Fifty Years of Supporting Global Health Research at the NIH Fogarty International Center

Leveraging the HIV response to strengthen pandemic preparedness

The COVID-19 pandemic and the expectation of future pandemic threats have generated a global dialogue on strengthening pandemic preparedness and response (PPR). Thus far, this dialogue has largely failed to fully consider the critical role that established, disease-specific programs played in national and regional COVID-19 responses, and the potential for these programs to contribute to stronger pandemic preparedness for the future. The HIV response is an important example of a global health initiative that is already making substantial contributions to PPR. Both the infrastructure and core principles of the HIV response have much to contribute towards pandemic preparedness that is more effective and equitable than seen in the response to COVID-19. This review examines how HIV-related resources and principles can support communities and countries in being better prepared for emerging disease threats, with a specific focus on evidence from the COVID-19 pandemic. Drawing on the current literature, the review explores the clear, multi-faceted intersection between the HIV response and the central elements of pandemic preparedness in areas including surveillance; supply chain; primary care; health care workforce; community engagement; biomedical research; universal access without discrimination; political leadership; governance; and financing. There are many opportunities to be more strategic and purposeful in leveraging HIV programs and approaches for preparedness. Avoiding the longstanding temptation in global health to create new siloes, PPR initiatives, including the new Pandemic Fund at the World Bank, should invest in and build out from existing programs that are already making health systems more inclusive and resilient, including the global response to HIV.

Bibliometric analysis of sub-Saharan African and US authorship in publications about sub-Saharan Africa funded by the Fogarty International Center, 2008-2020

BACKGROUND

Authorship and author order have been used as one measure to characterise equity in research partnerships. First and last (senior) authorships often denote scientific merit as well as potential for research career advancement. A previous analysis found that only about 20%-25% of publications about Africa with coauthors from top-ranking US universities had a first or last author from the topic country. In this bibliometric analysis, we evaluated authorship of publications about sub-Saharan Africa (SSA) funded by the Fogarty International Center (FIC) of the US National Institutes of Health, an institution with a mission of training and capacity building in low-income and middle-income countries.

METHODS

We analysed publications from PubMed and Web of Science that were funded by FIC, about SSA, and published between 2008 and 2020. Relative citation ratio (RCR) data from iCite were used to compare group citation impact measures using the Wilcoxon rank sum test.

RESULTS

A total of 3446 publications met the inclusion criteria, with annual number increasing from 114 in 2008 to 352 in 2020. SSA-affiliated first authors increased from 53 (47%) in 2008 to 224 (63%) in 2020. SSA-affiliated last authors increased from 32 (28%) to 166 (47%). For both first and last authorships, the median RCR value of publications with SSA-affiliated authors was lower than for US-affiliated authors (first authors: 0.84 vs 0.95, p=0.0021; last authors: 0.88 vs 0.91, p=0.010).

CONCLUSION

The increase in first and last authorships by SSA-affiliated authors of publications about SSA suggests increasing equity in research activities funded by FIC. Further investigation and actions are needed to establish how authorship reflects other aspects of equity, the implication of the lower RCR in papers with SSA-affiliated first and last authors and what policies and practices are needed to further promote equity in global health research.

Factors associated with producing a scientific publication during medical training: evidence from a cross-sectional study of 40 medical schools surveyed in Latin America

Background: Scientific publication during medical training is key to promote enduring cutting-edge knowledge. The promotion of science among medical students in Latin America is a multi-sphere issue hampered by the unawareness of governments to invest in national research, as well as a lack of support from local universities. This study aims to determine the factors associated with producing a scientific publication during medical training among Latin American medical students of local scientific societies. Methods: This is a secondary data analysis of a cross-sectional study initially conducted in 2016 to evaluate the use of information and communications technologies (TICs) among medical students of 40 local scientific societies of medical students affiliated to the Latin American Federation of Medical Students Scientific Societies (FELSOCEM, in Spanish). Teams in each local scientific society surveyed self-reported scientific publications and explored its association with socioeconomic, academic, and research training conditions. We included medical students enrolled in the 2016-I term and excluded medical interns. We implemented nested models to identify covariates associated with self-reported scientific publication until reaching a parsimonious mixed-effect multilevel model clustered by medical scientific society. Results: We surveyed 11,587 medical students. The prevalence of scientific publications increased in 36% among medical students affiliated to a Scientific Society of Medical Students [parsimonious prevalence ratio (PRp)=1.36, 95%CI=1.16-1.59], 51% among medical students with advanced English proficiency [PRp=1.51, 95%CI=1.21 - 1.87], 85% among medical students who attended a scientific writing skills course [PRp=1.85, 95%CI=1.59-2.15], 81% among medical students who use Sci-Hub [PRp=1.81, 95%CI=1.50-2.20], and 108% among medical students who have access to a pirated academic account [PRp=2.08, 95%CI=1.83-2.36]. Conclusions: Producing a scientific publication among medical students is associated with being affiliated to a Scientific Society of Medical Students, English proficiency, training in scientific writing, use of Sci-Hub, and pirated academic accounts.

Factors associated with producing a scientific publication during medical training: evidence from a cross-sectional study of 40 medical schools in Latin America

Background: Scientific publication during medical training is key to promoting enduring cutting-edge knowledge. The promotion of science among medical students in Latin America is a multisectoral issue that is hampered by the lack of governmental knowledge to invest in national research, as well as by the lack of support from local universities. This study aims to determine the factors associated with the production of a scientific publication during medical training among Latin American medical students of local scientific societies. Methods: This is a secondary data analysis of a cross-sectional study conducted in 2016 that assessed the use of information and communication technologies (ICTs) among medical students from 40 local scientific societies of medical students affiliated with FELSOCEM. Teams from each local scientific society surveyed self-reported scientific publications and explored their association with socioeconomic, academic, and research training conditions. We applied nested models to identify the covariates associated with self-reported scientific publication, obtaining a parsimonious mixed-effects multilevel model grouped by medical scientific society. Results: Of 11,587 participants, the prevalence of scientific publications increased in 36% among medical students affiliated to a Scientific Society of Medical Students [parsimonious prevalence ratio (pPR)=1.36, 95%CI=1.16-1.59], 51% among medical students with advanced English proficiency [pPR=1.51, 95%CI=1.21 - 1.87], 85% among medical students who attended a scientific writing skills course [pPR=1.85, 95%CI=1.59-2.15], 81% among medical students who use Sci-Hub [pPR=1.81, 95%CI=1.50-2.20], and 108% among medical students who have access to a pirated academic account [pPR=2.08, 95%CI=1.83-2.36]. Conclusions: Producing a scientific publication among medical students is associated with being affiliated to a scientific society of medical students, English proficiency, training in scientific writing, use of Sci-Hub, and pirated academic accounts. The results will help clinical educators and medical programs improve resources for training students in high-quality research.

Impact of the Fogarty Training Program on Trainee and Institutional Research Capacity Building at a Government Medical College in India

Background

Strengthening health research is essential to inform public health policies. However, few research training programs have systematically measured their impact on capacity building and most evaluations have been limited to reporting of individual trainee metrics. Hence, we conducted an evaluation of the impact of a five-year training program focused on building both trainee and institutional research capacity at a public medical college in India.

Methods

Quantitative and qualitative methods were used to assess the individual and institutional research capacity building of a five-year HIV-TB research training program at Byramjee Jeejeebhoy Government Medical College in Pune, India, supported by the US National Institutes of Health, Fogarty International Center. In addition to documentation of the number of trainee research projects initiated, the number of research papers produced by the Fogarty Scholars (FSs) available on PubMed was calculated. The institutional impact of this program was assessed by documentation of research training activities conducted by the FSs, as well as by surveys and in-depth interviews conducted at the beginning and end of the program.

Results

Twenty-one mid-level BJGMC faculty were provided training in HIV-TB research competencies. Between 1 April 2014 and 1 April 2019, 13 of these FSs designed and implemented new IRB-approved research studies and contributed to 49 PubMed listed research papers, including 11 first-authored manuscripts. FSs also conducted 36 journal club discussions, mentored 58 student research projects and conducted 5 institutional research method workshops. Pre- and-post-program surveys and in-depth interviews documented a perceived increase in institutional research capacity, particularly in TB research (epidemiology, clinical research, laboratory research). The impact of the Fogarty Training Program on institutional scientific output was perceived to be marginally improved.

Conclusion

The Fogarty Training Program had a significant impact on building individual research capacity. To sustain this impact beyond the five years of Fogarty support, additional governmental and institutional resources, the establishment of dedicated space for faculty research and protected faculty time for research are needed. These findings can inform the design and implementation of future health research capacity building initiatives.