic involvement is needed to guide and 

coordinate the research. 

Investigators need not be U.S. citizens to apply for select NIH 

research grants, including the following: 

•	 R01s—support biomedical research and development based 

on the NIH mission 

•	 R03s—support small research projects that can be carried 

out in a short period of time with limited resources 

•	 R21s—encourage exploratory research projects by supporting 

the early and conceptual stages of development 

Another opportunity for funding is the NIH Pathway to 

Independence Award (K99/R00), which is available to investigators with a clinical or research doctorate and no more than 5 years 

of postdoctoral research training at the time of application. 

The K99/R00 does not require citizenship or permanent U.S. 

residency, but the applicant should have a visa that allows him 

or her to be in the country for the duration of the grant. 

NIAID IRIDA Program 

The NIAID International Research in Infectious Diseases including 

AIDS (IRIDA) Program solicits R01 applications from organizations/ 

institutions in eligible foreign countries that propose research 

related to infectious diseases. NIAID funds up to 10 IRIDA grants 

each year to encourage the development of scientific expertise 

and research infrastructure and to increase collaborative 

research partnerships at NIAID-funded international sites. 

Studies may be proposed for the IRIDA program on any aspect 

of infectious diseases (except clinical trials). The following are 

some examples: 

•	 Epidemiology, pathogenesis, and immunopathogenesis of 

infectious diseases 

•	 Identification of resistance patterns 

• Characterization of susceptible cohorts for a particular pathogen 

•	 Pilot and feasibility studies in preparation for larger studies 
 

 

 

 

 

 

 

 

How To Apply for Grant Funding 

Research funds are paid to institutions only, not to individual 

scientists. Foreign institutions must be registered with 

Grants.gov and with the NIH Electronic Research Administration 

Commons Web site prior to applying for NIAID or other NIH 

grants. It may take 4 to 6 weeks to complete the registration 

process, so interested institutions should start well in advance 

of the application due date. 

Before applying, institutions should read current NIAID funding 

opportunity announcements and consider whether their projects 

fit within the NIAID mission. Successful grant applications often 

depend on collaborations. Scientists from foreign countries may 

find it helpful to partner with U.S. institutions when applying. 

Contracts 

NIAID uses contracts to purchase items it needs or to perform 

research and development. Through contracts, NIAID funds clearly defined projects of scientific need or interest. NIAID closely 

supervises projects funded by contracts. NIAID uses a variety of 

contract mechanisms to accomplish its research goals, such as 

contracts for developing animal models, developing and testing 

vaccines, conducting clinical trials, and developing and maintaining reagent and specimen repositories for investigators. 

CRADAs 

NIAID often uses Cooperative Research and Development 

Agreements (CRADAs) to facilitate the development of specific 

technologies or projects that originate in NIAID laboratories. 

Under a CRADA, NIAID may provide personnel, services, facilities, equipment, or other resources. See the CRADA Web site 

listed at right for more information. 

Online Resources 

NIAID International Awards 

funding.niaid.nih.gov/researchfunding/int/pages/default.aspx 

IRIDA Program Announcement 

grants.nih.gov/grants/guide/pa-files/PAR-08-130.html 

K99/R00 Program Announcement 

grants.nih.gov/grants/guide/pa-files/PA-10-063.html 

Grants.gov 

www.grants.gov 

Foreign Grants Information 

grants.nih.gov/grants/foreign/index.htm 

Electronic Research Administration Commons 

commons.era.nih.gov/commons 

CRADAs 

www.ott.nih.gov/cradas/model_agree.aspx 

THROUGH PARTNERSHIPS WITH ACADEMIA, PRIVATE 

INDUSTRy, PHILANTHROPIC ORGANIzATIONS, AND 

OTHER RESEARCH -SUPPORTING AGENCIES, NIAID 

HELPS GUIDE AND ENHANCE MEDICAL RESEARCH. 

NIAID I IMPROVING HEALTH IN A CHANGING WORLD 

19 
 

 

Training Opportunities for Foreign Scientists
 

NIAID I TRAINING OPPORTUNITIES FOR FOREIGN SCIENTISTS 

Training at NIH 

The NIH Visiting Program provides opportunities for foreign postdoctoral scientists to train and conduct collaborative research. 

Annually, more than 2,000 scientists from other nations conduct 

research in the basic and clinical science laboratories on the NIH 

campus in Bethesda, Maryland, and in several field units across 

the United States. NIH has long considered close interaction 

with foreign scientists in the conduct of collaborative research 

to be an essential ingredient in achieving its objectives. 

There are two categories of Visiting Program participants: 

Visiting Fellows, who receive awards for research training, 

and Visiting Scientists, who receive appointments to conduct 

research. Each participant works closely with a senior NIH investigator who serves as a sponsor or supervisor during the period 

of award or appointment. 

Visiting Scientists and Visiting Fellows hosted by NIAID receive 

a salary or stipend according to their particular appointment. 

How To Apply for Training Opportunities 

Foreign postdoctoral scientists who wish to participate in the 

Visiting Program must first secure an invitation from a senior 

scientist at NIH. The award (Visiting Fellow) or appointment 

(Visiting Scientist) is offered based on a candidate’s qualifications and the research needs of the host laboratory. 

Individuals interested in an NIAID fellowship or appointment 

should write to a senior scientist at an NIAID laboratory who 

works in the same research field, enclosing a resume and brief 

description of their particular research area and interests. 

Guest and Volunteer Researchers 

Foreign predoctoral and postdoctoral scientists may work at 

NIAID without salary or stipend as Volunteer Researchers. It 

also is possible for foreign scientists to receive a salary or stipend from their home institution and work at NIAID as Guest 

Researchers. Interested individuals should contact a senior 

scientist at an NIAID laboratory who works in the same research 

field, enclosing a resume and brief description of their particular 

research area and interests. 

ICSSC Assists Clinical Investigators in Developing 

Countries 

The International Clinical Sciences Support Center 

(ICSSC) provides support to clinical investigators funded 

by the NIAID Division of Microbiology and Infectious 

Diseases and whose work focuses on treatment, prevention, and control of infectious diseases in developing 

countries. 

This support includes the following: 

•	 Assistance with research planning, protocol development, and study implementation 

• Training and workshops on topics such as study 

design, data management, and ethical conduct of trials 

•	 Opportunities to communicate and share experiences 

with other investigators 

The ICSSC Web site includes a service-request form and 

links to resources such as protocol templates, informed 

consent checklists, and online tutorials. 

Online Resources 

International Clinical Sciences Support Center 

www.icssc.org 

Training in NIAID Labs 

www.niaid.nih.gov/labs/training 

Opportunities at the NIH for Non-U.S. Citizens 

www.jobs.nih.gov/jobsearch/noncitizen.htm 

20 
i 21 

-

NIAID Contact Visit NIAID on the Web 

Office of Global Research www.niaid.nih.gov 

National Institute of Allergy www.facebook.com/niaid.nih 

and Infectious Diseases twitter.com/niaidnews 

National Institutes of Health 

U.S. Department of Health and 

Human Services 

6610 Rockledge Drive 

Bethesda, MD 20892-6613 

Tel: (301) 496-0070 

Fax: (301) 480-2954 

E-mail: niaidogrppc@niaid.nih.gov 

Photo Credits 

Cover (left to right): Worker at Ethiopian pharmaceu 

ticals factory; WHO/P. Virot. Boy, woman, and smiling 

boy; David Snyder for Fogarty International Center/ 

NIH. Caucasian man; iStockphoto. Staphylococcus 

aureus bacteria escaping destruction by human white 

blood cells; NIAID 

Inside front cover: Worker at Kilimanjaro Christian 

Medical Centre, Moshi, Tanzania; NIH/J. Haliski 

Page 3: Anthony S. Fauci, M.D.; NIAID 

Page 6: Phlebotomist drawing blood; PunchStock 

Page 7 (top): District of Baraoueli in Mali; NIAID 

Page 7 (bottom): Family in Delhi, India; WHO/P. Virot 

Page 8: Scanning electron micrograph of HIV particles 

infecting a human T cell; NIAID 

Page 9 (left): Burmese children looking out window; 

PunchStock 

Page 9 (right): Thai children; PunchStock 

Page 10: Mycobacterium tuberculosis; CDC 

Page 11: Investigator at South Korea’s National Masan 

Tuberculosis Hospital; NIAID 

Page 12: An Anopheles funestus mosquito takes a 

blood meal from its human host; CDC 

Page 13: Woman and child in Bohicon, Benin; WHO/B. 

Carpentier 

Page 14: Negative-stained transmission electron 

micrograph of an influenza virus particle; CDC 

Page 15: Train passengers in Mexico City; Eneas, 

www.flickr.com/eneas 

Page 16: Peruvian girl; David Snyder for Fogarty 

International Center/NIH 

Page 17: Phagocytosis of yeast particle by human 

neutrophil; NIAID 

Page 18 (top): NIAID researchers; NIAID 

Page 18 (bottom): NIAID researcher in his lab; NIAID 

Page 19 (left): NIAID scientist conducts research on 

the immune system; NIAID 

Page 19 (right): NIAID researcher studies cells 

infected with dengue virus; NIAID 

Page 20: NIAID researcher checks culture volume in a 

fermenter; NIAID 

Printed with vegetable inks on paper containing 

50 percent recycled content, including 25 percent 

post-consumer waste. 

niaid IMPROVING HEALTH IN A CHANGING WORLD 
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 

National Institutes of Health 

National Institute of Allergy 

and Infectious Diseases 

NIH Publication No. 11-6433 

February 2011 

www.niaid.nih.gov