23 November 2009
U.S. Agency Contributes to Health, Education in Middle East
National Institutes of Health works through partnerships
Washington — From its early days in 1887 as a one-room, one-employee laboratory charged with caring for merchant seamen, the National Institutes of Health (NIH) has protected the well-being of Americans.
The country’s premiere medical research agency, the NIH has expanded from its meager beginnings to encompass 27 institutes and centers. In 2009, its reach also extends beyond the weary sailors who once were its primary clients. The NIH, through collaboration with international partners, now promotes worldwide its goals of fostering creativity and innovation in medical research, developing and maintaining scientific resources and promoting scientific integrity, among other endeavors.
Through several projects in the Middle East and North Africa (MENA), the NIH has collaborated with local organizations and institutions to improve health care infrastructure and practices not only in the host country, but at home as well. These exchanges of knowledge and research range from education programs to collaborative research grants to newborn screening.
IMPROVING RESEARCH ETHICS THROUGH ACADEMIC DISCOURSE
One NIH-sponsored educational exchange program is the Middle East Research Ethics Training Initiative (MERETI). Dr. Henry Silverman, a pulmonary and critical care physician at the University of Maryland, piloted the initiative in 2004 with a grant from the Fogarty International Center, an NIH institution dedicated to supporting international partnerships that improve global health research.
Silverman leads a 12-month certificate program that brings practicing health care professionals from MENA countries to the University of Maryland. Candidates have come from Egypt, Jordan, Sudan, Syria and Yemen, among other nations. The professionals spend two months in the United States engaging in discussions with each other and their American counterparts on ethical scientific research practices. They then return home and implement what they have learned.
“During course time, the major goal is to enhance the candidates’ skills in research ethics so they can assume leadership positions in their institutions in their country,” Silverman said. “The whole goal is to make sure clinical trials and research are done in an ethical manner.”
Course participants have conducted impressive, informative projects after leaving Maryland. One Egyptian candidate completed a 600-patient survey in hospitals across Egypt that explored patient attitudes about donating blood samples for research. The results from this project and others help candidates design patient-education programs to remedy lack of understanding of the purpose of medical research and the sense of insecurity some patients have about signing consent documents.
Silverman said the course is equally beneficial to the American participants.
“Sometimes people worry we’re training people to take back Western ideas to their countries, but that is not the purpose and it is not what is happening. If anything, it’s a melding of ideas. I learn from them because they come up with excellent ideas on how to do it better,” Silverman said.
RESEARCH TO FIGHT DISEASE, TREAT CANCER, REGULATE HIV/AIDS
The NIH, through its various centers and institutes, supports several research initiatives in the Middle East and North Africa.
In June 2009, the National Institute of Allergy and Infectious Diseases (NIAID), an institute within the NIH, co-hosted in Tunisia a conference entitled “Leishmaniasis: Collaborative Research Opportunities in North Africa and the Middle East.” Presented in collaboration with the Institut Pasteur de Tunis, an NIAID-sponsored tropical medicine research center, and several other international partners, the conference focused on expanding research on prevention and treatment of leishmaniasis, a disease spread by sand flies that can cause chronic skin lesions and fatal organ damage.
The conference brought together scientists from Afghanistan, Algeria, Egypt, Jordan, Libya, Iran, Mali, Morocco, the Palestinian Authority, Sudan, Syria, Turkey, Tunisia and the United States to discuss targeted research efforts and funding opportunities.
In his opening remarks at the conference, U.S. Ambassador to Tunisia Gordon Gray said, “One of the goals of this symposium is to highlight opportunities for collaborative international research.
“My hope is this symposium will accomplish this goal and that Tunisian, American and international scientists will continue the dialogues you start here with mutually beneficial collaborations that last for years to come.”
Another NIH body, the National Cancer Institute (NCI), funds and provides as-needed governance to the Middle East Cancer Consortium (MECC). The MECC began in 1996 as an agreement between the ministries of health of Cyprus, Egypt, Israel, Jordan and the Palestinian Authority, with Turkey joining in 2004. The organization strives to promote scientific exchange among the participating countries to decrease cancer and improve cancer research in the region.
Today, the MECC also focuses on palliative care, as some countries lack systems to care for cancer patients, said Dr. Ben Prickril, international programs officer at NCI. NCI has helped improve the MECC’s palliative care initiative by arranging exchange programs with U.S. hospitals where physicians, nurses, social workers and psychologists from MECC countries spend a few weeks training at facilities in New York and Boston. In 2009, the MECC also sponsored two Jordanian nurses to pursue doctoral degree programs at U.S. graduate schools. The candidates’ theses will explore topics related to palliative cancer care.
On the HIV/AIDS front, several NIH institutions together manage the Collaborative HIV/AIDS Studies in the Middle East and North Africa. This program funds research and development work in Algeria, Djibouti, Egypt, Iran, Iraq, Jordan, Lebanon, Libya, Morocco, Oman, Syria, Tunisia, West Bank, Gaza and Yemen. Projects can relate to epidemiologic topics or social factors that affect the spread of HIV/AIDS in the region. For each project, a United States organization partners with local research teams to help create an ongoing research infrastructure in the region.
JOINING WITH MENA COUNTRIES TO ENHANCE TECHNOLOGY
The NIH’s programs also include collaborative technology projects with Egypt and Israel. Established in 1995, the U.S.-Egypt Joint Science and Technology Fund provides grants to American and Egyptian scientists interested in working together on research projects. The fund aims to promote mutual expansion of scientific knowledge for peaceful purposes and increased communication among the countries’ scientific communities.
Similarly, the U.S.-Israeli Binational Science Foundation (BSF) awards grants for cooperative research among scientists from the United States and Israel. Also designed to promote peaceful technological research advancements, the BSF began in 1972. The foundation has announced many research advancements, noting in its September 2009 newsletter progress in areas including epilepsy, anti-cancer drugs, depression treatment for terror attack victims, and stem cell treatments for learning disabilities.
PARTNERING TO IMPROVE NEWBORN SCREENING
Since 2006, the NIH’s National Institute of Child Health and Human Development (NICHD) has worked with organizations in the Middle East and North Africa to enhance newborn screening capabilities to better track and treat congenital disorders in the region.
The effort has resulted in an ongoing global dialogue, last revisited in 2008 at the “2nd Conference of the MENA Newborn Screening Initiative: Partnerships for Sustainable Newborn Screening Infrastructure and Research Opportunities.” NICHD, other NIH institutions and the Egyptian Ministry of Health and Population organized the conference, which took place in Cairo, Egypt, and brought together more than 30 health care professionals and advocates from 17 countries in the Middle East, North Africa, Europe, Asia and North America.
According to the conference report, participants began to conceive of infrastructure that would enable screening for congenital hypothyroidism. In the future, the countries could replicate the systems put in place to screen for this disease to expand screening to other conditions.
The NIH has begun collaborating with partner organizations on plans for a follow-up conference in 2010.
