Global Health: Infectious disease; burden of illness; expanding threat; vaccines and control strategies.
Infectious diseases are major contributors to the global burden of illness in terms of morbidity and mortality. Over the past few decades and in spite of earlier achievements in controlling few major infections, the global effort is being undermined by emergence or re-emergence of new pathogens, development of resistance in microbes and their vectors and the added threat of intentional use of microorganisms to cause harm. The global community is less than prepared to address these challenges. For example, the ability to detect and assess these threats is modest and tools for responding by antimicrobials, vaccines or environmental adjustments are not keeping pace with the expanded threats. The problems are compounded by absence of political will at global or national levels.
My research focus is on two areas related to global infection. First is a detailed examination of causes of emergence and re-emergence of microorganisms. These include evolution of human-microbe relationship, environmental and genetic influences and the role of selective pressures e.g. antimicrobials on development of resistance in the causative organisms or their insect vectors. Several strategies for controlling infectious disease at the national level, are being examined including chemotherapy, vaccines and community containment. As an extension of this area, I became involved in examining the intersection of life sciences and national and global security. Dual use technology raises multiple concerns. The challenge is to maintain the culture of science openness and free communication balanced with responsibility and awareness.
The second major area of investigations involves discovery, development and global deployment and use of vaccines. Among infectious diseases control measures, vaccines have proven most effective and cost saving. Over the past decade, I have led the effort to develop and launch four new vaccines. These include vaccines for infection with rotavirus, human papillomavirus, shingles and combination of measles, mumps, rubella and varicella. While these and other previously developed vaccines should have an impressive impact on the global burden of illness from infectious disease, the reach of vaccines and their central role in controlling infection is inadequate. A detailed examination of the global gap in vaccination is being conducted as well as strategies for expanding their beneficial role at public health and policy levels.