On May 15, Research!America hosted a forum, “Neglected Tropical Disease Research in Louisiana: Saving Lives and Creating Jobs.” The forum, featuring leading NTD experts from the region, was held at Tulane University School of Public Health and Tropical Medicine in New Orleans.
Pierre Buekens, MD, PhD, dean of the Tulane University School of Public Health and Tropical Medicine, made opening remarks. He set the scene for the day, reminding us that there is a false divide between global and domestic health. Dr. Buekens pointed out that borders don’t matter when we share climates and that NTDs can affect people in all corners of world, including New Orleans. He argued that the US is not doing enough to address the threat of NTDs and said that it is “really time to wake up, we really can’t tell other countries what to do if we don’t address it at home.”
The first panel focused on NTDs and NTD research in the U.S. and Louisiana in particular. The panel was moderated by Dean Buekens and featured the following panelists: Patricia Dorn, PhD, Professor of Biological Sciences at Loyola University New Orleans; John B. Malone, DVM, PhD, Professor of Pathobiological Sciences at Louisiana State University; Raoult C. Ratard, MD, State Epidemiologist at the Louisiana Department of Health and Hospitals and Dawn Wesson, MS, PhD, Associate Professor of Tropical Medicine at Tulane University.
Raoult Ratard has seen first-hand the impact these diseases have on Louisianans. He stressed the importance of being able to conduct observational studies, and to collaborate with universities to conduct public health research, utilizing each others’ skills and resources to best understand transmission and prevention methods. Dawn Wesson discussed the rise in mosquitoes that can transmit dengue fever in New Orleans after Hurricane Katrina. The insects that transmit Chagas disease, called “kissing bugs” are also found in the southern half of the US and studies have shown that up to 60% of the bugs in parts of New Orleans are infected with the Chagas parasite. Put simply, Wesson said that the “bugs are here, they are infected and transmission is possible.” The panel reminded us these bugs can fly higher than any wall, and that Americans are contributing to the spread through demand for air travel, through cruise ships and other tourist activities, and through globalization and trade generally.
The panel then turned to the importance of continued research to fully assess the threat of these diseases in the U.S. Dean Buekens pointed out that it is extremely difficult to find funding to study the prevalence of NTDs in the US because most people don’t associate NTDs with this country. Improving awareness of NTDs among the public, policymakers and the medical community is critical to changing this perception. Panelists also identified other remaining research gaps, including breaking down the barriers between biomedical research and public health practice as well as the need for better surveillance tools, diagnostics and insect-trapping technology. They discussed the promise of genomics but cautioned that we need the research infrastructure and the training in place for the next generation of global researchers to move forward on this promise.
The second panel focused broader issues of federal funding in NTD research, as well as challenges and successes in NTD work in the southern U.S., and was moderated by Maria Calzada, PhD, Dean of Humanities and Natural Sciences at Loyola University New Orleans. The afternoon session featured the following panelists: Kenneth J. Linthicum, PhD, BCE, Director of USDA-Center for Medical, Agricultural & Veterinary Entomology; Jeffrey C. Luvall, PhD, Global Hydrology and Climate Center at NASA; Kristy O. Murray, DVM, PhD, Associate Professor of Pediatrics at the National School of Tropical Medicine, Baylor College of Medicine and Dawn Roellig, MS, PhD, Microbiologist at the Centers for Disease Control and Prevention.
Panelists first discussed the role of federal funding in NTD research and the importance of intra-agency collaboration to combat NTDs. For example, Jeffrey Luvall spoke about NASA’s responsibility to use their resources and data in the most responsible way, including its use of satellite mapping technology to track diseases. He gave the example of being able to derive whether and where a disease was going to emerge based on soil moisture and vegetation, among other variables. Dr. Linthicum explained the USDA’s role in studying insect vectors, citing research collaborations with the Department of Defense and a mission to control insect vectors and pests that threaten agriculture crops, and transmit human and animal diseases. Several panelists also highlighted federally funded NTD success stories, including Dr. Linthicum who brought up USDA’s program to utilize global climate change data to predict disease outbreaks in Africa and allow countries to be better prepared and contain outbreaks more quickly. Dawn Roellig pointed out that remarkable efforts by the CDC and other partners to eradicate guinea worm diseases have resulted in a 99% reduction of cases since 1986, and serve as a beacon of hope for current NTD efforts.
Despite these successes, panelists also acknowledged that critical research needs remain. Echoing sentiments from the morning, Kristy Murray discussed the important economic impact these diseases have on both workforce productivity and the healthcare system, and the need for research to fully understand the scope of NTDs in the U.S. She spoke about her own research on dengue and Chagas in Texas, citing that 5% of dogs in Houston have Chagas, but no one yet knows what risk this holds for humans in the state. All panelists agreed that continued investment in NTD R&D and the development of new tools was the most critical component of successful NTD programs moving forward.
Collaboration: A final overarching theme from the afternoon was the importance of interdisciplinary research efforts to combat these diseases. Factors such as socioeconomic status, climate change, animal health and sanitation can all play an important role in the transmission of NTDs and it is important for experts from all disciplines to work together to develop comprehensive solutions. Panelists were asked about emerging diseases that kept them up at night. Viruses like SARS and flu were cited repeatedly, as were dengue and chikungunya. But rather than pitting one disease against another, panelists stressed that this is not a zero sum game. To make the best use of our resources, we need to think in a one health approach and pursue programs to eliminate the threat of all diseases. For example, Patricia Dorn pointed to the success of a project in Guatemala to improve rural housing which not only resulted in decreased Chagas transmission, but also led to less hookworm and less diarrheal disease. In turn, this improved child health and the economic potential of families. As Dr. Dorn stated, NTDs are “a global issue that affect all of us as human beings.” We must continue to raise awareness about these diseases and prioritize the research necessary to develop new tools to combat NTDs in the U.S. and around the globe.
To tell Congress that this funding needs to be a higher federal priority, please visit http://capwiz.com/ram/issues/alert/?alertid=62659921.
This event also featured a screening of Research!America’s video on the impact of NTDs in the U.S. To watch this video and more, please visit https://researchamerica.wordpress.com/2013/04/24/ntds-louisiana/.