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Senator HARKIN. Dr. Schambra, the committee has your request of $19.9 million, which is $13.7 million more than last year.

We are familiar with your programs to support visits of foreign scientists to the United States and the placement of U.S. scientists overseas. The committee looks forward to hearing about your expanding Eastern European and Latin American initiatives.

Welcome and please proceed with your statement.

Dr. SCHAMBRA. Thank you, Senator.

Senator, I will be even briefer than the prepared summary of my opening statement, both of which I would like to submit for the record with your permission.

Senator HARKIN. Certainly.

Dr. SCHAMBRA. Mr. Chairman, I think it is clear that we live in a time of enormous changes and of enormous challenges and opportunities. The countries of central and Eastern Europe and the Soviet Union have opened up and our scientists have responded. We have much to give and much to learn in the exchanges which are taking place and growing day by day aided by our Eastern European initiative which the Congress has so strongly supported. I would be pleased to tell you more about what we are doing under that initiative later on in response to a question or for the record, if you wish.

Likewise, the importance of collaborating with scientists and institutions in developing countries is becoming increasingly clear. Not only must these countries deal with old, unconquered diseases such as malaria and cholera-and as you know from the papers right now, cholera is killing hundreds of people in South America even today-but also the poorer regions of the world are often the source of new diseases such as AIDS which threaten the entire world.


Our international AIDS training programs, now in their third year, constitute one of the most important responses by the U.S. Government to addressing the AIDS problem by helping developing countries participate in research on this disease and eventually participate in the field trials of vaccines now under development in the NIH and elsewhere.

Because of the threat which diseases in developing countries represent not only to the people of these countries, but also to the people ple of the United States, we began our Latin American initiative last year to expand cooperation between biomedical scientists of

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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.


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:]


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 spongiform encephalopathy in her native country, and its relationship to similar devastating neurological diseases such as CreuzfeldtJacob (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.
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
identified genes that may play an important role in

carcinogenesis, especially in a certain subgroup of susceptible
people. Through an analysis of genetic mechanisms which control
chromosome division, he identified genes responsible for
maintaining normal cell division. Such knowledge will be
important in developing new strategies for prevention or
treatment in susceptible persons.

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.
of the characteristic pathological changes in the brain of a
patient with Alzheimer's disease is the occurrence of multiple
areas of nerve degeneration containing an abnormal protein
called amyloid. These foreign scientists are working on the
cause of the amyloid formation. Such basic studies are needed
to develop methods of treatment and prevention.

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 opportunities 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 pioneering research on fatty acid metabolism and the role of lipids in the pathogenesis of cardiovascular disease. As a Fogarty Scholar he plans studies

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