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Meeting Minutes
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Public Health Service
National Institutes of Health
John E. Fogarty International Center
for Advanced Study in the Health Sciences
Minutes of the Advisory Board
Fifty-fourth Meeting
May 20, 2003

The John E. Fogarty International Center for Advanced Study in the Health Sciences (FIC) convened the fifty-fourth meeting of its Advisory Board on Tuesday, May 20, 2003, at 11:00 a.m., in the Conference Room of the Lawton Chiles International House, National Institutes of Health (NIH), Bethesda, Maryland.  The meeting was open to the public from 11:00 a.m. to adjournment at 12:00 p.m.   The meeting was preceded by the closed session, from 9:00 a.m. to 10:30 a.m. as provided in Sections 552b(c) (4) and 552b(c) (6), Title 5, U.S. Code, and Section 10 (d) of Public Law 92-463, for the review, discussion, and evaluation of grant applications and related information.[1]  Dr. Gerald T. Keusch, Director, FIC, presided as chair.  The Board roster is appended as Attachment 1.


* Board Members Present:

Dr. Cutberto Garza
Dr. Yvonne T. Maddox (ex officio)

Dr. Sharon L. Ramey
Dr. Robert R. Redfield
Dr. Robert E. Shope
Dr. Stephen E. Straus (ex officio)
Dr. Catherine M. Wilfert

* Board Members Absent:

Mr. Dikembe Mutombo
Dr. Theodore Reich 
Dr. Burton H. Singer

[1] Members absent themselves from the meeting when the Board discusses applications from their own institutions or when a conflict of interest might occur.  The procedure applies only to individual applications discussed, not to en bloc actions.

* Members of the Public Present:

Ms. Stephanie Bursenos, former Deputy Director, FIC

 

* Federal Employees Present:

Dr. Martin Alilio, FIC/NIH Dr. Linda Kupfer, FIC/NIH
Mr. Ray Atri, FIC/NIH Dr. James Lavery, FIC/NIH
Mr. Kevin Bialy, FIC/NIH Ms. Sonja Madera, FIC/NIH
Ms. Danielle Bielenstein, FIC/NIH Ms. Elizabeth Margeson, FIC/NIH
Dr. Joel Breman, FIC/NIH Dr. Jeanne McDermott, FIC/NIH
Dr. Kenneth Bridbord, FIC/NIH Dr. Mark Miller, FIC/NIH
Mr. Bruce Butrum, FIC/NIHMs. Sherri L. Park, NICHD/NIH
Dr. Lois K. Cohen NIDCR/NIHMs. Amanda Percival, FIC/NIH
Dr. Sherry Dupere, CSR/NIH Mr. Mark Pindeda, FIC/NIH
Ms. Irene Edwards, FIC//NIH Dr. Aron Primack, FIC/NIH
Ms. Lisa Foster, FIC/NIH Ms. Charlotte Quinn, FIC/NIH
Dr. Pierce Gardner, FIC/NIHMs. Minerva Rojo, FIC/NIH
Ms. Patricia Brandt Hansberger, OLPA/OD/NIHDr. Joshua Rosenthal, FIC/NIH
Ms. Mildred Hatton, FICI/NIHMs. Laura Rowe, FIC/NIH
Dr. Ruth J. Hegyeli, NHLBI/NIHDr. Luis A. Salicrup, FIC/NIH
Ms. Cherice Holloway, FIC/NIHDr. Hilary Sigmon, CSR/NIH
Dr. J. Allen Holt, FIC/NIHMs. Natalie Tomitch, FIC/NIH
Dr. Sharon Hrynkow, FIC/NIH Dr. Sandy Warren, CSR/NIH
Mr. Andrew Jones, FIC/NIH Ms. Brinah White, FIC/NIH
Dr. Gerald T. Keusch, FIC/NIH Mr. Randolph Williams, FIC/NIH
Dr. Richard M. Krause, FIC/NIH

 

 

OPEN PORTION OF THE MEETING

* I. CALL TO ORDER

Dr. Gerald T. Keusch called the meeting to order.  He acknowledged the presence of several NIH colleagues: Dr. Lois K. Cohen, National Institute of Dental and Craniofacial Research (NIDCR); Dr. Ruth Johnsson Hegyeli, National Heart, Lung, and Blood Institute (NHLBI); Dr. Sandy Warren, Center for Scientific Review (CSR); Dr. Sherry Dupere, CSR; and Dr. Hilary Sigmon, CSR. 

Dr. Keusch noted that the open session of the Board meeting would be shorter than at previous meetings because of FIC’s anniversary symposium, “Global Health: A Challenge to Scientists.”  He commented that the 2-day symposium, which would begin at 2:30 p.m. after the Board meeting and continue through May 21, would focus on major issues in global health and explore the importance of supporting research in global health.

* II. CONSIDERATION OF MINUTES OF PREVIOUS MEETING

The minutes of the Advisory Board meeting of February 11, 2003, were considered and accepted unanimously. 

* III. REVIEW OF REQUIREMENTS FOR CONFIDENTIALITY AND CONFLICT OF INTEREST PROCEDURES

The rules and regulations pertaining to conflict of interest were maintained.

* IV. FUTURE MEETING DATES

The following meeting dates were confirmed:

                      Tuesday, September 16, 2003

                      Tuesday, February 10, 2004
                     
Tuesday, May 18, 2004
                     
Tuesday, September 14, 2004

All subcommittees of the Board will meet on the Monday preceding each Board meeting.

Dr. Keusch asked the Board members to inform Ms. Irene Edwards, Executive Secretary, of any scheduling conflicts they may have with the future dates.

* V. REPORT OF THE DIRECTOR

Dr. Keusch reported on personnel changes, the FIC budget, FIC 35th anniversary events, and FIC programs and initiatives.  The written Report of the Director, which was mailed to Board members, is appended to these minutes as Attachment 2, Written Report of the Director.

Personnel Announcements

Dr. Keusch reported on several personnel changes at the U.S. Department of Health and Human Services (DHHS).  Dr. Eve Slater recently stepped down as Assistant Secretary for Health, DHHS.  Dr. Richard Carmona, the U.S. Surgeon General, is serving as Acting Assistant Secretary for Health.  Dr. Bernard A. Schwetz has been named to serve as Acting Director of the Office for Human Research Protections (OHRP), DHHS.  Dr. Greg Koski, who was Director, OHRP, left the position in 2002 to return to Boston. 

Dr. Keusch highlighted personnel changes at the NIH and FIC.  Dr. Raynard S. Kington is the new Deputy Director, NIH.  Previously he was Associate Director for Behavioral and Social Sciences Research, NIH.  Mr. Robert Eiss returns to the FIC as Senior Advisor for Strategic Initiatives.  He will lead FIC’s development and implementation of strategic initiatives and, initially, will guide the production of a comparative analysis of health research infrastructures in the United States and other nations, in preparation for the World Health Organization (WHO) 2004 global health report.  Mr. Eiss previously served as Director of FIC’s Division of Advanced Studies and Policy Analysis (DASPA) and left the FIC in 2000 to serve in the White House Office of Drug Control Policy. 

  FIC Budget

Dr. Keusch noted that the final NIH budget for Fiscal Year (FY) 2003 restores and increases the funds for FIC above those proposed in the amended President’s Budget, which would have reduced the FIC budget by about $300,000.  The final budget for the FIC in FY 2003 is approximately $61.82 million.

The budget process for FY 2004 is underway.  Included in the President's Budget for FY 2004 is approximately $64.3 million for the FIC, or an increase of approximately 4 percent over FY 2003.  Dr. Keusch noted that the funding of new initiatives planned for FY 2004 is dependent on the availability of funds.  Planned initiatives include collaboration with various NIH institutes and centers (ICs) to support, for example, research on trauma and injuries and on gender issues in global health.

  FIC 35th Anniversary Events

Dr. Keusch noted that FIC’s celebration of its 35th anniversary continues with the symposium on “Global Health: A Challenge to Scientists” which immediately follows the Board meeting.  In addition to the symposium, the FIC is hosting six lectures during FY 2003.  Four lectures have already taken place.  The presenters, topics, and dates of these lectures are as follows: Dr. Nevin Scrimshaw, “Determinants of Global Health: Nutrition, Immunity, and Infection” (October 28, 2002); Dr. D. A. Henderson, “Dreams and Realities in Disease Eradication” (January 28, 2003); Dr. Alan Lopez, “Global Health Priorities: Diseases, Injuries, and Risk Factors” (April 8, 2003); and Professor Sir David Weatherall, “Genomics and Global Health” (April 15, 2003).  

The two remaining lectures are as follows: Dr. Gail Cassell, “Global Health Inequities and the Critical Role of Public/Private Partnerships: Challenges and Opportunities” (June 12, 2003); and  Dr. Arthur Kleinman, “The Global Epidemic of Mental Health Problems in Developing Countries: Depression, Suicide, and Violence” (September 22, 2003). 

Dr. Keusch elaborated on Professor Weatherall’s participation in the anniversary symposium and as a Fogarty Scholar-in-Residence.  As a current Scholar supported by several ICs, Professor Weatherall will confer with NIH colleagues during 2003, for 6 weeks during the spring and 6 weeks during the fall.  In collaboration with the ICs and the FIC, he will be focusing on the global issue of sickle cell disease.  With the FIC, he also will explore the public health perspective on the genomic sciences in the post-genomic era and how best to promote genomic sciences in the global arena.  Dr. Keusch noted that the FIC has funded an initial set of grants to foster development of the genomic sciences in developing countries.  He invited the Board members to communicate directly with Professor Weatherall on these issues. 

  FIC Programs and Initiatives

Dr. Keusch highlighted an FIC collaboration with the National Institute of Environmental Health Sciences (NIEHS).  Dr. Sharon Hrynkow, Deputy Director, FIC, presented an update on FIC’s involvement in gender and global health.  For additional details on these activities and other programs and initiatives, see the written Report of the Director 

FIC-NIEHS Agreement.  Dr. Keusch reported that the FIC has entered into an agreement with the NIEHS to foster international efforts in the environmental sciences.  The NIEHS already is a collaborating partner in FIC’s new Health, Environment, and Economic Development (HEED) Program and several existing programs, including the International Bioethics Education and Career Development Award, the International Training and Research Program in Environmental and Occupational Health, the International Collaborative Genetics Research Training Program, and the Ecology of Infectious Diseases Initiative.  Dr. Keusch said that Dr. Kenneth Olden, Director, NIEHS, has asked the FIC to identify “frontier areas” in global environment and health issues and to advise the NIEHS on major new opportunities.  Under the agreement, the NIEHS will provide funds to the FIC to support FIC’s collaboration in guiding NIEHS thinking on international health, international meetings, and development of international initiatives.  Dr. Keusch commented that the agreement may prove to be a useful mechanism for formalizing interactions between the FIC and smaller ICs or those with limited international activities, enabling those ICs to strengthen their efforts internationally without having to replicate functions already offered by the FIC. 

Gender and Global Health.  Dr. Hrynkow presented an update on FIC’s efforts in gender and global health since the Board’s previous meeting on February 11, 2003.  At that meeting, the Board heard several presentations, from Dr. Miriam Stewart, Scientific Director, Institute of Gender and Health (IGH), Canadian Institutes of Health Research (CIHR), Edmonton, Alberta; Dr. Hrynkow; and Dr. Vivian Pinn, Director, Office of Research on Women’s Health (ORWH), NIH.  

Dr. Hrynkow noted that FIC is encouraging development of a research agenda on gender and global health.  She described a “cascade” of events that have taken place since the Board’s February meeting to increase understanding of the nexus between gender and global health and lead to the development of programs addressing this issue.  FIC helped to organize, and participated in, a CIHR/FIC/ORWH-sponsored International Symposium on “Global Impact on Women and Children,” held February 16-21, in Bangkok, Thailand.  A focus group convened during the symposium identified a list of gender and global health issues that will be addressed during a more in-depth discussion, which will be held at Yale University on June 20-22.  The Yale meeting is expected to include representatives from other ICs and countries (e.g., Korea and Mexico), as well as potential funding agencies.  Subsequently, a smaller group will focus specifically on development of a research agenda and policy perspective related to gender and health. 

Dr. Hrynkow noted that Dr. Karen Hoffman, Director, DASPA, and Ms. Emmy Cauthen, Program Analyst, DASPA, have been instrumental in helping FIC advance this activity.  Dr. Hrynkow also noted that FIC and staff from the Office of the Secretary/DHHS, ORWH, NIDCR, NHLBI, and the National Institute of Child Health and Human Development (NICHD) represented the United States at a U.S.–Israel Working Group on May 16 to prepare for a U.S.–Israel Binational Symposium on Women’s Health.  The representatives included Dr. Lois K. Cohen, NIDCR, and Dr. Ruth Johnsson Hegyeli, NHLBI.

Discussion

Dr. Hegyeli commented that the NHLBI has been involved in women’s health issues since 1988 when NHLBI cosponsored the First Joint U.S.–Italy Symposium on Cardiovascular Disease in Women.  Since 1965, NHLBI has cosponsored four international conferences in Italy and the United States on women’s health.  As followup to these conferences, NHLBI coordinated and published in July 2002 an international book on “Women’s Health and Menopause: A Comprehensive Approach.”  This book has been translated into 11 languages, including Russian and Japanese.  A fifth international conference on women’s health will be held in Italy in 2004.

The Board noted that gender and global health issues also relate to men, and the members encouraged FIC to address the needs of both genders.  Dr. Hrynkow said that men’s health issues are included in the discussions.

* VI. EXPANDING GLOBAL HORIZONS OF HEALTH CARE: THE NCCAM INTERNATIONAL PROGRAM

Dr. Stephen Straus, Director, National Center for Complementary and Alternative Medicine (NCCAM), NIH, described the mission, guiding principles, and research and training activities of NCCAM’s Office of International Health Research (OIHR).  The NCCAM, a small center at the NIH, has a broad research mission focused on medical and health care practices that are complementary and alternative to those of conventional medicine.  Dr. Straus noted that the research aim is to validate these practices using scientific methods and to develop research capacity in complementary and alternative medicine (CAM).  Internationally, NCCAM aims to expand the global horizons of health care and to include traditional medicines and practices in the discussion of global health issues.  Dr. Straus noted that NCCAM recently established OIHR and that he is currently interviewing applicants to head the office.

The mission of OIHR, which parallels that of NCCAM, is to identify promising international CAM practices, encourage rigorous scientific assessment of these practices, facilitate international scientific collaborations, educate and train CAM researchers, and disseminate authoritative information to the public and health professions.  Dr. Straus emphasized that OIHR is pursuing this mission through both direct outreach and partnerships and collaborations with other organizations. Two guiding principles which NCCAM follows to define whether traditional and indigenous medical and health care practices have a scientific basis are to (i) conduct research on traditional and indigenous health practices (at the most promising sites for CAM research, in coordination with international organizations, and with respect for the heritage and practices of indigenous peoples), and (ii) align international programs with existing NIH-funded and other international research programs (to ensure the availability of research expertise and infrastructure, maximum resources through collaboration with other ICs, and development of long-term sustainability).  

Dr. Straus highlighted examples of NCCAM’s research collaborations on global health issues with other ICs.  NCCAM is collaborating, for example, in the cofunding of FIC’s International Cooperative Biodiversity Groups, NICHD’s Global Network for Women’s and Children’s Health Research, NICHD’s Partnerships for  HIV/AIDS in African Populations, and FIC’s International Bioethics Education and Career Development Award.  Dr. Straus noted, in particular, that the issues of biodiversity and women’s health are important to the CAM community and indigenous peoples.

In addition to research collaborations, NCCAM has an active international outreach effort to establish connections with other countries and regions and with global organizations such as WHO and the World Bank.  NCCAM staff are organizing and participating in international meetings, briefing sessions, workshops, and seminars.  Dr. Straus highlighted two NCCAM workshops, held in Singapore in 2001 and in Hong Kong in 2002, to identify regional opportunities for collaborative research and to discuss grantmaking and funding opportunities for traditional medicine.  In July 2003, NCCAM will participate in the FIC-led Grantsmanship Workshop for Latin American and Caribbean Scientists, to be held in Cuernavaca, Mexico.  

Other countries and regions where NCCAM is cultivating research opportunities include India.  Dr. Straus noted that NCCAM participates in the Indo–U.S. Science and Technology Forum and acts as a catalyst to stimulate research collaborations between Indian and U.S. scientists.  The ultimate goal is to increase knowledge about the use and potential benefits of Indian systems of medicine (e.g., ayurvedic) and homeopathy products and therapies for diagnosing, preventing, and treating specific health-related conditions.

Opportunities for international training supported by NCCAM currently include the NCCAM Intramural Program and the NCCAM International Postdoctoral Fellowship (F05).  Dr. Straus noted that the F05 provides 1-3 years of support for training of researchers from other countries at a basic or clinical research facility in the United States.  The focus in on alternative medical systems, and the purpose is to prepare trainees to conduct high-quality research in CAM when they return to their home countries.  

The NCCAM also supports a centers program which was recently evaluated and reformulated.  International researchers can participate in the Phase I (planning grants) for International Centers for Research on CAM (PICRC), which NCCAM supports in collaboration with the FIC, and the Centers of Excellence for Research on CAM (CERC).  The goal of PICRC is to establish partnerships and cross-cultural exchanges that would stimulate research collaborations between foreign and U.S. institutions focusing on traditional indigenous medical systems within the cultures or environments where the systems originate.

In closing, Dr. Straus emphasized that these international efforts are a beginning for NCCAM and that NCCAM’s efforts can only succeed with the assistance of the FIC.  He complimented FIC staff for their outreach and contributions to NCCAM, and he suggested that the collaboration between NCCAM and FIC is a model for the collaborations that NCCAM hopes to cultivate with other ICs.  Dr. Straus welcomed the opportunity to continue to participate on the FIC Advisory Board.

Discussion

Dr. Keusch said that it has been a pleasure for the FIC to work with Dr. Straus as NCCAM shapes its research agenda and brings scientific rigor and sensitivity to a breadth of global health issues.  In response to questions, Dr. Straus commented on the difficulty of establishing scientifically the clinical effectiveness of indigenous practices and natural products; engaging the broad CAM community in scientific studies of these practices and products; educating interested groups, the public, and health professionals and administrators about the results of research in CAM; and encouraging appropriate, evidence-based regulation of CAM practices and products.  Dr. Keusch noted, in particular, that NCCAM has stimulated broader scientific exploration of two important issues in international research: the placebo effect and intellectual property.  Dr. Straus welcomed FIC’s continued assistance on these issues, as well as other topics, in NCCAM’s effort to encourage the sharing of information and research collaborations related to indigenous practices and natural products. 

* VII. CLOSED PORTION OF THE MEETING

This portion of the meeting was closed to the public in accordance with the determination that it was concerned with matters exempt from mandatory disclosure under Sections 552b(c)(4) and 552b(c)(6), Title 5, U.S. Code and Section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. Appendix 2).

There was a discussion of procedures and policies regarding voting and confidentiality of application materials, committee discussions, and recommendations.  Members absented themselves from the meeting during discussion of and voting on applications from their own institutions or other applications in which there was a potential conflict of interest, real or apparent.  Members were asked to sign a statement to this effect.

 * VIII. REVIEW OF APPLICATIONS

Dr. Sharon Hrynkow chaired the remainder of the meeting during which the Research Awards Subcommittee reported on its activities.  A total of 42 scored competing applications were reviewed by the FIC Advisory Board at the May 20 meeting.[1]  The applications were in the following programs


[2] Applications that were noncompetitive or unscored or were not recommended for further consideration by initial review groups were not considered by the Council.

 

 21 applications for the Fogarty International Research Collaboration Award (FIRCA) program, out of a total of 46 applications; 
 4 applications for the HIV-AIDS and Related Illnesses Collaboration Award (AIDS-FIRCA) program, out of a total of 5 applications;
17 applications for the Stigma and Global Health Research Program, out of a total of 35 applications.

The Board concurred with the initial review group recommendations for the 42 applications. 

 

* VIII. ADJOURNMENT

There being no further business, the meeting was adjourned at 12:00 p.m. on May 20, 2003.

 

 
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