Sites Chosen for NIH and Gates Foundation Global Network for Women's and Children's Health Research

The National Institute of Child Health and Human Development (NICHD) has selected the first eight research units for the Global Network for Women's and Children's Health Research, an international research network to improve the health of women and children throughout the world.

The Network was initiated in 2001 with $15 million each in funding from both major partners, the Bill & Melinda Gates Foundation and NICHD. Each unit in the network consists of a scientific team that includes a U.S. principal investigator and a senior scientist at an institution in a developing country. Each team will receive approximately $500,000 per year over five years, in addition to funding for the data coordinating center and special projects.

Research Triangle Institute International (RTI) will serve as the data coordinating center for the Global Network. RTI staff will work closely with NICHD scientific staff to provide communications support, as well as technical and statistical assistance to each research unit.

"Collaboration between U.S. and international experts in women's and children's health is critical to understanding and reducing global problems such as infant mortality, childhood illnesses, and complications of pregnancy," said Duane Alexander, M.D., Director of the NICHD.

"The Gates Foundation is committed to ensuring that mothers and children in developing countries have the same chance for health as those in other parts of the world," said Richard Klausner, M.D., Executive Director of the Bill & Melinda Gates Foundation's global health program. "We hope that research supported by the Global Network will lead to important advances against leading causes of maternal and infant mortality."

NICHD is also co-funding a complementary research training program managed and supported by NIH's Fogarty International Center (FIC). The FIC International Maternal and Child Health Research and Training Program provides research training to strengthen maternal and child health biomedical and behavioral research centers in low- and middle-income nations. Three of the new Global Network research units have companion FIC research training grants.

The eight research units of the Global Network for Women's and Children's Health Research are:

Richard Derman, M.D., M.P.H., University of Missouri at Kansas City Bhalchandra S. Kodkany, M.D, Jawaharlal Nehru Medical College, Belgaum, India

This research unit will address the problem of preventing post partum hemorrhage, a condition that threatens the mother's life after delivery of a child. The research unit will carry out a study of misoprostol, an inexpensive oral drug that causes uterine contractions and decreases blood loss after delivery. In this project, trained nurse midwives who assist home deliveries will administer misoprostol in the home or in a community clinic.

Pierre Buekens, M.D., Ph.D., Tulane University, School of Public Health and Tropical Medicine Jose Belizan, M.D., Centro Latinamericano de Perinatologia (CLAP), Montevideo, Uruguay

Post-partum hemorrhage remains a major cause of maternal death in some developing countries where effective drugs are available but potentially risky medical services and interventions are over-used. In this study, physicians will be selected to receive education about practices that previous research has shown to be effective. They will then be asked to persuade their colleagues to change their practices to prevent post-partum hemorrhage, and to encourage them to forego unnecessary obstetric procedures. This unit has a companion FIC International Maternal and Child Health Research and Training grant.

Michael Hambidge, M.D., Sc.D., University of Colorado Health Sciences Center Noel Solomons, M.D., Center for Studies of Sensory Impairment (CESSIAM), Guatemala City, Guatemala

This research unit will address the widespread problem of nutritional deficiencies in developing countries by comparing the nutritional benefits of high phytate corn to those of low phytate corn. Phytate is a form of phosphate found in whole grains, seeds, nuts, and legumes. Earlier research findings suggested that phytates in the diet interfere with the absorption of nutrients. If this study shows that low phytate corn can help to increase babies' birth weight, this inexpensive corn could improve the nutritional status of women and children in developing countries with a corn-based diet.

Robert Goldenberg, M.D., University of Alabama at Birmingham Saeed Akhtar, Ph.D., Aga Khan University, Karachi, Pakistan

This project will investigate the relationship between maternal vaginal infections, and maternal and newborn illness and death. The results of this study will be shared with the Pakistani medical system, health policymakers, and counterparts around the world and will be used to plan a trial to improve pregnancy outcomes. This research unit has a companion FIC International Maternal and Child Health Research and Training grant.

Pinaki Panigrahi, M.D., Ph.D., University of Maryland School of Medicine S.N. Parida, M.D., S.C.B. Medical College, Cuttack, India

This research unit in northern India will investigate strategies to prevent newborn sepsis, a severe infection in the blood that often develops when the mother has had pregnancy complications. Sepsis is the most common cause of newborn death in India. The researchers will test mothers and newborns in Indian villages to investigate the source of infection as well as the effectiveness of the antibiotic used to treat the bacteria that cause sepsis. A trial, based on the results of the first study, will test interventions to prevent newborn sepsis.

Joseph Spinnato, M.D., University of Cincinnati, Ohio Soubhi Kahhale, M.D., Ph.D., University of Sao Paolo Medical School, Brazil

Preeclampsia, the development of swelling, high blood pressure, and protein in the urine, can be a potentially fatal complication of pregnancy. It has no known cure and is a common cause of death worldwide. This Global Network research unit will examine whether taking vitamin C and E supplements during the second trimester of pregnancy can reduce the rate and severity of preeclampsia.

Jeffrey Murray, M.D., University of Iowa, Department of Pediatrics Eduardo Castilla, M.D., Estudio Colaborativo Latinoamericano de Malformaciones Congenitas (ECLAMC), Rio de Janeiro, Brazil

Birth defects and developmental disabilities are a leading cause of infant death and disease, particularly in developing countries. This research unit in Brazil, working with a consortium of South American countries, will study the association between folic acid supplementation and cleft lip and cleft palate in a high-risk population. This unit has a companion FIC International Maternal and Child Health Research and Training grant.

Michael Varner, M.D., University of Utah School of Medicine Dr. Tudeng, Tibetan Autonomous Region Health Bureau (TAR), Lhasa

The University of Utah and the TAR Health Bureau will conduct an ethnographic study of the customary practices associated with labor, delivery, and early newborn care. They will also conduct and evaluate training sessions for obstetricians and birth attendants to reduce the maternal and newborn death rate in Tibet, which is among the highest in the world. The results of these projects will be used to plan a trial to improve the outcome of pregnant women in TAR.

New Global Network research units in Africa will be added later this year.

In addition to the funds provided by the Bill & Melinda Gates Foundation and the NICHD, other NIH Institutes are providing financial, technical, scientific, training and administrative support. These include the National Center for Complementary and Alternative Medicine (NCCAM), the National Institute of Dental and Craniofacial Research (NIDCR), the National Cancer Institute (NCI), and the Fogarty International Center (FIC).

The NICHD is part of the National Institutes of Health (NIH), the biomedical research arm of the federal government. NIH is part of the U.S. Department of Health and Human Services. The NICHD sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. NICHD celebrates its fortieth anniversary in 2003. NICHD publications, as well as information about the Institute, are available from the NICHD Web site, http://www.nichd.nih.gov, or from the NICHD Clearinghouse, 1-800-370-2943; e-mail NICHDClearinghouse@mail.nih.gov.

FIC is the international component of the NIH. It promotes and supports scientific discovery internationally and mobilizes resources to reduce disparities in global health. FIC will commemorate its thirty-fifth anniversary in 2003 with a year-long lecture series on global health issues and a scientific symposium on May 20-21, 2003. Press releases, fact sheets, and other FIC-related materials are available at www.fic.nih.gov.

The Bill & Melinda Gates Foundation is building upon the unprecedented opportunities of the 21st century to improve equity in global health and learning. Led by Bill Gates' father, William H. Gates, Sr., and Patty Stonesifer, the Seattle based foundation has an endowment of approximately $24 billion.