Roger Glass: celebrating the Fogarty at 50

Featured Journal Content
 
The Lancet
May 05, 2018 Volume 391 Number 10132 p1749-1864
http://www.thelancet.com/journals/lancet/issue/current

Perspectives
Roger Glass: celebrating the Fogarty at 50
Marianne Guenot
Published: 05 May 2018
At the Fogarty International Center, “we’re small, but we’re catalytic”, says Roger Glass, the centre’s Director and Associate Director for International Research at the US National Institutes of Health (NIH). The Fogarty celebrates its 50th anniversary this month and has been under Glass’s leadership since 2006. By training scientists, supporting research, and building partnerships, the Fogarty serves a bridge between the NIH and the global health community. Since its creation in 1968, about 6000 scientists have received research training through its programmes and the centre funds about 500 projects. “We really invest in capacity building of young people interested in research in biomedical and health sciences”, says Glass. “I visit institutes and attend meetings in Africa, Asia, and Latin America and people come up to me and say ‘I was a Fogarty trainee and that experience transformed my career!’ It brings a smile to my face.” Many Fogarty trainees and grantees become leaders in health, politics, and other fields.

It was his work with diarrhoeal diseases that brought Glass into global health. After medical and public health studies at Harvard, he did research on cholera at the then International Centre for Diarrheal Disease Research in Bangladesh in 1979 for the US Centers for Disease Control and Prevention (CDC). He joined the NIH’s Laboratory of Infectious Diseases in 1984 and 2 years later became Chief of the CDC’s Viral Gastroenteritis Unit, a role he held until 2006. His work focused on rotavirus research. “Because new diagnostics were available, we developed epidemiologic and laboratory methods…we trained people from probably 50 countries around the world to conduct surveillance of rotavirus and participate in a global surveillance network now run by WHO. That surveillance system is ongoing today in over 60 countries, now managed by WHO and PAHO”, he explains.

The development of a rotavirus vaccine took another 30 years; the Indian Neonatal Rotavirus Vaccine Project, begun in 1985 as a collaboration with Maharaj Krishan Bhan and other colleagues, led to the licensure of the oral rotavirus vaccine, Rotavac. “Earlier vaccines from the multinational manufacturers worked well but were too costly for low-income countries”, he says. Glass and coworkers set out to develop a more affordable vaccine through a public–private partnership. “Through this extraordinary partnership, this vaccine probably cost less than US$80 million to develop compared with Big pharma that claims that a new vaccine would cost half a billion or more to produce”, he says. In 2016, the Indian Government introduced the vaccine into its national immunisation programme and on Jan 24, 2018, Rotavac was prequalified by WHO for distribution by UNICEF and Gavi, the Vaccine Alliance.

Glass’s work on enteric and diarrhoeal diseases has taken him to many countries and he is fluent in five languages, in which he often lectures and engages with researchers. “I learned from the experience that if you get people involved in research on an important problem early on in their career, many will end up pursuing this for their career, a great return on investment”, he says. Glass is proud of the Fogarty’s ability to accelerate globalisation of health research and training because he “feels strongly that we must take science where the problems are and where we can most rapidly seek their solutions”. Fogarty programmes have facilitated research and training collaborations between academic institutions in the USA and in low-income and middle-income countries. “We have no monopoly on knowledge in the USA, good ideas come from all over…We only have to listen, and maybe help them or bring something else to the table.”

A recent turning point, says Michele Barry, Senior Associate Dean for Global Health and Director of the Center for Innovation in Global Health at Stanford University, was when the Trump administration “tried to zero out the budget at Fogarty” in 2017. “Roger had so many supporters around the world that we all came together to stage a campaign. This was really because of Roger’s leadership”, says Barry, who has served on Fogarty’s advisory board. The centre’s budget for this year was not reduced.

Looking to the future, Glass thinks that while infectious diseases and pandemic control remain important, non-communicable diseases (NCDs) and environmental health will increasingly shape global health research. “There is an explosion of new research tools—in point-of-care diagnostics, genomics, mHealth, imaging—that will change our ability to work in the global space”, he says. Glass points out that “solutions will depend upon other partners—in business to consider supply chain logistics to deliver services, drugs, and vaccines; bioengineering to develop low-cost technologies and devices; law to write documents like the Framework Convention on Tobacco Control or laws to instate taxes to reduce the sugar content of beverages or the salt content of foods”.

Glass will be presented with the National Foundation for Infectious Diseases’ Jimmy and Rosalynn Carter Humanitarian Award on May 10. He is “optimistic about the future of the Fogarty International Center”, he says. “Our trainees and grantees have been on the cutting edge of research to make HIV/AIDS a chronic, treatable disease, of combating Ebola and Zika outbreaks, and of establishing research platforms in low- and middle-income countries. Fogarty trainees and grantees today will be on the cutting edge of research and leadership into the critical health problems of the NCDs, as well as the next pandemics of tomorrow.”