American Scientists Sacrifice for Global Health; The Unknown 'Medical Soldiers' Protect World Borders from Infectious Diseases

NORTHBROOK, Ill. -- For more than 15 years, Terrie Taylor has spent up to six months each year away from her Michigan home to share a rented home with several medical students that is prone to power outages and water shortages.  She leaves modern-day conveniences to conduct research in Malawi, a small African republic that is one of the poorest communities in the world, where more than 12 million citizens die each year due to infectious diseases such as malaria.

Taylor, a professor at Michigan State University, leads work at the Queen Elizabeth Central Hospital in Malawi specifically targeting the treatment of children with malaria, for which there is no vaccine.  "I see children as young as 18 months succumb to the disease," she explains.  "It is the most frequent cause of mortality in children under the age of 5 and causes more than 40 percent of deaths among children under the age of 2."

This year, if all goes well with expected funding, Taylor will soon receive a desperately needed MRI machine that will enable the physicians she is teaching to identify a brain image infected with the malaria parasite and aid them to treat the children faster and more effectively.  What keeps Taylor returning to Malawi?  "The support and collaboration that the Malawians offer me is quite rewarding.  Working together, both know we're making a difference for these children and for advancing treatment for this disease worldwide."

Taylor is one of several thousand members of the American Society of Tropical Medicine and Hygiene whose researchers often put their own health in danger to pursue the identification and treatments for diseases that originate outside the United States, but can potentially pose global health threats. It's thanks to these researchers that the U.S. has advance preparation for possible outbreaks for diseases such as West Nile disease and SARS.

Christopher Plowe, MD, MPH, chief of the malaria section of the University of Maryland's Center for Vaccine Development, has been traveling since 1993 to Mali, the largest country in West Africa, where he conducts research that he hopes will ultimately lead to a vaccine for malaria. Plowe's studies have already been instrumental in the development of a test to identify parasites resistant to chloroquine, the most commonly used anti-malaria drug in Africa.  He also directs a project in Malawi, Africa where his team discovered that chloroquine-resistant malaria disappeared after several years of stopping use of the drug.  This surprising finding raised the possibility that drug resistance, a major problem with malaria, can be managed by changing drug treatments on a regular basis.

In Mali, Plowe lives in a local house that offers a trickle of water from a cistern on the roof as a shower and lives primarily on a diet of rice, cous cous, lamb or goat.  He has been infected with several tropical diseases, including four bouts of malaria, and continues to take preventive vaccines for typhoid and yellow fever, which are still present in that region.

Even having to face reoccurring health issues, Plowe insists that the inequality he sees between the U.S. healthcare system and that of the countries he visits is what keeps him returning to these potentially hazardous living conditions.  "We think we have health care disparity issues in the U.S., and we do, but they dwarf in comparison to what I see elsewhere," says Plowe.  He explains that in some countries there is less than $5 per year allocated to a persons healthcare needs, so residents don't even bother going to the hospital because they know they can't afford the medication that will be prescribed.

It was "making a difference" that also led Gary Weil, MD, professor of medicine at Washington University School of Medicine, to devote his career to working on tropical infectious diseases. Weil's laboratory has focused on lymphatic filariasis, a deforming disease commonly referred to as "elephantiasis," a disease brought to the general public's attention in the movie "The Elephant Man."  Filariasis affects more than 100 million people in 83 countries and is a major cause of disability in the developing world.  Weil's research group has improved understanding of the biology of the tiny worm parasites that cause this condition and developed important new tests for early detection of human infections.

Thanks to research by Weil and his colleagues, major changes are happening in lymphatic filariasis, including an initiative by the World Health Organization for a mass treatment program to eradicate the disease by the year 2020. Weil now focuses his work on assessing the impact of mass treatment on filariasis infection and transmission in Egypt and Papua New Guinea.

Although these and thousands of other physicians are working tirelessly to help keep new and old strains of infectious diseases from spreading further, funding is desperately needed to expand the work elsewhere around the globe, according to Robert Gilman, MD, who has spent more than 20 years conducting research outside of the U.S. on diseases ranging from tuberculosis to malaria. Gilman's early research helped identify causes and treatment options for cyclospora, an infection of the small intestine, and gastric cancer, which affects more than 22,000 persons in the U.S. each year and is the most prevalent form of cancer in Latin America.

Currently, Gilman splits his year between serving in the division of geographic medicine at Johns Hopkins University and in Peru, continuing research in intestinal-related diseases.   His collaborative work in Peru has developed an improved diagnostic test for tuberculosis that is being refined and simplified to bring high quality diagnostic tests for tuberculosis and drug resistant tuberculosis to those in the greatest need.  "The fact that our work has significantly decreased the rate of infectious disease in several countries and that we are well on our way to creating vaccines that will eradicate more diseases like we did with smallpox," says Gilman, "makes any inconveniences and all our efforts worthwhile."

Founded more than 100 years ago, the American Society for Tropical Medicine and Hygiene is the principal organization in the United States representing researchers and physicians specializing in tropical medicine, parasitology, and infectious disease. 

Source: American Society for Tropical Medicine and Hygiene