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Global health leadership role at risk in Trump budget: Column

Pandemics cross borders faster than ever. Why eliminate a giant in the fight against them?

Michele Barry and Derek Yach
Andrea Marzi conducts Ebola blood tests in Liberia in 2014.

We live in a time when pandemics cross borders faster than ever. Yet to the horror of many of us working in global health, President Trump’s budget would completely eliminate the National Institutes of Health’s Fogarty International Center — one of the most effective tools we have to fight global diseases.

For almost 50 years the center has done exactly what it was set up to do: Promote and facilitate international health research of mutual benefit to the U.S. and other countries, while training thousands of health researchers in more than 100 countries. And it has done this on a meager $69.1 million, less than 0.1% of the NIH’s overall $31.3 billion budget.

The tangible benefits of Fogarty’s work are many: Albert Sabin, originally a Fogarty Scholar in Residence, mobilized efforts to eliminate polio and measles. The AIDS International Training and Research Program revolutionized scientific research and training and helped build HIV expertise in sub-Saharan Africa, where suffering was greatest. New insights to guide Alzheimer’s research have come from collaboration with Colombian researchers. South African scientists are partnering on better ways to address multidrug-resistant tuberculosis, an emerging global problem. The genetics of obesity and diabetes are being tackled with Indian experts able to draw upon their populations. And early warning systems for pandemics are under development and testing with many African, Asian and South American scientists. These projects enhance the health of Americans in ways not possible without global insights.

Yet these direct benefits are not the full story. The vision of Rhode Island congressman John Fogarty — that international research could advance peace and understanding — is even more true and more needed today than when he first proposed it in 1968. Created with a tiny investment, the Fogarty Center is now a giant in global health. Its most important accomplishment has been training scientists in low-and middle-income countries. They have become established experts, rising to important leadership positions in academia, health ministries and the private sector in their countries and as part of the global scientific community.

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We have each seen and experienced the impact of the Fogarty Center over many decades.

When one of us moved to the World Health Organization to lead development of its international Framework Convention on Tobacco Control, a unique partnership between Fogarty and WHO emerged to foster the science-based policies required to drive effective tobacco control in the U.S. and globally. A recent evaluation indicates that in its first 10 years the program not only led to new insights about what really works to address the terrible toll of tobacco use (6 million deaths a year globally, including nearly 500,000 in the U.S. each year), it created an influential global network of scientists that has advanced progress in many countries.

Another one of us was part of the Medical Education Partnerships Initiative, a Fogarty Center program that paired 13 leading U.S. academic institutions with universities in 12 African countries to improve medical curriculum and strengthen research capacity, especially in HIV prevention and treatment. One MEPI partnership, matching two U.S. institutions with the University of Zimbabwe, revitalized medical education, research and leadership capacity. The result was a 61% increase in medical student enrollment and significant faculty retention at a time of political instability. The partners also did ground-breaking research on HIV in Zimbabwe that increased knowledge of the disease and helped bring new antiretroviral drugs to market.

Fogarty support of Uganda’s Infectious Diseases Institute began as an emergency response to train doctors as HIV drug therapy became available in Africa. In its first decade, the institute leveraged Fogarty funding to train 15,000 health professionals and develop second-and third-line drug therapies. Its scientists, experts in Ebola containment, contributed to emergency response and training in West Africa. The IDI now has nearly 1,000 health professionals and is self-sustaining through its own grants.

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The U.S. has achieved a substantial return on investment from Fogarty. For 50 years, it has steadily created networks of influence around the world that have materially demonstrated the best of America’s values and expertise in science. The human capital it has created constitutes a global public good and a diplomatic resource for America. Fogarty’s work has profoundly influenced leading global health donors and the World Health Organization about where impact is possible and how to achieve it.

To eliminate the Fogarty Center now would undermine progress, erode trust in America’s leadership in global health, and increase the risk of a devastating and preventable epidemic in the U.S. Keeping Fogarty would preserve health, both of Americans and populations all over the world.

Michele Barry is director of the Center for Innovation in Global Health and senior associate dean for Global Health at Stanford University. Derek Yach is a current consultant to the Vitality Institute for Health Promotion and a past cabinet director at the World Health Organization. Both have served on the Advisory Board for Fogarty International Center at NIH.

In addition to its own editorials, USA TODAY publishes diverse opinions from outside writers, including our Board of Contributors. To read more columns like this, go to the Opinion front page and follow us on Twitter @USATOpinion

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