President Donald Trump’s proposed budget calls for eliminating the Fogarty International Center at the National Institutes of Health (NIH). Last year, just $69 million of the NIH’s $31 billion budget was allocated to Fogarty.
Founded in 1968, the Fogarty Center serves as a bridge between the NIH and the greater global health community by facilitating exchanges among investigators, providing training opportunities, and supporting promising research initiatives in developing countries.
Over the 50 years of its existence, Fogarty has provided training for more than 6,000 scientists worldwide. Those researchers and clinicians collaborate with U.S. scientists to create the local capacity necessary to detect and address pandemics and new disease outbreaks wherever they occur.
Research collaborations work best when teams combine scientific expertise with a knowledge of local priorities and culture. Building such teams around the world has been one of Fogarty’s important goals.
The Botswana Harvard AIDS Institute Partnership (BHP), a collaboration between the Harvard AIDS Initiative (HAI) and Botswana’s Ministry of Health, has benefited significantly from Fogarty programs, such as their HIV Research Training Program, launched in 1998 to strengthen research capacities in developing countries.
“The Fogarty training is unique,” said Max Essex, the Mary Woodard Lasker Professor of Health Sciences at Harvard and Chair of the BHP. “It builds expertise in exactly those places where the next round of epidemics like Ebola, Zika, AIDS, or flu are most likely to occur. This provides immediate benefits for local control of such epidemics, which in turn minimizes their impact on the U.S. and the rest of the world.”
Many of the African scientists now working at the BHP in Gaborone received training through Fogarty. Currently, in the Essex Lab at Harvard, five young women from Botswana are learning the latest laboratory techniques for genetic sequencing of HIV.
With Fogarty, training goes both ways. Their Global Health Fellowships provide U.S. scientists and clinicians with opportunities to work and learn in countries like Botswana, where HIV prevalence is high and resources are limited.
Would Eliminating Fogarty Put America at Risk?
Americans benefit from global health research. By developing scientific expertise in African countries and elsewhere, Fogarty helps to ensure that trained researchers are in place to detect and address infectious disease outbreaks at their point of origin—before they reach America.
When Ebola struck western Africa in 2014, countries with little or no scientific capacity suffered the most. When Zika spread through Brazil in 2015, Fogarty-trained Brazilian scientists used their expertize to investigate and find answers.
”I’d rather fight Ebola in West Africa than in West Dallas,” said Rep. Tom Cole, a Republican from Oklahoma, at a March budget hearing.
Harvard’s Max Essex agrees. “It’s easier and cheaper to prevent and contain a new epidemic in a small population,” he summarized.
Writing in JAMA Forum this April, Prof. Lawrence Gostin of the Institute for National and Global Health Law at Georgetown University decried the proposed elimination of the Fogarty Center. “Although we sometimes view national security in terms of military might, strengthening health systems outside the United States can do as much, or more, to keep us safe,” wrote Gostin. “Few wars would have the same cost in human lives and treasure as a pandemic. . . At about 20 cents per U.S. resident per year, why would we eliminate this national treasure?”