IC Directors' Meeting Highlights
April 11, 2002
Dr. Kirschstein hosted a breakfast for Ms. Quantius. Ms. Quantius said she was already impressed by NIH when she came but she leaves with even more respect for the energy, skill, and enthusiasm of everyone here. She hopes to serve both NIH and the House Appropriations Subcommittee well.
I. Report by Dr. Clifton Barry on Experiences in Afghanistan
Dr. Kirschstein said the Secretary is determined to aid the Afghan people by improving their health care. Dr. Gallin is the NIH lead for this program. Dr. Gallin introduced Dr. Barry, a TB researcher in NIAID who has extensive experience working in refugee camps as a volunteer. Dr. Barry has worked with the American Refugee Committee (ARC), which is actively combating infectious diseases, as an extracurricular activity for about 10 years. He has been on two missions as an HHS assignment since September 11. He visited Pakistan in November and Afghanistan in January. He used photographs and statistics to provide background on Afghanistan (for example, only 13 percent of the Afghan people have access to safe drinking water) as well as the current grim status of the Afghan refugee population. There are roughly 4.5 million Afghan refugees, the vast majority located in Pakistan. He compared health care in Afghanistan to that in the Middle Ages. The life expectancy of men is 45 and of women, 47; 25 percent of the children die before age 5. Within the refugee camps there is only one basic health unit (a medical professional of some kind) for every 20,000 people. He also noted that TB is a major problem (60,000 - 70,000 cases/year) and is a women's health issue in Afghanistan, because 80 percent of the cases occur in women. To add to the woes of the people, the Kabul area has been in a serious drought for eight years; the area is desolate and land mines are everywhere. Dr. Barry said virtually all health care is now provided by nongovernment organizations (NGOs). Dr. Barry and his group have written a proposal to control TB within the refugee camps. They are applying to the Global Fund for AIDS, TB, and Malaria for funds to rebuild the Afghan Ministry of Health's disease control program.
Dr. Gallin attended a meeting yesterday at USAID to discuss what is being done across the Federal government to help the Aghan people. USAID is performing a needs assessment, and Dr. Gallin reiterated that these people's needs are very basic: clean water, heat, basic sanitation, and medicine. He stressed that the Secretary has a major interest in this effort. HHS has five working groups, and Dr. Gallin is leading the hospital/clinical infrastructure group. He distributed a chart showing the participation across HHS on this working group, which includes NIH, IHS, HRSA, and FDA representatives. NIH's major efforts are to help develop a clinical microbiology lab and offer training in hospital techniques (i.e., maintenance of a safe blood supply, clinical microbiology, pharmacy management, and nursing). Dr. Gallin will provide a copy of the draft HHS plan to anyone who is interested. There is a meeting today with the Deputy Secretary to plan for trans-government working groups.
Dr. von Eschenbach noted that a significant number of Afghan physicians and health care providers live and work in the US. He asked whether HHS has any way to mobilize them. Dr. Kirschstein said this had been explored. Many are interested in going back, but only on a short-term basis. This effort is being orchestrated by USAID and the Peace Corps. Secretary Thompson would like to create a Health Corps as well. Dr. Straus said that NGOs can often do more than government entities can in these situations. Dr. Barry said the WHO is trying to coordinate the efforts of the NGOs, who are also trying to coordinate better among themselves. Dr. Maddox asked about clothing needs. Dr. Barry said the biggest problem is trying to deliver clothing to the people; few people are allowed into Afghanistan and there are few flights in and out of the country. He takes several huge duffel bags filled with children's clothing whenever he goes. Dr. Fauci suggested that the Global AIDS Trust Fund could be an additional source of funding.
II. Disease Control Priorities in Developing Countries
Dr. Keusch said the situation in Afghanistan is not unique and introduced Dr. Dean Jamison, who was one of the lead authors on the World Bank's World Development Report of 1993 on Investing in Health as well as the World Bank/WHO report, Disease Priorities in Developing Countries, published in 1993. He is currently working for FIC and will soon begin work on the second edition of Disease Priorities in Developing Countries (DCP2). The new study will be based at FIC and is being financed by the Gates Foundation. Dr. Jamison distributed the proposed table of contents for DCP2. Unlike the first edition, the new study will explore the potential of science to contribute to new solutions to improve health in developing countries, and the editors hope to engage many at NIH in this effort. Dr. Jamison hopes to complete the work over the next three years. Dr. Fauci spoke in support of FIC's plan to involve the ICs early in this process.
III. Information Items
Dr. Kirschstein reported that Senator Frist made a statement on the Senate floor Tuesday supporting a ban on human cloning. The President issued a similar statement Wednesday. Drs. Kirschstein and Maddox both received letters from Dr. Leshner conveying the AAAS position on cloning. The group agreed that no response is necessary.
Dr. Kirschstein noted that the appropriations hearings have gone well. The last House hearing will be held on April 16. The group briefly discussed requests by Mr. Regula and Mr. Obey for NIH delegations to visit their districts in May. Dr. Kirschstein and Mr. Smolonsky encouraged IC Directors to personally participate in these visits if at all possible, despite the many competing demands on their time during May.
Dr. Kirschstein mentioned that a small group of IC Directors and Senior Staff is working on plans for the NIH Budget Retreat. There was a question of whether Dr. Fauci should talk about the bioterrorism budget at the Retreat or at an IC Directors' meeting. Dr. Kirschstein asked him to present it at an IC Directors' meeting.
Dr. Kirschstein reported that her first meeting with Dr. Zerhouni was very positive.
Dr. Rohrbaugh reported that OTT signed a final agreement with ESI, an Australian company, on use of its stem cell lines. ESI essentially agreed to the WiCell model terms. Intramural scientists can begin to use these cell lines immediately, and ESI has agreed to the same terms for the extramural community. We will issue a press release shortly, after which the terms of the agreement will be posted on the OER stem cell Web site.
Karen Pelham O'Steen
This page was last reviewed on August 18, 2003 .
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