Disease has no borders - we need to think globally about health and disease. U.S. and international teams funded by NIH have made important progress in both infectious and chronic, non-communicable diseases affecting people worldwide. Modern research tools and an ability to read the genetic language of disease-causing bacteria, viruses, and parasites have led to new approaches to well-known threats like malaria, tuberculosis, and HIV/AIDS. Chronic, non-communicable conditions like cancer, heart disease, low birth weights, and obesity, contributing to more than half of all deaths in the developing world, likewise require focused attention. NIH is providing financial and human resources to attack these diseases, and is fostering teamwork among scientists, health organizations, and regional governments.
The NIH Common Fund supports three global health programs, the Medical Education Partnership Initiative (MEPI), the Human Heredity and Health in Africa (H3Africa) initiative, and the Household Air Pollution Investigation Network (HAPIN) initiative. In collaboration with the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), MEPI is supporting medical education in Sub-Saharan Africa by strengthening clinical and research capacity. The aim is to improve the quantity, quality and retention of health professionals in Africa in order to provide services and conduct locally relevant research. H3Africa, a partnership with the Wellcome Trust in the UK, is creating and supporting the development of expertise among African scientists in order to establish networks of African investigators and facilitate the study of genomics and environmental determinants of common diseases. HAPIN is partnering with the Gates Foundation, the Global Alliance for Clean Cookstoves (GACC), and the Global Alliance for Chronic Diseases (GACD) to reduce household air pollution in Low and Middle-Income Countries and its associated negative health outcomes through clean cooking interventions.
The Human Heredity and Health in Africa (H3Africa) Initiative aims to enhance the capabilities and capacities of African scientists to enable a contemporary research approach to the study of the genomics and environmental determinants of disease and to use this information to improve the health of African populations. H3Africa is contributing to the development of a viable and productive genomics-based research infrastructure through a combination of leveraging the existing capacity, expertise, and infrastructure within African institutions and making investments in new approaches to developing world-class genomics research capability.
During its first stage of funding, H3Africa established a Bioinformatics Network (H3ABioNet), set up three Biorepositories, and launched Biomedical and ethical, legal and social implications (ELSI) research projects focused on genomics, environment, and disease. The research projects fall into two categories; independent single-investigator research projects and large, multi-investigator collaborative center research projects intended to address more complex biomedical questions that may span multiple African countries. H3Africa investigators have developed bioinformatics training resources, published original research in respected peer-reviewed journals, and developed ELSI guidelines and best practices for genomics research in Africa.
H3Africa was recently approved for a second five years of funding beginning in fiscal year 2017 to expand upon the accomplishments of the first stage. Unique aspects of H3Africa stage 2 include an Administrative Coordinating Center and a Bioinformatics Research Training Program. Through the support of infrastructure development, training, and specific research projects, H3Africa is bring the technology and strategies of contemporary genomics research to studies of diseases of particular relevance to African populations, and by doing so is benefiting societies around the world.
The Medical Education Partnership Initiative (MEPI) Program aims to provide support to improve quantity, quality and retention of health professionals in Africa through capacity building and locally relevant research projects. MEPI is a joint-program funded by the President’s Emergency Plan for AIDS Relief (PEPFAR) and the National Institutes of Health.
MEPI was launched in 2010 providing direct support for transformative models of medical education in Sub-Saharan Africa by strengthening clinical and research capacity. A total of 20 awards were made to in 13 African institutions in 12 countries after a competitive grants review process: 11 programmatic awards (~ 2 million USD per year for 5 years with emphasis on HIV/AIDS, TB and malaria as PEPFAR-focused areas), 6 linked awards (500,000 per year for 5 years with emphasis on other health areas such as malignancy, maternal and child health, mental health, cardiovascular health, emergency medicine), 2 pilot awards (250,000 per year for 5 years), one coordinating center award to a joint US-African Institutions. MEPI is administered by the Fogarty International Center of NIH and the HIV/AIDS Bureau of the Health Resources and Services Administration (HRSA).
The Common Fund of NIH supports six linked awards and two pilot awards in support of the Medical Education Partnership Initiative. The supported research training and research projects vary in scope including maternal child health, cardio-vascular health, HIV-related malignancy, emergency medicine, and mental health, among others. Office of AIDS Research provides support to 7 programmatic awards while other Offices, Institutes and Centers such as ORWH, NHLBI, NCI, NIMH, NINDS, NHGRI and FIC provide support to various linked awards.
The newest NIH-supported component of MEPI is intended to to foster the next generation of African faculty researchers by providing research training and mentored research opportunities for junior faculty in MEPI-supported institutions.
The HAPIN initiative aims to accelerate the development and testing of solutions to household air pollution (HAP) and associated disease in Low and Middle Income Countries (LMIC). HAPIN is a partnership between the Gates Foundation, the Global Alliance for Clean Cookstoves (GACC), and the Global Alliance for Chronic Diseases (GACD).
The Common Fund will provide $6 million towards the Household Air Pollution Health Outcomes Trial to support biomarker development and validation. The biomarker development and validation initiative will identify biomarkers of exposure associated with solid fuel usage – an underfunded area of research – and make them available to the global community for assessing the health impact of reducing HAP. Common Fund will also provide support for the Implementation Science Network (ISN). The ISN will comprise 25-30 scientists who will study the adoption of new technology and household behavior change in LMICs around the basic daily tasks of cooking in order to design implementation plans for the sustained replacement of solid-based fuels with clean fuels.
HAPIN is assisting a global initiative to begin transitioning roughly 3 billion people in LMICs away from pollutant-emitting solid fuels towards cleaner and safer fuels. Additional information is available through the Fogarty International Center (HAP news and ISN news).