NEI’s Research Partnerships Around the World & Vision Loss Prevention Activities

1. NEI’s Research Partnerships Around the World & Vision Loss Prevention Activities World Sight Day 2012: From Vision Research to Vision Loss prevention October 11, 2012 John Prakash, PhD, MBA Associate Director, International Programs National Eye Institute- National Institutes of Health Tel: (301) 496-2234; Fax:301-496-9970 Email: prakashg@mail.nih.gov Department of Health and Human Services

2. Contents • 1. Goals of the NEI International Program • 2. Research Partnerships Around the World • Intramural Collaborations • Extramural Collaborations • 3. Sample Case Studies • Trachoma • Corneal ulcer • Brain neuroplasticity

3. NIH MISSION STATEMENT An agency of the United States Department of Health and Human Services, the NIH conducts and supports medical research to uncover new knowledge that will improve the health of all Americans and the human condition throughout the world.

4. High-throughput technologies in genomics and nanotechnology Developing diagnostics, preventative strategies and therapeutic tools through public–private partnerships Reining in the costs of health care with comparative-effectiveness research and personalized medicine Expanding research into diseases affecting the developing world Increasing budgets and investing in training & peer review to achieve a predictable funding trajectory

5. NEI Mission http://www.nei.nih.gov/ “…to conduct and support research, training, and other programs with respect to blinding eye diseases, visual disorders, mechanisms of visual function, preservation of sight, and specific health problems and needs of the blind.”

6. Office of International Programs-Global Health “Good Eye Research Anywhere is Good Eye Research Everywhere”

7. Office of International Programs-Global Health • Broad Functions • Coordinate and support collaborative international research programs that focus on selected eye diseases of substantial health importance to the US and other countries • Maintain a knowledge base of the Institute's research programs and policies in coordination with the National Institutes of Health - Fogarty International Center (FIC) • Identify relevant programs of other federal domestic agencies, bilateral research agencies, multilateral research organizations, and volunteer agencies involved in international health activities • Advise the NEI Director on program relationships and opportunities for collaboration

8. Goals • Three Goals for NEI International Programs • Goal I: Coordination • Address the daily needs of the international business and actively participate in the NIH and the USG wide programs that may affect vision research and training • Goal II: Research Collaboration • Foster a sustainable international research environment, expand collaborations in the countries across the globe that are interested in the advancement of vision research, and support international partnerships providing scientific value to the NEI-NIH programs • Goal III: Training • Develop human capital in the US to support the future needs in the areas of vision research and training, support mentoring activities for the next generation of scientists and professionals interested in global health and vision research

9. Contents • 1. Goals of the NEI International Program • 2. Research Partnerships Around the World • Intramural Collaborations • Extramural Collaborations • 3. Sample Case Studies • Trachoma • Corneal Ulcer • Brain neuroplasticity

10. Summary of the Latest International Collaborative Activities at NEI-intramural • >50 international collaborations, projects, affiliations, CRADAs, and other engagements on all 6 continents • 40% collaborative engagements are in Asia, 35% in Europe and 25% in other countries • 23 Major International Initiatives over past 2 years • 6 Recent Achievements in Global Health Activities • 10 International Partnerships & Collaborations • 5 Current Memberships on Global Health Committees/Working Groups • Currently training 66 international scientists and fellows • 18 scientists trained in the past two years have gone back (to their native countries)

11. Major International Initiatives over Past Two years

12. Summary of New International Partnerships & Collaborations • US-NIH & UK-NIHR Collaboration with NEI, UCL and University of Bristol - UNITE • CRADA with Genomatix in Munich, GERMANY, to develop meta-analysis tools for “omic” data to identify novel biomarkers and to develop therapies for retinal and macular diseases • CRADA with Zhongshan Ophthalmic Center, Sun Yat-sen University, China • Indo-US Joint Working Group • Various ARVO – international group participation and support • Lowy Institution, Sydney, Australia. Participation in design & conduct of a natural history study & clinical trial • Retina Institute, Japan, Serving on the Scientific Advisory Board • Pierre and Marie Curie University, Paris, France: Collaborations with several scientists • Cell Cure Neurosciences, Israel. Serving as a board member for the Medical Advisory Board • Singapore Eye Research Institute. Serving as a member of the Scientific Advisory Panel

13. Current Visiting Scientists/PDFs (66) International Scientists in DIR (As reported in June 2012) Trained Scientists (18), (Gone back in past 2 yrs.)

14. NEI Extramural Programs Funded NEI Grants – International Programs Supports 26 grants and 36 foreign sites in 15 countries • Argentina Primary Open Angle Glaucoma • Australia Nuclear Cataract • Canada Retinal Stem Cells • China Genetics of Age-related Macular Deg. • Denmark Diabetic Retinopathy • Ethiopia Trachoma • France Retinal Pigment Epithelial/Stem Cells • Germany Advanced Imaging for Eye Diseases • Ghana Glaucoma Genetic Risk Factors • India Cornea Ulcers Trial • Project Prakash • Israel Phototransduction • Italy Oxidative Damage to TM-Glaucoma • Japan Macular Degeneration • Switzerland Nanofabrication technology/T cells • UK Various Eye Disorders

15. Contents • 1. Goals of the NEI International Program • 2. Research Partnerships Around the World • Intramural Collaborations • Extramural Collaborations • 3. Sample Case Studies • Trachoma • Corneal Ulcer • Brain neuroplasticity

16. Civilian Populations – Crowded Slums of Industrial Revolution US Public Health Service officers examining migrants at Ellis Island —slide (modified) courtesy of Prof. Hugh Taylor

17. Avoidable Blindness: Trachoma affects 11 Million People Worldwide Chlamydia trachomatis bacterial infection —photos courtesy of Emily West, STAR Study Team

18. STAR TRIAL - Eye Research Leads the Way: Single-dose Antibiotic Reduces Recurrence of In-turned Eyelashes after Surgery STAR Study - Surgery for Trichiasis, Antibiotics for Recurrence. An NEI-funded clinical trial partnered with ORBIS International. in Archives of Ophthalmology, March 2006 —photo courtesy of Emily West, STAR Study Team

19. Biannual Treatment of Azithromycin is Effective 145 million doses to date —slide (modified) courtesy of Prof. Hugh Taylor

20. Trachoma Vaccine ? A new vaccine tested in monkeys shows promise against the disease. • If successful in humans, it could be a very helpful tool within the global strategy • NIAID, NIH-funded research • J. Exp. Med. 2011;208(11):2217-23.

21. NEI-supported International Research Treatment – Topical Corticosteroids Found To Heal Severe Bacterial Corneal Ulcers • Researchers found significant vision improvement—one and a half to two lines of improvement on an eye chart—by using corticosteroid therapy on patients with severe ulcers. • Steroids for Corneal Ulcers Trial (SCUT) - Arch Ophthalmol:130, Feb 2012 • UCSF and the Aravind Eye Care System, in Madurai, India • 500 participants with culture-positive bacterial corneal ulcer from US & India • Randomized placebo-controlled trial from September 2006-February 2010 • Half of the patients received 1% topical prednisolone sodium phosphate treatment and the other half received placebos. • No difference in overall group, but a difference in severe ulcers subgroup

22. PROJECT PRAKASH

23. Project Prakash-Video

24. The NEI’s New World Questions/Comments?