Breakthroughs Blog: NTDs

Faces of Innovation—a new GHTC project that features scientists on the front lines of research and development on new global health tools and technologies—profiles Dr. James Mutunga, who we met at the American Society of Tropical Medicine and Hygiene (ASTMH) Annual Conference, who does research on developing and testing new methods of controlling vector-borne diseases as well as pathogen surveillance in arthropod disease vectors at the US Army Medical Research Directorate-Africa in Kisumu, Kenya. My Name: James Mutunga, PhDWhere I work: US Army Medical Research Directorate-Africa in Kisumu, KenyaI’m funded by: US DoDThe views I express here are my own and do not and are not to be construed as official, or as reflecting true views of the Department of the Army or the Department of Defense. My research: I work on surveillance for vectors—that is, arthropod disease vectors. I work in the Entomology lab in Kisumu. Under the surveillance program, we do collection of field samples of mosquitoes, ticks, mites, fleas, any arthropod that we can imagine, sandflies included—we bring them to the lab and we do pathogen testing to detect diseases that they may carry. We also do morphological and molecular identification of these vectors. Eventually, what we create is a heat map of potential pathogens in circulation and the areas they are circulating so we can advise on the areas that are high-risk and therefore give this information to the US Army for deployment purposes, and protection. The vectors we currently mostly target are mosquito vectors. These transmit malaria, dengue, Zika, chikungunya, and many other different diseases. Motivation: A couple of years ago, I worked for a research institution that primarily researches on arthropod vectors called the International Center for Insect Physiology and Ecology, based in Nairobi, Kenya. And from there, my passion for mosquito research transitioned to what I undertook for my masters and my PhD. I undertook my PhD at Virginia Tech here in the US, and I worked on developing new carbamate molecules and testing them for malaria control. So that kind of invoked my passion, given that it is a disease [with] a broad burden [in] the world. That still is the focus of the work that I do, and I enjoy it.Why federal support is critical: The work we do, and the many years that the US government has invested in vector-borne disease research and control, is commendable. We still do not want to relent. We are facing challenges in vector control. We are having problems [with] insecticide resistance, we are having problems of changing vector behavior, and therefore, the investment in terms of financial support for researchers in the US—and all over the world—is more than needed. We are having challenges with the issues of climate change and habitat change—places that never used to have disease transmission are actually now having active indigenous transmission and therefore there is a need to continue investing and ensuring that policies that are being made to support this research.When I’m not in the lab: I spend time with family, friends. I like traveling, doing road trips. I also like charity work.

Faces of Innovation—a new GHTC project that features scientists on the front lines of research and development on new global health tools and technologies—profiles Dr. Mary Kamb, who we met at the American Society of Tropical Medicine and Hygiene Annual Conference, who leads the Elimination and Control Epidemiology team at the Centers for Disease Control and Prevention, Division of Parasitic Diseases and Malaria.My Name: Mary Kamb, MD.Where I work: Centers for Disease Control and Prevention (CDC), Division of Parasitic Diseases and Malaria in Atlanta, Georgia.I’m funded by: the US federal government. My research: I lead the Elimination and Control Epidemiology team in the Parasitic Diseases Branch. We focus on neglected tropical diseases that are able to be eliminated through one method or another, usually preventative chemotherapy, like Lymphatic filariasis and Onchocerciasis…but also diseases like Guinea worm, which don’t have a treatment but have strong public health programming that, in that case, can lead to eradication.We [CDC] work primarily with ministries of health on programs to improve programmatic implementation and surveillance. It’s very practical, on what we call program operations research or program science, to ensure and improve high-quality programs. My team is made of scientists who come from a number of backgrounds. Some are medical doctors, like me, some are epidemiologists, or social scientists, or have training in other areas. We work closely with people from our laboratory…very closely, hand in hand, and also with people who work on the drivers behind people’s behavior around programs. For example, why people would not want to participate in a mass drug administration, or why might people be fearful of using drugs or not seek care…really working across disciplines. I think it makes for a stronger program and for better understanding of all the issues around ensuring high-quality programs. Most of our work involves collaborating with partners, often other health ministries, the World Health Organization, and other international partners working on neglected tropical diseases. We also try and work with other branches and teams across CDC, for example with people working in Global Water, Sanitation, & Hygiene (WASH), immunizations, malaria, or other areas because we can learn from and support each other. Many of these areas can really inform elimination and control of neglected tropical diseases.Motivation: I worked for many years on the elimination effort of mother to child transmission of HIV and syphilis. I worked most of my career focused on HIV and other sexually transmitted diseases. Working in neglected tropical diseases is very interesting both because there are diseases that can be eliminated, but also because…it’s an area of great need that affects people and countries who are often living in poverty. The longer I work in public health, the more interested I am in health equity and understanding the real drivers of why certain countries are affected by diseases that we feel should be gone but aren’t necessarily gone. We have to dig deeper to find out what are those other drivers…those social issues that are affecting good health. Why federal support is critical: I think living in the United States, we might think we are immune from some of these diseases that affect other countries, but we’re not. Having people who are living healthily in other countries across our borders doesn’t just help people across the border, it helps Americans. In today’s world, diseases can cross borders so easily. Having healthier neighbors also makes for a stronger and safer world. When people don’t have to worry about diseases, they can focus on other issues that are important and making a stable community. I think that global health is such a win-win for everyone in the world. When I’m not in the lab: One of the things I really like to do is keep in touch with friends around the world…I like to keep in touch with people and travel. I also like to bird watch.

Faces of Innovation—a new GHTC project that features scientists on the front lines of research and development on new global health tools and technologies—profiles Dr. Peter Hotez, who we met at the American Society of Tropical Medicine and Hygiene (ASTMH) Annual Conference, who does research to develop vaccines for neglected tropical diseases as professor and Dean of the National School of Tropical Medicine at the Baylor College of Medicine in Houston, Texas. My name: Peter Hotez, MD, PhDWhere I work: National School of Tropical Medicine at the Baylor College of Medicine in Houston, TexasI’m funded by: National Institutes of Health, Department of DefenseMy research: At the National School of Tropical Medicine, we established what’s called the Texas Children’s Hospital Center for Vaccine Development, which is a non-profit—what’s sometimes called a product development partnership, a PDP. These are non-profit agencies that use industry practices to make stuff—in our case, it’s vaccines. So we’re making vaccines for neglected tropical diseases, the most common afflictions of the world’s poor. We have vaccines for hookworm and schistosomiasis in clinical trials now, and hopefully soon a new Chagas vaccine will go into the clinic. This is co-directed by myself and my science partner for twenty years, Dr. Maria Elena Bottazzi. We like to say that we develop the vaccines that no one else will make. Motivation: I have an unusual story in that ever since I was a teenager, I wanted to study tropical diseases. And then I went to Yale as an undergraduate specifically to work at a lab on African sleeping sickness, and then I did the MD-PhD program at Rockefeller-Cornell, the medical scientist training program, where I got started on developing a hookworm vaccine in the laboratory of Anthony Cerami, who let me bring hookworms into the lab. So, this is a lifelong passion and calling, and I think you’ll find that for a lot of researchers, especially here at the American Society of Tropical Medicine and Hygiene.Why federal support is critical: In terms of federal agencies that support us, we have support, of course, from the NIH, National Institute of Allergy and Infectious Diseases, which has been a stalwart supporter of our vaccine development program, but also, the Department of Defense is now supporting our leishmaniasis vaccine program through CDMRP [Congressionally Directed Medical Research Program]. We’re extremely grateful for our federal support. We’d be nowhere without it.…[From] 2015-2016, I was in the Obama Administration—I served as US Science Envoy. There’s a few things going on with that. One, in one of my books, Blue Marble Health, we found that most of the world’s poverty-related neglected diseases are not necessarily in the poorest, most devastated countries of Africa and Asia as many people think, but actually, it’s the poor living among the wealthy in G20 countries, the Group of 20 countries. So, for instance, we now estimate that there are 12 million Americans living in extreme poverty with a neglected tropical disease. [Research] on these diseases is not only helping people abroad, it’s actually helping the poorest Americans. So that’s a very important aspect. Another is—I think in my time as US Science Envoy, one of the things that I kept on seeing is the admiration for America, not because of our military prowess, but because of our research universities and our research institutes. This is why people love America: We’re a science horsepower; the fact that we use our science towards bettering the world, developing new technologies for global health. This is one of the things that makes America great—this is what I tell policymakers and leaders on both sides of the aisle.When I’m not in the lab: One of the things that’s my new passion is—I’ve become a writer. Since moving to Texas Children’s Hospital and Baylor College of Medicine, I’ve written and published three books, and now about to work on my fourth. So, writing has become a new passion of mine, and it reaches a different audience than scientific papers. It helps to explain why science is important and do that public engagement, and that’s so critical, especially in this time now when we’re seeing this rise in anti-science, anti-vaccine movements. More than ever, we need to do public engagement. That’s why GHTC is so important. It’s a key component of that public engagement.

Interested in more global health innovation news? Every week GHTC scours media reports worldwide to deliver essential global health R&D news and content to your inbox. Sign-up now to receive our weekly R&D News Roundup email. An Ebola vaccine developed by Merck & Co was approved by European regulators on Friday in a move hailed as a “triumph for public health” by the World Health Organization (WHO). The vaccine, which protects against the Zaire strain of the Ebola virus—the one that most commonly causes outbreaks—, is being used on an emergency basis during the current outbreak in the Democratic Republic of the Congo. The regulators recommended conditional marketing authorization for the vaccine, which the European Commission is likely to affirm in the coming weeks, granting full marketing authorization to all member states under its purview. The vaccine is also under review by the US Food and Drug Administration using a fast-track pathway, with a decision expected in the first quarter of next year. Last week, WHO released its 2019 Global Tuberculosis Report which highlights several new technologies in the pipeline to diagnose and treat tuberculosis (TB), including a promising vaccine that could prevent people with latent TB from developing the disease. The report cites that the vaccine is one of 23 drugs, combination regimens, and vaccine candidates currently in clinical trials. Though funding for TB research and development reached US$772 million in 2017, it remains well below the target of $2 billion annually agreed to by United Nations member states at the High-Level Meeting on TB in 2018. Researchers in Brazil have identified a new parasitic disease that causes severe damage to the liver, spleen, and skin and is believed to have infected more than 150 people and caused two deaths in a northeast region of the country. The disease displays similar symptoms to two forms of leishmaniasis–a neglected tropical disease spread by infected female sandflies that attacks both the skin and internal organs. However, this new disease, which is caused by the Cridia sergipensis parasite, does not appear to respond to conventional treatments for leishmaniasis. A researcher involved in the journal article identifying this new disease emphasized the need for further research. “This is the first warning. We still need to diagnose where this parasite is located, what the vectors are, how it is transmitted, and develop an effective medicine,” he said.