tropmed2013-blog
ASTMH Annual Meeting 2013
Curation of #TropMed2013, the premier international forum for the exchange of scientific advances in tropical medicine, hygiene and global health. Nov. 13-17, Washington, DC. ASTMH.org
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ONE Campaign Blog Highlights ASTMH's Unique Role in the Global Effort to Improve Health
In a reflection on the Annual Meeting, Anupama Datha, a health research assistant at ONE, pinpoints why the meeting is valuable for global health professionals who might not come from a medical or scientific background. Here's an excerpt (the bold is our emphasis):
I’d always known about the issue, but hearing speakers as widely ranged as Margareth Ndomondo-Sigonda of the African Union’s regulatory arm to Connie Jung of the FDA’s Office of Drug Security discuss regulatory policy and scientific developments with first-hand experience helped me appreciate just how difficult it is to control and fight fake medicines and showed how prevalent the problem is.
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The main reason I found these issues – all things I already knew about – so interesting was because I had a chance to hear about them from a new perspective. And that only reinforces the value of multidisciplinary conferences like this one, where people from all parts of the issue get together. Next year’s conference is in New Orleans – hope to see you there!
Read the full thing.
Crowd listens to presentation at an Annual Meeting symposium.
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A very informative blog post from Claire Barnard on the BioMed Central blog:
Dengue fever was one of many tropical diseases discussed at the recent American Society of Tropical Medicine and Hygiene (ASTMH) 62nd annual meeting, where experts across all areas of tropical medicine came together in Washington, D.C. to share their knowledge in this fascinating area of medicine.
Read the rest.
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For those of us in the neglected tropical disease (NTD) community, Washington, DC was an exciting place to be recently.
A nice roundup of some of the neglected tropical disease content at the Annual Meeting from our friends at the Sabin Vaccine Institute.
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From our colleagues at the Malaria Control and Evaluation Partnership in Africa (MACEPA).
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Four Thoughts on the 2013 ASTMH Annual Meeting
Written by Daniel G. Bausch, MD, MPH&TM, ASTMH Councilor, Tulane University Medical Center, New Orleans/NAMRU-6, Lima, Peru.
Another ASTMH Annual Meeting down, by rough count my 19th. Cutting through the fatigue of 5-days of non-stop juggling of symposium attendance, satellite conferences, and impromptu meetings with collaborators and friends, I identify what have come to be the usual mix of thoughts and emotions, which keep me coming back year after year:
Inspiration! Everywhere you turn amazingly smart and productive people are doing great science and public health work! How can I take what I learned from listening to researchers talking about their one-health projects in Kenya or studies in urban slums in Brazil to make the best of my present work in Peru?
Intimidation. Wow, these people all have their act together. Can I compete? Hope so. Keep learning from them.
Keep your eyes on the prize. As successful as we may aspire to be, remember that it’s not supposed to be about us. It’s health research that is supposed to be about, well, health. We need to keep pushing to ensure that our work translates, on the short or long-term as the case may be, to better health for the populations on whose behalf we work.
Despite the challenges, the future is bright! Sure, we’re in a global economic crisis and we face significant challenges with regard to funding, government red-tape, and commitment of our sponsors. Nevertheless, the meeting site is teeming with a combination of wise elders and young protégées, leaders in the making, who can weather this storm and come out stronger on the other side. Don’t worry. Be happy. Keep working.
Attendees wiz through the hotel lobby to attend sessions at the 62nd Annual Meeting.
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Science is a long way from achieving gender equality, say women leaders in the field, but many scientists of both genders can't see it.
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Via nprglobalhealth: Yoset, a spiritual healer near Arua, Uganda, works with the Centers for Disease Control and Prevention to detect the plague in his village.
Full story.
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"It's no longer one drug, one bug" #tropmed2013
— ASTMH (@ASTMH) November 16, 2013
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The mosquito-borne infection is cropping up in Florida, but mysteriously not in similar regions in the nation
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What is SporoBot?
Find out more here.
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Q&A With New ASTMH President Alan Magill
Alan J. Magill formally assumed the presidency of the American Society of Tropical Medicine and Hygiene (ASTMH) at the Society’s Annual Meeting in Washington, DC. Magill’s research work has focused mainly on malaria and leishmaniasis. He previously served as program manager for the Defense Advanced Research Projects Agency (DARPA) from 2009 to 2012, where he was closely involved with DARPA’s pandemic influenza initiative and efforts to develop plant-based vaccine production capabilities.
What are we to make of the fact that US government officials continue to prohibit many of our nation’s top scientists—in some cases, even those willing to travel on their own time and own dime—to attend major conferences like the ASTMH annual meeting?
These are unbelievably short-sighted and really damaging decisions that have no basis in reality and are fundamentally detrimental to everyone. I view this as a failure at the highest levels of government. How is it that the politics of a single event are allowed to drive a policy for the entire government with little regard for the effects on people or their mission?
We’re not talking about people trying to take a junket to Hawaii to play in the sand. These are productive, hard working scientists interested in attending conferences where they would be in meetings and discussions from seven in the morning until ten at night. They are among our best and brightest, and right now they are missing in action.
The alarming thing is that we may be witnessing a pivot point, a true change and not a temporary shift. But we at ASTMH are hoping to find a coalition of people who share our concerns, because it is not just tropical medicine and global health feeling the effects. There are a number of associations who want to see a more rational approach to professional development, and it is important that we actively engage them.
What is your take on the budget situation in Washington, where discretionary programs like health-related R&D are enduring across-the-board cuts and could be facing flat or reduced funding for years to come?
We’re very concerned about what is happening to intramural and extramural budgets at the NIH and to operational budgets at CDC (U.S. Centers for Disease Control and Prevention) and DOD (Department of Defense) programs. What’s frustrating is that we’re talking about a small decimal point in the overall federal budget. It’s the big-ticket items, the massive spending on benefits, that are driving our budget problems, and you’re not going to solve them by cutting spending on scientific research.
I think most members of Congress understand this, and investments in R&D still remain popular and pretty bipartisan. We still have a strong case to make that federal R&D spending, particularly investments in medical research and global health, generate a good return for taxpayers, including the creation of high-paying jobs. But in any given hour there are a lot of issues competing for the attention of members of Congress and their staffers, and they can only retain so much. We need to find ways to reach out to them and help them feel more personally and permanently connected to the work we do.
What can ASTMH do to help cultivate the next generation of global health investigators, particularly at a time when so many young people are expressing interest in global health issues?
A core issue for the ASTMH is getting people excited about global health. And it’s good to see that young people today are extremely attracted to this field.
But the next question is, how do we tap into this enthusiasm? For a lot of young people, they want to know how they can get a job and work in this area. We can point to the traditional pathways in the CDC, the NIH, or DOD. But those are not what they used to be. We can also point to the big NGOs, to the Peace Corps, to the faith-based programs, but a big chunk of what they have to offer is volunteer work, not real jobs.
Clearly, it is a difficult time to cultivate a career in global health. But there are opportunities out there. And for ASTMH, the best thing we can do as an organization is to hold the annual meeting. It is a fabulous networking opportunity. It’s a place where young people can make a lot of connections.
I also would like to see us fund programs that encourage young people to actually go out into the field and get some hands-on experience. That kind of work can be life-changing and can provide an opportunity to launch a career.
You always have been passionate about projects that take scientists into the field, and the collaborations involved in such pursuits. Is this still a neglected area, from a funding perspective?
My personal view is that fieldwork is essential. But the rewards systems in place today continue to be stacked against it. They reward papers, publication, and patents, and high-powered laboratories that can get a lot done in a relatively short time. These things are important, but it’s not of real benefit unless it is connected to clinical, translational work in the field. The problem is that with most clinical or fieldwork, it’s hard to do quality projects and publish more than a paper every few years.
Part of the issue is that academic medicine is focused on individual effort. There have been efforts at NIH to address the problem, like creating the translational medicine center. But overall, the incentives still favor the individual.
What excites you at the moment in global health R&D, and where do you see areas that are ripe for progress?
Over the last decade, investments in global health, especially in product development partnerships, have primed us for success. In malaria, HIV and TB, in particular, we now see robust pipelines and new ideas for drug and vaccine development. Ten years ago that was not the case.
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Arbovirologist Charles Calisher Discusses the History of Viruses
In the midst of the various presenter booths during the ASTMH annual meeting, many participants were surprised to see an especially familiar face: Charles Calisher. For 27 years, Calisher worked at the Centers for Disease Control and Prevention as chief of the Arbovirus Reference Branch and Director of the World Health Organization (WHO) Collaborating Center for Arboviruses in the Americas. He recently published a new book, “Lifting the Impenetrable Veil: From Yellow Fever to Ebola Hemorrhagic Fever and SARS”-- part-memoir, part-detailed history of arbovirology and hemorrhagic fever virology. Attending his 48th annual meeting, Calisher spoke briefly to writer Matthew Davis.
Why do you feel it is so important to tell these stories and what do you want people to know?
I’ve been working in virology since 1961, and I had an opportunity to meet a lot of fascinating individuals and be involved in a number of very interesting epidemiological investigations. I wanted people to understand that every disease and every epidemic is just completely different. It can be influenced by everything from weather conditions, to religions, to local customs and the different animals and arthropod vectors.
I want people to know things I’ve learned along the way, like the fact that there are 1,000 species of bats and they represent 25 percent of all mammal species in the world. And some eat frogs and some eat insects and some eat blood. When you are investigating a disease, you can’t just say a bat is a bat. When someone calls you up and says a bat just fell out of a belfry, and we tested it, and it’s not rabies, you need to know what kind of bat it is.
What was one of your more memorable disease investigations?
There was a very unusual case of equine encephalitis that started out in South America, probably caused by a vaccine that was not completely inactivated. It roared through Central America and Mexico, and then wound up in south Texas. The American Quarter Horse Association got in touch with Richard Nixon, and he brought to bear the force of government on the problem. We took over a hotel in South Texas and knocked down the walls, and if there was anything we needed, we got it. We ultimately stopped the virus, and we learned a lot about it and a lot about related viruses as well.
Was there any time when you felt in personal danger from a disease?
There were a couple of times when I experienced lab infections. I got Central European Encephalitis Virus working in a supposed isolation facility that was not worth a damn. It somehow got aerosolized and I breathed it in. I also got what I think was the first human case Bhanja virus, which is a tick-borne disease. I got a fever and a headache, but luckily, that was all.
Why should people pay attention to the history of the fight against arboviruses?
If you don’t know what happened before you, if you don’t know where you came from, you’re just going to repeat all the same mistakes all over again.
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Mass Drug Administration Gets a Fresh Look as Way to Eliminate Malaria
At ASTMH Annual Meeting, a focus on treating entire populations regardless of symptoms; strategy could be way to fight spread of drug-resistant parasites
Written by Matthew Davis
As the malaria community sets its sights on moving beyond controlling the disease to eliminating it from remaining strongholds, disease experts are taking a fresh look at “mass drug administration” (MDA) as a way to wipe out malaria parasites in areas where transmission has fallen to relatively low levels.
“A strategy that focuses on treating entire populations regardless of symptoms has been used to deal with other parasitic diseases, and it appears to have been deployed to fight malaria in China and the former Soviet republics in the 1970s with good effect,” said Roly Gosling with the Global Health Group at the University of California, San Francisco (UCSF).
Jimee Hwang with the US Centers for Disease Control and Prevention (CDC) presented a review of published literature and unpublished work as well, which revealed multiple instances over the last few decades in which various forms of MDA have been used to combat malaria. They ranged from small, pilot studies that involve only about 100 people to an effort in Nicaragua that essentially targeted the entire nation of 2.5 million people.
Hwang said reports from the published literature generally indicated that effects of MDA campaigns have been short-lived. She noted instances in which there initially was a “strong impact” on parasite levels followed by a “slow and gradual decay back to baseline.” Hwang said one exception was an effort in Cambodia in which an MDA strategy that deployed artemisinin combination therapies (ACTs) followed by a low-dose of primaquine achieved a sustained impact that appeared to last for several years.
ACTs treat malaria infections while primaquine is the only drug currently available that is capable of entirely ridding the body of malaria parasites, which is critical to any effort to interrupt transmission.
Hwang also considered unpublished results that offered evidence of MDA being practiced in the former Soviet republics and in East Asia during the 1970s that reached millions of people and appeared to have success at interrupting malaria transmission.
Nick White, with the Mahidol Oxford Research Unit in Bangkok, Thailand said that MDA is mainly being considered as a potential malaria elimination strategy in areas where there are low levels of disease transmission.
“No one is recommending it in areas of high transmission, and even in areas of moderate transmission, it’s debatable whether it would be effective,” he said.
But White believes that in areas where disease transmission is low—but where there is still a significant portion of the population carrying parasites that can be passed along to mosquitoes— “this strategy deserves consideration.” He is particularly interested in whether MDA could be used in Southeast Asia to halt the spread of artemisinin-resistant parasites now emerging in the region.
“We do need to become more aggressive in Southeast Asia where we are losing the battle against artemisinin resistance,” White said.
White said an effective MDA treatment strategy would need to involve medications that are long-lasting and can kill off all remaining parasites. He said the drug primaquine could be effective at eliminating parasites from a population, but if used at high doses, it would need to be accompanied by a test for the G6PD blood, deficiency, which can lead to dangerous and even fatal reactions to the drug.
John Miller with PATH discussed the issues encountered in conducting a mass testing and malaria treatment campaign in Southern Zambia with the Malaria Control and Evaluation Partnership in Africa (MACEPA). He said while it covered a large proportion of the targeted population, the effect on malaria incidence was of “marginal significance.”
He said they likely would have achieved better results if they had “provided treatment to more than just those who tested positive,” such as treating their entire household.
Alan Magill said the malaria community is relatively inexperienced in how to “go out and clear parasites from asymptomatic people.” But he observed that fighting a disease by treating asymptomatic populations should not be seen as an insurmountable obstacle.
“We do it all the time when we deliver vaccines to asymptomatic individuals,” he said. He also noted that the MDA strategy is being used successfully in elimination campaigns against other parasitic diseases, such mass treatment with ivermectin to eliminate river blindness.
Magill believes employing MDA as an effective malaria elimination strategy will involve “lots of learning.” But he said that the emergence of a single-dose treatment for clearing parasites and more accurate diagnostics “could change some of the dynamics.”
Image via UCSF Global Health Sciences.
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Scientists are particularly concerned about the emergence of the virus in Jenson Beach, Florida. It means that dengue fever is spreading north from Key West, where one of the earliest outbreaks in the US was recorded in 2009. Previously there had been no outbreaks of the fever in Florida for decades.
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US researchers have reported preliminary success using genetically engineered probiotics against hookworms, an intestinal parasite which infects millions of people, particularly pregnant women and children in the developing world.
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Despite their obvious differences in geography and climate, Tucson, Arizona, and Key West, Florida, have similar risks for dengue fever. But why the disease has spread from the island haven into th...
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