According to new figures from the Fogarty International Center (FIC), the branch of the National Institutes of Health (NIH) in charge of coordinating foreign research efforts, NIH spent $272 million abroad in 1999, up from $204 million in 1997. In fact, the fiscal year 1999 saw the largest increase in domestic grants with foreign components for 25 years. While the big money still goes to developed countries—collaborations with Canada amounted to $14 million—liaisons with developing countries are on the increase. Malaysia, for example, benefited from $1 million of NIH money in 1999 against only $4,000 1997. Comparative sums for Zimbabwe are $3 million and $324,000.

There appears to be confusion, however, over precisely what is covered with NIH funding to foreign institutions. Direct costs are permitted, but indirect are not. Just what indirect and direct costs are is not clear, says Ray Loomis, director of fiscal affairs in the Department of Microbiology and Tropical Medicine at George Washington University Medical Center.

Loomis explains that direct costs include travel, long distance telephone calls and faxes, but not rental of the telephone lines. Indirect costs include electricity, purchasing services and rent for laboratory space. However, for an off-campus site, telephone lines, rent, and electricity could be considered direct costs. Such is the confusion that an NIH committee, led by NIH deputy director for Extramural Research, Wendy Baldwin and FIC director, Gerald Keusch, is investigating the spending policy.

James Kazura of Case Western Reserve University notes that his university has the largest amount of NIH funding for overseas extramural research. He studies filariasis and malaria in Kenya and Papua New Guinea and explains that whereas an NIH grant may cover the cost of an expensive piece of equipment, such as a liquid scintillation counter, no overhead is allowed for maintainance the equipment. His group's work to develop a malaria vaccine in Kenya was interrupted recently because of a powercut, yet for a $100,000 investment in a generator and an additional $50,000 in petroleum, research would not have stopped. Such expenses, however, are not currently allowed under NIH rules.

Some groups that promote research in foreign countries have now picked up on the issue. Greg Gonsalves, policy director of the Treatment Action Group, an AIDS advocacy group, is drafting a letter to Health and Human Services Secretary, Donna Shalala, to plead that NIH be allowed to alter its policy and fund overheads in collaborating countries as a means of strengthening infrastructure.