William Schaffner, M.D., left, talks with Abelardo Moncayo, Ph.D., of the Tennessee Department of Health, during a break at the Global Health Research Symposium last week.
photo by Dana Johnson
Global health research efforts take center stage
From treating AIDS in Haiti to thwarting malaria in Gambia, Vanderbilt University researchers increasingly are working on the frontlines of global health.
Their efforts were highlighted Friday during the first Global Health Research Symposium, convened by the new Vanderbilt University Institute for Global Health.
“The talent here at Vanderbilt devoted to global health research is impressive. We hope the institute will further nurture and inspire this work,” said institute director Sten H. Vermund, M.D., Ph.D., Amos Christie Professor of Global Health.
The intent is not to do "parachute research," where scientists drop into a developing country, collect their data, and scurry home, speakers said. The aim here is to help countries build their own research capacity, so findings relevant to their unique circumstances can be translated quickly into action.
"Cultural sensitivity is a major issue," explained Mario A. Rojas, M.D., assistant professor of Pediatrics, who helped organize the first randomized, controlled multi-center studies aimed at improving the care of sick newborns in Colombia.
"We all have some degree of ethnocentric views,” Rojas said. “We have to check ourselves … in order to be able to sit down with people from other communities and different cultures, and work together to solve specific problems."
AIDS is another example.
For more than a year, a small team of Haitian health professionals struggled against extreme poverty, rioting and often-interrupted supply lines to deliver anti-retroviral therapy to more than 1,000 AIDS patients.
The result of their efforts, reported last week in the New England Journal of Medicine, was impressive. One-year survival among their patients tripled to about 90 percent, similar to outcomes seen in the United States.
The report indicates that even "in as dismal an environment as Haiti is, you'll have clinical outcomes that stand up very well with what you find in this country," said Peter Wright, M.D., chief of Pediatric Infectious Diseases who participated in the study.
“That doesn't mean it's easy,” said Wright, who meets with his research colleagues in Haiti at least four times a year. “You really need to put down roots.”
Vanderbilt's outreach is not limited to clinical studies.
Laurence J. Zwiebel, Ph.D., associate professor of Biological Sciences, described his research aimed at preventing the mosquito that transmits malaria from “smelling” its way to its victims.
Zwiebel, principal investigator of an $8.5 million “grand challenge” grant from the Bill and Melinda Gates Foundation, has pioneered the identification of odorant receptors in the female mosquito's antennae.
He and colleagues here, at Yale University, in the Netherlands, Tanzania and Gambia are developing repellant compounds that, when embedded in mosquito netting, for example, would steer the insects away from their intended targets. Other compounds could act as attractants to trick them into entering pesticide-containing “traps.”
“We want to create ecologically sound, economically viable strategies,” Zwiebel said. “The Gates Foundation is adamant that the deliverables – the actual outcomes of these strategies – become resident in the developing world.”
A major goal of the Vanderbilt effort: encouraging more medical and graduate students and faculty to participate in global health research.
“The students need to get out; the faculty needs to get out,” said Arnold W. Strauss, M.D., chair of Pediatrics, during a panel discussion that concluded the symposium. “One of my goals is to have a more broad-minded, culturally sensitive approach. We need to do that if we're going to take care of patients even here in Nashville.”
Others who participated in the symposium included Gregory F. Barz, Ph.D., associate professor of Ethnomusicology, Anthropology and Religion, who discussed his study of music as an AIDS intervention in Uganda; and Scott M. Williams, Ph.D., associate professor of Medicine, Pediatrics and Molecular Physiology & Biophysics, who has been studying the genetics of cardiovascular disease in Ghana.
Xiao Ou Shu, M.D., Ph.D., professor of Medicine, and Wei Zheng, M.D., Ph.D., professor of Medicine and Ingram Professor of Cancer Research, discussed their epidemiological studies of cancer and nutrition in a cohort of more than 140,000 men and women in Shanghai.