BOX 4-1Building Capacity of Researchers: The Role of U.S. Federal Executive Branch Agencies

U.S. government agencies have successfully contributed to building the capacity of international partners in health research. Two noteworthy efforts are those of the NIH’s Fogarty International Center and the CDC’s Field Epidemiology Training Program.

NIH’s Fogarty International Center

The Fogarty International Center (FIC) at NIH runs a highly successful AIDS International Training and Research Program (AITRP) that brings scientists from low- and middle-income countries to the United States to train in multidisciplinary biomedical and behavioral research in HIV/AIDS and the related epidemic of tuberculosis in their countries.

AITRP trainees are sponsored for a master’s or doctorate degree or hold postdoctoral positions. The program uses several scientific, political, and economic strategies to encourage scientists to return to their home countries after training. By focusing on research that is responsive to priorities in the home country—and maximizing the amount of training conducted there—trainees are better equipped to find jobs or funding in their home countries once training is complete. A trainee may be allowed to retain an e-mail address and access to journals through the U.S. host institution even after training. Trainees come to the United States under nonimmigrant temporary visas; some sign agreements that require them to reimburse their training costs if they do not return to their home country (Kupfer et al., 2004).

A 2002 survey of five of AITRP’s longest-funded programs showed an average return rate of 80 percent among their 186 long-term trainees (Kupfer et al., 2004). An evaluation of the entire program this past year showed an 85 percent rate of return among trainees over 15 years (Kupfer, 2009). FIC recently built on the AITRP model and designed the Millennium Promise Awards to extend research

capacity to cancer, cerebrovascular disease, lung disease, obesity, lifestyle factors, and genetics as related to chronic diseases (FIC, 2008).

CDC’s Field Epidemiology Training Programs

The Field Epidemiology Training Program (FETP) and the Field Epidemiology and Laboratory Training Program, which offers an added laboratory component, are applied epidemiology programs offered by the CDC’s Division of Global Public Health Capacity Development (DGPHCD). Both programs help countries develop and implement dynamic public health strategies to improve their health systems and infrastructure.

An in-country resident adviser is assigned to provide training and technical assistance for four to six years. The curriculum of both two-year programs is modeled on CDC’s Epidemic Intelligence Service, typically involving classroom instruction (25 percent) and field assignments (75 percent). In class, trainees take courses in epidemiology, communications, economics, and management, while learning quantitative and behavior-based strategies. In the field, trainees conduct epidemiologic investigations and field surveys, evaluate surveillance systems, perform disease control and prevention measures, report their findings to decision makers, and train other health workers.

Since 1980, DGPHCD has helped to establish 30 field epidemiology training programs that have produced more than 1,000 graduates. In 2008, the programs had 276 active trainees; together, trainees and graduates conducted more than 300 outbreak investigations and gave 280 presentations at international conferences. As of April 2009, 17 resident advisers for epidemiology and laboratory were supporting 12 programs in Central America, Asia, the Middle East, and Africa. Located at CDC’s headquarters in Atlanta, Georgia, DGPHCD staff provide additional scientific support and advice to sustain FETPs and related programs around the globe. This division of CDC also supports the technical components of five other mature programs in Brazil, Egypt, Jordan, Saudi Arabia, and Thailand. Plans for the establishment of new programs are under way in 14 countries, including Afghanistan, Central Africa, Iraq, and Yemen (CDC, 2008).

From: 4, Invest in People, Institutions, and Capacity Building with Global Partners

Cover of The US Commitment to Global Health: Recommendations for the Public and Private Sectors
The US Commitment to Global Health: Recommendations for the Public and Private Sectors.
Institute of Medicine (US) Committee on the US Commitment to Global Health.
Washington (DC): National Academies Press (US); 2009.
Copyright © 2009, National Academy of Sciences.

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