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NIMH has an annual budget of nearly $1.5 billion, much of which comes from Congress, to conduct research within the United States for cures that will make a difference to the American people. This being said, about 220 grants each year—as of 2006—were international grants and many of them were concerned with HIV. These grants were made partially because the principal investigators were domestic, but working in an international or global context. Perhaps 10 percent of those grants were actually to principal investigators outside the United States. For the most part, that 10 percent was funded outside the United States because there was some special expertise or some special value to the United States in supporting someone in Iceland, South Africa, or China to do the research.

In the context of this meeting, much of NIMH research really looks not so much at violence per se, but at the consequences of violence, which he stated is also true for its international portfolio. NIMH studies posttraumatic stress disorder in Israel, mothers and children following Chernobyl, the effect of HIV infection on mothers and children in South Africa, the influence of torture in Nepal, and the victims of war in Kuwait. He described a second component relevant to how they engage in violence prevention with long-term NIMH funding for projects such as the nurse visitation studies of David Olds for nearly 30 years. He stated that there are now several replications of this nurse visitation intervention in pregnancy and postdelivery that show the efficacy and the cost-effectiveness of reducing violence both of children and to children. The greatest impact of the past and current NIMH work is a focus on self-directed violence. He reiterated the statistic of 54 percent of violent deaths globally being related to suicide. This remains a problem of great and often understated importance in the United States with 30,000 suicides each year, relative to about 18,000 homicides, and of global importance with 800,000 deaths annually. NIMH has projects in Russia, China, and Scandinavia—three of the countries with the highest rates of suicide—examining how suicide can be reduced and how to improve monitoring. In conclusion, he stated that a great deal of the suicide rate in both the United States and the rest of the world is related to mental illness and there is abundant evidence that treating depression, substance abuse, and mental illness reduces the rate of suicide. He also stated that reducing access to weapons is equally important to this goal.

Kent Hill, of the U.S. Agency for International Development (USAID), stated that the agency considers violence to be a pervasive public health and human rights problem and that, programmatically, USAID has been making efforts to respond to victims’ needs, as well as to prevent violence, since the early 1990s. He identified three important areas of its work: (1) conducting demographic and health surveys, particularly for the issues of female genital cutting and domestic violence to support accurate data collection; (2) providing grants for building global capacity to address violence prevention and

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