By John Balbus
From its inception, the NIEHS Global Environmental Health (GEH) program has prioritized initiating and coordinating training and capacity building activities across the institute. One of the first projects of the newly constituted program in 2013 was to conduct a needs assessment for GEH training and capacity building. The report concluded that NIEHS could leverage the expertise of its grantees and intramural scientists, as well as its international reputation, to provide locally tailored training and capacity building opportunities around the world. This emphasis on training and capacity building aligned with the NIEHS strategic plan that had just been developed in 2011-2012, which articulated NIEHS’ vision for global leadership in environmental health and devoted two of 11 primary goals to education and training. And in its most recent revision, the NIEHS strategic plan identifies Training and Capacity Building in Global Health as one of six goals under the theme of Enhancing EHS Through Stewardship and Support.
NIEHS brings a variety of mechanisms and activities to achieve its global training and capacity building goals. Since its founding in 1966, the institute has committed to providing on-site training opportunities for foreign doctoral students and postdoctoral fellows. In fact, since 2000, nearly half of all NIEHS intramural fellows have come from outside the United States. In addition to training opportunities in our intramural laboratories, the institute’s extramural division has supported extramural training opportunities for foreign students and scientists through a number of programs; this includes GEH capacity building programs involving multiple NIH institutes and centers, like the Global Environmental and Occupational Health (GEOHealth) Hubs. NIEHS has also brought resources to promote research in environmental health within NIH’s H3Africa program by supporting the analysis and archiving of environmental and biological samples to measure environmental exposures within the program’s cohorts.
With additional resources dedicated to building GEH capacity, the GEH program has extended the institute’s ongoing and historic efforts by supporting international training events and workshops, and by sponsoring the attendance of students and junior researchers from low- and middle-income countries (LMICs) at major environmental health conferences.
Looking forward, the GEH program sees important new themes in training and capacity building:
- Solving health problems in LMICs requires environmental health expertise. The recently published Lancet Commission on Pollution and Health report underscored and expanded a point that has been made by the World Health Organization for decades. The scourge of environmentally related infectious and chronic diseases continues to be felt most heavily in LMICs. Those countries not only have higher absolute mortality from water and air pollution than more developed countries, they also have the highest proportion of mortality arising from environmental causes. Improving health, and assisting in the eradication of poverty through improved health at all ages, requires a cadre of researchers and professionals who can address complex environmental health problems.
- Research ideas and hypotheses coming from within affected communities and countries solve public health challenges. Capacity building requires sustained, robust activity to succeed. The model of capacity building that NIH has implemented has changed over the years, with more funding going directly to foreign institutions, which expands opportunity for independent researchers in those countries as well as more globally collaborative research. Equally important is the concept of community-based participatory research (CBPR). Not only are the research projects initiated within country, but the design of the project is co-created with the affected populations and communities themselves. NIEHS is keen on sharing its experience in CBPR globally and supporting the development of locally relevant approaches by researchers from LMICs.
- Training must build disciplinary skills in a multidisciplinary environment. A series of recent events and workshops has highlighted the transdisciplinary nature of many environmental health problems, including:
- The interactions of toxic chemicals and environmental microbes within and outside the human body, which requires collaboration between microbiologists, infectious disease specialists, and environmental health scientists.
- The study and control of zoonotic and other disease systems that affect both animals and humans, which requires collaboration between veterinary and environmental health scientists.
- Interactions between extreme weather and climate events and human populations, which requires collaboration between social, earth, and health scientists.
And there is a need to support all of these interdisciplinary collaborations with a generation of data and information scientists who are familiar with such disparate types of datasets and methods for integrating and analyzing them.
New partnerships and collaborations give NIEHS and the GEH program some new opportunities to apply these principles and further build environmental health science capacity around the world. New bilateral research funding agreements between NIH and China and Brazil offer opportunities for collaboration among scientists from these and potentially other countries for developing technologies and skills in environmental health research. A memorandum of understanding between the U.S. Agency for International Development (USAID) and NIH will facilitate more collaboration on environmental health issues and allow NIEHS and USAID to better complement each other in their environmental health training and capacity building activities. Lastly, the new Belmont Forum Collaborative Research Action on Climate, Environment, and Health will provide opportunities for NIEHS and other NIH institutes and centers to partner with research funding organizations in other countries to build capacity for multidisciplinary research, specifically engaging social scientists, on climate and health topics.
As the complexity and extent of environmental health problems increases, and as new tools and interdisciplinary approaches are developed to deal with the complexity, the need for state-of-the-art training and capacity building is great. The NIEHS GEH program endeavors to stay on top of the emerging science of GEH and to support the training and development of new environmental health scientists around the world who will be equipped to work in collaborative and powerful ways to help improve and protect the health of people around the world.