Alison Smith

Alison is a fourth-year medical student at Emory University interested in pursuing a career that combines practicing as an infectious disease specialist with conducting clinical and translational global health research. A native of Chapel Hill, North Carolina, she studied biology at Williams College, Mass., then worked as a post-bachelor fellow at the University of Washington’s Institute for Health Metrics. At IHME, she gained in-depth experience with epidemiologic methods and learned to think critically about how competing research priorities fit into the landscape of global health. As a medical student,  she has been most motivated by opportunities to advocate for the most vulnerable patient populations in Atlanta, inside and outside of the hospital setting. Throughout her career, she hopes to conduct infectious diseases clinical and translational research that addresses global health priorities and advocates for the needs of low-resource or “neglected” tropical populations, particularly as climate change threatens to worsen the infectious disease burden of many tropical settings. In her spare time, she enjoys exploring Atlanta’s running and cycling routes, cooking and hiking around the north Georgia mountains. 

What does the Kean Fellowship mean to you?
The Kean Fellowship provides a unique and unparalleled opportunity for me to spend time in Addis Ababa, Ethiopia assisting in data collection and study design on two parallel research projects: one examining the relationship between Type 2 diabetes severity and the acquisition of latent tuberculosis infection (LTBI) among the household contacts of tuberculosis patients, and a secondary project evaluating the treatment outcomes of multi drug-resistant (MDR)-TB patients with novel anti-tuberculosis medications bedaquiline and delamanid. Participation in these projects will allow me to develop a framework for understanding the logistical, ethical and social challenges of conducting clinical and translational research in a low- income, high-burden international setting, and I hope to carry the lessons from this project forward throughout the rest of my career.

While my planned travel to Addis Ababa was postponed to summer 2021 because of the COVID-19 pandemic, I’m immensely grateful to the ASTMH for their flexibility in extending the timeline of funding for the project. 

What do you anticipate learning?
As a fourth-year medical student, I am quite early in my career and have much to learn about the process of designing and implementing clinical and translational research, particularly how this work is conducted in international settings. While in Addis Ababa, Ethiopia, I hope to gain a first-hand understanding of the process of clinical trial implementation and household contact tracing as part of a multi-national NIH-funded Tuberculosis Research Unit (TBRU) trial. Even more importantly, spending time in-country will provide context for the research findings, and to gain appreciation for both true burden of tuberculosis in the community and for the challenges of treating MDR-TB in lower-resource tropical settings.

What interests you about tropical medicine and what problems are you interested in solving?
Since childhood I’ve been fascinated by infectious diseases: their transmission dynamics, their myriad effects on human health, and the societal and socioeconomic factors that put certain segments of the population at greatest risk for high burdens of infection. The field of tropical medicine provides the opportunity to care for and advocate for the most vulnerable populations in global health, and to directly address the needs of the communities that are hardest-hit by infectious diseases. In the coming decades, climate change will greatly further the need for this research in tropical settings as shifting weather patterns will alter the burden of infectious diseases in ways both predictable and unpredictable. The increasing burden of chronic diseases further complicates the infectious disease burden in tropical settings, as highlighted by the ‘dual epidemic’ of diabetes in regions with a high burden of tuberculosis. Ultimately, I hope to conduct research that addresses how health systems in tropical medicine settings can best adjust to this shifting landscape of global infectious disease priorities.