U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 

National Institutes of Health 

THE JOHN E. FOGARTY INTERNATIONAL CENTER 

ADVANCING SCIENCE FOR GLOBAL HEALTH 

PATHWAYS TO GLOBAL HEALTH RESEARCH 

STRATEGIC PLAN 2008-2012 
Vision

The Fogarty International Center’s vision is a world in which the 

frontiers of health research extend across the globe and advances 

in science are implemented to reduce the burden of disease, 

promote health, and extend longevity for all people. 

Mission

The Fogarty International Center is dedicated to advancing the 

mission of the National Institutes of Health by supporting and 

facilitating global health research conducted by U.S. and 

international investigators, building partnerships between 

health research institutions in the U.S. and abroad, and training 

the next generation of scientists to address global health needs. 
 

PATHWAYS TO GLOBAL HEALTH RESEARCH
 

STRATEGIC PLAN 2008-2012
 

1. Welcome from the Director 
 3 

2. Executive Summary 
 5 

3. Introduction: A Global Imperative 9
 

4. Trends in Conducting Global Health Research 15
 

5. The Fogarty Goals: Extend the NIH Research Mission Globally 19
 

GOAL I: Mobilize the scientific community to address the shifting 

global burden of disease and disability 19
 

GOAL II: Bridge the training gap in implementation research 21
 

GOAL III: Develop human capital to meet global health challenges 23
 

GOAL IV: Foster a sustainable research environment in 


low- and middle-income countries 25
 

GOAL V: Build strategic alliances and partnerships in global health 


research and training 27
 

6. Fogarty Adapts to Serve Changing Needs in Global Health Research 29
 

7. Appendix: Development and Implementation of the Strategic Plan 30
 

FOGARTY STRATEGIC PLAN 2008-2012 1 

 

1. WELCOME FROM THE DIRECTOR
 

As we enter our 5th decade, and as global health has become a worldwide 

priority, it is time to reflect on the new connectivity of the global community 

and consider a new Strategic Plan for the Fogarty International Center. 

We encourage you to read through the new Strategic Plan that is presented in 

this document and reflects the input of hundreds of stakeholders and experts 

from abroad and the U.S. 

As you will see, Fogarty has a long history of investment in low- and middleincome countries working with NIH colleagues to support research, train health 

researchers, and promote collaboration. As we go forward with this plan, we 

hope to build on our past successes and bring new dimensions and a new vision 

to our programs in the next five years and for the century ahead. 

Thank you for joining us as a partner in this effort. 

Sincerely, 

Roger I. Glass, M.D., Ph.D. 


Director, Fogarty International Center and 


Associate Director for International Research,
 

National Institutes of Health
 

FOGARTY STRATEGIC PLAN 2008-2012 3 
What is Global Health? 

The term global health has been defined by the 

Institute of Medicine of the National Academies to 

refer to “health problems, issues, and concerns that 

transcend national boundaries, may be influenced by 

circumstances or experiences in other countries, and 

are best addressed by cooperative actions and solutions.” Such a concept goes beyond the notion of 

global health as a simple “absence of disease” and 

beyond a focus on exotic tropical diseases that galvanized much of international health research in 

early days. Addressing global health challenges 

today means marshalling experts in many fields of 

behavioral and biomedical research, from anthropology to zoonotic infections, along with studies of the 

impact of economics, ecology, healthcare systems, 

and public health policies on health and disease. 

There is also a more idealized concept of global 

health that sees global health as a state that would 

be achieved when individuals everywhere are free to 

develop to their full physical and mental capacity in 

a safe, unpolluted environment, with access to clean 

water, adequate nutrition, and health care services 

appropriate to maintain health and prevent and treat 

diseases. It is an ideal and, like all ideals, is the 

inspiration for the actions of many global health 

leaders, both in research and in philanthropy. 

Indeed, it is the inspiration that drives the commitment that the Fogarty Center’s staff brings to their 

work. 
 

2. EXECUTIVE SUMMARY
 

The Fogarty International Center Strategic Plan: 2008-2012 

The Fogarty International Center enters its fifth decade with a new strategic plan— 

Pathways to Global Health Research. Inspired by the desire of all humankind to live a 

long and healthy life, Fogarty sees opportunities for addressing and resolving major global 

health problems by conducting research at places where those diseases are especially problematic, because of genetic, environmental or other causes. Such a strategy in our increasingly connected world stands to benefit people everywhere, whether they live in developed 

or low- and middle-income countries (LMICs). This strategy is embodied in Fogarty’s vision. 

Crucial to this ideal of “taking science where the problems are” is having the people 

and resources in place around the globe to do the work. This new strategic plan proposes 

ways to build upon decades of Fogarty research and research training programs focused 

in LMICs that have resulted in the growth of a worldwide community of global health 

scientists who have made remarkable advances and discoveries and become leaders in 

the research enterprise. It describes strategies to address global health disparities through 

the development of new tools to apply evidence-based knowledge. Ultimately what is 

learned abroad from these research and training activities will come home to help all 

Americans as well. 

Changing patterns of disease. Today, thanks to public health measures and biomedical 

advances worldwide, life expectancy and prosperity are generally increasing across the 

developing world with the exception of sub-Saharan Africa, which continues to be heavily 

impacted by AIDS, malaria, tuberculosis and childhood diarrheal and respiratory diseases. 

But along with getting older, people become vulnerable to noncommunicable, chronic 

diseases including cancer, diabetes, heart disease and the risk factors that cause them. 

Social and economic changes such as migration to cities, adoption of more sedentary 

lifestyles and rich diets, and smoking and addictions add further risk factors to a healthy 

life. The result is that the biomedical and behavioral research agendas of LMICs and 

developed countries are merging. Fogarty’s new strategic plan takes these epidemiologic 

facts to heart in a set of five goals and strategic priorities, beginning with the need to 

focus on chronic, noncommunicable diseases, while remaining committed to the still 

unfinished agenda of infectious diseases. 

FOGARTY STRATEGIC PLAN 2008-2012 5 
FOGARTY GOALS: 

EXTEND THE NIH RESEARCH MISSION GLOBALLY 

GOAL I: Mobilize the scientific community to address the shifting 

global burden of disease and disability. 

STRATEGIC PRIORITIES 

•	 Expand Fogarty’s investment in noncommunicable diseases research 

and research training. 

• Continue to invest in infectious diseases research and research training. 

GOAL II: Bridge the training gap in implementation research. 

STRATEGIC PRIORITIES 

•	 Support and expand the development of research training programs 

for implementation research. 

•	 Support the application of implementation research to the 

recommendations from the Disease Control Priorities Project. 

GOAL III: Develop human capital to meet global health challenges. 

STRATEGIC PRIORITIES 

•	 Expand programs to provide early global health research 

experiences for U.S. health science students and junior faculty. 

•	 Sustain research training for future generations of foreign 

health scientists. 

•	 Expand research support for foreign researchers to promote 

pathways to independence. 

GOAL IV: Foster a sustainable research environment in 

low- and middle-income countries. 

STRATEGIC PRIORITIES 

•	 Support the development of research hubs in low- and 

middle-income countries. 

•	 Bolster the development of expertise and use of information and 

communication technologies (ICT) in support of research and research 

training programs. 

• Sponsor the development of Fogarty alumni networks. 

GOAL V: Build strategic alliances and partnerships in global health 

research and training. 

STRATEGIC PRIORITY 

• Forge partnerships based on mutual interest and complementary strengths. 

* * * 

Acknowledgement. The Strategic Plan reflects the collective wisdom of the Fogarty staff, the 

Fogarty Advisory Board, and the hundreds of stakeholders who provided advice and comments at 

national and international meetings or through the Fogarty Web site. A full copy of the Strategic 

Plan is available at: www.fic.nih.gov/about/plan/strategicplan_08-12.htm 

6 PATHWAYS TO GLOBAL HEALTH RESEARCH 
 

Implementation Science. To assure that the results of research do not languish in the lab, 

but reach the public for whom they are intended, Fogarty has formulated a goal to support 

research training in the field of “implementation science.” This research training will help 

scientists to create generalizable knowledge that can be applied broadly to address central 

questions about health-care scale-up and determine the strategies that will work in the 

field. Local practitioners and the public need access to the deployment of the best of 

scientifically tested interventions. This goal also strongly supports research in relation 

to recommendations in the updated World Bank publication, Disease Control Priorities 

in Developing Countries (DCP2), which is focused on cost-effectiveness of health 

interventions and identified a series of “best buys” in a variety of settings. 

Research capacity and training. Two strategic goals are designed to maintain and augment 

activities where Fogarty programs have had a strong impact. One relates to building and 

sustaining the research environment in LMICs so that scientists will have the support 

necessary to conduct their research. Key strategic priorities here are to establish linkages 

or hubs where resources and knowledge can be shared across sites, and to exploit more 

advanced information and communication technology platforms. 

The other area where Fogarty’s impact has been significant is in capacity building, 

developing the pipeline of U.S. and foreign research talent. Fogarty will provide increased 

opportunities for early career U.S. health science professionals, both predoctoral and 

postdoctoral students, fellows, and new faculty, to work at research sites abroad to help 

launch careers in global health research. Fogarty will also continue its research training 

partnerships between U.S. and foreign institutions and enhance opportunities of foreign 

scientists to further their careers when they return home. 

FOGARTY STRATEGIC PLAN 2008-2012 7 

Promoting partnerships. Fogarty’s final goal is to capitalize 

on the rising tide of private and public funding devoted to 

advancing global health and help provide vision and leadership for the future. Fogarty will work to maintain and 

forge new partnerships to support the Plan’s agenda, in 

particular with its NIH partners, as well as seeking common cause with other U.S. government agencies and the 

many new private sector donors in global health. 

 

3. INTRODUCTION: A GLOBAL IMPERATIVE
 

The fundamental aspiration of all humankind is to live a long and healthy life. The last 

half century has shown marked progress toward that end with dramatic increases in life 

expectancy in many countries. These gains are largely due to improvements in public health 

and advances in biomedical research that have furthered investigators’ understanding of 

disease processes and led to new treatments and means of prevention. For many countries 

including the United States, the trend towards increased life expectancy has not peaked. 

We foresee a further lengthening of human life free of disabilities through advances in 

biomedical research. Fueling this hope are new discoveries in genomics, molecular biology, 

nanotechnology, bioengineering and imaging—discoveries that are providing powerful 

tools and techniques that promise an accelerating pace of new innovations in diagnosis, 

treatment and prevention. 

Nevertheless, in many low- and middle-income countries (LMICs), serious challenges to 

health remain where access to care and availability of advances are sorely lacking and 

where inequalities in the delivery of care persist. Research is needed to understand how to 

disseminate, adapt and apply relevant knowledge effectively to ensure the implementation of health care systems and delivery to achieve maximum impact. Fogarty will invest 

in research training in implementation research to address this challenge. 

In contrast to sub-Saharan Africa, countries undergoing rapid development like China, 

India, and Brazil have seen life expectancies grow every decade for the past forty years 

(Fig 1). With the aging of their populations, however, these countries now must cope with 

the dual burden of the infectious diseases of childhood and the chronic diseases of aging. 

Consider that life expectancy in China was 37 years in 1960. People died before developing diabetes, cancer, heart disease or dementia. By 2004, with life expectancy reaching 

72 years, and with unhealthy lifestyle choices, those conditions and others, especially 

tobacco-related diseases, stroke and trauma and injuries are now increasing in tandem 

with industrialized countries. Depression, substance abuse and other behavioral and mental health problems increase in response to stressful and disordering effects of increasingly 

rapid global change. International collaborations to study these diseases makes sense 

and could well speed knowledge on how to treat and prevent them around the world. 

FOGARTY STRATEGIC PLAN 2008-2012 9 

fig 1 

Gapminder Life Expectancy Chart 

Chart created at www.gapminder.org. 
 

 

box 1 

The Benefits of Investment in Global Health Include: 

•	 Advancing biomedical discoveries by taking research where 

the problems are (to high-risk communities or populations). 

•	 Improving the economy in developing countries. 

•	 Extending security of the U.S. by the early identification of new 

threats from infectious disease, environmental hazards and 

lifestyle changes. 

•	 Promoting health diplomacy, extending a positive, 

humanitarian image of America to those in greatest need. 

•	 Increasing competitiveness of U.S. biomedical science. 

To address this common agenda, Fogarty will 

increase investments in noncommunicable 

diseases research and training, while continuing 

to support programs in infectious diseases. 

The idea that the U.S. could benefit from 

international collaborative research was central 

to the creation of the Fogarty International 

Center in 1968 (Box 1). John Fogarty, the 

Rhode Island Congressman for whom the Center 

is named, foresaw that international studies in the 

health sciences would pay double dividends: 

The research would help build healthier, more 

politically and economically stable societies 

overseas and U.S. citizens would reap the 

benefits of international discoveries. 

Our Nation of Immigrants. International research is particularly relevant in the U.S., 

which is made up of immigrants from every continent. Much can be gained by understanding the genes and predilection for diseases that these groups brought from their 

ancestral populations abroad. The health of all Americans has benefited greatly from 

discoveries made outside the U.S. and will continue to do so in the future (Chart 1). 

Today, Fogarty funds some 400 projects awarded to both foreign and U.S. institutions 

(Fig 2). Approximately 20% of Fogarty awards are made directly to highly capable research 

institutions in LMICs. In many of the Fogarty programs, scientists in the U.S. collaborate 

with colleagues in foreign institutions, mostly in LMICs (Box 2). About one-third of 

Fogarty grants focus on scientific discovery; the remaining two-thirds provide support to 

train research scientists in global health. Fogarty programs actively promote long-term 

collaborative efforts. 

fig 2 

Fogarty International Center, Major Research and Training Sites 

10 PATHWAYS TO GLOBAL HEALTH RESEARCH 
 

Disease Discovery Implication for Global Health & the American Public 

Huntington’s Disease Venezuela—Gene for Huntington’s Prenatal diagnosis now possible for more than 30,000 Americans 

Disease (HD) identified in an extended with HD and over 200,000 who carry the gene. 

family, all descended from a single 

woman immigrant from Europe in 

early 1800s. 

Diarrheal Diseases Bangladesh/India—U.S. and local ORT prevents over a million deaths per year, is the first line 

scientists pioneered development of treatment for childhood dehydration worldwide, and is 

oral rehydration therapy (ORT) for recommended for treatment of every American child with diarrhea. 

treatment of cholera. 

Breast Cancer Nigeria—High fatality rates and In addition to several other factors such as poor access to care, 

ineffectiveness of treatment of African genes play a key role in the poor prognosis of breast cancer and 

women with breast cancer, compared the lower success rates of treatment of the disease in African 

with Caucasian women in the American women. Knowledge of genetic markers can facilitate 

United States, was linked to 3 genes. personalization of treatment. 

Hepatitis B Australia—Hepatitis B antigen All American children and many children in the developing world 

discovered in blood samples of are currently immunized against hepatitis B. First cancer vaccine— 

Australian aboriginals led to discovery a model for other viral associated cancers (e.g., cervical cancer 

of the virus, development of a vaccine, and papilloma virus). 

and the prevention of related liver cancer. 

Malaria China—A traditional medicine made More than 1 million Africans, mostly children < 5 years, die from 

from wormwood, Artemisia annua, malaria. More than 1,000 American travelers infected annually and 

is found to be highly effective for hundreds of thousands at risk. Artemesinin-derived medicines are 

treatment of malaria. the treatment of choice for saving lives. 

Tuberculosis Treatment India—Adherence of patients to Success of this program abroad has led to adoption of DOT TB 

long-term treatment for tuberculosis treatment in the U.S., where close to 14,000 new cases were 

enhanced by a program of directly reported in 2006. 

observed therapy (DOT), a strategy 

that also reduces the emergence of 

drug-resistance. 

Worldwide Discoveries Help People Everywhere 

chart 1 

FOGARTY STRATEGIC PLAN 2008-2012 11 
12 PATHWAYS TO GLOBAL HEALTH RESEARCH 

In 1993, to foster long-lasting transnational research 

teams, the Center created the Fogarty International 

Research Collaboration Award (FIRCA), an innovative 

small grants program. FIRCA funds collaborations 

between U.S. scientists holding NIH research awards 

and partners in LMICs. NIH partners collaborating 

in FIRCA include NIEHS, NIDCR, NCCAM, NEI, NIA, 

NIAAA, NIBIB, NIDCD, NIDA, NINDS, and OBSSR. 

An independent evaluation found that the program 

fills a unique and underserved niche, noting: 

Productivity: In just over a decade since 1992, 

more than 460 grants were awarded, generating 

more than 1,500 peer-reviewed publications. 

Sustainability: The majority of researchers’ 

collaborations continue after the grant ends; more 

than 30 percent continue to publish together. 

Long-term career commitment: Developing country 

investigators report that the program launched 

their careers and helped them gain recognition 

and credibility in the global research community. 

Diffusion of training and technology: New tools and 

techniques acquired by foreign partners through 

the program have diffused to other laboratories 

in LMIC institutions. In addition, grantees have 

reported “second generation” effects, with the 

majority of foreign partners now using some of 

their grant funds to support travel, education and 

research training for their students. 

“FIRCA allows us to maintain strong links with 

outstanding groups in the U.S. This has improved 

our research strength.” 

— FIRCA Collaborator, Brazil, 2006. 

box 2 

Sustaining International Research Partnerships 
 

Fogarty is not alone in its investments in global health. 

International research funding by NIH has increased 

significantly from roughly $50 million in 1997 to over 

$500 million in 2005. Improving global health has also 

become the rallying cry on U.S. college campuses and 

at medical schools and spawned increased investment 

by donors throughout the world—so much so that a 

commitment to global health appears to have reached 

a tipping point (Box 3). Fogarty will harness this energy 

by broadening its sponsored training of the next 

generation of U.S. global health research leaders. 

Donors and philanthropists are making huge investments in global health programs and the need for 

research to guide these initiatives has never been more 

critical. Equally important is the need to leverage these 

investments, to ensure their sustainability. Fogarty, 

working with new and current partners, will fund 

research training of LMIC health scientists and 

institutional leaders to address this challenge. 

box 3 

Global Health Has Reached the Tipping Point 

In his book, The Tipping Point, Malcolm Gladwell 

describes a moment in time when a new idea or 

innovation catches on with the general public so 

that overnight it becomes commonplace, accepted, 

if not adopted. Has that point been reached with 

global health? The evidence suggests it has: 

•	 The last decade has seen phenomenal growth in 

private funding and advocacy for global health 

featuring some of the world’s most visible 

personalities—Bill Gates, Warren Buffett, Ted 

Turner, Presidents Clinton, Carter, and Mandela, 

and rock stars like Bono. 

•	 New partnerships and public sector efforts have 

emerged, such as the Global Fund to Fight AIDS, 

Tuberculosis, and Malaria, the President’s Malaria 

Initiative, and the President’s Emergency Plan for 

AIDS Relief. Global health is also a G8 priority. 

•	 Governments in countries such as India and 

China have increased investments in research, 

recognizing the importance to their own economic 

development to join a global health work force. 

•	 Funds for global health are no longer considered 

merely a humanitarian charity but recognized as 

important in creating economic growth and 

political stability, producing scientific advances, 

providing security against emerging disease 

threats, and enhancing the competitiveness of 

the U.S. biomedical enterprise. 

The critical next step is to move global health 

research and research training to the tipping point. 

FOGARTY STRATEGIC PLAN 2008-2012 13 
14 PATHWAYS TO GLOBAL HEALTH RESEARCH 
 

4. TRENDS IN CONDUCTING GLOBAL HEALTH RESEARCH 

Team Science. Health research in the 21st century is increasingly a team effort. Just as 

scientists have come to understand the relationship between health and the environment 

as a result of the joint research of medical specialists, epidemiologists, mathematicians, 

ecologists, microbiologists, and geneticists, so must the same kind of interdisciplinary 

approach be brought to bear on complex global health problems (Box 4). 

Interdisciplinary research teams have been prime movers in the development of low-cost 

diagnostics and cost-efficient ways to prevent or treat disease. Such teams are best suited 

to address global health issues when the investigators are multi-national and sensitive 

to culture and context. Building such teams in local institutions across the world is 

precisely the strategy Fogarty has employed for decades in its research and research 

training programs. 

Program graduates have gone on to distinguished careers in public health and health 

research. Others have continued as independent investigators, heads of departments, and 

directors of medical schools and clinics. Graduates have assumed high-ranking positions 

in their governments’ health agencies. Many are engaged in the President’s Emergency 

Program for AIDS Relief, the Global Fund to Fight AIDS, TB and Malaria, WHO, and 

UNAIDS. Several alumni have been recognized by the Elizabeth Glaser Pediatric AIDS 

Foundation for outstanding leadership in AIDS prevention (Box 5). 

From Cell to Society. Over the last decade, biomedical research has been evolving from 

reductionism, an approach which remains enormously useful in understanding how 

living organisms function at the molecular level of genes and proteins, toward a systems 

approach where the interactions of these components are addressed together— i.e. as a 

system. This can range from analyzing the behavior of a single cell and its surroundings 

to understanding how behavior is integrated at the level of tissues, organs, the individual, 

and collectives of individuals in populations in their environments. It is an interdisciplinary approach that can exploit advances in informatics and computer science to collect, 

analyze, model and integrate masses of data. 

box 4 

Understanding the nexus between ecological 

disturbance and infection 

Major ecological and environmental change resulting from rapid 

industrialization, clearing of lands for agriculture, and the growth and 

migration of populations, have at times created ideal living conditions 

for rodents, insects, and other disease-carrying organisms. To focus 

research on these issues and their effects on human health, Fogarty 

created the Ecology of Infectious Diseases (EID) program. It is jointly 

administered by NIH and the National Science Foundation and 

supported by NIH partners including NIEHS, NIGMS, and NIAID. 

Interdisciplinary by design, this program draws upon experts in fields 

such as ecology, hydrology, microbiology, entomology, demography, 

modeling, epidemiology, and genetics. Most awards have involved 

international collaboration, exploring issues such as the environmental determinants of schistosomiasis in Kenya and the causes of an 

emergent new threat such as Nipah Virus in Malaysia. 

FOGARTY STRATEGIC PLAN 2008-2012 15 
In terms of global health, a systems approach 

may include ecological, socio-behavioral, economic, and policy influences and extend beyond 

national boundaries. In studying malaria, for 

example, local climate variations and previous 

control methods can influence mosquito density, 

feeding behavior, and population dynamics, so 

that proposed interventions to control malaria 

must be tailored to take these and other contextual variables into consideration (Box 6). 

Similarly, due to the increasing life expectancy of 

populations in LMICs, tobacco-associated diseases 

have become a serious health issue. To counter 

potential epidemics of lung cancer and other diseases, researchers must not only understand the 

neurobiology of nicotine addiction, but also the 

dynamics of personal behavior, social norms, the 

availability of smoking cessation and patient education programs, and the impact of taxation policies to discourage smoking in young adults. This 

means that behavioral and social science research 

is important to the kind of biosocial understanding of global health problems that supports the 

implementation and evaluation of interventions 

among local populations. 

To address the major global health challenges 

box 5 

A vision to create world leaders 

in AIDS research 

Twenty years ago Fogarty launched 

the AIDS International Training and 

Research Program (AITRP) to build 

epidemiology expertise in LMICs devastated by HIV. The program unites 

U.S. and foreign research institutions 

and has become the model for building 

and sustaining research capacity in 

low- and middle-income countries. 

AITRP supports training in research 

institutions in over 50 countries. The 

program has funded over 1,300 recipients of doctoral and master’s degrees and is supported by NIH partners including NCI, 

NIAID, NIDCR, NIDA, NIMH, NHLBI, NINR, OAR and ORWH. 

Program graduates have gone on to distinguished careers in 

public health and health research. Others have continued as 

independent investigators, heads of departments, and directors 

of medical schools and clinics. 

box 6 

Fogarty foresees, the Center’s Strategic Plan 

establishes five goals, each with a set of strategic 

priorities, to be pursued over the next five years. 

Goal I highlights the demographic shift towards 

increased aging populations, and the need for 

more chronic diseases research, in addition to 

studies of ever-present infectious disease threats. 

Goal II calls for the training of scientists who can 

study evidence-based interventions that can be 

transferred and scaled-up in communities in an 

area called “implementation science.” Goals III 

and IV describe strategies to build a cadre of U.S. 

and foreign researchers and strengthen the 

research capacity of institutions overseas. Goal V 

focuses on the importance of both maintaining and 

forging new partnerships to promote the research 

agenda. Fogarty will rely on internal working 

groups and consultations with stakeholders to flesh 

out details and develop strategies for implementing 

the Plan’s goals and strategic priorities. 

16 PATHWAYS TO GLOBAL HEALTH RESEARCH 

A Systems Approach: Pioneering Computer Models of Epidemics 

Fogarty researchers use mathematical models and computer simulations to 

study disease epidemics of global import. Since 2000 these scientists, with 

collaborators in more than 24 countries, have developed dynamic models to 

explain how outbreaks of malaria, cyclical epidemics of influenza, and other 

vector-borne disease epidemics occur. The models have also been used to 

predict the effects of future epidemics on people in the U.S. and abroad and 

to guide domestic and international policy. The group recently developed a 

model to explore the role of international transportation 

networks in the potential spread of influenza. 
 

Guiding Principles. Governing those implementation strategies will be a set of core 

operating principles, which have served Fogarty well in the past. They have enabled 

Fogarty to invest in new or neglected areas of global health research, provided successful 

models for international collaborations, and helped to build global health research 

capacity at home and abroad. 

Fogarty’s Core Operating Principles 

Pioneering Discovery and Filling Gaps. Fogarty pioneers new fields in global health, stimulating research 

and research training programs in new areas of science as well as filling gaps in the global health research 

workforce and enterprise (such as current Fogarty research and research training programs in tobacco, trauma, 

stigma, and ethics). Many initiatives are interdisciplinary and conducted with partners in other agencies as 

well as NIH Institutes and Centers. 

Promoting International Research Training and Collaboration. Fogarty funds training of the next generation 

of researchers in global health—both foreign and U.S. scientists—including new investigators on the cutting 

edge of a career in discovery. Fogarty programs to build the research pipeline are anchored to peer-reviewed 

research grants and designed to be collaborative, long-term, and flexible, meeting the research priorities of 

both the U.S. and foreign collaborators. Newly trained foreign scientists are encouraged to return home with 

the skills that allow them to conduct research on their own. 

Advancing Global Health Research at NIH. Fogarty serves as the global health focus at the NIH, advising 

the NIH Director on issues and concerns and alerting other NIH components to opportunities to advance 

global health science. Fogarty also co-funds global health research programs initiated by other NIH Institutes 

and Centers. 

Encouraging Science for Diplomacy. Years of experience and unique geographic expertise have 

established Fogarty as a key player in the international health arena. Fogarty engages directly 

with national or international funding agencies on health science issues and has a long history 

of helping to develop bilateral or multilateral agreements on global health. In the context of 

advancing science and health, Fogarty seeks opportunities to bridge differences between countries that might otherwise not engage and build trust by having scientists and institutions from 

different countries work in collaboration to address common health research concerns. 

FOGARTY STRATEGIC PLAN 2008-2012 17 

 

5. THE FOGARTY GOALS: 


EXTEND THE NIH RESEARCH MISSION GLOBALLY 

The mission of the NIH is “science in pursuit of fundamental knowledge about the 

nature and behavior of living systems and the application of that knowledge to extend 

healthy life and reduce the burden of illness and disability.” Fogarty incorporates and 

extends this mission to reduce global burdens of disease and disability. Fogarty brings 

science and scientists to places in the world where specific diseases and disorders are 

concentrated, whether due to the environment, socioeconomics, genetics, infectious 

agents or any combination of these. Collaborations with these communities can accelerate the pace of progress, help build the local science base, and ultimately reduce the 

burden of illness and disability. The plan will be realized through Fogarty’s investments 

in investigator-led training and research programs, creating partnerships between U.S. 

scientists and institutions and counterparts in low- and middle-income countries. 

Central to Fogarty’s investment in both chronic, noncommunicable and infectious 

diseases is the underlying research support that the Center’s partners provide. 

GOAL I: Mobilize the scientific community to address the shifting global 

burden of disease and disability. 

The dramatic gains in life expectancy in many low- and middle-income countries dictate 

the need for increased research on chronic, noncommunicable diseases related to age 

and lifestyle. These increases, particularly among middle-aged and older adults, are 

mainly due to declines in childhood mortality, more effective public health measures 

and improvements in economic and social welfare (e.g., increased per capita income). 

Population forecasters now predict that by 2030, one out of eight people in the world 

will be 65 or over—1 billion adults. The most significant growth in older-aged groups 

is expected to occur in rapidly growing LMICs such as India, China, and Brazil. One 

result of these gains in aging is an increase in the length of time adults are exposed to 

or will live with known risk factors for noncommunicable diseases, such as smoking, 

hypertension, diabetes or obesity. 

At the same time, many people in these countries are now suffering from the dual burden 

of the chronic, noncommunicable diseases of aging and infectious diseases. Infectious 

diseases account for one-third of all deaths worldwide. More than 10% of children die 

before the age of 5 years in LMICs versus only 0.6% in high-income countries. Even 

when diseases are controlled, scientists need to be ever vigilant due to the rapid rate at 

which microbial agents evolve, adapt, and develop resistance to antibiotics. As well, global travel and trade facilitate the rapid spread of infection and toxins in the food supply. 

Global climate change adds yet another potential threat, as it may 

enable infectious pathogens and vectors to move to new environmental niches to infect new hosts. 

FOGARTY STRATEGIC PLAN 2008-2012 19 
While lifestyle factors and risky behaviors, such as alcohol and drug disorders, contribute 

to the growing magnitude of chronic, noncommunicable diseases, recent discoveries 

suggest that infectious disease agents may also play a role. For example: 

•	 Cervical cancer is associated with infection by a type of human papillomavirus, 

a finding that led to the development of a vaccine. 

•	 Epilepsy and seizure disorders in parts of Peru are associated with the pig parasite that 

causes the disease, cysticercosis. Treatment with a drug can cure this condition, which 

is also found in Hispanic populations in the U.S. 

•	 H. pylori infection of the stomach, known to be the cause of stomach ulcers, is 

confirmed to be a risk factor in some types of stomach cancer. 

•	 Liver cancer is often causally associated with hepatitis B and C virus infections. 

As a result of these associations, understanding the nexus between infectious diseases 

and chronic, noncommunicable diseases are emerging as a cutting-edge area of 

biomedical research. This field of investigation is especially relevant to countries 

experiencing a disproportionate burden of infectious diseases. 
 

STRATEGIC PRIORITIES 

• Expand Fogarty’s investment in noncommunicable diseases research and research training. 

Fogarty will enhance its portfolio to include more research and training in noncommunicable diseases and their risk factors such as diet and lifestyle. Current investments 

in chronic, noncommunicable diseases include Fogarty programs in tobacco, trauma 

and injury, bioethics and environmental and occupational health. Fogarty will promote 

the exploration of the relationship of infectious diseases to chronic, noncommunicable 

disorders in some of these programs. 

• Continue to invest in infectious diseases research and research training. 

Fogarty will maintain its investments in research and research training programs 


in HIV (such as the AIDS International Research and Training Programs) and other 


infectious diseases (such as the Global Infectious Disease Research and Training
 

Program) tailoring them to meet current and future needs. 


GOAL II. Bridge the training gap in implementation research. 

There is a formidable knowledge gap between innovations in health (including 

vaccines, drugs and strategies for care) and their delivery to communities, which 

allow disparities to persist and prevent the reduction or elimination of problems. 

As a result, nearly 14,000 people in sub-Saharan Africa and South Asia die each day 

from HIV, malaria and diarrheal disease, even though scientific advances have enabled 

prevention, treatment and in some cases elimination 

of some of these diseases in developed countries. 

Implementation science is a field of research that 

addresses these issues by seeking ways to optimize scientific advances and use evaluation to facilitate adoption in 

the real world through health care systems and health 

policy. Research has shown the risk of transmission of 

HIV can be reduced with condom use and male circumcision, for example, but infection rates continue to rise 

and further research is needed to develop safe, culturally 

acceptable and accessible methods for surgery and care. Implementation research identifies 

barriers to the use of proven interventions and develops locally relevant strategies to overcome them for scale-up. It is interdisciplinary in nature, involving collaborations between 

behavioral and social scientists and clinicians, epidemiologists, mathematical modelers, 

operations engineers, business analysts and importantly policy makers. 

STRATEGIC PRIORITIES 

• Support and expand the development of research training programs for implementation research. 

Fogarty will identify the tools, methods, and training needed to build a research 

workforce able to advance implementation research. Fogarty will encourage the use 

of complex systems analysis and predictive modeling as research tools, using its inhouse expertise to advance this approach. New grants and enhancements of existing 

programs, such as Fogarty’s programs to support clinical, operational, and health services 

research, will also be used to build Fogarty’s portfolio for implementation science. 

FOGARTY STRATEGIC PLAN 2008-2012 21 
•	 Support the application of implementation research to the recommendations from the Disease 

Control Priorities Project. 

Over a four-year period starting in 2002 Fogarty partnered with the World Bank, the 

World Health Organization, the Population Reference Bureau, the National Library of 

Medicine, National Institutes of Health, and the Bill & Melinda Gates Foundation to 

publish the 2nd edition of the 1993 World Bank publication, Disease Control Priorities 

in Developing Countries (DCP2), its companion volume Global Burden of Disease 

and Risk Factors, and a summary of the DCP2 volume, Priorities in Health. 

(http://www.dcp2.org/pubs/DCP). These volumes provide detailed data on health in lowand middle-income countries, and, in DCP2, list ten “Best Buys” for improving global 

health (Box 7). Fogarty will work with NIH colleagues to address the research agenda 

associated with DCP2 and the Best Buys. The next challenge will be to work with 

researchers to assess the impact of key strategies and to extend knowledge so that the 

findings of the DCP2 can be updated. 

box 7 

Disease Control Priorities Project 10 Best Health Buys 

1. Vaccinate children against major childhood killers, including measles, polio, tetanus, 


whooping cough and diphtheria. 


2. Monitor children's health to prevent and treat childhood pneumonia, diarrhea and malaria. 

3. Tax tobacco products to increase consumers' costs by at least one one-third, to curb smoking 

and reduce the prevalence of cardiovascular disease, cancer and respiratory disease. 

4. Attack the spread of HIV through a coordinated approach that includes: promoting 


100% condom use among populations at risk; treating other sexually transmitted 


infections; providing antiretroviral medications, especially for pregnant women; and 


offering voluntary HIV counseling and testing. 


5. Give children and pregnant women essential nutrients, including Vitamin A, iron and 


iodine, to prevent maternal anemia, infant deaths and long-term health problems. 


6. Provide insecticide-treated bed nets in malaria-endemic
 

areas to drastically reduce malaria.
 

7. Enforce traffic regulations and install speed bumps at 


dangerous intersections to reduce traffic-related injuries. 


8. Treat TB patients with short-course chemotherapy to cure 

infected people and prevent new infections. 

9. Teach mothers and train birth attendants to keep newborns 

warm and clean to reduce illness and death. 

10. Promote use of aspirin and other inexpensive drugs to 

treat and prevent heart attack and stroke. 

* * *
 

There are researchable implementation questions related to each of these 10 Best Buys. 


For example, How can resistance to vaccination programs be overcome? What are the most 


cost-effective and reliable ways to monitor children’s health? How can acceptance and 


regular use of condoms be encouraged? 


These “best buys” were calculated based on DALYs—Disability-Adjusted Life Years—a unit measuring the amount of health lost 

due to a particular disease or condition. DALYs are useful for policymakers because they are a more comprehensive measure of 

population health than merely counting deaths and because they allow comparisons among a wide range of health interventions. 

The publication, Global Burden of Disease and Risk Factors, provides comprehensive DALY information. 

Source: Disease Control Priorities Project (www.dcp2.org) 
 

GOAL III: Develop human capital to meet global health challenges. 

The most important resources in global health are people. U.S. engagement in global 

health, represented by a cadre of global health experts, was instrumental to historic 

achievements such as the eradication of smallpox and the establishment of oral 

rehydration therapy. This critical resource must be renewed and diversified within 

U.S. universities and research institutions to meet contemporary global health problems. 

While the 20th Century saw most emphasis in training Americans around key infectious 

diseases, the 21st Century will see the rapid expansion of opportunities in other medical 

specialties of noncommunicable diseases. 

Fogarty will extend the reach of its training of investigators in low- and middle-income 

countries to meet strategic needs through pre- and post-doctoral research awards to conduct studies in disease-endemic countries, among other initiatives. The robust demand 

for research training and career development related to global health is exemplified by 

what is now a prevalent trend among U.S. academic institutions: the establishment of 

global health curricula as well as interdisciplinary centers focusing on research, training 

and service in LMICs. 

STRATEGIC PRIORITIES 

•	 Expand programs to provide early global health 

research experiences for U.S. health science students 

and junior faculty. 

Fogarty’s program for clinical research scholars 

allows health science students to work with scientists abroad, developing the skills, cultural sensitivities, and collaborations they need to build future 

careers. Fogarty will expand eligibility for the 

program to include support for advanced students, medical residents and fellows, 

graduate students in health-related fields, junior faculty and postdoctoral fellows. 

• Sustain research training for future generations of foreign health scientists. 

Research training of foreign scientists has been and will remain a high priority and 

Fogarty will continue to employ the well-established strategies and models used in 

many existing research training programs. Over the years these programs have generated thousands of investigators currently active in health research and medical education 

and priority-setting for health care around the world. 

• Expand research support for foreign researchers to promote pathways to independence. 

Foreign institutions suffer a loss of talent when investigators, faced with limited resources and opportunities,
 

leave their countries for greater rewards and scientific
 

opportunities elsewhere. The problem may be especially
 

acute when U.S.-trained researchers return home and
 

want to continue their research yet have limited opportunities. To facilitate this transition, Fogarty will expand
 

its competitive re-entry global research grant awards.
 

This program enables foreign investigators trained at the
 

NIH or through Fogarty-funded training programs to continue their research at home, providing the stability of
 

support they need on their path to independence. 


FOGARTY STRATEGIC PLAN 2008-2012 23 

 

GOAL IV: Foster a sustainable research environment in low- and middle-income countries. 

The development of priority interventions for global 

health requires a sustainable base of research sites 

in LMICs. Establishment of highly capable research institutions in these countries will be critical to achieving 

solutions to current disease burdens, and to training the 

research workforce of the future. 

Fogarty is committed to help build a sustainable research 

environment through centers of research excellence in 

low- and middle-income countries. Past Fogarty investments have multiplied the number of foreign investigators working at research institutions abroad—scientists 

at the forefront of global health research who will benefit 

from the support of increased resources and facilities. 

Fogarty will foster the evolution of their local 

institutions into centers of excellence by promoting 

research “hubs,” advancing the use of sophisticated information and communication 

technologies (ICT), and encouraging the formation of Fogarty alumni networks. 

STRATEGIC PRIORITIES 

•	 Support the development of research hubs in low- and middle-income countries. 

Fogarty envisions research “hubs” as a way to enrich and sustain the research capacity 

of any single institution by linking that institution with other sites, or nodes, within a 

country or across a region. The institutes linked to a hub will constitute a network to 

provide a variety of opportunities. Depending on the varying individual strengths of 

network members, a hub or its nodes will provide a resource for training in areas such 

as bioinformatics, bioethics, clinical trials, research management and administration. 

A hub also might promote interdisciplinary approaches to address research problems. 

For example, an institution with a strong infectious disease focus might link through 

a hub to an institution providing curricula and resources to support the exploration of 

the relationship between infections and chronic, noncommunicable diseases. Individual 

hubs themselves could also in turn be networked to each other and other centers of 

research in a region or country. 

•	 Bolster the development of expertise and use of information and communication technologies 

(ICT) in support of research and research training programs. 

The past two decades have seen explosive expansion of cell phone technology and 

global access to broadband internet connections that has changed the panorama of 

communication and information exchange. This has afforded researchers new opportunities for training, access to the medical literature and collaboration. ICT usage ranges 

from simply enabling colleagues to keep in touch and access the scientific literature 

to sophisticated systems for long distance learning, experimental design, and data 

management and analysis. As Fogarty moves towards developing global health research 

hubs, strengthening appropriate ICT core capability among researchers and between 

institutions will be a key element that will ultimately benefit all areas of Fogarty and 

NIH international investment. It will allow physicians and health scientists and their 

staff in the most remote areas to access state-of-the-art information and consultations 

in their own languages and in real time. 

FOGARTY STRATEGIC PLAN 2008-2012 25 
Fogarty will work to extend some successful global health research initiatives with 

ICT resources in LMICs, by Fogarty grantees and others, and explore current and future 

needs and opportunities in this area. There are clearly some challenges to existing 

ICT tools and networks, such as cost and limitations of bandwidth. This effort will 

be undertaken to enable the research environment in the hubs to be as effective as 

possible in supporting and sustaining research collaborations and training programs. 

Efforts to increase ICT infrastructure are underway worldwide, but research-relevant 

training to creatively address the challenges of managing information and extracting 

new data remains an underserved need. Since 1998, Fogarty has supported a dedicated 

program in informatics research training to produce master’s and doctoral level experts. 

Fogarty also provides ICT training relevant to specific research programs. Expanded 

ICT initiatives linked with research hubs will translate into informatics cores able to 

supply ICT training for all research teams at an institution. 

• Sponsor the development of Fogarty alumni networks. 

To advance the careers of scientists who have completed Fogarty research training, 

Fogarty will support the creation of alumni networks linking the newest generations 

with established leaders in global health science. Alumni networks can promote the 

exchange of information and advice, address queries, and publicize research opportunities in LMICs. The existence of alumni organizations will enable Fogarty to capitalize 

on the resources of over 2,700 former trainees and cultivate relationships between 

recent graduates, their mentors, and other senior scientists. 

26 PATHWAYS TO GLOBAL HEALTH RESEARCH 
 

GOAL V: Build strategic alliances and partnerships and in global health 

research and training. 

Over the past decade a transformation has occurred in the diversified and integral role 

that foundations and corporate entities have taken in the arena of global health ranging 

from the delivery of childhood vaccines to the development of therapeutic innovations 

for diseases of poverty. Strategic partnerships will be an essential component of each 

of the priorities outlined in the Fogarty plan, with the overarching goal to seed research 

and related training as integral components of disease control and prevention activities. 

Collaborative arrangements with external organizations will incorporate the working 

principles of Fogarty: co-sponsored programs will be based on objective assessments 

of medical and public health needs, the state of scientific knowledge in a given field, 

application of the best evidence-based practices, and technical advances that make new 

approaches feasible. 

Fogarty will continue to work closely with the State Department and other federal agencies, NIH partners, the National Academies of Sciences, Non-Government Organizations, 

philanthropies, private and not-for-profit groups and other national and international 

agencies to promote greater scientific collaboration across nations, by building bridges 

and partnerships between scientists and institutions. Since its establishment, the 

Fogarty Center has served as the NIH nexus for international research by informing, 

initiating, and coordinating international health and research activities for the agency. 

With the growth of global health investments by the U.S. government and other donors, 

as well as the development of new national health systems and public health policies in 

low- and middle-income countries, the partnership opportunities for Fogarty to promote 

international research collaboration can be expected to grow. 

FOGARTY STRATEGIC PLAN 2008-2012 27 
STRATEGIC PRIORITY 

• Forge partnerships based on mutual interest and complementary strengths. 

As the premier medical research funding agency in the world, the NIH represents a 

rich store of intellectual capital that can be mobilized to support global health research. 

To address the goal of research on noncommunicable and infectious diseases, Fogarty 

will work with NIH colleagues committed to research in these areas and identify ways 

to support their mission through international research opportunities. Fogarty will also 

enhance NIH overseas investments by continuing to build a critical mass of scientists 

abroad who can collaborate and partner with U.S. colleagues. 

As the economies of LMICs strengthen, many recognize the value of health research 

and scientific infrastructure and are expanding their investments. For example, in 2007, 

the African Union established a wide-reaching research agenda for Africa, accompanied 

by pledges from African leaders to increase government funding of research and development. Countries like China, India and Brazil realize that scientific innovation can pave 

the way to growth and prosperity, and are building major research institutions and 

attracting the best and brightest scientists from around the world. In response, Fogarty 

will foster new relationships with these scientific agencies and professional bodies in 

these nations, working with these groups as partners in supporting health research and 

research training. Where new challenges to global health arise, such as that posed by 

climate change, Fogarty will work with these and other partners to take advantage of 

existing and new programs to advance priority research and research training. 

28 PATHWAYS TO GLOBAL HEALTH RESEARCH 
6. FOGARTY ADAPTS TO SERVE CHANGING NEEDS IN 


GLOBAL HEALTH RESEARCH 

International trade, travel and the Internet have created a world that is connected as 

never before. Opportunities to advance science for global health, promote transnational 

research collaborations, and apply life-saving and life-extending medical advances 

abound, paving the way for a world of healthy societies and sound economies tomorrow. 

Already distinctions between developed countries and LMICs are blurring so that the 

emerging global health agenda is truly global—addressing diseases, risk factors and 

lifestyles common to all countries. At the same time, experience has taught us that the 

solutions to many genetic diseases, cancers, infections, and environmental problems 

can be developed faster by enabling science in settings where diseases are concentrated 

and by promoting collaborations with local investigators. 

Congressman John E. Fogarty was visionary in arguing the needs and rewards of global 

health research a half century ago. This Strategic Plan extends the Congressman’s foresight, setting an ambitious course for the years ahead, taking Fogarty’s programs in fresh 

directions, embracing new partnerships, and helping to build the global health research 

enterprise in the U.S. and around the world. It is dedicated to moving us closer to the 

ideal of global health, one that reflects the aspiration of every human being on the planet 

to live a long and healthy life. 
7. APPENDIX 

Development and Implementation of the Strategic Plan 

An inclusive process. The development of the Fogarty Strategic Plan began with the 

arrival of Dr. Roger I. Glass as the new director in the summer of 2006. The goal was to 

create a transparent and inclusive priority-setting process. So it was that Fogarty held 

staff retreats, consulted its advisory board, conducted analyses of current activities and 

programs, and, most importantly, listened to what stakeholders around the world had 

to say in person (holding stakeholder meetings in Maryland and Cairo) and via the Web. 

Throughout the planning process, Dr. Glass engaged in a “listening tour,” in which he 

conferred with fellow NIH Institute and Center Directors, leaders of non-governmental 

organizations and others prominent in global health research. A final draft of the plan 

was posted on the Fogarty Web site for comments in January 2008 and with further 

changes went to press in June 2008. 

Implementation and Evaluation 

For each of the five strategic plan goals, one or more Fogarty inter-divisional working 

groups have been formed. These groups will develop implementation plans and performance targets to document progress under each goal, facilitated by consultations with 

outside experts in specific areas. Fogarty programs are evaluated every five years using 

outside experts and consultation and follow the Fogarty Framework for Evaluation 

http://www.fic.nih.gov/about/plan/eval_framework.pdf. 

30 PATHWAYS TO GLOBAL HEALTH RESEARCH 
 

Photo Captions and Credits 

Front cover (from left to right): 

Children living in resource-poor countries, such as these in Nepal, are 

particularly vulnerable to health issues. Stock Connection RM Rights Managed 

Photograph 

Fogarty’s training programs are designed to build local research capacity in 

low-and middle-income countries. Here an Ethiopian scientist works in a 

laboratory in Addis Ababa. Copyright: WHO/P. Virot 

Mosquitoes transmit a number of infectious diseases. Stockbyte Royalty Free 

Photograph 

Smoking contributes to the growing epidemic of chronic, non-communicable 

diseases throughout the world, a focus of the new strategic plan and Fogarty’s 

International Tobacco and Health Research and Capacity Building Program. 

This Lebanese smoker is at increased risk of cancer and heart disease. 

Curt Carnemark/The World Bank 

Many infectious diseases are caused by viruses, such as this one rendered in 3d. 

Copyright: Alexander Kozachok 

Inside Cover 

Fogarty’s new strategic plan promotes healthy lives from childhood into old age. 

Copyright: Getty Images 

Interior Photos (all left to right) 

Page 2 

Having the people and resources in place to do the work is central to Fogarty’s 

ideal of taking science to places where health problems exist, such as this 

flooded area of Nigeria. Yosef Hadar/The World Bank 

Fogarty’s training programs are designed to build local research capacity in 

low-and middle-income countries. Here an Ethiopian scientist works in a 

laboratory in Addis Ababa. Copyright: WHO/P. Virot 

Page 3 

Fogarty Director Dr. Roger I. Glass accompanied HHS Secretary Mike Leavitt 

to Africa in August 2007 to observe U.S. government-supported programs in 

action. Photo courtesy of Dr. Roger I. Glass 

Page 4 

Increased urbanization can often lead to a rise in both infectious and chronic 

diseases. Here a densely populated section of Ankara, Turkey is shown. 

Copyright: Getty Images 

In September 2007, Fogarty and the National Institute of Allergy and Infectious 

Diseases sponsored a polio symposium examining eradication efforts. Here a 

child receives oral polio vaccine in Angola. Copyright: WHO 

Page 5 

Countries experiencing rapid economic growth like China have also seen major 

increases in life expectancy. Copyright: Getty Images 

Fogarty is a major proponent of implementation science. Here a doctor visits a 

patient through Progresa, Mexico’s incentive-based development program that 

targets the very poor. Copyright: InterAmerican Development Bank 

Mosquitoes transmit a number of infectious diseases. Stockbyte Royalty Free 

Photograph 

Page 6 

Fogarty Scholar Paul Drain checks blood pressure at a rural clinic in Tanzania 

as part of his year-long global health research project. Photo courtesy of 

Paul Drain 

Page 7 

These women laborers carrying mud in Bangladesh exemplify the conditions 

in which many people in low-and middle-income countries exist. Scott 

Wallace/The World Bank 

Scholars supported by Fogarty’s International Cooperative Biodiversity 

Groups program conduct research in Papa New Guinea. Photo courtesy of 

Dr. Joshua Rosenthal 

Fogarty’s Clinical Scholar program offers an opportunity for highly motivated 

individuals to experience mentored research training at top-ranked NIH-funded 

research centers in developing countries throughout Africa, Asia and the 

Americas. Photo courtesy of Dr. Aron Primack 

Children living in resource-poor countries, such as these in Nepal, are 

particularly vulnerable to health issues. Stock Connection RM Rights 

Managed Photograph 

Page 8 

As life expectancy increases, people like this Indian boy will be more 

susceptible to chronic, non-communicable diseases such as diabetes, heart 

diseases and cancer. Ray Witlin/The World Bank 

Fogarty grantee Dr. Nirbhay Kumar and colleagues at Johns Hopkins are 

working to develop a human malaria transmission-blocking vaccine that would 

interfere with the development of sexual stages in mosquitoes and could significantly reduce malaria transmission. Photo courtesy of Dr. Nirbhay Kumar 

Page 9 

Both infectious and chronic non-communicable diseases pose health problems 

for slums such as this favela, rising on the outskirts of Salvador de Bahia, Brazil. 

Scott Wallace/The World Bank 

Page 10 

Representative John Fogarty in front of the U.S. Capitol. 

Fogarty’s AIDS International Training and Research Program supports training 

of local scientists to help them address the HIV/AIDS epidemic affecting so 

many, including this widow in Kenya. Copyright: 2005 Felix Masi/Voiceless 

Children, Courtesy of Photoshare 

Page 11 

Fogarty grantee Dr. Chris Plowe tests a new malaria vaccine in Bandiagara, 

Mali. Photo courtesy of Chris Plowe 

Fogarty develops local research capacity to improve the care provided in 

the developing world, including in hospitals such as this one in Ethiopia. 

Copyright: WHO/P. Virot 

Page 12 

Fogarty’s Ecology of Infectious Diseases program supports research to examine 

how environmental events—such as habitat destruction, biological invasions 

and pollution—alter the risks of emerging diseases in humans and animals. 

Recent studies suggest a correlation between rice farms, such as this one in 

Vietnam, and the spread of bird flu by infected ducks drawn to the paddies. 

iStockphoto/Copyright: Ashley Whitworth 

President and Mrs. Carter give a long-lasting insecticidal bed net, which 

prevents malaria, to Mrs. Hlmenlike, who hosted the Carters in her home 

during their tour of the Center’s health work in the remote village of Afeta 

in southwest Ethiopia. Copyright: Louise Gubb/The Carter Center 

In 2002, President Clinton established the Clinton HIV/AIDS Initiative (CHAI) 

to reorganize markets and work with governments to make treatment more 

accessible in the developing world. Now, more than 1.4 million people living 

with HIV/AIDS have access to lifesaving antiretroviral treatments purchased 

under CHAI pricing agreements. Photo and caption courtesy The Clinton 

Foundation; Copyright: Ralph Alswang/The Clinton Foundation 

Page 13 

Fogarty-supported researchers from the University of Papua New Guinea 

and the Forestry Research Institute study native plant and marine sources of 

therapeutic molecules as part of the International Cooperative Biodiversity 

Groups program. Photo courtesy of Dr. Joshua Rosenthal 

Bill and Melinda Gates visit a children’s ward inside the ICDDR,B 

(International Centre For Diarrhoeal Disease Research, Bangladesh clinic and 

Research Center and BRAC (Bangladesh Rural Advancement Committee) 

Center in Dhaka, Bangladesh. Photo and caption courtesy of the Bill &

Melinda Gates Foundation) 

FOGARTY STRATEGIC PLAN 2008-2012 31 
Page 14 

Deforestation poses a number of public health concerns, including increases 

in malaria and other vector-borne diseases. Copyright: istock 

Many infectious diseases are caused by viruses, such as this one rendered in 3d. 

Copyright: Alexander Kozachok 

Page 15 

Fogarty’s ecology of infectious diseases program focuses on major ecological 

and environmental changes resulting from the growth and migration of 

populations, rapid industrialization and clearing of lands for agriculture. 

Copyright: Getty Images 

Page 16 

Though Fogarty’s new strategic plan addressed the growing prominence of 

chronic diseases, the huge toll taken by HIV/AIDS cannot be ignored. 

Here, an Indian woman with AIDS convalesces in a hospital. John Isaac/ 

The World Bank 

Page 17 

Fogarty’s strategic plan seeks to both create new partnerships and to strengthen 

existing international alliances. Here Fogarty’s director Dr. Roger Glass looks 

on while NIH Director Dr. Elias Zerhouni signs an agreement with Dr. Raj 

Bhan, India’s Secretary to the Department of Biotechnology. Photo: NIH 

Fogarty’s International Cooperative Biodiversity Groups program supports 

efforts to examine the medicinal potential of the earth’s plants, animals and 

microorganisms—such as the algae shown here. Copyright: Dennis Kunkel 

Microscopy 

Fogarty’s International Training and Research Program in Environmental and 

Occupational Health program was established to train researchers in the 

developing world to investigate occupational and environmental problems, 

such as exposures to toxic chemicals and pollutants. China’s air pollution 

is a health concern for these women who commute by bicycle. Curt 

Carnemark/The World Bank 

Page 18 

People such as this Nigerian man have become more susceptible to 

non-communicable chronic diseases as their life spans have increased. 

Curt Carnemark/The World Bank 

Page 19 

Smoking contributes to the growing epidemic of chronic, non-communicable 

diseases throughout the world, a focus of the new strategic plan and Fogarty’s 

International Tobacco and Health Research and Capacity Building Program. 

This Lebanese smoker is at increased risk of cancer and heart disease. 

Curt Carnemark/The World Bank 

Access to safe drinking water in countries such as India is a major health 

concern. Copyright: WHO/P. Virot 

More than 10 percent of children die before the age of 5 in low- and middleincome countries such as Peru. Scott Wallace/The World Bank 

Page 20 

Improving environmental health continues to be one of Fogarty’s strategic 

priorities. Urban areas such as this one in China are exposed to a wide range 

of environmental health hazards. Curt Carnemark/The World Bank 

Reducing the prevalence of childhood diseases in low-and middle-income 

countries through vaccinations is a continuing mission for Fogarty. 

Photo courtesy of Dr. Roger Glass 

Page 21 

Fogarty’s strategic plan emphasizes the use of implementation science to 

address the gap between health innovations and their delivery to communities 

in need such as this village in Africa. Photo courtesy of Dr. Roger Glass 

Infectious diseases may play a role in chronic diseases. Women across the world 

are at risk from cervical cancer associated with a type of human papillomavirus. 

Curt Carnemark/The World Bank 

Page 22 

One of the “10 Best Health Buys” of the Disease Control Priorities Project is to 

monitor the health of children such as this young Bangladeshi child. Shehzad 

Noorani/The World Bank 

Page 23 

Fogarty’s Stigma and Global Health Research Program was designed to stimulate 

interdisciplinary research on the role of stigma in health, and on how to 

mitigate its negative effects on the health of individuals and societies 

worldwide. Here Fogarty grantee Gretchen Birbeck works with Zambian 

children who suffer from epilepsy. Photo courtesy of Gretchen Birbeck 

Chris Plowe, principal investigator on a Fogarty Global Infectious Disease 

Research Training program, and his Malian colleague, Abdoulaye Djimde, 

conduct malaria research. Photo courtesy of Chris Plowe 

Fogarty is building the next generation of global health innovators through 

its program for clinical research scholars. The program allows health science 

students to work with scientists abroad, developing the skills, cultural 

sensitivities, and collaborations they need to build future careers. Photo 

courtesy of Dr. Aron Primack. 

Page 24 

Waterborne diseases pose a serious health threat in many countries. Thomas 

Sennett/The World Bank 

Fogarty is committed to building centers of research excellence throughout the 

world. Here a researcher from Papa New Guinea conducts works in a laboratory 

supported by Fogarty’s International Cooperative Biodiversity Groups program. 

Photo courtesy of Dr. Joshua Rosenthal 

Page 25 

The establishment of a sustainable base of research expertise throughout 

low- and middle-income countries will be essential to improving global health. 

Here scientists work at the Joint Clinical Research Center in Kampala, Uganda. 

Photo courtesy of Dr. Linda Kupfer 

The expansion of broadband internet and other communications technologies 

have transformed global health research and research training. Here a 

researcher funded by Fogarty’s International Cooperative Biodiversity Groups 

program utilizes an internet connection in Papa New Guinea. Photo courtesy 

of Dr. Joshua Rosenthal 

Page 26 

Fogarty’s Global Infectious Disease program supports research training on 

communicable diseases. Here an Ethiopian child receives poliomyelitis 

vaccination and immunization. Copyright: WHO/P. Virot 

Researchers in Uganda, including former Fogarty trainees, attend a journal 

club talk sponsored by the Uganda Society for Health Scientists at Makerere 

University Medical School in Uganda. This group has received supplemental 

funding to form a Fogarty alumni association through an AITRP grant. Photo 

courtesy of Dr. Jeanne McDermott 

Dr. Akira Masaike discusses US-Japanese cooperation with Fogarty director 

Dr. Roger I. Glass and Dr. Michael Gottesman, Deputy Director of Intramural 

Research at NIH during a reception to honor the new Japan Society for the 

Promotion of Science fellows. Photo: NIH 

Page 27 

Fogarty’s International Clinical, Operational and Health Services Research 

and Training Award supports training for researchers in low- to middle-income 

countries, such as these in the Ukraine. Photo courtesy of Alexis McLean 

Page 28 

High concentrations of arsenic in drinking water pose a health risk in India 

and other countries. Copyright: Curt Carnemark/The World Bank 

In October 2007, Fogarty sponsored an event to launch the Council of Science 

Editors’ 2007 Global Theme Issue. More than 230 journals throughout the 

world simultaneously published articles devoted to the topic of poverty and 

human development. Photo: NIH 

Page 29 

Rhode Island Representative John Fogarty (1913-1967) was a lifelong 

advocate of international biomedical research, claiming “disease knows no 

national boundaries.” 

Lack of clean water and unsanitary living conditions pose health challenges 

in many parts of the world including this shantytown in Rio De Janeiro, Brazil. 

iStockphoto/ Copyright: Joseph Luoman 

Page 30 

As life expectancy increases, this African man shares many of same 

health concerns of a man of the same age in the developed world. Copyright: 

Getty Images 

Page 31 

Cairo was the site of one of many consultations to elicit input from Fogarty’s 

stakeholders as the new strategic plan was developed. Watercolor painted 

by and courtesy of Joan Wilentz 

Page 33 

Despite numerous advances in global health, problems still exist in many 

low-and middle-income countries. This elderly Indian woman who fled hardship 

in the Andes now lives in a Lima shantytown. Scott Wallace/The World Bank 

32 PATHWAYS TO GLOBAL HEALTH RESEARCH 

The John E. Fogarty 

International Center 

31 Center Drive
 

MSC 2220
 

Bethesda, Maryland 


20892-2220
 

301-496-2075
 

www.fic.nih.gov
 

NIH Publication No. 08-6261
 

May 2008