Global health experts have called on the United States Congress and development community to defend a “vital, lifesaving, modestly funded” global health training and research facility which is earmarked for elimination under U.S. President Donald Trump’s latest budget proposal.
The Fogarty International Center, based in Bethesda, Maryland, and founded in 1968, is the only one of the U.S. National Institutes of Health’s 27 institutes and centers to be singled out for closure in the draft budget released last week.
The document outlining “major savings and reforms” calls for the elimination of the Fogarty center with little explanation, leading some to speculate the NIH center was singled out because its grants fund the training of foreign doctors and research in developing countries which is at odds with Trump’s “America First” policy.
Global health professionals have reacted to the proposed cut with dismay, arguing that the center is of vital importance to keeping Americans and non-Americans safe from deadly viruses which originate in developing countries, such as Zika and Ebola, but do not respect borders.
They also point out that with a budget of only $70 million in the financial year 2017, the center’s closure will hardly create meaningful savings for the administration.
Speaking at a webinar hosted by the Fogarty center last week, Christine Lubinski, vice president of the Infectious Diseases Society of America, said the work the Fogarty center funds was necessary to help predict and contain epidemics, and called on the global health community to defend it.
“This vital, lifesaving, modestly funded program has been earmarked for elimination … to preserve Fogarty is a vital public and global resource,” she said.
Lubinski urged supporters to contact their government representatives to make the case for continued funding, since despite enjoying bipartisan support in the past, and even a funding boost in the financial year 2017, Fogarty was an easy target for cuts.
“Fogarty is still a well kept secret and we have a great deal of education to do,” she said, and warned that programs which members don’t hear about can get “short shrift when funding decision are made.”
The center’s Director Dr. Roger Glass described Fogarty as the largest funder of biomedical research in the world, with approximately 500 active grants in a diverse range of fields from HIV, mobile health and non-communicable diseases, and integral to U.S. leadership in the space.
“[Fogarty] is building out the frontiers of science around the world so the U.S. maintains its position as world leader in global health research,” he said.
He was also keen to point out that the center is actually aligned with the Trump’s “America First” position, since 80 percent of grants go to support U.S. institutions for their international programs, and 100 percent of grants involve some U.S. scientists.
Many of the doctors and scientists who are developed by Fogarty’s multiple training programs, go on to become global health leaders, such as Dr. Marcos Espinal, now chief of the communicable diseases and health analysis at the Pan American Health Organization, Glass said.
“By capturing young investigators, and early in their career giving them [the] skill set needed to be incredibly important future researchers and leaders … it’s a huge return on investment,” he said.
Fogarty alumni are on the frontline in the fight against Zika and HIV/AIDS
Bob Bollinger, from the Johns Hopkins Bloomberg School of Public Health, made a similar point in relation to the Zika virus, explaining that doctors and scientists funded by the Fogarty center are at the forefront of the effort to control the Zika outbreak, which poses a major health threat to the U.S.
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“Thank goodness Fogarty invested in Latin America over the years — because for those of you concerned about Zika infection, and you should be … we have investigators and alumni from the Fogarty program in South America which are looking into solutions now,” he said.
In fact, a Fogarty trainee — Dr. Martin Casapia — is leading the current Zika vaccine trials in Peru, and it makes financial sense for the U.S. to continue to support such efforts, Bollinger added.
“Fogarty alumni are the global health experts that we, in the U.S., need to help address these and future pandemics,” he said.
Chris Beyrer, also from the Bloomberg School of Public Health, outlined the significant role played by Fogarty through its funding of key research on HIV/AIDS, which provided “the glue that holds the international HIV collaborations together,” he said.
He also described the center’s work as having “laid the foundations” for the U.S. President's Emergency Plan for AIDS Relief, set up under former U.S. President George W. Bush.
Fogarty Center activities can help prevent and contain future epidemics
The Fogarty center’s director said the Ebola outbreak in West Africa, which cost the U.S. approximately $2 billion to contain, would have been much less damaging and less expensive had the Fogarty center had a greater presence in the countries most affected.
“In West Africa we had a limited number of research activities in those countries most affected by the Ebola epidemic … and the consequences of that were really quite evident … If we had spent more on prevention … we would have spent much less money,” he said.
Related to this, Fogarty alumni are conducting research in Colombia which could lead to breakthroughs in preventing or delaying the onset of Alzheimer’s disease — which it is estimated could cost the U.S. $1 trillion annually by 2050, Glass said.