Environmental Factor, June 2008, National Institute of Environmental Health Sciences
Fogarty Director Highlights Benefits of Global Health Research
By Eddy Ball
For NIH Fogarty International Center (FIC) Director Roger Glass, M.D., Ph.D., re-visiting NIEHS May 2 was a bit like coming home. In the course of his Frontiers of Environmental Sciences Seminar talk on "Global Health in the 21st Century: A Fresh Perspective," Glass referred several times to the way his experiences with NIEHS have profoundly influenced his 36-year career in global environmental health.
"It gives me great nostalgia to be back here," Glass(http://www.fic.nih.gov/About/Pages/director.aspx) noted as he began his lecture, "because early in my career, the first job I had after my internship was here with [then NIEHS Director] David Rall working on a detail in Russia for NIEHS." That experience was an important step in what Glass described as "a personal journey in public health" that helped to shape the FIC 2008-2012 Strategic Plan(http://www.fic.nih.gov/About/Pages/Strategic-Plan.aspx) . He also credited the NIEHS Strategic Plan, especially Goal IV that addresses global environmental health, as "a model for my own strategic planning activity at the Fogarty."
During his talk, which was hosted by NIEHS Acting Deputy Director Bill Suk, Ph.D., Glass outlined what he envisions as the changing priorities of global health. People of nations, such as China and India, that are now experiencing rapid economic growth and increasing life expectancy, he said, are also seeing dramatic increases in diseases linked to pollution, traffic congestion, heart disease, obesity and smoking. These chronic and development-related health issues, he explained, have created "a completely different pattern of disease in the 21st century than we had before."
In marked contrast to the developing countries of Asia, people in Sub-Saharan Africa, where infectious diseases continue to be major issues, have experienced decreases in life expectancy primarily due to AIDS and tuberculosis. According to Glass, these trends taken together have changed the spectrum of health agendas and research priorities worldwide.
In addition to formulating a new global health model, Glass continued, planners need to better understand the challenges and benefits of expanding partnerships worldwide - fostering collaborative research, developing institutional capacity and promoting the training of the next generation of environmental and public health scientists worldwide.
"It's been a wonderful asset to be able to link ourselves globally," Glass asserted. "Here in the United States, we are a melting pot of people from every country and every corner of the earth. We've all brought our diseases with us and our genes with us, and if you want to decipher those diseases, sometimes it's easier to go back to founder populations [elsewhere]."
As Glass maintained, some of these diseases, such as the focal cancers, "are like the malarias of the past: you almost have to go to the places where they originated to find them in density and study them and understand them." One example he cited was the discovery of a viral cause for Burkitt lymphoma, which "wouldn't have happened if it had be pursued in a U.S. research lab."
Countries now experiencing economic growth are at the same time beginning to put substantial money into researching the same problems that Americans are having with chronic diseases and using the expertise of people trained through NIH collaborations. "If we use these contacts and links, we actually have opportunities to benefit from research funded in China, India, Brazil and Singapore in clear collaborations with us," he said.
As he surveyed current global health opportunities, Glass struck an optimistic note about the future. "We've seen major changes in the last decade in global health.... [with] some of the most visible people in the world involved. There's a lot of new money and a lot of global interest in this field."
As he concluded his talk, Glass described an agenda of environmental hazards, obesity, traffic accidents and climate change that nearly every country shares in common. "How we will deal with these issues in the future," he proposed, "will really be a function of the globalization of the research agenda."
Overcoming Health Disparities -
A Goal of NIH Global Health Programs from the Beginning
On July 1, 1968 President Lyndon Johnson issued an Executive Order establishing the John E. Fogarty International Center for Advanced Study in the Health Sciences at the National Institutes of Health. The center was named in honor of Rhode Island Congressman John Edward Fogarty, who died the previous year. For the past forty years, FIC has served as the NIH center specifically charged with promoting global health research partnerships and encouraging the other institutes and centers to become more engaged.
"John Fogarty was an interesting congressman," Glass said. "He came from Rhode Island, and he was a brick layer.... His interest [in global health] was sparked because in the brick layer's union, there were a lot of immigrants from places where their health and the health of their families were less than they were in the U.S. He saw this as a problem of equity and social justice."
According to Glass, it is fitting that health disparity should be a central issue in global environmental health - disparity based on wealth, race, class and gender. By addressing inequity globally, he said, "We can [also] learn about our own society from the lessons we learn abroad."
In 1959, Fogarty was quoted in the Congressional Record as saying, "Time and time again, it has been demonstrated that pursuing the goal of better health has the capacity to demolish geographic and political boundaries and to enter the hearts and minds of men, women, and children in the four corners of the earth. It is an issue which serves as a forceful reminder of the oneness, the essential brotherhood of man."