At this year's Annual Meeting in Philadelphia, Christopher Plowe, MD, MPH, FASTMH, an Investigator at the Howard Hughes Medical Institute and Founding Director of the Institute for Global Health at the University of Maryland School of Medicine, ended his term as ASTMH President and handed the reins to President-elect Stephen Higgs, PhD, FRES, FASTMH, Director of the Biosecurity Research Institute at Kansas State University.
Dr. Plowe sat down recently with writer Matthew Davis to discuss an eventful year for tropical medicine and why he’s very optimistic about the future, for ASTMH, and for biomedical research. He also touched on why he is inspired by his friend Alan J. Magill, MD, FASTMH, the immediate past-president of ASTMH, who died unexpectedly on September 19, 2015.
This has been a very active year for the society and for tropical medicine. Many ASTMH members were closely involved in the fight against Ebola. The society also played an active role in organizing a historic meeting in Washington between rival factions from Myanmar to discuss the fight against drug-resistant malaria. Tropical medicine was very visible in the Nobel awards, with developers of ivermectin and artemisinin both gaining recognition. And this week the society is hosting yet another historic event with the appearance of Cuban researchers at the annual meeting. As you look back on the last year, what stands out?
Clearly the biggest event by far in the last year has been the Ebola pandemic. It created unprecedented awareness of tropical infectious diseases in both the public and political sector, and there were good and bad aspects of that awareness. I hope the lessons learned will stay with us. The public and politicians have very short attention spans. It’s easy to imagine the next epidemic coming along, and we will be as woefully unprepared as we were for Ebola.
But thinking more optimistically, it’s my hope that this was such a powerful and emotional experience that for the foreseeable future, the global community is going to be smarter about fighting infectious diseases, and it will continue to remind policy makers that the work we do in tropical medicine can have a significant impact.
In particular, I hope we have learned that disease surveillance is critical and that it is a relatively low cost activity that can produce high yields for a number of threats, including drug-resistant malaria and TB, HIV, or for any new pathogen that might emerge. We need to make sure that if someone in a clinic in rural Tanzania is seeing something strange, there is a way to get that information disseminated to their ministry of health and to places like the CDC (the US Centers for Disease Control and Prevention).
Looking ahead, a major concern for many ASTMH members will undoubtedly be the precarious situation with funding for the NIH and the CDC, among others. How do you view the budget landscape and what should ASTMH members be doing to help more policy makers understand the importance of a muscular US presence in all aspects of global health?
I’m hopeful that we will at least see an increase for the NIH this year. And we need to keep making the case for more stable and increased funding and for the importance of research focused on tropical medicine and global health. We are losing an important voice for biomedical research with the retirement of Barbara Mikulski from the Senate. (The Maryland Democrat has previously chaired and is now vice-chair of the powerful Senate Appropriations Committee.).
But I get a sense that young people today, who will be our next generation of political leaders, are more attuned to global health issues. They are very interested in what is going on in the rest of the world. And even though we’ve had this tough period that began with the economic crash of 2008 and now involves the budget gridlock of today, the wheel eventually will turn, and I’m hopeful the situation will significantly improve.
I also advise our members to be persistent and build relationships with members of Congress. When you get a grant or publish in a journal, send a letter or email or tweet to your congressional office and stay in touch with your representative. Sometimes it takes two or three visits, talking about chikungunya or malaria, before it finally sinks in. I heard a nice story from a colleague who had been interacting with a member of Congress, and the member seemed to have zero interest in science and no interest at all in any kind of increase in government spending. But then he had a risk of chikungunya in his district and, suddenly, he remembered all those interactions and started talking about the need for mapping tropical diseases.
As a scientist and infectious disease expert, what do you see as the biggest disease threat facing the world today?
While Ebola is a really scary, very dramatic disease, and the number of people who died of Ebola is terrible, it’s just dwarfed by the number of people who die every year of malaria. I may be biased because I have 25 years or more working with malaria, but if we lose our current generation of drugs, it will be catastrophic. When I started my career there were three to five million people dying every year from malaria. We have made great progress against malaria, but if the drugs and insecticides start failing in places like sub-Saharan Africa, it could be a crisis unlike anything we have seen in our lifetime.
After spending a year as president of ASTMH, how do you view the health of the society and its role in the world today and what have been the highlights of your tenure?
My first ASTMH meeting was 31years ago, and when I look at the growth of the society since that time, it’s incredible. We have grown tremendously both in size and in the resources we have available. We also have developed a stronger voice in terms of advocacy. We are now visible nationally and internationally, and we are viewed as a respected, authoritative source that promotes good science and the global importance of public health.
In terms of the highlights of my year, it would probably be the event we held in conjunction with the Center for Strategic and International Studies (CSIS) and the University of Maryland Institute for Global Health that brought together military and civilian leaders from across Myanmar to talk about malaria elimination. This is a country that has 17 armed ethnic militias, and many of the people who were at the meeting in Washington have historically had very adversarial relationships and really don’t sit down to talk to each other about much of anything. It was a little tense at first. But people got to know each other and, ultimately, we were able to have a press event where you had a brigadier general and a representative from opposition leader Aung San Suu Kyi’s party, ethnic health leaders and government officials all agreeing to work together against malaria.
It was a situation made possible by ASTMH actively engaging with a bipartisan foreign policy think tank to promote science diplomacy. We really were seen as the honest broker that could bring people together from different political factions to focus on important issues in global health, and as a society, that’s not a role we have played before.
What are your priorities for the future, both in your work with ASTMH and in your research endeavors?
In my role as past-president, I want to continue to find ways to engage with international members and encourage them to take leadership positions and assume a more visible role in our society. I like the fact that we are becoming a more international society. We have made it easier for students and others from lower income countries to join ASTMH, and we are seeing our international membership really rise.
As for my malaria work, I plan to shift my research a little bit away from more fundamental, basic science toward more applied, public health research focused on developing new tools, and especially surveillance tools, that can help advance the effort to eradicate malaria. I will also follow up on our initiative of using malaria elimination as a catalyst for political reconciliation.
I have been inspired by Alan Magill’s life. It’s still very hard to accept that someone so vital and energetic and at the peak of his powers, with so much more to do, could be taken from his family, his friends, his colleagues and from a society that held him in high esteem. Many of us have been talking a lot about Alan’s dedication to eradicating malaria. I know one of his colleagues decided to get a tattoo in his honor with “Malaria depends est”, the Latin words for “malaria must be destroyed.” We don’t all have to get tattoos, but I would like to see all of us follow Alan’s lead and take up his vision of a world free of the terrible burden of malaria.