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this hemisphere. And I would be happy also to tell you more about what we are doing under this initiative.

Finally, we continue our efforts to bring together the scientists from the leading laboratories of the United States and those in Western Europe, Japan, and other developed countries, among the best and brightest in the world. And I might say, Mr. Chairman, that that includes in recent years three bright young scientists from abroad who have gone to institutions in Iowa and four leading Iowan scientists who went to different places around the world, and all of these to work on such problems as heart disease, cancer, diabetes, and Alzheimer's disease, among others.

PREPARED STATEMENT Senator, with our 1992 budget request of $19,922,000, I expect that the Fogarty Center will not only continue, but expand its critically important role in the world's No. 1 goal, which is better health for all.

I would be pleased to respond to any questions. (The statement follows:)

STATEMENT OF DR. PHILIP SCHAMBRA

The global biomedical research community is being influenced increasingly

by a rapidly changing world--scientifically, politically, and economically. The emergence of democratic governments in Central and Eastern Europe and

Latin America, the collective decision by the countries of Western Europe to

unify their economies, and the movement by many former socialistic societies

toward a free market have provided new challenges and new opportunities for

scientists and institutions dedicated to biomedical research.

These events

have stimulated a climate of greater openness on the part of scientists

throughout the world and have made possible extraordinary opportunities for

scientific collaboration.

The worldwide pattern of diseases threatening human well-being is

continually changing.

The programs of the Fogarty International Center weave

together tightly to form a comprehensive yet flexible response to these

challenges. During FY 1990, FIC programs increased the number of collaborating scientists worldwide, and enabled newfound discoveries to be

discussed and studies to be undertaken in laboratories in remote areas of the

world.

Through continuing such combined and collaborative efforts the nature

of these diseases can be understood and their incidence reduced.

It is the mission of the Center to stimulate and enhance this

collaboration at all levels..scientist-to-scientist, institution-to

institution, and nation-to-nation.

We can count a number of successes toward

this objective this past year.

We have begun new initiatives in International

cooperation that take advantage of the improved political climate in Latin

America and Eastern Europe.

We are working closely with the NINDS to develop

a program of cooperation on international aspects of the "Decade of the

Brain," including joint support for a targeted fellowship program, as well as

international workshops and conferences.

The Fogarty Center's ability to marshall NIH research expertise in

response to changing world conditions are exemplified by its two regional

initiatives in Latin America and the Caribbean, and Central and Eastern

Europe, which were implemented in FY 1990.

To date FIC has provided support

for 18 scientists from 6 NIH institutes to conduct cooperative research

activities in 5 countries in Central and Eastern Europe; and for 20 scientists

from 10 NIH Institutes to conduct cooperative research activities in 10

countries in Latin America and the Caribbean.

FIC has also provided support

for 17 scientists from these regions to conduct research in 7 Institutes of

the NIH.

An example is the support provided for a Czechoslovakian scientist

to work in the laboratory of an NIH Nobel Laureate to develop an understanding

of an epidemic of spongiforn encephalopathy in her native country, and its

relationship to similar devastating neurological diseases such as Creuzfeldt. Jacob (CJD) Disease. This collaboration appears to have led to the discovery

of a genetic defect in CJD victims.

Based on the high level of interest in

these two regional initiatives, it is expected that activities will greatly

expand in Fiscal Years 1991 and 1992.

The Center employs a variety of fellowship and exchange programs that

support scientists at every level of experience to promote the interchange of new ideas and scientific knowledge. The research of these FIC-supported

scientists spans the breadth of biomedical investigation. Research

discoveries that have been made in the fields of cancer, neurobiology,

diabetes, and AIDS illustrate this diversity.

Our Senior International Fellowship (SIF) program supports experienced American scientists to conduct research overseas with foreign colleagues.

Since 1975, the SIF program has funded nearly 700 U.S. scientists; In Fiscal

Years 1991 and 1992, the Center expects to award fellowships to 87 U.S.

investigators.

o An American scientist at the Imperial College in London has

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o An American scientist at the Institute for Cancer Research in

London has studied a particular oncogene associated with the

malignant transformation of normal cells.

He found that this

oncogene alters the structure of regulatory proteins which

control normal cell division.

By identifying such individual

steps in carcinogenesis, more specific and effective therapies

can be developed.

Since 1958, FIC's International Research Fellowships (IRF) have been

awarded to more than 2,700 scientists from over 50 developed and developing

countries.

In Fiscal Years 1991 and 1992, FIC plans to fund 190 new IRF

awards to applicants to conduct research in laboratories in more than 20

states.

In addition, during this same period, FIC expects to fund second year

awards for 108 IRFs who began their fellowships in Fiscal Years 1990 and 1991.

Research funded through this program is finding solutions to problems that

affect mankind.

o Two foreign scientists are working on the cause of Alzheimer's

disease, an increasingly important public health problem due to

the increase in life expectancy of the world's population.

One

of the characteristic pathological changes in the brain of a

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O A Hungarian scientist at the Joslin Diabetes Center of Harvard

University has conducted studies on human cell receptors for

insulin.

These receptors are the passage ways through which

insulin gains entry into the cell.

It is within the cell that

insulin has an influence on the metabolism of sugars.

For this

reason this scientist is seeking ways to hasten the entry of

Insulin by modifying the insulin receptors-to "widen the

passage ways", so to speak.

This sort of research may open up

the prospect of new op

ortunities for the treatment of diabetes.

Much is expected of FIC's Scholars-in-Residence who represent the best

the world has to offer in biomedical research.

Eight to ten Scholars work at

the NIH at any one time.

A Norwegian Scholar is internationally known for his with NCI investigators on the relationship between dietary nutrients and

pioneering research on fatty acid metabolism and the role of lipids in the

pathogenesis of cardiovascular disease.

As a Fogarty Scholar he plans studies

cancer.

These efforts will include research on the role of retinoids--vitanin

A and related compounds--on cell growth.

Such studies may lead to new

strategies for cancer therapy.

The FIC AIDS research and fellowship training programs, mandated by

Congress, have been established in 11 U.S. universities.

Now in their third

year of operation, they have trained epidemiologists, postdoctoral scientists,

and clinical investigators from 44 countries primarily in the developing

world.

By the end of this fiscal year, 90 scientists will have received a

graduate degree in public health or sc:

ce, and 50 will have received post.

doctoral research training. Approximately 3,500 health care workers will have

taken U.S. supervised short-term courses in their own country in epidemiology

and laboratory procedures. Through these efforts these countries can and are

joining with us in international cooperation in AIDS research.

Under this AIDS training program two scientists from Uganda are in

advanced training at Case Western Reserve University.

One scientist is

conducting research on the influence of the AIDS epidemic on the occurrence of

tuberculosis (TB).

TB has become a major complication in AIDS patients in all

parts of the world including the United States.

New strategies must be

developed to combat this double threat.

The other scientist is examining the

influence of protein-energy-malnutrition (PEM) on HIV infection in infants and

young children.

The seriousness of PEM as a common problem in Africa is

compounded by the alarming increase in AIDS in infants and young children.

This research should lead to new strategies for nutrition therapy in AIDS

infected infants.

The Fogarty Center plays a major role within the NIH in facilitating

scientific cooperation between NIH scientists and those of other countries of

the world.

Staff of the Center provide policy guidance and direction, assist

in the development and management of bilateral and multilateral biomedical

agreements, programs and initiatives, and analyze international health and biomedical issues to support NIH, Departmental, and Administration decision

makers.

The Center also links the NIH with other international components of

the Department of Health and Human Services, the Department of State,

the

White House Office of Science and Technology Policy, foreign scientific

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