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institutions, multilateral organizations and non-governmental bodies concerned

with international health and biomedical research.

FIC currently administers

NIH participation in 73 formal biomedical agreements with 39 countries.

To illustrate our role in providing policy guidance and technical

support, in FY 1990 I was appointed Vice Chairman of the Federal Coordinating

Council for Science, Engineering and Technology Committee on International

Science, Engineering and Technology, and Chairman of its Subcommittee on

Cooperation with Industrialized Countries.

These bodies provide government

wide policy guidance on international S&T issues and serve as mechanisms for

interagency planning and coordination.

FIC staff led committee activities to

assess the effects of European economic integration on science and technology

relations with the U.S. and provided guidance for the White House Office of

Science and Technology Policy in this critical area.

As a result of these

efforts, the United States has formed a Joint Consultative Group with the

Commission of the European Economic Community which is chaired on the U.S.

side by the Science Advisor to the President.

In conclusion, the budget request before you will enable the Fogarty Center to significantly enhance its ability to promote International

cooperation in the biomedical sciences for the benefit of all mankind.

We

will be able to expand research in the neurosciences as our contribution to

the "Decade of the Brain,"

as well as expand activities under our two regional

initiatives.

We stand on the threshold of a rapidly changing world that offers new

opportunities for scientific collaboration and the exchange of

ideas. Through our expanded outreach efforts, we can bring home to the

American people the best dividends that derive from medical research wherever

it occurs in the world--better health for all.

Our 1992 budget request is $19,922.00. Mr. Chairman, I will be pleased

to answer any questions you may have. Thank you.

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1956-1958

1958-1961

1961-1963

1964-1965

1964-1967

1966

1967-1968 1968-1971

Research Assistant, Biophysics Department, Yale
University.
Predoctoral Fellow, National Cancer Institute,
Biophysics Department, Yale University.
Research Associate, Institut für Strahlenbiologie,
Karlsruhe, Germany.
Instructor, Department of Medical Physics,
University of California, Berkeley.
Research Biophysicist, University of California,
Berkeley.
Laboratory Director, National Science Foundation
Summer Institute in Radiobiology, University of
California, Berkeley.
Grants Associate, National Institutes of Health.
Budget Examiner, Office of Management and Budget,
Executive Office of the President.
Staff Member, Council on Environmental Quality,
Executive Office of the President.
Associate Director for Interagency Programs,
National Institute of Environmental Health Sciences,
NIH.
Chief, International Coordination and Liaison
Branch, Fogarty International Center, NIH.
Science Attache and PHS International Health
Representative, U.S. Embassy, New Delhi, India.
Director, Fogarty International Center, National
Institutes of Health

1971-1974

1974-1980

1980-1984

1984-1988

1988

Honors and Awards:

1989
1982-1990
1986-1988
1984
1987
1964-1966

PHS Superior Service Award
Outstanding Performance Ratings
Merit Performance Awards
NIH Merit Award
Secretary DHHS Certificate of Appreciation
NASA Research Fellowship, University of California,
Berkeley

NEUROSCIENCE FELLOWSHIPS Senator HARKIN. Dr. Schambra, you have a request for a new program called neuroscience fellowships. What is this?

Dr. SCHAMBRA. Sir, this is a part of our participation in the Decade of the Brain-it's the international dimensions. With the encouragement of the Congress in our 1991 budget, and in collaboration with the Neurology Institute, we plan to initiate a special program of fellowships for senior neuroscientists from Eastern European countries. These people for a number of years have not fully been in contact with the leading scientists in the West and the United States. This new fellowship will bring them to the United States for periods of up to 3 months, which may then be repeated in successive years, to bring their skills up to date. We are providing the travel and the stipend for these senior fellows. The Neurology Institute is providing the support for their research while they are in the United States.

AFRICAN INITIATIVES Senator HARKIN. The President sent Secretary Sullivan to Africa in January to determine ways the United States could improve the dismal health situation for children on that continent.

Does the Fogarty International Center have any plans to help this situation?

Dr. SCHAMBRA. Yes, sir; indeed we have. To place them in perspective, you may recall that last December there was held in New York, at the United Nations, the World Summit for Children, which was the greatest gathering of the largest number of heads of state and heads of government in history. President Bush in his appearance before the summit declared that he was sending Secretary Sullivan and a team to Africa to study the health situation there, especially as it involved children, and to report back on what the United States might do to respond to that situation. I might mention in addition to Secretary Sullivan, Assistant Secretary Mason and the Director of the Child Health Institute, Duane Alexander, participated in that delegation.

The information that they came back with is really quite striking and disturbing. Just to cite some of the information that they reported, of the 15 countries in the world with the highest infant mortality rates, 14 are found in Africa. The child mortality rate is 10 to 15 times higher in sub-Saharan Africa than it is in the United States, and maternal mortality is up to 100 times higher. Major causes of childhood morbidity and mortality include respiratory diseases, diarrheal diseases, malaria, and other parasitic diseasesabout 1 million children a year die from malaria-malnutrition and HIV infections acquired from mothers. There are about 500,000 children in Africa now that are infected with the AIDS virus transmitted from their mothers. And then, of course, the problems associated with high frequency of pregnancies in the population.

What they reported and what they found was that there are needs and opportunities to train African biomedical scientists and health professionals so that they can participate in understanding and assessing their health and population problems and participate in their solution. There is a need to strengthen a few selected health and medical education centers throughout Africa that can provide training, conduct research, disseminate information, and help local governments set priorities for delivery of health services. And there is a need to apply American scientific skills in cooperation with African scientists to find some solutions, such as new and improved vaccines and other means of preventing these diseases.

Even prior to Secretary Sullivan's departure for Africa in January, we worked with our Child Health Institute and our Allergy and Infectious Diseases Institute to try to find ways that we might be prepared to respond to the opportunities and the needs identified there and, in fact, came up with a five-point program. I would be pleased to submit the details for the record. But basically it would consist of a child survival training grant that would be modeled on our very successful AIDS international training grants that we have now, fellowships for Americans to go to Africa and for Africans to come to leading U.S. institutions to gain the necessary skills.

Senator HARKIN. When would that start? Would that start soon?

Dr. SCHAMBRA. As soon as we find the money to do it, sir. (Laughter.)

We would also provide research grant supplements to American scientists already supported by NIH but who need a little extra money to develop the knowledge needed to solve some of these problems.

Senator HARKIN. Well, is that part of your budget request for next year?

Dr. SCHAMBRA. No, sir; this proposal was developed since the visit of the Secretary and others to Africa in January.

Senator HARKIN. Well, I think we ought to ask the Secretary if he would like to increase your budget a little bit to do that then.

Dr. SCHAMBRA. I would be pleased if you would.

Senator HARKIN. We will ask the Secretary. If he wants to follow through, let's match the rhetoric with some resources here.

Thank you very much, Dr. Schambra.

AIDS TEST KIT

Dr. RAUB. Mr. Chairman, you might be interested to know that, complementing the efforts Dr. Schambra was describing, is an activity that is the byproduct of the revenues from the AIDS test kit. The Department of Health and Human Services and the Pasteur Institute in Paris are the co-owners of that invention, which provides a substantial revenue stream. A big fraction of that goes into a foundation called the World AIDS Foundation that is jointly overseen by the two institutions. Dr. Schambra and his staff provide the principal staff support for it. It has created the means to give various types of grants for training especially related to health services associated with AIDS in Africa and Central America, the Far East, and other regions where the AIDS epidemic is either already burgeoning or threatening. It is emerging as a very important complement to the research training and research activities that we do.

QUESTIONS SUBMITTED BY THE SUBCOMMITTEE Senator HARKIN. Thank you both very much. Again, I appreciate your staying here over the lunch hour. There will be some additional questions which will be submitted for your response in the record.

[The following questions were not asked at the hearing, but were submitted to the Center for response subsequent to the hearing:)

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