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with NCI investigators on the relationship between dietary nutrients and
These efforts will include research on the role of retinoids--vitamin
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
By the end of this fiscal year, 90 scientists will have received a
graduate degree in public health or science, 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 occur ence 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
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
The Fogarty Center plays a major role within the NIH in facilitating
scientific cooperation between NIH scientists and those of other countries of
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
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
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.
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
We stand on the threshold of a rapidly changing world that offers new
opportunities for scientific collaboration and the exchange of
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.
Research Assistant, Biophysics Department, Yale
Honors and Awards:
PHS Superior Service Award
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.
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.