The past 20 years have seen an unprecedented interest in global health among faculty and students in North American universities. The impact of basic and translational research combined with resources provided through the President’s Emergency Plan for AIDS Relief (PEPFAR) on the global epidemic of HIV has been transformational.1 Recognizing that cardiovascular and pulmonary diseases, diabetes, and cancer are now the leading causes of death worldwide, the United Nations General Assembly held a high-level meeting on non-communicable diseases in September 2012, only the second such meeting on a health topic.2
In 2008, the National Heart, Lung, and Blood Institute (NHLBI) established an Office of Global Health3 to guide its activities in the global health arena. The NHLBI has been a leader in addressing non-communicable diseases at the National Institutes of Health (NIH), co-hosting the trans-NIH working group on global health and the Global Alliance for Chronic Diseases.4 Essential to effective engagement is the development of a diverse, multifaceted workforce of U.S. and international investigators. The NHLBI has been an active participant in the Global Health Program for Fellows and Scholars, which provides early-stage investigators from the United States and lowand middle-income countries opportunities to enhance their global health research expertise and their careers.5 The program is run by the Fogarty International Center at NIH, with funds provided by categoric Institutes, including NHLBI, for work within our mission areas. The program has enabled U.S. subspecialty trainees to gain international experience with mentors from their home institutions and from international centers. Two cardiology trainees supported under this program have published about their experience,6 emphasizing both the importance of overseas training and home institutional support to successful research collaborations and the personal challenges of the experience.
Many potentially productive research opportunities in hematology require engagement in collaborative global investigation. Basic and clinical research on Burkitt lymphoma in Africa has informed cancer biology and treatment. Scientific discoveries can be made by studying diseases that are rare in the United States, but are common in other areas, such as hemoglobinopathies. Basic and translational research, identification of new targets for therapy, and health systems research opportunities abound. Developing new approaches to bringing the benefits of existing interventions and creating new approaches to health-care delivery may come from collaborations with investigators in diverse settings. In addition, developing new approaches to improving the availability of blood resources would improve health in areas in which trauma, complications of pregnancy and delivery, cancer, and surgical interventions lead to preventable death and disability. As cancers are defined by their molecular signatures, international partnerships will be essential to ensure adequate study participation to assess new therapies. Iron deficiency remains the world’s most common hematologic disorder, adding significantly to the global burden of disease and actually worsening over the past two decades in children under age five.7 Common and rare disorders of thrombosis and hemostasis require studies at a population level.
The NHLBI is eager for hematologists to join the cardiologists and pulmonologists now taking advantage of opportunities to train and do research in international settings. Strong support from home institutions, collaborations with international partners who are full participants in design and conduct of research, and creation of sustainable career pathways will enable the hematology community to exploit opportunities and improve health with broad impact and new frontiers. You can learn about the program on the NIH website and by contacting Dr. Myat Htoo Razak, Division of International Training and Research in the Fogarty International Center at NIH.
