April 1, 2009 — Researchers at the University of Virginia School of Medicine will lead the largest-ever worldwide effort to investigate how malnutrition and intestinal infections lead to serious lifelong physical and mental problems in children living in developing countries. The five-year study will be funded by a $30 million grant from the Bill and Melinda Gates Foundation made to the Foundation for the National Institutes of Health.
Nearly one-third of all children in developing countries and more than 1 billion people worldwide suffer from malnutrition – a condition that has a severe and far-reaching impact on the global population.
"Malnutrition is a devastating condition which can ravage the human body," said Dr. Richard L. Guerrant, director of U.Va.'s Center for Global Health and lead researcher for the study. "While it can be harmful to adults, children who are malnourished face a lifetime of challenges as they do not reach their full physical and mental potential."
Dr. Tachi Yamada, president of global health for the Bill & Melinda Gates Foundation, said it's critical to understand the complex relationship between malnutrition and intestinal infection.
"We hope this research network will make discoveries that will in turn help us save the lives of those most at risk," he said.
The Foundation for the National Institutes of Health, with the Fogarty International Center, is coordinating the research effort, called the Global Network for Malnutrition and Enteric Disease Research – or "Mal-ED" Network. Research will be conducted in collaboration with a number of partners, including universities in the United States and institutions in the developing world. U.Va. is leading the efforts in Brazil, South Africa, Bangladesh and Tanzania.
In addition, U.Va. and Washington University in St. Louis will study genetic differences in the populations involved in the network to learn what factors account for susceptibility to infectious organisms and malnutrition.
"We don't sufficiently understand the causes of malnutrition. It's not solely the access to food, because there are many children who have enough to eat but are malnourished," said Dr. William A. Petri Jr., chief of the Division of Infectious Diseases and International Health at U.Va.'s School of Medicine.
"The ability of a person's gut to absorb nutrients is influenced by the complex interaction among a person's genetic makeup, the natural microbes in a person's gut and their resistance to infections. This grant will allow us to explore this interaction on all levels."
Petri has received a separate $6.8 million award from the Gates Foundation to chair the Malnutrition Biomarkers Discovery section of the Mal-ED Network. Stephen S. Rich, chairman of the Center for Public Health Genomics at the School of Medicine, will help lead U.Va.'s work in genetics, and Dr. Eric Houpt will develop molecular diagnostic tests for infections linked to malnutrition.
"We know that some people are better protected from malnutrition based on their genetic makeup. We want to identify which genes provide this protection," Rich said.
Poor nutrition in early childhood may lead to cognitive defects and poor physical development, increase susceptibility to and severity of infections, and diminish the effectiveness of childhood vaccines.
Meanwhile, infections causing diarrhea can damage the intestines, impair nutrient absorption and impact the immune system. Despite recent advances in treatment of diarrheal disease that have dramatically decreased deaths, the vicious cycle of diarrheal diseases and malnutrition negatively impacts the long-term health and development of tens of millions of children living in resource-poor areas of the world.
"With the establishment of this remarkable partnership, we hope to shed light on critical questions such as which organisms or infections disrupt growth and development, as well as identify the time in early life when those factors have the greatest impact on morbidity and mortality," said Dr. Charles A. Sanders, chairman of the NIH foundation.
The network will be coordinated by co-principal investigators Michael Gottlieb of the NIH foundation and Dr. Mark Miller of the Fogarty Center.
"The interactions between diarrheal diseases and malnutrition produce a vicious cycle that has devastating developmental consequences for the world's poorest children," said Dr. Roger I. Glass, director of the Fogarty Center. "We have much to learn about this relationship and expect that the robust and expanding network that we are establishing will provide us with a wealth of useful information."
The network's main objectives are to create a standardized and harmonized set of epidemiological tools to accurately study the links between intestinal infections and gut physiology as risk factors for malnutrition across a number of diverse sites in the developing world. By mapping and modeling the data obtained from these and other studies, the network also will be able to quantify the global burden of disease and evaluate effective interventions in an effort to promote the health and well-being of children around the world.
Dr. Richard Guerrant
Guerrant, the Thomas H. Hunter Professor of International Medicine at the U.Va. School of Medicine, is an internationally-recognized expert on enteric infections. He is the most recent recipient of the Walter Reed Medal from the American Society of Tropical Medicine and Hygiene.
Dr. William Petri
Petri, the Wade Hampton Frost Professor of Epidemiology, is the chief of Infectious Diseases and International Health at the U.Va. School of Medicine. He is a worldwide leader in the study of amebiasis, an intestinal illness.
Foundation for the National Institutes of Health
The foundation was established by Congress to support the mission of the National Institutes of Health: improving health through scientific discovery. The foundation is transforming the way biomedical research is initiated, supported and conducted, and blazing the trail for a new era of discovery through innovative public-private collaborations. The foundation provides expertise, experience and an integrated infrastructure for creating new biomedical research and training initiatives across multiple disciplines in support of the mission and causes of NIH. It brings together industry, academia and the philanthropic community to collaborate, leverage resources and create unique opportunities to accelerate the pace of scientific discovery and biomedical research that may translate into successful healthcare solutions.
The foundation is a nonprofit, 501(c)(3), corporation that actively seeks funding partners for a broad portfolio of groundbreaking programs and projects in support of biomedical research.
Fogarty, the international component of the NIH, addresses global health challenges through innovative and collaborative research and training programs and supports and advances the NIH mission through international partnerships.
The National Institutes of Health – the nation's medical research agency – includes 27 institutes and centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases.