RELEASE DATE:  June 26, 2003

RFA:  TW-03-008

Update: The following update relating to this announcement has been issued:

  December 24, 2008 - This RFA has been reissued as (RFA-TW-09-001).

Fogarty International Center (FIC)
National Library of Medicine (NLM) 
National Institute of Biomedical Imaging and Bioengineering (NIBIB) 
National Human Genome Research Institute (NHGRI) 




o Purpose of this RFA
o Research Training Objectives
o Mechanism of Support
o Funds Available
o Eligible Institutions
o Individuals Eligible to Become Principal Investigators
o Special Requirements 
o Where to Send Inquiries
o Letter of Intent
o Submitting an Application
o Peer Review Process
o Review Criteria
o Receipt and Review Schedule
o Award Criteria
o Required Federal Citations


The Fogarty International Center (FIC), in collaboration with the 
National Library of Medicine (NLM), the National Institute of 
Biomedical Imaging and Bioengineering (NIBIB), and the National Human 
Genome Research Institute (NHGRI), invites applications for the 
establishment or continuation of training programs in informatics for 
global health to address the needs of developing country institutions 
for information technologies and associated sciences to support 
biomedical research.  U.S. institutions, in partnership with developing 
country institutions that have strong, independent or collaborative, 
funded medical research programs are eligible to apply with the goal of 
enhancing and further strengthening those research activities.  
Applicants are expected to develop innovative training programs for 
developing country biomedical and behavioral scientists and engineers, 
clinicians, librarians, and other health professionals that increase 
their capacity to access, manage, analyze, interpret, manipulate, 
model, display, and share biomedical information electronically.  
Programs that include training in data management, biostatistics, 
biological imaging, disease surveillance, epidemiology, computer 
modeling, and bioinformatics are particularly encouraged.  It is 
envisioned that developing country institutions participating in the 
program may eventually serve as regional centers for medical, genome, 
and global health informatics training.  Training programs should be 
directed toward building informatics capacity in the partner foreign 
country that can contribute directly to research in disease 
pathogenesis, prevention, diagnostics, or treatment.  Inclusion of 
countries in the program with particularly severe endemic or epidemic 
malaria, HIV/AIDS, tuberculosis, or a growing burden of chronic, non-
communicable diseases is encouraged.

Institutions carrying out biomedical and behavioral research are usually 
composed of multiple individual laboratories and departments working on 
many separate research problems.  However, many of these projects have 
common needs for research expertise and infrastructure.  For example, 
within a single institution, training in information sciences, molecular 
genetic technologies, and bioethics would each benefit a large number of 
groups and strengthen the research capacity at the institution overall.  
Creating a core of expertise in these fields within institutions could 
serve to "glue" the disparate laboratories into a more efficient and 
interactive entity.  Moreover, experts in any of these fields might 
choose to collaborate widely with a variety of institutional programs, 
further strengthening those ties. 

This RFA is a first step toward realizing the goal of "gluing" 
outstanding research institutions in developing countries into more 
cohesive and efficient operational units.  Information technology is 
required in almost all research programs, both to access the vast 
information resources available internationally and to apply to research 
design and analysis.  This need is even more pressing in the 
increasingly multidisciplinary and multilaboratory projects in global 
health, such as the recent human, Anopheles, and Plasmodium genome 
consortia, or in multi-site clinical trials or international disease 
surveillance and prevention programs.  In these projects, large datasets 
must be shared between unrelated laboratories, posing significant data 
management and analysis challenges.  In addition, advances in global 
health may be increasingly driven by new technologies that emerge at the 
interface of computational and biomedical science.  The genomics and 
proteomics revolutions are stunning examples of such creative 
collaborations.  Finally, there is a need to learn how to archive and 
retrieve new types of data, such as the enormous amount of information 
contained within images.  For all of these reasons, information 
technology can be seen as a cornerstone of institutional research 

To achieve these goals, applicants should focus on developing a training 
program in partnership with a single developing country institution that 
serves as a "center of research excellence" in their region, in the 
sense that they have active research programs of high quality in a 
number of areas.  The objectives are: (1) To train individuals who will 
apply state-of-the-art information and communication technologies to 
research, health surveillance, and other biomedical applications and who 
will function in their home institutions as trainers or leaders in these 
technologies; (2) To raise awareness of and access to informatics 
resources within the larger scientific community at the institution; and 
(3) To develop a plan to create a sustainable medical and global health 
informatics training program at the institution.  Training plans should 
be directly integrated with the research activities at the institution.  
Technologies and skills that are emphasized during training must be 
directly related to research applications, and capacity-building 
activities should be substantially focused on skills beyond basic 
computer operations.  Within that context, it is envisioned that 
trainees will represent a range of skill levels and responsibilities, as 
relevant to the specific research training and capacity building 
objectives of the program and the environment of the home institution.

This RFA follows an earlier RFA (TW-99-003), International Training in 
Medical Informatics (ITMI), which focused broadly on building medical 
informatics capacity in developing countries of sub-Saharan Africa, 
Latin America, and the Caribbean.  The present RFA represents a further 
evolution of this program.  The geographical focus has been expanded to 
include any country that meets the World Bank criteria of a low- to 
middle-income economy (see below).  The current focus on foreign 
institutions with substantial research programs is intended to encourage 
the integration of medical, genome, and disease informatics training 
with ongoing research activities to more directly create and more 
efficiently deploy biomedical and behavioral research informatics 
capacity for the region.  As a critical mass of trainees return to their 
home institutions, it is envisioned that some of these individuals may 
in turn become mentors for future trainees, such that a sustainable 
training program can eventually be developed to serve the larger region.  


Improving our ability to prevent and treat diseases depends 
fundamentally on discovery, compilation, analysis and subsequent access 
to scientific information by researchers, clinicians and public health 
professionals.  Our ability to manage and communicate scientific 
information has increased exponentially in recent years, as computer-
based tools have been developed to aid the process of inquiry and 
analysis.  The sheer volume of data generated in biomedical and 
behavioral research and in clinical trials can no longer be effectively 
managed without electronic help.  Access to computers and the Internet 
is becoming more commonplace in research institutions throughout the 
developing world.  To take full advantage of these tools, however, 
individuals with the advanced skills to use them are critically needed.

This program is intended to increase the capacity of developing country 
scientists and medical professionals to design, access and use modern 
information technology in support of health sciences research.  For the 
purposes of this RFA, "informatics for global health" is broadly defined 
as all computer-aided manipulation of medically-relevant scientific 
information.  It encompasses data management, exploratory data analysis 
and biostatistics, algorithm-driven analysis of large data sets 
(bioinformatics, including genomics and proteomics analysis), access 
portals to public databases, computational biology and computer 
modeling, disease surveillance and epidemiology, and image analysis, 
among many other subdisciplines.  

Specifically, this program is designed to:

o  Improve the health informatics capacity of developing country 
institutions to advance biomedical research activities by training key 
researchers and institutional support staff in those institutions in the 
use and development of modern information technologies in the health 

o  Provide targeted short-term training in informatics to address 
specific needs of the biomedical and research community of the 
collaborating institution;

o  Provide workshops, seminars, and conferences at the foreign 
institution to raise awareness of informatics approaches and resources 
of relevance to the research community in the foreign country;

o  Provide medium- to long-term training for individuals from the 
partner developing country who will become leaders and teachers of 
health-related informatics in the home institution;

o  Initiate or enhance research activities in the partner institution 
through the use of informatics expertise, particularly in the context of 
multidisciplinary approaches to public health priorities in the home 

o  Expand and improve collaborative research possibilities between U.S. 
and developing country scientists in the prevention, control and 
treatment of diseases of public health relevance in the home country; 

o  Take initial steps or strengthen ongoing efforts towards building a 
sustainable training program in Global Health Informatics for health 
professionals within the developing country and surrounding geographical 

Required Elements of the Application

The application must include the following sections:

o  A discussion of the need for increased informatics expertise at the 
foreign institution.  This should include a description of the current 
informatics capacity, including skilled professionals and 
infrastructure at the institution, any barriers to use of this 
infrastructure, and any modest enhancements of this infrastructure that 
would be necessary to carry out the research-training program.  These 
descriptions can establish a baseline against which progress may be 
measured and the impact and success of the program eventually 

o  A description of the ongoing NIH- and other funded biomedical and 
behavioral research and training projects at the foreign institution 
that the proposed training and capacity-building efforts will draw upon 
and support. 

o  Identification of appropriate collaborators at both the developing 
country and U.S. training sites, including a primary foreign 
collaborator at the foreign institution (see below for eligibility 

o  Design of a training plan that addresses the needs identified and 
that provides for integration of informatics training with ongoing 
biomedical and behavioral research and training programs at the foreign 
site.  The training plan should include sufficient detail to judge the 
opportunities available to trainees, specific adaptations to curricula 
or programs already available at the U.S. or foreign site, design of 
new curricula to meet specific needs of the trainees, as necessary, and 
any other details that will create a clear picture of the training 
options.  Training may focus on strengthening a single area of Global 
Health Informatics or providing a broader set of options, as consistent 
with the needs of the institution.  Provisions for mentoring of 
students at both the U.S. and foreign sites should be emphasized.  The 
training plan may include suggestions for short courses targeting end-
users in the foreign institution/region, which address the needs 

o  An explicit description of how the training program will be linked 
to ongoing biomedical and behavioral research and training projects at 
the foreign site, with appropriate letters, where necessary, expressing 
willingness to integrate informatics trainees into these projects.
o  A detailed plan for recruitment of trainees to ensure that the most 
qualified individuals can be identified, and a description of the 
criteria and process for trainee selection.  One criterion of selection 
should be the likelihood that the chosen individuals will return to or 
remain in their home countries and contribute their new skills to the 
biomedical research and training enterprise there.  Thought should also 
be given to preparation of medium- to long-term trainees in English 
language and/or computer skills in the summer preceding studies in the 
U.S. or at the foreign site, where appropriate, to allow them to make 
optimal use of their formal training period.  Fees for such courses are 
allowable costs.  Degree candidates must meet all entrance requirements 
of the grantee degree-granting institution.

o  A discussion of how activities undertaken during the award period 
might begin to build a sustainable global health informatics training 
program in the partner foreign institution.  For example, by the end of 
the award period this might include a plan to offer short-courses or 
workshops on a fee basis in the collaborating country, engaging former 
trainees as faculty for these courses [Note that other NIH/FIC training 
and research grants or other private-public sources of research funding 
may be able to pay some fees for this training.]; the introduction of 
informatics courses into existing curricula; development of distance 
learning courses; negotiations with host-country institutions to 
establish certificate or degree programs in some area of global health 
informatics; and other relevant activities.  While a sustainable 
training program may not be achieved within the time period of the 
award, a plan and progress towards this end should be developed during 
the grant period.  For those programs based on ongoing collaborations or 
previous International Training in Medical Informatics awards, some of 
these efforts may have already been initiated, in which case the 
applicant should describe how the current program will strengthen, 
secure, and/or expand those efforts.
o  Evidence should be provided of substantive institutional commitment 
in the foreign country (this may include space, positions, matching 
funds, infrastructure support, access to data and systems, trainee 
support during their re-entry period, a commitment to establish a 
degree or certificate program, etc).

o  A plan for self-evaluation of the program, including a plan to track 
trainees for at least five years after completion of their training.  
Awardees will be required to track and document the long-term impact of 
this training program on the success of the trainees as measured by the 
number and quality of publications, electronic products, presentations, 
courses developed, awards, subsequent employment, involvement in 
research or public health, career advancement, etc.; their sustained 
commitment to research careers involving medical informatics in their 
home countries; their ability to attract funding for their work; their 
contributions to future international collaborations, conferences, and 
training; their influence on the development and use of informatics in 
their countries; and their ability to act as consultants, teachers, 
collaborators and role models to other local investigators and further 
disseminate the lessons learned.  Metrics should eventually encompass 
both the success of the individual trainees and the success in capacity-
building at the institution, including the impact of the program on 
biomedical and behavioral research capacity at the institution and the 
establishment or strengthening of informatics training capability.  An 
evaluation of the impact of training resulting from each program will be 
considered an important criterion during any re-competition of this RFA.  
Applicants should establish some mechanism to periodically review the 
progress of the trainees and the effectiveness of the program.  This may 
consist of regular meetings among faculty participating in the program 
or periodic review by an outside group of consultants.

Types of Training

Many types of training plans could be considered responsive to this RFA.  
In considering types of training, program directors should develop a 
plan in consultation with the foreign collaborator that addresses the 
needs of the foreign institution.  Training should include outreach to 
the larger biomedical community at the foreign institution, for example, 
through short courses, workshops, or conferences.  Training may occur in 
either the U.S. or developing country institution.  However, applicants 
are strongly encouraged to provide support and mentoring by U.S. and 
developing country faculty for trainees to conduct the research related 
to their training in the host developing country.  The training program 
might include but would not be limited to combinations of the following:

o  Short-term targeted training of biomedical research and allied health 
personnel in the host country (e.g. medical librarians, technicians, 
database managers, researchers and students requiring specific 
informatics expertise to carry out their work, physicians, nurses, 
midwives, health administrators, and other health professionals).  Short 
courses and workshops may present overviews of global health informatics 
or address specific topics of interest to the local scientific 
community.  Excellent examples of such short courses in the U.S. are the 
NLM-funded Medical Informatics Course at Woods Hole and the NHGRI-funded 
Computational Genomics Course at Cold Spring Harbor Laboratories.  Short 
courses are also a useful way to identify candidates for longer-term 
training.  While short courses may be appropriate during each year of 
the program, it may be particularly effective to plan for short courses 
in the first year, during the period when longer-term candidates are 
being identified and recruited.  It is expected that some of these short 
courses will also be open to NIH trainees in other programs in the 
region, whenever feasible, as a means of enhancing research capability 
and of fostering research collaborations among trainees from different 
programs within the country.  For a list of FIC-sponsored training 
programs and PIs, see and 
linked sites therein.  For programs from other NIH Institutes, see the 
corresponding websites.

o  Medium-term advanced training (three to six months), such as 
intensive courses carried out in the U.S. or in the foreign country in 
targeted subject areas.  In some cases, this might accommodate 
researchers in the host country that require specific training to 
advance their research (for example genomics projects that require 
bioinformatics support or clinical trials that require biostatistics 

o  Longer-term advanced training to develop a core of specialists who 
will become professional global health informatics research 
investigators and future leaders for global health informatics at the 
host institution and in the region.  Training might include any area of 
computer-assisted data analysis and management for biomedical and 
behavioral research applications (e.g. biostatistics, Geographic 
Information Systems [GIS], epidemiological modeling, bioinformatics, 
database construction, and access and use of public biomedical databases 
such as GenBank, Ensembl, UniProt, or PubMed) and should be at a level 
that might lead to an M.S. or equivalent degree for individuals with 
degrees in biomedical or other health-related sciences.  A smaller 
number of individuals may then continue on to Ph.D.s in Medical 
Informatics or other medically relevant informatics fields.  Training 
and follow-up research projects should emphasize skills that will 
contribute to biomedical and behavioral research per se, as opposed to 
purely medical or public health uses such as telemedicine and the design 
of medical records systems, unless these are linked directly to a 
research program.  Such training would normally require that trainees 
already have basic computer skills and a demonstrated aptitude for 
computer use.  

o  Advanced informatics postdoctoral training and research experiences 
in the U.S. (generally, one to two years duration) for developing 
country health scientists.  Long-term trainees and post-doctoral fellows 
may also benefit from learning grant-writing skills through workshops or 
courses offered during their training, and should be encouraged to 
compete for grant support from other NIH or international programs, such 
as the Fogarty International Research Collaboration Award (FIRCA) or the 
Global Health Research Initiative Program for New Foreign Investigators 

o Advanced research training support ("re-entry" funding), generally for 
one to two years duration, to enable trainees with advanced degrees or 
health care professionals to continue mentored informatics research in 
their home country as a continuation of their training program.  
Research projects should be related to ongoing research at the 
developing country institution.  Such funds for a mentored research 
experience should not exceed $15,000 direct costs per year.  Projects 
exceeding this limit require pre-approval from the FIC.  In the 
interests of developing teaching programs within the home institution, 
some trainees may choose to develop short courses or more comprehensive 
curricula for use in the home country.  Such activities should also be 
mentored and support can be provided through this grant as re-entry 

Applicants should describe how requests for re-entry funds will be 
reviewed and evaluated, and how such projects will be mentored and 
monitored.  Such research is subject to all the restrictions, 
assurances, and permissions required of any research program funded by 
the NIH.  Research involving human subjects, including use of data from 
previous studies that contains identifiable, private information from 
living individuals, must be conducted under an already funded, approved, 
and current grant protocol from the NIH (see Regulation 45CFR46.102F).  

o  Conferences that highlight the interconnections between informatics 
and research addressed to pressing health issues in the country.  At 
later stages of the program, this might also provide a forum for 
trainees to present their research and as a reunion for former trainees 
and a means to assess the impact of the program on their careers.

Integration of training with on-going biomedical or behavioral research, 
training, and/or hypothesis-driven health surveillance projects in the 
home institution is a fundamental and required aspect of this program 
and innovative approaches to this objective are encouraged.  Medium- and 
long-term trainees are expected to develop independent or collaborative 
research projects to deepen, apply and disseminate their new skills in 
their home countries.  These projects should be integrated with or 
topically related to ongoing research projects at the home institution, 
and examples of potential projects that would achieve this objective 
should be presented in the application.  In addition, ways in which the 
trainees might interact with existing research programs at the foreign 
institution (either directly through collaborative research or 
indirectly through common research meetings or opportunities to present 
research results) should be described. 

Examples of trainee projects include:  the development of a regional 
database to track the incidence of an important disease and ask explicit 
research questions using it; bioinformatics research based on genomics 
projects related to human disease agents (such as Plasmodium falciparum 
or M. tuberculosis) or human haplotypes that affect disease 
susceptibility or resistance; collaboration with a chronic disease 
research group (for example, hypertension, stroke, diabetes, or cancer) 
to design a system to manage and mine data; collaboration with an 
occupational and environmental health or epidemiological research 
project to test innovative approaches to data collection or contribute 
to biostatistical design and analysis; data analysis to support clinical 
trials or to assess the effectiveness of HIV-prevention projects; work 
with a team of collaborating laboratories to design a system to record 
and share data from dispersed sites, especially to develop a database 
system to share data from multiple resource-poor sites that might serve 
as a model for other groups with similar needs to share information; or 
computational modeling projects involving disease agents or basic 
metabolic processes.  Collaborations to develop new technologies, such 
as might apply to disease diagnostics in resource-poor settings, are 
also appropriate.  Applicants and trainees should work together to plan 
and develop projects that complement the objectives of the linked 
research or surveillance programs and are appropriate to local needs and 
resources.  Where appropriate, the design of projects should take into 
account potential sex and gender differences that may affect the 
questions asked and the analyses performed.  These might include 
different responses to and impacts of health interventions, differences 
in physiology, and different behavioral bases for disease prevention 


Trainees should be individuals who are currently involved or will be 
involved in biomedical or behavioral research or health surveillance 
activities in their home country.  A research institutional base for 
trainees to return to is an integral part of the eligibility of the 
trainees.  Initially, trainees should be drawn from individuals who work 
or intend to work at the partner institution.  However, as the needs of 
the institution are met, trainees may be recruited more widely from 
surrounding institutions in the region.  The "region" may be defined as 
deemed appropriate by the applicants.  Program directors are strongly 
encouraged to include women and individuals from underrepresented 
racial, ethnic, and socially disadvantaged groups in the country as 

The following categories of individuals are eligible for training:
o  Foreign researchers and other health professionals (M.D., 
D.D.S./D.M.D., Ph.D., or equivalent);
o  Foreign professionals with a bachelors or masters degree in a basic 
or health science; 
o  Medical technicians, computer technicians, nurses, midwives, and 
other health care workers;
o  Allied health professionals, such as medical librarians; and
o  Highly qualified current or former trainees from other FIC or NIH 
programs involved in advanced research or research training in their 
home countries.

Project Organization 

To achieve the objectives of this RFA, it is likely that creative 
coalitions of investigators and institutions will be required.  The 
team should be multidisciplinary and include experts in medical 
informatics as well as in research areas related to the linked research 
projects targeted towards the health concerns of the collaborating 
foreign country.  While the intention of this RFA is to build research 
capacity within a single foreign institution in the partner developing 
country, there may be compelling reasons to include more than one 
institution from that country within the training program.  For 
example, it may be the case that active research projects are carried 
out in a research institute or medical center that does not have the 
capability to develop didactic degree or certificate programs in 
medical informatics.  In this case, a plan to develop a sustainable 
training center for medical informatics might require a coalition with 
a more appropriate partner institution, such as a nearby university.  
Alternatively, the research programs of two institutions may be tightly 
linked.  If more than a single institution in the developing country is 
proposed, these institutions should have an explicitly expressed desire 
to work together.  Letters to this effect must be provided.  At least 
one of these institutions must fulfill the full eligibility 
requirements of this RFA and will be considered the primary foreign 
partner.  If more than one institution is proposed, a strong 
justification must be provided why both institutions are necessary to 
realize the objectives of the training program. 


This RFA will use the NIH D43 (International Training Grant) award 
mechanism.  As an applicant you will be solely responsible for 
planning, directing, and executing the proposed project.  This RFA is a 
one-time solicitation.  The anticipated award date is May 31, 2004.  


The participating NIH Institutes and Centers (ICs) intend to commit 
approximately $1.5 million in fiscal year 2004 (FY04) to fund up to six 
new and/or competing continuation grants in response to this RFA.  An 
applicant may request a project period of up to five years and a budget 
of up to $250,000 total costs [direct plus facilities and 
administrative costs] per year.  Consortium costs are included in the 
$250,000 total cost cap.  Because the nature and scope of the proposed 
research will vary from application to application, it is anticipated 
that the size and duration of each award will also vary.  Although the 
financial plans of the ICs provide support for this program, awards 
pursuant to this RFA are contingent upon the availability of funds and 
the receipt of a sufficient number of meritorious applications.  


You may submit (an) application(s) if your institution has all of the 
following characteristics:

o  Non-profit
o  Public or private organizations, such as universities, health 
professional schools, and research institutions capable of meeting the 
objectives of the RFA
o  Domestic

Applicants, from U.S. institutions, must collaborate with a single 
institution in an eligible developing country and must name an 
individual at that institution as a primary foreign collaborator.  If 
more than one institution is named (see "Project Organization", above), 
collaborators at each institution should be identified.  Eligible 
countries are defined as low- to middle-income countries.  See the World 
Bank website for a list of these countries 

The collaborating foreign institution on this application must be a non-
profit public or private institution.  At the time of anticipated award 
for this training program, this institution must be an NIH grant 
recipient or a substantial foreign partner in a minimum of three active 
FIC- or NIH-funded major research or training grants (R01, U01, P01, 
D43, U19).  "Substantial" participation requires that scientists from 
the foreign institution must be listed as "key personnel" on the NIH 
grant.  At least one of the three qualifying grants must be for 
research.  R03 grants and current ITMI awards do not contribute to 
eligibility, although they may increase the attractiveness of the 
foreign site as a research partner.  In addition, the developing country 
institution must have sufficient computer infrastructure and Internet 
connectivity in place (subject to only modest enhancement) to build upon 
for a training program, as the focus of these awards is training and not 
infrastructure development, per se.  

Multiple U.S. institutions may collaborate to jointly submit a single 
application to work with an eligible developing country institution.  
While not disallowed, in the interests of using this training program as 
a "glue" for the foreign research institution, it is desirable to have 
only a single training program at any individual foreign site.


Any individual from an eligible institution with the skills, knowledge, 
and resources necessary to carry out the proposed research is invited to 
work with their institution to develop an application for support.  
Women, individuals from underrepresented racial and ethnic groups, as 
well as individuals with disabilities, are always encouraged to apply 
for NIH programs.

At the time of application, applicant Principal Investigators (PIs) must 
be the PI or Project Director on at least one active research grant, 
training grant, or cooperative agreement from the NIH or another U.S. 
government agency or organization in the medical informatics or linked 
research area proposed for training.  NIH-sponsored research project 
grants (R01) or center grants, program project grants or cooperative 
agreements ("P" and "U" series), and D43 grants qualify for this 
requirement.  Equivalent research grants from other sources, including 
all non-NIH grants, may qualify if approved by the FIC program officer 
before submission of the application. 

The applicant training institution must demonstrate either an ongoing 
collaborative research relationship or high potential for development of 
collaborative research with the developing country institution named in 
the application.  The foreign collaborator must have a position that 
will allow him or her adequate time and provide appropriate facilities 
and resources to participate in the proposed medical informatics 
research-training program.  Finally, the proposed training program must 
be explicitly linked, through the PI, a co-investigator, or the foreign 
collaborator of the proposed project, to at least one of the qualifying 
funded research or training efforts at the collaborating foreign 
institution.  The application must demonstrate that the award is 
relevant to and will enhance the activities of the related research 
grant(s), as well as the research needs and public health interests of 
the collaborating country.


The grantee institution must show evidence of approval for collaborative 
research and training between the U.S. and foreign institutions included 
in the program.  This can be documented by providing a letter of 
endorsement from the appropriate officials at the collaborating 
institutions at the time of application. 

Re-competing ITMI applicants must include a description of the 
activities and achievements of their current ITMI award.  This should 
include a list of the trainees and their accomplishments to date and, 
where appropriate, the percent of trainees that were trained in the U.S. 
and subsequently returned to their home countries.  A list of 
publications in peer-reviewed scientific journals in which trainee 
research was supported by the previous ITMI award, i.e. publications in 
which trainees are authors or co-authors and the FIC award is cited in 
the acknowledgements, should be included.  Since it is expected that 
other research products, particularly electronic resources, will be 
generated in these programs, non-publication type products should also 
be cited.  Any other parameters that measure the impact of these 
programs on the collaborating foreign country's biomedical research, 
medical, or public health capacities should be described.

Training in Responsible Conduct of Research:  Applicants must include 
plans for training in responsible conduct of research for long-term 
trainees.  For more information on this provision, see the NIH Guide for 
Grant and Contracts (volume 21, number 43  NIH 
does not require a specific curriculum or format for instruction but the 
following areas should be included:  conflict of interest, responsible 
authorship and institutional policies for handling scientific 
misconduct, human subjects, animal studies, data management and data 
sharing.  The inclusion of international perspectives on these topics is 
strongly encouraged.  An award will not be made unless a description of 
such training is included.  The description should include the topics, 
format, faculty participation, instructional materials and the frequency 
and duration of the training provided.

Communication and Network meetings:  ITGH programs should endeavor, 
whenever possible, to ensure that research results and training 
innovations are accessible to other ITGH programs and to relevant 
programs in the home countries or internationally by means such as:  
making presentations at local and international conferences and 
publishing results in local and international journals; exchanging 
newsletters, CD-ROMs or other products among grantees; inviting trainees 
from other FIC programs within the home institution, country, or region 
to apply for short-term workshops conducted within the foreign country; 
or posting materials on websites accessible to the public.  In addition, 
FIC will periodically convene network meetings of grantees and funds 
should be budgeted in the application to allow PIs and foreign 
collaborators to attend these meetings in each year of the award.  As 
the programs mature, it will be desirable to have trainees also attend 
these meetings.


We encourage inquiries concerning this RFA and welcome the opportunity 
to answer questions from potential applicants or discuss prospective 
proposals and eligibility issues.  Inquiries may fall into three areas:  
scientific/research, peer review, and financial or grants management 

o  Direct your questions about scientific/research issues to:

Dr. Flora Katz
Division of International Training and Research 
Fogarty International Center
National Institutes of Health
Building 31C, Room B2C39
Bethesda, MD  20892-2220
Telephone:  (301) 402-9591
Fax:  (301) 402-0779

o  Direct your questions about peer review issues to:
Dr. Merlyn Rodrigues
Scientific Review Administrator
Division of Extramural Programs
National Library of Medicine
6705 Rockledge Drive, Suite 301
Bethesda, MD 20892-7968 (for US mail)
Bethesda, MD 20817 (for express/courier service)
Telephone:  (301) 496-4253
Fax:  (301) 402-2952

O  Direct your questions about financial or grants management matters 

Mr. Bruce Butrum
Grants Management Officer
Fogarty International Center
National Institutes of Health
Building 31, Room B2C39
Bethesda, MD  20892-2220
Telephone:  (301) 496-1670 
Fax:  (301) 402-0779


Prospective applicants are asked to submit a letter of intent that 
includes the following information:

o Descriptive title of the proposed research
o Name, address, and telephone number of the Principal Investigator
o Names of other key personnel, including the major foreign 
o Participating institutions
o Number and title of this RFA 

Although a letter of intent is not required, is not binding, and does 
not enter into the review of a subsequent application, the information 
that it contains allows NIH staff to estimate the potential review 
workload and plan the review.

The letter of intent is to be sent by the date listed at the beginning 
of this document, either by mail or electronically.  The letter of 
intent should be sent to:

Dr. Flora Katz
Division of International Training and Research
Fogarty International Center
National Institutes of Health 
Building 31, Room B2C39
31 Center Drive, MSC 2220
Bethesda, MD  20892-2220
Telephone:  (301) 402-9591
Fax:  (301) 402-0779


Applications must be prepared using the PHS 398 research grant 
application instructions and forms (rev. 5/2001).  The PHS 398 is 
available at in 
an interactive format.  Applicants should follow the instructions for 
the institutional NRSA found at the end of the PHS 398 instructions to 
construct their application.  For further assistance contact 
GrantsInfo, Telephone (301) 710-0267, Email:


All expenses related to trainee participation in the program should be 
itemized on the PHS Form 398 (NRSA substitute budget pages 4 & 5) in 
the appropriate categories.  All expenses related to faculty 
participation in the program should be itemized on the PHS Form 398 
(budget form pages 4 & 5) in the appropriate categories.  The total 
direct costs of the faculty participation budget should be identified 
on PHS Form 398 (NRSA substitute budget pages 4 & 5) in the "Other" 
category.  The combining of the budgets will allow reviewers and FIC 
staff to review a composite budget of all costs.

The grantee institution may request a Facilities and Administrative (F & 
A) cost allowance based on eight percent of the total allowable direct 
costs, exclusive of tuition and related fees and expenditures for 
equipment.  Note that using PHS 398 budget calculations, F & A costs on 
a subcontract become a part of the direct costs of the grant.

Although the U.S. institution will serve as the grantee institution for 
the purposes of this award, it is envisioned that the focus of training 
will gradually shift toward the host country over the course of the 
award period.  By the fifth year of the award, it is expected that the 
majority of the funds will be expended in support of activities at the 
foreign institution. 

Budgets may include costs to support the various types of training 
proposed (tuition, academic fees, stipends, salary, travel, per diem, 
trainee self-only or family medical insurance) for trainees and faculty, 
and costs to support the administration of the program and grant.  The 
salary for the PI, other training faculty and administrative staff must 
be commensurate with the salary structure and benefits at the 
corresponding institution.  The percent effort for administrative 
support at either the U.S. and/or the foreign site must be justified in 
relationship to the number of trainees expected to be in residence at 
either institution.  Programs are encouraged to seek cost-sharing 
arrangements with the grantee institutions in order to provide reduced 
tuition for long-term trainees and tuition-free short courses.

Trainees may be paid a stipend, comparable to the scientist's 
professional level and compatible with established NIH guidelines, while 
undergoing training or conducting research in the U.S., or at a level 
comparable to that received by similar professionals in-country while 
undergoing training or conducting research in their home countries, but 
in neither case to exceed $50,808 per annum.  Applicants may wish to 
refer to the NRSA stipend levels described at
Costs for computer hardware and software for establishment of 
workstations in the home country institution for use by trainees are 
allowable.  In addition, costs to establish and maintain Internet 
connection at the foreign site, including telephone and Internet service 
provider fees, at a cost consistent with current rates available in the 
foreign country, are allowable.  Together, these costs should not exceed 
$25,000 per year without prior permission from FIC.

Additional trainee support of up to $15,000 direct costs per person per 
year for research in the home country is allowable.  This may include 
funds to support training-related research projects, advanced research 
training, or preparation of teaching courses and materials in the home 
country.  The program director is expected to ensure that activities to 
be supported receive appropriate review and guidance, as described under 
"Types of Training: Advanced research training support", above. 

USING THE RFA LABEL:  The RFA label available in the PHS 398 (rev. 
5/2001) application form must be affixed to the bottom of the face page 
of the application.  Type the RFA number on the label.  Failure to use 
this label could result in delayed processing of the application such 
that it may not reach the review committee in time for review.  In 
addition, the RFA title and number must be typed on line 2 of the face 
page of the application form and the YES box must be marked.  The RFA 
label is also available at:

SENDING AN APPLICATION TO THE NIH:  Submit a signed, typewritten 
original of the application, including the Checklist, and three signed 
photocopies, in one package to:

Center For Scientific Review
National Institutes Of Health
6701 Rockledge Drive, Room 1040, MSC 7710
Bethesda, MD  20892-7710
Bethesda, MD  20817 (for express/courier service)

At the time of submission, two additional copies of the application 
must be sent to:

Dr. Merlyn Rodrigues
Scientific Review Administrator
Division of Extramural Programs
National Library of Medicine
6705 Rockledge Drive, Suite 301
Bethesda, MD 20892-7968 (for US mail)
Bethesda, MD 20817 (for express/courier service)
Telephone:  (301) 496-4253
Fax:  (301) 402-2952

APPLICATION PROCESSING:  Applications must be received on or before the 
application receipt date listed in the heading of this RFA.  If an 
application is received after that date, it will be returned to the 
applicant without review.

Although there is no immediate acknowledgement of the receipt of an 
application, applicants are generally notified of the review and 
funding assignment within eight weeks.

The Center for Scientific Review (CSR) will not accept any application 
in response to this RFA that is essentially the same as one currently 
pending initial review, unless the applicant withdraws the pending 
application.  However, when a previously unfunded application, 
originally submitted as an investigator-initiated application, is to be 
submitted in response to an RFA, it is to be prepared as a new 
application.  That is, the application for the RFA must not include an 
Introduction describing the changes and improvements made, and the text 
must not be marked to indicate the changes.  While the investigator may 
still benefit from the previous review, the RFA application is not to 
state explicitly how.  

Upon receipt, applications will be reviewed for completeness by the CSR 
and responsiveness by the FIC.  Incomplete and/or non-responsive 
applications will be returned to the applicant without further 

Applications that are complete and responsive to the RFA will be 
evaluated for scientific and technical merit by an appropriate peer 
review group convened by the ICs in accordance with the review criteria 
stated below.  As part of the initial merit review, all applications 

o  Receive a written critique
o  Undergo a process in which only those applications deemed to have 
the highest scientific merit, generally the top half of the 
applications under review, will be discussed and assigned a priority 
o  Receive a second level review by the FIC Advisory Board and possibly 
by the Advisory Councils of other co-funding ICs. 


The goals of NIH-supported research and training are to advance our 
understanding of biological systems, improve the control of disease, 
and enhance health.  In the written comments, reviewers will be asked 
to discuss the following aspects of the application in order to judge 
the likelihood that the proposed research training will have a 
substantial impact on the pursuit of these goals: 

o  Significance 
o  Approach 
o  Innovation
o  Investigator
o  Environment

The scientific review group will address and consider each of these 
criteria in assigning your application's overall score, weighting them 
as appropriate for each application.  Your application does not need to 
be strong in all categories to be judged likely to have major 
scientific and capacity-building impact and thus deserve a meritorious 
priority score.  For example, you may propose to carry out important 
work that, by its nature, is not innovative but is essential to move a 
field forward.

o  The expected scientific and public health contributions of the 
proposed activity;
o  The strength of the training program and its potential contribution 
to creating a "center of excellence" for research and training at the 
foreign host institution, including raising the general level of 
awareness in the scientific community of the potential impact of 
information sciences on research and clinical practice;
o  The potential to increase the critical mass of informatics expertise 
at the foreign institution over the course of the award period and the 
likelihood that this will build toward a sustainable global health 
informatics research and training capability at the foreign institution. 

o  Appropriateness of the training plan to address the needs identified 
by the foreign institution;
o  The appropriate mix of long- and short-term, initial and follow-up 
training to achieve the goals of this RFA;
o  The appropriate integration of didactic training with opportunities 
for trainees to become involved in biomedical and behavioral research or 
disease control and prevention projects conducted in their home country;
o  Adequacy of proposed procedures and criteria for 1) recruitment, 
review, and selection of trainees, and 2) peer review of trainee-related 
and re-entry research in informatics applications to biomedical and 
behavioral research, disease control and prevention projects;
o  Adequacy of plan for documenting the long-term impact of the program 
on research and public health capacity in the home countries of 
trainees, including the impact of the program on the careers of ITMI 
o  Effectiveness of plans to disseminate newly acquired informatics 
skills within the foreign institution;
o  Overall cost-effectiveness of the training and research plan.

o  Adequacy and creativity of plans to build modern information 
technology capacity in an institution that may currently have limited 
resources, limited access to the Internet, or limited integration of 
modern information sciences with research programs; 
o  Overall creativity in integrating the training program with ongoing 
research activities so that the newly generated informatics expertise 
enhances the research capacity at the foreign institution; and
o  Creativity in putting together a team of computer scientists and 
biomedical or behavioral scientists that, through their synergy, can 
create an exciting and innovative research-training program.

o  Qualifications of the program director to lead and the named faculty 
to participate in the proposed research training program, including 
their collective depth of experience in the fields of biomedical and 
behavioral research and informatics, research support from the NIH and 
other sources, and sensitivity to the special requirements for 
developing country trainees; 
o  Previous success in training scientists and others in biomedical 
research and informatics.  Training accomplishments should be included 
in addition to Biographical Sketches and Other Support forms for each 
faculty participant;
o  Potential for or strength of the collaborative relationship between 
the applicant and foreign institutions' research and teaching faculty;
o  For re-competing applications, the success of the applicant in 
strengthening medical informatics capacity in the partner developing 
country during the previous award period, as requested under SPECIAL 

o  Demonstrated funding for relevant research and training activities 
from the NIH for the developing country institution and from the NIH or 
other approved sources for the U.S. investigator;
o  Quality of training environment in the foreign institution as 
evidenced by 1) the quality of local teaching and research facilities 
and other resources; 2) the availability of high-quality candidates for 
training; and 3) past history of institutional commitment to former 
trainees in other internationally-funded programs upon returning to 
their home institution; 
o  Quality of training environment in the U.S., including the  
institutional commitment, the caliber of preceptors, the quality of 
teaching, and research facilities and resources.

The initial review group will also examine the adequacy of the process 
for the protection of human and animal subjects and the safety of the 
research environment where relevant. 

ADDITIONAL REVIEW CRITERIA:  In addition to the above criteria, your 
application will also be reviewed with respect to the following:

human subjects and protections from research risk relating to their 
participation in the proposed research will be assessed.  (See criteria 
included in the section on Federal Citations, below).

of plans to include subjects from both genders, all racial and ethnic 
groups (and subgroups), and children as appropriate for the scientific 
goals of the research.  Plans for the recruitment and retention of 
subjects will also be evaluated.  (See Inclusion Criteria included in 
the section on Federal Citations, below).

are to be used in the project, the five items discussed under Section f 
of the PHS 398 research grant application instructions (rev. 5/2001) 
will be assessed.


DATA SHARING:  The adequacy of the proposed plan to share data. 

BUDGET:  The reasonableness of the proposed budget and the requested 
period of support in relation to the proposed training program.


Letter of Intent Receipt Date:  September 26, 2003 
Application Receipt Date:  October 23, 2003
Peer Review Date:  January 31, 2004
Council Review:  May 18, 2004
Earliest Anticipated Start Date:  May 31, 2004 


Award criteria that will be used to make award decisions include:

o  Scientific merit and responsiveness to the research, training, and 
capacity-building objectives (as determined by peer review)
o  Availability of funds
o  Programmatic priorities, including the interests of co-funding ICs 
and geographic distribution considerations.  We strongly encourage 
independent U.S. applicant institutions that wish to work with the same 
foreign institution to consider forming a collaborative joint program 
and submitting a single application together.


It is not expected that human and animal subjects will be a routine 
component of these training programs except as related to associated 
funded research projects.  It is the responsibility of the PI to ensure 
that all required assurances are in place for any research carried out 
by a trainee funded through this program.  Applicable provisions are 
listed below.

SUBJECTS:  The NIH maintains a policy that children (i.e., individuals 
under the age of 21) must be included in all human subjects research, 
conducted or supported by the NIH, unless there are scientific and 
ethical reasons not to include them.  This policy applies to all 
initial (Type 1) applications submitted for receipt dates after October 
1, 1998.

All investigators proposing research involving human subjects should 
read the "NIH Policy and Guidelines" on the inclusion of children as 
participants in research involving human subjects that is available at 

policy requires education on the protection of human subject 
participants for all investigators submitting NIH proposals for research 
involving human subjects.  You will find this policy announcement in the 
NIH Guide for Grants and Contracts Announcement, dated June 5, 2000, at

HUMAN EMBRYONIC STEM CELLS (hESC): Criteria for federal funding of 
research on hESCs can be found at and 
Only research using hESC lines that are registered in the NIH Human 
Embryonic Stem Cell Registry will be eligible for Federal funding (see  It is the responsibility of the applicant to 
provide the official NIH identifier(s)for the hESC line(s)to be used in 
the proposed research.  Applications that do not provide this 
information will be returned without review. 

The Office of Management and Budget (OMB) Circular A-110 has been 
revised to provide public access to research data through the Freedom of 
Information Act (FOIA) under some circumstances.  Data that are (1) 
first produced in a project that is supported in whole or in part with 
Federal funds and (2) cited publicly and officially by a Federal agency 
in support of an action that has the force and effect of law (i.e., a 
regulation) may be accessed through FOIA.  It is important for 
applicants to understand the basic scope of this amendment.  NIH has 
provided guidance at

Applicants may wish to place data collected under this RFA in a public 
archive, which can provide protections for the data and manage the 
distribution for an indefinite period of time.  If so, the application 
should include a description of the archiving plan in the study design 
and include information about this in the budget justification section 
of the application.  In addition, applicants should think about how to 
structure informed consent statements and other human subjects 
procedures given the potential for wider use of data collected under 
this award.

The Department of Health and Human Services (DHHS) issued final 
modification to the "Standards for Privacy of Individually Identifiable 
Health Information", the "Privacy Rule," on August 14, 2002.  The 
Privacy Rule is a federal regulation under the Health Insurance 
Portability and Accountability Act (HIPAA) of 1996 that governs the 
protection of individually identifiable health information, and is 
administered and enforced by the DHHS Office for Civil Rights (OCR). 
Those who must comply with the Privacy Rule (classified under the Rule 
as "covered entities") must do so by April 14, 2003  (with the 
exception of small health plans which have an extra year to comply).  

Decisions about applicability and implementation of the Privacy Rule 
reside with the researcher and his/her institution. The OCR website 
( provides information on the Privacy Rule, 
including a complete Regulation Text and a set of decision tools on "Am 
I a covered entity?"  Information on the impact of the HIPAA Privacy 
Rule on NIH processes involving the review, funding, and progress 
monitoring of grants, cooperative agreements, and research contracts 
can be found at  

proposals for NIH funding must be self-contained within specified page 
limitations.  Unless otherwise specified in an NIH solicitation, 
Internet addresses (URLs) should not be used to provide information 
necessary to the review because reviewers are under no obligation to 
view the Internet sites.  Furthermore, we caution reviewers that their 
anonymity may be compromised when they directly access an Internet site.

HEALTHY PEOPLE 2010:  The Public Health Service (PHS) is committed to 
achieving the health promotion and disease prevention objectives of 
"Healthy People 2010," a PHS-led national activity for setting priority 
areas.  This RFA is related to one or more of the priority areas.  
Potential applicants may obtain a copy of "Healthy People 2010" at

AUTHORITY AND REGULATIONS:  This program is described in the Catalog of 
Federal Domestic Assistance at and is not subject 
to the intergovernmental review requirements of Executive Order 12372 
or Health Systems Agency review.  Awards are made under authorization 
of Sections 301 and 405 of the Public Health Service Act, as amended 
(42 USC 241 and 287b) and under Federal Regulations 42 CFR 52 and 45 
CFR Parts 74 and 92.  All awards are subject to the terms and 
conditions, cost principles, and other considerations described in the 
NIH Grants Policy Statement.  The NIH Grants Policy Statement can be 
found at and under 
Federal Regulations 42 CFR 52 and 45 CRF Parts 74 and 92.

The PHS strongly encourages all grant recipients to provide a smoke-
free workplace and discourage the use of all tobacco products.  In 
addition, Public Law 103-227, the Pro-Children Act of 1994, prohibits 
smoking in certain facilities (or in some cases, any portion of a 
facility) in which regular or routine education, library, day care, 
health care, or early childhood development services are provided to 
children.  This is consistent with the PHS mission to protect and 
advance the physical and mental health of the American people.

Weekly TOC for this Announcement
NIH Funding Opportunities and Notices

H H S Department of Health
and Human Services

  N I H National Institutes of Health (NIH)
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Bethesda, Maryland 20892