One of the intentions of the US NEI-AOS Thailand Symposium on Vision Health Science was to discuss the priorities and opportunities for international engagement in scientific and public health research in ophthalmology, as well as provide researchers with an overview of the US National Institutes of Health-National Eye Institute (NIH-NEI)’s work in Southeast Asia.
The session began with Dr. Gyan “John” Prakash, director of the Office of International Programs at the NEI, who gave an overview of the work done by the NEI. With a budget of USD$835 million, the NEI is dedicated to increasing collaboration between researchers from all over the world, with the aim of eliminating unnecessary blindness. Internationally 2.2 billion people suffer from some form of vision impairment, almost half of which could have been prevented if the patient had received treatment at the right time. It’s this shortfall in treatment — resulting in unnecessary and lifelong eye problems — that the NEI is trying to address.
The NEI supports the entire research continuum, from basic discovery and translation to clinical trials, and awards more than 200 international grants annually, to which anyone doing research anywhere in the world can apply. One of the most important aims of the NEI is to promote international research and networking between scientists, creating global connections and collaborations that wouldn’t have existed otherwise. In addition to their worldwide work, one of the aims of the NEI is to fund more projects and do more work with scientists working in Southeast Asia, with the hope to encourage more ASEAN participation in NEI international fellowship programs.
As well as expanding into ASEAN countries, the NIH wants to expand into the developing world, in general. This is for a lot of reasons — there are a large number of unique populations where diseases have different presentations and where varying cultures, diets and environments create different exposure and patient experiences. In addition, scientists in the developing world have unique insight and expertise with large, potentially treatment-naïve populations; this is where greater communication between scientists can potentially be of great benefit to both groups. The NIH believes that more collaboration between scientists working in the developed and developing worlds can be very beneficial for everyone involved.
NEI Focuses on Special Programs
The next presentation was given by Dr. Lisa Neuhold, program office director at the Extramural Science Program at the NEI. She discussed the current priorities for NEI-funded research and grants.
At the moment, the NEI has three special programs currently running with smaller programs underneath, each of which gives funding and grants. The aim of the “Audacious Goals Initiative” is to restore vision through the regeneration of neurons and neural connections in the eye and visual system, so that cells of the retina that have been damaged by disease or injury can be replaced by healthy cells. Through this initiative they have supported Models for Eye Disease Research, Discovery-based Projects and Imaging Projects. Under these three special programs, the NEI has funded at least 16 other research projects — all with the aim of helping repair damaged cells in the retina.
The second initiative Dr. Neuhold discussed was the “Anterior Segment Initiative.” The initiative aims to encourage knowledge and skill sharing in order to help identify major gaps in knowledge and to fund research in order to close these gaps.
The final initiative is the “Microbiome Initiative,” which aims to characterize the microbiome on the ocular surface in order to understand whether or not it may contribute to eye disease. It proposes to develop an open resource database, characterizing resident ocular microbial communities, and to promote research into how these microbiome communities exist in healthy individuals. The NEI plans to host a workshop on the standardization of methodologies before further developing this concept.
Diversity is Key in Peer Review
The next presentation was by Dr. Seetha Bhagavan, coordinator for Review of International Programs at the NIH, who discussed how the NIH does peer review, as well as the process for the approval of grant applications.
Dr. Bhagavan works under the Center for Scientific Review (CSR), whose aim is to ensure all NIH grant applications receive fair, independent, expert and timely reviews. The CSR is the body through which all applications — which can be up to 85,000 per year — go through. Although they both come under the umbrella of the CSR, the application and review areas of the CSR are kept very much separate in order to ensure fairness and to make sure that no individual who is involved in the application is also involved in the possible approval of the grant. The review side is made up of five divisions and 25 review groups, all with their own speciality and specific purview. All reviewers have a PhD or equivalent and are recognized authorities in their field, with a proven track record of NIH funded projects. The CSR strives to ensure all review panels are diverse and include people from all walks of life.
When reviewing an application, the board makes an assessment of the likelihood for the project to exert a sustained, powerful influence in the field of study. Taking into account the potential significance of the investigation; the credentials of the investigators; how innovative it is; the approach the investigators will be using, as well as their potential impact on the environment. In addition to these core considerations, the grant review board will also take into account the protection of human subjects; the diversity of human subjects; the appropriate use of vertebrates and the management of biohazards.
The CSR takes confidentiality and conflict of interest very seriously. All reviewers operate under a lifelong statute of confidentiality, all materials must be returned or destroyed at the end of a meeting and no recording is permitted in a review meeting, regardless of the purpose.
Revealing Annual Report Highlights
The final speaker was Dr. Michael Cheetham from the Fogarty International Center at NIH. He told the symposium about the yearly report on NIH grants done by the NIH, especially in relation to the work done in ASEAN Countries.
Every year the NIH produces a world report, which is available to the public, so anyone can see how the NIH funding is being allocated. The NIH is very involved in ASEAN countries, with nine of the 10 countries participating (Brunei being the only exception) in NIH-funded research, whether as direct grantees or as collaborators. Over the past five years the NIH has given more than 450 separate grants to 174 different research institutions.
Between 2015 and 2019 in the ASEAN area, the NEI gave grants to 10 different projects in six institutions in Thailand and Singapore, so there’s plenty of opportunity for more applications. Through the world report it’s possible to see not only an abstract of all the projects that have been approved, but also the names of all the grantees. This is a great resource for scientists and researchers who are looking for collaborators in their field, or who are looking for funding opportunities, especially for those looking to break into NIH-funded research.
Editor’s Note: Organized by the Association of Southeast Asian Nations Ophthalmology Society (AOS), with support from the United States Embassy in Thailand, the NIH-NEI, and Thailand’s Ministry of Public Health, the US NEI-AOS Thailand Symposium on Vision Health Science was held on March 11, 2021. Reporting for this story took place during this event.