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BALTIMORE -- The Bill & Melinda Gates Foundation has awarded the Johns Hopkins School of Public Health $20 million to find the precise combination of vitamins and other micronutrients that will most effectively prevent illness and save lives among impoverished mothers and children in the developing world.
The grant—the Foundation's third to the School of Public Health in just over three years—will be used to strengthen and expand time-critical research already planned or under way in Nepal, Bangladesh, Ghana, Zanzibar and India.
"The results of these studies are likely to prove crucial to the well-being and survival of millions of women and children each year," said William R. Brody, President of The Johns Hopkins University. "The university is grateful to Bill and Melinda Gates and their foundation for making it possible for us to do this research thoroughly and quickly, so that it will have the broadest possible impact."
The projects currently are funded in part by the U.S. Agency for International Development and the National Institutes of Health. According to Alfred Sommer, Dean of the School of Public Health and principal investigator in the research, the new grant will enable researchers to gather and analyze far more data—information that is urgently needed but unaffordable without the Foundation's help.
In the developing world, an estimated one in four children dies before reaching the age of five. Worldwide, some 11 million children and 7 million adults die each year from diseases associated with poverty.
"Reducing mortality rates for women and children in developing countries is a global health priority for the Foundation," said Dr. Gordon Perkin, Executive Director, Global Health Program at the Bill & Melinda Gates Foundation. "The work being done by Johns Hopkins on micronutrients shows the potential for dramatic health improvements at relatively little cost."
The research funded by the grant is the direct descendant of Sommer's finding in the early 1980s that small doses of vitamin A, costing only pennies and intended to prevent blindness among children in developing nations, also protected them from a range of killer infections and cut their mortality rate by as much as 50 percent.
Despite initial skepticism from some colleagues, Sommer replicated and expanded his research, proving that the lack of vitamin A was a threat, not only to children's sight, but to their lives. Within a decade, the international public health community, including the World Health Organization and UNICEF, had launched major efforts to eliminate vitamin A deficiency in the Third World.
Today, the question for researchers is what other micronutrients—chemicals such as zinc, folate, iron, or B-complex, needed by the human body in trace amounts—should be used in combination with vitamin A to achieve the maximum protective effect. The current research focuses not only on children, but also on expectant mothers. Studies show prenatal supplements of vitamin A or its precursor, beta-carotene, reduce maternal deaths related to childbirth.
The Johns Hopkins team's fear is that, without adequate research to find the precise best "mix" of micronutrients, the world community will rush to adopt a standard "package" of nutritional supplements that does not provide the best possible improvement on the benefits of vitamin A given alone. Worse, an improperly mixed formula might reduce or even eliminate the benefits of vitamin A.
"We have limited time to answer questions that much of the scientific community does not even recognize we lack answers to," Sommer said. "That's why this research must be accomplished now. If we wait, we run the risk that nutritional programs will be put in place based on what we think we know, rather than on real science."
The Foundation's first grant to Johns Hopkins, $2.25 million announced in May 1997, established the School of Public Health's training and research program for family planning and reproductive health specialists from developing nations. The second, a $20 million grant announced in May 1999, built on the first by establishing the Bill and Melinda Gates Institute for Population and Reproductive Health (<www.jhlpp.jhsph.edu/>). The institute brings scholars from Latin America, Asia and Africa to Hopkins to earn advanced degrees, and provides additional training and support for family planning and reproductive health specialists from developing nations.