 Oh, thank you, Mark. I don't know whether I should say that or not. Well, I was going to start this with thanking Eric for the kind words he said this morning, and thanking counsel and all the councils that I've worked with for the great advice they've given NHGRI and all the precursors of NHGRI through all these years. It's been great not only working with my colleagues in the Institute, but with the council. It's always been a really a very wise source of advice, and now I get to work with a board. I have to take a whole course on how to work with the boards. But thank you, Mark, for the effort of trying to embarrass me. You did a good job. So part of my leaving is, of course, very bittersweet, because I am very dedicated, as Mark said, to this project. I've been working on it, I think, for about three or three and a half years. It's a very exciting project, and I've learned a lot. I've learned a lot about developing countries. I've learned a lot about science in developing countries. And I think the project's going very well. You'll see the next few, the next year probably will be with the proof of the pudding, whether we start to actually get results. But it's very different working in developing countries, and I think that all of us working on this project are learning that. And it'll be important, and some of you on council already know that, but it'll be important for council to know that, too, as we come along. So I want to remind you just a little background that this is a joint project between the Welcome Trust, the NIH, and the Common Fund, and several ICs. And you'll see who those are. And the African Society of Human Genetics. I'm going to skip all the background about how it came to be, but I think it's important for you to remember the key aspects of H3Africa. Importantly, the awards are made directly to African institutions and PIs. This is not totally unique at NIH, but it is not very often done. Usually, Africans are funded through American grants, which then subcontract to the Africans. In these cases, the African PIs in control, and the American collaborator is very often a subcontractor. The PIs, the projects must deposit their data in public databases, and they must deposit their biospecimens in an H3Africa biorepository. And these two bullets are really unique to Africa. And you'll see that the policies are now being approved, but it has been a long discussion with the PIs to get these policies in place. And the grants that came in could propose collaborations with the H3A bioinformatics network. And I'll tell you a little bit more about that. And they all had to include a training component. Now, this is what the current map looks like. It is much many more sites than I ever dreamed of when we started this program. You can see there's a lot of stars. That means there are primary awards in South Africa and a lot in Nigeria. Those two aren't too surprising. But I think what's really surprising, and I said this last time I gave an update, is how much activity we have in West Africa. The prediction was that we would have a struggle getting good grants out of West Africa. And in fact, some of our best grants came out of West Africa. South Africa, of course, has a lot more infrastructure than many of the other countries. And we're now beginning to build our infrastructure and our presence in East Africa that has come more gradually than the other parts of Africa. And then the dots, of course, are all the collaborations. And you can see they really do cover the continent. And this is not a sub-Saharan African project. This is an African project. So it does include Northern Africa, which oftentimes is not included in the African project. OK. I said a little bit about the Bioinformatics Network. It is called H3A Bionet, and it is run out of South Africa, out of the University of Cape Town. It has 34 partner institutions, 32 of which are in 15 countries, and then two are in the United States. And what's really exciting about this in concept and now in reality is that it is beginning to form the glue that is holding the collaboration of H3Africa together. Because as you'll see in a minute, everyone in the consortium is working on different diseases. So naturally, they wouldn't come together if it weren't for H3Africa. And the common goals of building infrastructure and getting genomics going on the continent. So the role of H3Africa, I'm going to take a couple of slides and describe it because it really has started getting going. And I think there's a lot of interest in this. They will be the tools through which the PIs will submit their data to EGA. They will provide data storage backup and transfer. They will provide data access and visualization both to the public and to the investigators. They will provide training in bioinformatics. They will provide support for analysis and large-scale data analysis for these various ways of looking at genomes. I wonder why that didn't go forward. Oh, I think I left out a slide. Well, I can't remember what else on that slide. Oh, I see what happened. So the support for analysis is particularly important and I think one of the really novel things they're doing is providing e-bio kits to all the sites. They've also had some challenges in working with the sites, especially the center sites throughout Africa because we unknowingly, unwittingly in our RFA said that the centers didn't have to collaborate with H3A Bionet because we wanted them to also have their own abilities at analysis and so now we have some centers that don't need H3A Bionet to help them and so we're working with them to make sure that they use what's available that they don't have already on site or through a collaboration. So the next bio, the next infrastructure project that is part of H3Africa is the biorepositories and this is a two-phase approach. We are using a mechanism that allows a two-year pilot biorepository and we have started four pilots and then after two years there's an administrative review and we're coming up on that now in March during which a scale-up decision will be made and we can scale up between one and three biorepositories depending on how many funds we give them. So this will be something that you'll be hearing more about in the coming summer as we get the decisions from this administrative review and try to actually scale up a biorepository on the African continent. The four pilot projects that I mentioned have been working well together even though they are involved in the competition so that has been quite rewarding to see them trying to work together and they're scattered over the entire continent so this is not an easy challenge. So next we'll turn to the collaborative centers. I'm not gonna go through these but I just wanted to put them up so you would get a sense of the diversity of the projects. There really are no two projects working on the same thing and these are the smaller research projects. You can see that they are also spread all over and some of these are in very resource and infrastructure challenged countries so it will be very interesting for us to see what kind of infrastructure we can build in those countries. So progress report for the first year which we finished in August so we're halfway into the second year. Several of the sites have already especially the sites that were funded initially. We funded a group of grants in August a year ago and then we funded another group in this past August. The grants that were in the first group have almost all gotten their ethics approval. Now this is a challenge in Africa because we're recommending that they get open ethics approval that means that their data can be shared, their samples can be shared and that there can be secondary use of the data. There is some discomfort with that and I'll tell you a little bit about that in a minute. So they're now submitting their data especially the newer projects are submitting their data to the ethics review boards for their approval. As of the end of December we have eight sites that have gotten their ethics approval and they're actively recruiting samples and they're being restored on site and that's because we don't have a biorepository. So that is out of the group of about six grants that we funded in the initial phase. We expect from what we read in the applications and what the groups have now told us is that there will be about 50 to 75,000 participants recruited in total and these will of course all be genetically analyzed in either by genotyping or sequencing and the samples will be available in a biorepository. Most of them will collect blood and send the DNA to the biorepositories and freeze plasma which they will hold in their centers until there's additional funding to send that to the biorepositories also. And some of the centers are willing to collaborate our partner with other groups to provide additional samples and an example is NIDDK is considering an add-on program to collect urine samples from projects that are willing to participate and the NIDDK and several other institutes are very excited about this because of the additional information this is gonna add to the genetic information. Typical of an NHGRI project that we have formed many working groups. This takes a lot of time and I think it was probably a bit of a shock to Africans that we could possibly spend this much time on conference calls which has been an incredible challenge. Not just because they're not used to it but the telephone system and the internet has been a real challenge. And these are the ones that we have formed and they've been really very productive. Some of them, at least one has already sunset much to their delight. This is their achievements. The biorepository working group has developed a set of SOPs and they've developed this sample access policy that is going to be approved soon we hope. The Ethics and Regulatory Issue Working Group developed a set of open informed consent guidelines which is published on our website. The white paper is published on the website, excuse me. And I'll tell you a little bit more about this too that for the next upcoming consortium meeting they have organized a working group or a workshop of ethics chairs from around Africa. We wanted to do this because we know there's concern about the consent and we want to have a discussion with the people who will be approving the consents to make sure they understand that this is an international standard in the genomics community and that this is something that H3Africa is promoting. Then the Publications Working Group has developed a publications policy and the marker paper has been written and submitted to science. The Data Sharing Access and Release Group, there is a data access and sharing policy that is being reviewed by the steering committee and that's the last step before it's accepted. The phenotype harmonization working group has made recommendations about standardizing phenotypes among all the groups and then the genome analysis working group is working with other groups that have been sequencing and have SNP data throughout the African continent to develop a genotyping chip and that's going to be another side meeting at the next consortium meeting. We had one at the previous consortium meeting which we didn't get to go to because of the government being shut down but this will be a follow-on to that. As Mark said, we have had three meetings and then this is the fourth that we're about to have in Kampala, Uganda and the associated meetings are mentioned there. The NIDDK and the NHLBI and H3Africa have been working to put together a cardiovascular research meeting in Kampala where Macquarie University is and there are quite a few researchers at Macquarie that are interested in this field and we of course are going to advertise it as broadly as possible to interest Africans and any investigators from the North who might be interested in this problem in Africa. So there are, even though all of our grants are working on different diseases, there is a group of them that are working on cardiovascular diseases. So they will be speakers in addition to some invited speakers. And the idea is to try to tie together some of the commonalities and to encourage collaboration between these groups in whatever way might make sense. Then I mentioned that the development of the African-specific genotype, CHIP, that will be another workshop that will happen after the consortium meeting and then the ethics committee chairs will be meeting also. So what have been the challenges for us and for the Africans to date? A big challenge for us was the 40% failure rate of applications getting into the electronic application system. I think one of the other challenges I mentioned here is the difficulty with setting up grants offices in institutions that don't have them or trying to find a person that can actually sign and submit your application. That's one barrier, but the barrier of getting the application into the system and then correcting all the errors is another huge barrier, especially if people don't realize at the last minute that they have errors. There is that challenge. There's also a challenge in making awards at some of the under-infrastructured institutions and our grants management people have been incredible in getting these awards made, even though sometimes they're made and it's totally, all the funds are restricted because there's so many things that have been ironed out, but they have made awards at some institutions that have never had NIH awards before. And then we're finding now that in some of the more under-resourced countries that there's even a problem in getting the funds to the bank so that they can use them. That's taking, well there are researchers who were funded in September and they still don't have access to their money for that reason. I told you about the IRBs being concerned about some of the issues. And I mentioned teleconference communications problems. It continues to be a problem. So our challenges for the future will be establishing the full-scale bio-repositories as I mentioned. One of the expected challenges is shipping samples across the countries within the continent and then also outside Africa. We do have one pilot bio-repository that is the most like a business, a bio-repository business that we have run into and that we are funding and they have actually successfully shipped across country lines in many African countries. So we'll see if they continue to succeed to be able to do that. We need to be sure that we promote regular data release and from the research sites in accordance with the policies and we need to affect sample release. And this is the sample release policy that we hope will be accepted is one where the samples will be placed in the bio-repositories but not released to the public until the data is released. And then we will encourage anyone who gets the African samples to collaborate within Africa. And that really is within, that's very much like the mission of H3Africa to encourage collaborations in Africa. So letting go of your samples in Africa is very new. The idea of data release doesn't seem to be as striking as the sample release. So this will be a challenge but I think everyone's on board with policy once they hear it, they seem more comfortable with it. And this is a Charles Rattini saying he likes to say we've been struggling with the brain drain of the Africans coming to the North and we're hoping that H3Africa will help reverse that and we'll have a brain gain instead. And then in about a year or so we will face an extension of an application for an extension of H3Africa for another five years so that the whole program will be 10 years. And this will be a challenge. I think there's a lot of support for the program now within the institutes as well as within OD. So we're hoping that this happens and the program can come to fruition in 10 years. And of course, a big concern, probably the major concern when we started proposing this program was long-term sustainability and we certainly don't have any new ideas on how to do it other than what we said at the beginning but the longer that we are able to keep H3Africa going and people collaborating, I think the more likely there will be sustainability. So successes so far, we really are seeing that we've been empowering African scientists. They, as I said earlier, they are the PIs on these grants, they manage the science. I think that the Americans at first had a little more trouble understanding that. They couldn't just call us up and say, this is something that we need to do on this project. I'd have to say, you need to put your PI on the phone. And they've gotten used to it now but it has been a learning experience for both of them because neither of them were used to playing those roles. We've also started hearing the Africans play major roles and having significant ideas that are determining the course of the consortium and forming the consortium in a way that wasn't true at first. They really are speaking up on the conference calls and it's really great to see. I have to say this makes it harder to leave. And I think that they're starting to see that even though we have all these conference calls that the consortium working together can do a lot and can affect changes in a way that a single PI can't at times. And the whole fact that they're meeting and collaborating with scientists outside the home institution is one of the novel things about this program. The very first meeting several people came up to me and said, I have never been in a room with other Africans that I'm gonna collaborate with. I'm always in the room with northerners, Europeans or Americans, but this is really empowering. And we continue to get that sentiment although I think now it's not so novel and they're really enjoying it. So that's been really rewarding. We have been able to fund high quality applications that meet the standards of NIH review and that has been, that has been I think the hallmark of this program. We are really are doing exciting high quality research. When new people come to the consortium meeting, new people from America or Europe, they often say I was very impressed with the quality of the research. And then the whole difficulty of building infrastructure in under infrastructure countries is hard. We have begun those steps. We I think we are starting to make inroads but it really is not easy to do and you wanna be sure that that sequencer you're sending to a remote country doesn't turn into a doorstop and that's a major challenge. And I think one of the most recent developments has been people calling us up and saying, you know I work in Africa, the Africans aren't funded directly like in H3 Africa, but I wanna be, they wanna be part of the H3 Africa movement. How can we do that? Or I'm going to put in a application to NIH and the PI will be African. How do we become part of H3 Africa before we put that application in? So we're getting a lot of outside interest now. So one of the new working group communication and outreach is working on a set of guidelines for groups to become collaborators but not actually be members of H3 Africa. So I don't know quite what that'll look like but I think it could really spread the H3 Africa mission across Africa in a way that I hadn't really anticipated was going to happen this quickly. So I need to thank the H3 Africa team particularly here at NHGRI. We've worked together, some of us now for three and a half years and we've gotten through all the challenges that have been presented to us and I'm sure there will be new ones after I leave and they'll have lots of fun addressing those. Mark is now a project coordinator which is what I was before. Jennifer Troyer in the back who you met earlier will take over many of my duties and my activities. Jeff Struing has been a program director with us for the last year and he is managing the centers. Ebony Madden is not here. I think she got Snowden or Sick or something like that in North Carolina. She directs the ELSI part of the program. We have two of the best grants management people you could possibly have because they managed to get these grants made and awarded and up and running and funded. And that's Chris Darby and Diane Patterson. And of course, Queen Yuen who is our new program analyst and I think you all remember, Cheng Ge from last year, she was our two analysts have been terrific and they are sort of the glue that hold us together because they know everything when we need something. And then Sue Peno is a contractor we use and has helped us with the bio repository. So thank you to all of you for your support of me and to Eric and the Institute for their support of the program. Oh my gosh, can you see that? The Institute names are in black and the names of the people who are participating, you can see there. NIAID, OAR, NINDS, NIMH and NICHD have actively given money to the program. I didn't mention how much money there is in the program now. We started with exactly $5 million from the common fund. So that would be per year for five years, $25 million. Through contributions from the institutes and including NHGRI, it's now up to $62 million. So these people have really helped us raise money and we've actively gone out and gotten contributions from institutes that find this program to be exciting. Louise Witterhoff is in charge of bio repositories. The NIDDK group is the group working on this cardiovascular workshop and then Kim and Demali are other institutes that are very interested in getting more involved and our common fund liaison is Leslie Durr and she's been really important in promoting this program to the common fund and helping us get more funds. And I think that's it. We have a Facebook account, a Facebook site, and you can follow us on Twitter. And we also have an NH3Africa website. So I'm happy to take any questions that you might have. That's it. Jane, thank you very much for making this happen. It's amazing to see what's happened such a quick period of time. You mentioned that you were getting the ethics committee chairs together from various countries and that, which is wonderful. I think that's a great start. Is there similar activities going on with ministries of science and ministries of health from a sustainability standpoint that at some point in time, if they see value, there is some money, maybe not as much as we used to have, but there is some money in many of these countries and if they see value, they will pay. Yes, the outreach and communications working group. Its chair is a person who is very, very excited about getting the governments involved, which clearly is needed. NIH can't continue to be the only source of research and the welcome trust, I shouldn't say just NIH. And that committee has an idea of recruiting ambassadors from throughout the continent. They've already recruited two. One is South Africa and Botswana and I can't remember where the other one is, it's further north. And the role of these people will be to advocate to the ministers of science on the behalf of H3 Africa. I think it's gonna be a challenging program to keep going because it's gonna need some money and this isn't something the federal government can really invest in. But we're also inviting, every time we go to a different country, we're trying to invite the ministers of health or a major person to come to the meeting. And that's happened at a couple of meetings and I think it's gonna happen at this next one, but they're kind of hard to get there. And I think what you really need is a sit down discussion with them. Yeah. Often peer, if it's a peer event, they'll show up in my limited experience. The other thing is the ambassadors to this country are not that far from the Smithsonian, for example, where there's an NHGRI collaborative event that's been going, so there might be some things like that that you might get the word in via, just as long as the word starts getting into the government said, a lot of them may not even know this is all happening. No, no. If not the ambassadors, their staff. Yeah. Is there any significance to the places in Africa where you don't have any penetration? Do you hear about institutions or governments that kind of push back against these kind of programs? Let me see if we had... Intrusive or, you know, back... Well, no, I just don't think there's much science there. Well, but the Francophones are funded. I mean, this is the Francophone area. You know, the Benin's French and it is difficult with the Francophone countries. This is Congo, I think. This is... That's Malawi. This is Zimbabwe. I don't... It seems like we had an application from Zimbabwe and there was a site, an East Africa site, in the Congo for a while and I don't know what happened to that. I'm sorry. I don't know. I know there's, you know, there are universities, I think, in Kinshasa and, of course, Egypt, it's a real... It's very sad that we don't have anything from Egypt. We do have, I think it's this person here, has a new grant from the Egyptian government. So, they are working. Where have the PIs trained? A couple of them, a lot of them, have been trained in the United States and Europe. The PI in Ghana and the PI in Botswana have returned to the continent after they've retired from major roles in science in Europe. So, that's two really great recruits. Many of the others, the bioinformatics person was trained at EGA, for example, the H3A Bionet person. Some of them are certainly have their early education in Africa, but their PhDs may be done abroad. Yeah. A scientific question is, given the tribal, ethnic, religious, and national boundaries, what was the justification for building and using a genotyping chip instead of pursuing sequencing? It's hard for me to believe that the chip is going to be applicable to all of these regions with equal informant. Well, we will be collecting from a lot of regions. Money. If someone could give us money to sequence all these samples, we'd do it. Yeah. This just seems like a little thing, but do all of the PIs have satellite hookups and satellite modems to try to get around some of these communication issues? The... I don't know if they all do. I've been to a remote site that did. The broadband is there. The problem is it comes and goes. The electricity comes and goes. And I don't know what happens with the satellite dish. One of the things that H3I Bionet is doing that I forgot to mention is that they are actually doing a survey of the broadband width in all these different places. And who was it that told me, oh, somebody is able when they have a communication going on with a specific African country to go to Verizon and say, okay, widen the bandwidth for this amount of time. And apparently a lot of what's going on is the governments are restricting it. I know one government that's definitely restricting it and I think it's the fear of everyone having internet. So there are ways to get it improved at times. Yeah. Kind of on the lines of what Howard was saying in terms of gaining other types of support, is USAID involved? Oh, no. Because that'd be another avenue, like here I see USAID and GE partner with the Commercial Bank to Open Health Financing, for example, and this is in an engineering project that we did, USAID teamed with the Minister of Vietnam and Intel for significant funding for some projects that we were doing there. And I could see a similar kind of partnership for this project in Africa. The communications and outreach group is being challenged with trying to do something about this. I mean, taking really starting an advocacy group in Africa to go to the governments and say, if you want scientific progress in this country, you've got to improve the bandwidth and see how far we can get with that. But yes, we're trying to collaborate with the World Bank, for example, just gave one of our PIs a huge grant and that completely dovetails with something that we are doing, funding with them. We are trying to get more influence with the African Union and NEPAD, which is a subgroup. So yeah, and actually we have had some contacts with UNESCO, but they're not very responsive. But any information you have, we'd love to have. OK, Lucilla and Tony, and then I'm going to have to curtail the discussion. Yeah, I was just going to ask about other European countries because there are Swiss, Spanish, and my colleague in Mozambique was, he had a PhD from Sweden. So somehow other countries are also investing. So that's one question. The other one is about how connected to the MAPI program you plan to do. That always comes up when I talk. So the other countries, certainly the French are very involved in that Benin project and there's another one with very close ties to a Francophone country. And we would like to know about those projects. We would like to let them know that H3Africa wants to be involved with anyone who's interested in genomics and working on the continent. And the funders are trying to become more active in bringing northern funders to our meetings. So for example, someone from Canada is going to come this next time. And then there's another Canadian program. I don't really know the funders in Spain. And obviously I know them in England. But I don't know too many European funders. So any names you can give us, that would be great. And MAPI. Yes, we're trying to coordinate our meetings. They're always one step ahead of us. They met in Uganda about six months ago. And once they've got their calendar set, we're not able to dovetail the calendar. So we've got to do something about it. I just thought whether you could comment on what the Welcome Trusts experience was with this program. As I understand it, you didn't co-fund projects. You chose separate projects to fund. And I don't know how those decisions were made, but given their long history in infectious disease and global health with infrastructure that they fund directly in those countries, I was curious to know what their experience was. Those are listed here in those bottom three. You can see where they are. This South African one was further north, it was in another country initially. So what we did, and Welcome Trust actually did this for the very first time, was allow PIs to submit identical proposals to both places, like we do for NIH and NSF. And we didn't end up wanting to fund the same proposal. So it didn't even really matter, but it made the PIs feel better. They had a peer review as well. And they made their decisions based on their criteria. They have all centers, they don't have the other infrastructure parts, the pieces that we have. They are now contributing to the H3A Bionet, to the, we have a center within H3A Bionet to support meetings, et cetera. And they are starting to co-fund some of our infrastructure projects that way now. So I don't know what else you'd want to know about their decisions. I'm not privy. I'm not so curious about the decisions, but how did they find managing the projects? You described a lot of challenges. And I just wonder whether they experienced the same challenges or because they've done this before in Africa in some ways. They've found fellowships there. I think they've had the same challenges. One of their challenges is working with us. We get along great. But we have all these working groups and they're not used to that at all, but they've adapted. So, you know, I think it's going pretty well. And they, Francis had a chance to talk with the new director and I think he's very interested in it. Kay Davies is the co-chair of the advisory group and she's very, very excited about the program. But Mark, you had something to add? Yeah, Tony. Once the awards were made, once the grants were funded, we've been pretty much co-managing the program with the trust. We have bi-weekly calls with them. All of the meetings are co-funded and we're trying to completely coordinate the management of the program with the trust. Okay, thank you. Thank you, Jane. NHGRI is at the very beginning of a process to plan what the next phase, the large-scale sequencing program is gonna look like. So over the next six or seven months, we're gonna be collecting a lot of information, a lot of data from a lot of different sources and stakeholders and we'll be bringing that information to the council at this meeting and the subsequent to in May and September. We thought a nice way to initiate that information flow would be to invite the three center directors, Richard Gibbs, Rick Wilson and Eric Lander, to come and give a presentation to the council about the opportunities that they saw for biomedical research and employing the large-scale sequencing program. So it's their peak at the future. And I think we're gonna have a group presentation. Is that right? We're doing a tag team. All right, tag team and Eric's gonna start us off. I will.