It has been 100 years since the Influenza outbreak in 1918 that killed around 50 million people globally, and this year’s ASTMH conference had a focus on disease outbreak, preparedness and intervention to mark this occasion. In an increasingly interconnected world, the ability to predict and prepare for outbreaks has become of utmost importance. In addition, with finite resources, we need to be able to better target those who need help the most, and in a timely manner.
if we are able to better understand where outbreaks are happening and how various factors may influence these, we can better target interventions.
Several excellent sessions stimulated discussion on issues to do with mapping and aetiology of infectious disease foci and outbreaks – if we are able to better understand where outbreaks are happening and how various factors may influence these, we can better target interventions. John Edmunds and Neil Ferguson chaired a session on real-time epidemic analysis and forecasting, used to make public health decisions during rapidly evolving epidemiological situations where data is often scare and unreliable. Of course, a prime example of this is the past and recent Ebola outbreaks. Thibaut Jombart gave an excellent presentation on use of Whole Genome Sequences (WGS) within real time modelling of outbreaks, explaining that while it is costly and not generally useful for forecasting spread, it is valuable to detect superspreading and is useful in complementing exposure/contact tracing data.
Data underlying research are, of course, paramount in informing response and preparedness. But there are challenges in data management, ownership and accessibility. In an excellent panel chaired by Phaik Yeong Cheah, the provocative statement ‘Secondary Data Users Should Pay to Access Individual Level Research Data’ was debated. Ric Price and Nick Day argued that data gathering and management is a significant and not cost-free endeavour, often undertaken by poorly paid researchers in low- and middle- income countries. As such, they feel that the costs of these undertakings should be recompensed by secondary data users, who are often from better resourced countries or institutions. They argued that this would increase equity, incentivise the primary researcher to obtain and share quality data, and also place more value upon that data. Laura Merson and Azra Ghani, on the other hand, argued against the motion. Primary concerns were that, even if the intention of monetising data was not to turn a profit but just to cover costs, there is a negative perception in paying for data, and it in fact may exacerbate inequalities by creating another barrier for data accessibility.
Her excellent presentation covered the larger burden carried by women in terms of health inequities on the African continent, and why there is a need for interventions that address these that go beyond the health sector.
Inequalities were also discussed in Dr Matshidiso Moeti’s keynote address on repositioning women as drivers for Universal Health Coverage. Her excellent presentation covered the larger burden carried by women in terms of health inequities on the African continent, and why there is a need for interventions that address these that go beyond the health sector. Her own appointment as Regional Director for the WHO in the African Region is perhaps an indicator of improvements in equity, and is timely in the wake of #MeToo era and recent staff walk out at Google over women’s treatment there.
Challenges within tropical medicine research over the past 100 years have been met with substantial progress. However, new trials remain, and it will be interesting to see how the research community will deal with these to achieve health equity for all.
For more on the latest mapping research and reviews/comments, please see our newly launched article collection: Spatial epidemiology and infectious diseases