Category Archives: Uncategorized

A Cross-disciplinary Approach to Eradicating Malaria

malariasymposium-55-300x200There is an arsenal of cost-effective tools available to combat malaria but getting people to adhere to treatment regimens can be challenging, said Jessica Cohen, assistant professor of global health, at a symposium focused on “The Last Mile to Malaria Eradication,” held December 4, 2014 in Kresge G3. It was sponsored by the Department of Immunology and Infectious Diseases and the Harvard Institute for Global Health and included a poster session and reception in the FXB Atrium.

This was the second such event sponsored by the cross-Harvard initiative Defeating Malaria: From the Genes to the Globe. This effort brings together experts from different disciplines within the University to address complex issues related to eradicating malaria. Dyann Wirth, who heads the Harvard Malaria Initiative and is also Richard Pearson Strong Professor and chair, Department of Immunology and Infectious Diseases, called the Defeating Malaria initiative “a transformational way to focus on major public health problems.”

Cohen discussed the challenges of increasing use of bed nets, which provide protection for people while they sleep against malaria-carrying mosquitos. Some people don’t use them properly; others don’t use them at all and subject themselves to hungry mosquitos looking for a blood meal.

She also noted the challenge of getting patients to finish all of their malaria medication. Often they stop taking it because they think that when they start feeling better that they are cured, or if they continue to feel sick during treatment, they blame the medicine and stop taking it. Others may decide to save pills for later for themselves or other family members.

When people don’t finish their medication, they can have lingering parasites. This can lead to reccurrence of the malaria infection and can accelerate the emergence of resistance (i.e. the parasite becoming resistant to the medication). “This is dangerous because we don’t have any other very effective malaria medications available if the current one fails,” she said.

In a test group in Africa, Cohen and her colleagues found when they experimented with adding simple stickers to bottles of medication that read “Malaria is not gone until all tablets are finished,” that compliance to the regimen increased about 7%. They also are experimenting to see if more attractive and simplified medication packaging will help.

Nick Baro of the Wirth Lab, with master’s student Francisco Cai.

Postdoctoral fellow Nick Baro discusses poster with student Francisco Cai.

According to the World Health Organization’s World Malaria Report for 2014 released on December 9, 2014, 3.2 billion people in 97 countries and territories are at risk of being infected with malaria. In 2013, there were an estimated 198 million malaria cases worldwide and an estimated 584,000 deaths. Ninety percent of the deaths occurred in Africa. The disease killed an estimated 453,000 children under five years of age.

“We’ve made tremendous progress over the last 50 years thanks to the global investment that has led to a remarkable scale up of key interventions, but we’re not anywhere close to the last mile in many countries,” said speaker Günther Fink, associate professor of international health economics. Over the last 150 years, about half the world’s countries have eliminated malaria, he said. “Fifty percent of the world lives malaria-free, but this means 50% of the world still has malaria. We need new tools and we need to move fast.”

Perrine Marcenac, PhD student, with Kristine Werling, and Douglas Paton, research fellow from the University of Perugia.

From left to right: Doctoral student Perrine Marcenac, student Kristine Werling, and Douglas Paton, research fellow from the University of Perugia, at the poster session.

While global incidence of malaria is down, in parts of Africa it’s up, said Barry Bloom, Harvard University Distinguished Service Professor and Joan L. and Julius H. Jacobson Professor of Public Health. Fifty-nine countries are expected to meet the United Nations’ malaria reduction targets by 2015 and more than 50 will exceed the targets. “Only 18 countries are responsible for 80% of the cases,” he said. Most deaths from malaria occur in the Democratic Republic of the Congo and Nigeria.

Matthias Marti, associate professor of immunology and infectious diseases, co-hosted the symposium and Michael Reich, Taro Takemi Professor of International Health Policy, was a moderator. Other speakers included Caroline Buckee, assistant professor of epidemiology; Marcia Castro, associate professor of demography; Flaminia Catteruccia, associate professor of immunology and infectious diseases; Manoj Duraisingh, professor of immunology and infectious diseases, and Sarah Volkman, principal research scientist.

Support for the symposium included ExxonMobil, Bill & Melinda Gates Foundation, Sumitomo Chemical, MCJ/Amelior Foundation, and Malaria No More.

– Marge Dwyer

photos: Craig LaPlante

Symposium Gathers Experts on Homeostatic Regulation

JBL-Hotamisligil-Little-Boice-470x313-470x313November 3, 2014 — Cutting-edge work on homeostatic regulation—the process through which the human body maintains stability in response to changes in external conditions—was the focus at the 17th annual John B. Little Symposium, held October 24-25, 2014 at Harvard School of Public Health (HSPH).

About 180 attendees heard from numerous experts in the field, who discussed topics ranging from radiation epidemiology to fat synthesis and storage to how certain genes and small molecules extend lifespan. HSPH faculty presenters at the symposium included Robert Farese, professor of genetics and complex diseases, and Gökhan Hotamisligil, chair of the Department of Genetics and Complex Diseases.

Robert Farese

HSPH’s Robert Farese discusses fat synthesis and storage in lipid droplets.

The John B. Little Symposium is hosted each year by the John B. Little (JBL) Center for Radiation Sciences and Environmental Health. Both the symposium and the center are named for John B. Little, James Steven Simmons Professor of Radiobiology Emeritus, one of the first scholars to characterize problems in public health as interactions between environmental stressors and humans’ response to those stressors.

In his introduction to the symposium, Hotamisligil praised Little as the “inspirational leader in our department, and father of this field, and father of the symposium.” Little was on hand to welcome attendees.

Both Hotamisligil and Dean for Academic Affairs David Hunter, who gave opening remarks, also acknowledged the support of alumnus Gerald Chan, SM ’75, SD ’79, a former student of Little’s and a director of the Morningside Foundation. The Foundation and Dr. Chan have provided crucial support for the JBL center and the symposium. They also supported the establishment in 2012 of the Morningside Professorship in Radiobiology, in honor of Little. In September of this year, the Morningside Foundation and the Chan family gave HSPH a transformational gift of $350 million in unrestricted endowment—the largest single donation in Harvard’s history and, according to Hunter, the 6th largest to any university in the world. In acknowledgement of the gift, the School will be renamed the Harvard T.H. Chan School of Public Health, in honor of Gerald Chan’s father.

Hunter also announced that the JBL Center will become a school-wide collaboration among the Department of Genetics and Complex Diseases (its current home), the Department of Environmental Health, and the Department of Epidemiology. Hunter said the move is being made possible by a generous gift from an international donor.

This year’s symposium was organized by Zhi-Min Yuan, professor of radiobiology and director of the JBL Center; James Mitchell, associate professor of genetics and complex diseases; and Brendan Manning, professor of genetics and complex diseases.

Karen Feldscher

photos: Tony Rinaldo

$350M gift to tackle public health challenges

BuildingChan family’s gift to School of Public Health largest in Harvard’s history Subtitle

Harvard University will announce today a $350 million gift — the largest in Harvard’s history — to support efforts at the School of Public Health(HSPH) to tackle the world’s toughest health challenges.

The gift comes from Newton, Mass.-based The Morningside Foundation, established by the family of the late T.H. Chan, which has focused its philanthropy primarily on education, health, and faith-based organizations in North America and Asia. The gift will also lead to the renaming of the School, which will be called the Harvard T.H. Chan School of Public Health.

Harvard School of Public Health Dean Julio Frenk said the gift will focus on four global health threats: pandemics old and new, such as malaria, Ebola, cancer, and obesity; harmful physical and social environments such as those resulting from tobacco use, gun violence, and pollution; poverty and humanitarian crises such as those stemming from war and natural disasters; and failing health care systems around the world.

“The Chan family’s commitment to education and their belief in the power of public health is an inspiration, and their generosity will ensure we have the resources to continue to develop the most innovative solutions that will enable millions of people to live longer and healthier lives, now and in the future,” Frenk said.

Harvard President Drew Faust said the gift signals that this is a “public health moment,” a time of action and opportunity to improve people’s health and lives around the world.

“The field of public health drives discoveries that lead to healthier, longer, more-productive lives,” Faust said. “This extraordinary gift from the Chan family will enable Harvard’s School of Public Health to tackle intractable health problems and to translate rigorous research into action and policy worldwide. The Chan family’s generosity sends a signal to the world: This is the public health moment. We are honored by this gift. It will inspire a new generation of public health leaders.”

The $350 million gift will be formally announced during an event live-streamed from the School today at 12:30 p.m. The donation comes as part of The Harvard Campaign, a seven-year, $6.5 billion fundraising effort that kicked off its public phase a year ago and which by the end of May had raised more than $3.8 billion from more than 100,000 donors.

Gerald Chan, a director of The Morningside Foundation who received master’s and doctorate degrees from HSPH in the 1970s, said his father was a “staunch supporter of education” and would be pleased with the gift.

“On behalf of my mother and my brothers, I want to express how pleased we are that the legacy of our late father can be honored by this gift to HSPH,” Chan said. “He was a generous man who was a staunch supporter of education. He also wanted to support scientific research to alleviate human suffering. He would be very pleased with this gift today and all the good works that this gift will enable.”

The gift, which will be added to the School’s endowment funds, is the second The Morningside Foundation has given to the School. In 2012 it endowed a professorship in radiobiology.

Meredith Rosenthal, professor of health economics and policy and the School’s associate dean for diversity, said the gift is “unprecedented” in size and can transform what the School does, how faculty and students work, as well as allow HSPH to bring in a more diverse population of faculty and students.

Rosenthal said that increasing diversity has always been a priority at the School, but the gift could allow HSPH to increase support for qualified students from lower socioeconomic backgrounds and from developing nations. Such support, she said, would allow such students to graduate from HSPH and return home to work free of the burden of loans.

Another possible impact would be to lessen dependence on government research grants that finance much of the work at HSPH. Though grants allow research to move forward, they also keep faculty members focused tightly on specific work, Rosenthal said. Additional funding, she said, could enable more collaboration across disciplines, potentially fostering new approaches and problem-solving.

However it is used, Rosenthal said she believes the gift represents the donor’s commitment, not just to HSPH, but to the importance of improving health around the world.

“This gift is really a commitment to population health on a global scale,” Rosenthal said. “We are incredibly privileged at the Harvard School of Public Health to get it.”

David Hunter, the Vincent Gregory Professor in Cancer Prevention and the School’s dean for academic affairs, said faculty and students will see changes from the funds in several ways. Not only will the money help hire faculty at the top of their fields and reduce the financial burden on talented but disadvantaged students, it will support changes to the doctoral program and boost a fund to provide initial support for research not ready to qualify for more traditional grant programs.

In his own research field of cancer prevention, Hunter said the gift sends a message that prevention is critical, particularly because the number of people with cancer is expected to double worldwide in the next 25 years. It also provides encouragement to faculty and students that they will have the resources over time to address the daunting, globe-spanning problems on the world’s health agenda, he said.

“Each of these areas represent major, complex problems in the world for which simple solutions are not available,” Hunter said of the School’s four areas of emphasis for the gift. “A gift like this really helps us organize for the long term, but gives us confidence we can make near-term progress … and faculty and students can commit themselves to finding solutions to those problems.”

As academic dean, Hunter said he was particularly gratified that the gift came from an alumnus, illustrating the link between the School, its students, and its alumni community, and linking the past and the future.

The four areas identified by Frenk encompass some of the most pressing challenges the world faces in any field and areas where HSPH faculty members are already at work.

Global pandemics include both old ailments, like malaria, which has been around for millennia and still kills hundreds of thousands annually, and new ones that take their own deadly toll, like AIDS, SARS, and Ebola. It also includes noncommunicable diseases such as cancer, and conditions related to lifestyle, such as obesity and diabetes.

HSPH researchers are already at work in many of those areas: Richard Pearson Strong Professor of Infectious Diseases Dyann Wirth focuses on malaria, heading the Harvard Malaria Initiative, while Mary Woodard Lasker Professor of Health Sciences Max Essex’s contributions to fighting AIDS continue to mount through the Harvard School of Public Health AIDS Initiative he heads and its Botswana-Harvard AIDS Institute Partnership. Fredrick Stare Professor of Epidemiology and Nutrition Walter Willett and data from the long-running Nurses’ Health Study and related surveys, meanwhile, shine a bright light on diet and nutrition.

A second major focus includes ills related to physical and social environments, such as gun violence, tobacco use, and substance abuse, as well as environmental issues such as air and water pollution. Associate Dean Jay Winsten and the Center for Health Communication he directs are following on the dramatic success of the center’s designated driver campaign in the late 1980s and early 1990s. Now it is working to end distracted driving caused by cellphones and other technology in automobiles, which killed 3,328 in 2012 alone, according to the National Highway Traffic Safety Administration.

Failing or nonexistent health care systems are a major source of suffering not just in the U.S., but also around the world, where they mainly affect the global poor, who die from infection, disease, childbirth, and other causes that rarely kill in developed nations. Faculty research seeks to address the problem in a variety of ways, while initiatives such as the Ministerial Leadership in Health Program, a joint program between HSPH and the Harvard Kennedy School led by Executive Director Michael Sinclair, aim to strengthen health care systems by strengthening leaders to better meet the steep challenges they face and expand access and quality of care, both domestically and internationally.

Humanitarian crises, whether from war, natural disaster, or other causes, remain a significant source of human suffering and another key area of emphasis for HSPH moving forward. The Harvard Humanitarian Initiative, headed by Professor of Global Health and Population Michael VanRooyen, and the FXB Center for Health and Human Rights, led by François-Xavier BagnoudProfessor of the Practice of Health and Human Rights Jennifer Leaning, are just two organizations based at the School that foster research and teaching to both improve the response to large-scale humanitarian crises, such as the 2010 Haiti earthquake, and instill the idea of health as a basic human right, applicable to Syrian refugees living in Lebanon, enslaved laborers in factories and fields around the world, and exploited and trafficked women and children.

“The Chan family’s transformational gift will help us empower current and new generations of talented and diverse students and faculty to address the complex health threats challenging the U.S. and the world,” Frenk said.

A live stream of the event will be available online today at approximately 12:30 p.m. EDT.

By Alvin Powell, Harvard Staff Writer

Viral load as an anti-AIDS hammer

EssexHarvard-backed Botswana project to test treatment-as-prevention on wide scale

After decades on the front lines of the HIV pandemic, Max Essex has seen his share of both setbacks and victories.

There have been far too many deaths, some among colleagues in Botswana, where the Harvard AIDS researcher does much of his work. There have been frustrating years in the lab searching for a vaccine to master the disease, with nothing so far to show for it in clinics and hospital wards.

But there have also been important successes, such as the research that showed anti-retroviral drugs given to pregnant or breastfeeding women can stop HIV transmission to their babies. Today, that practice can protect more than 98 percent of such babies — better than the best vaccines.

The use of drug treatment to prevent new infections was further validated in research on so-called discordant couples, where just one partner is infected with HIV. Studies, including those conducted in part by Essex and the Harvard School of Public Health AIDS Initiative (HAI), have shown that treating the infected partner with powerful antiretroviral drugs can prevent transmission to the non-infected partner.

Those victories, and similar work by researchers around the world, have fueled the latest attempt to corral HIV. The strategy, called “treatment as prevention,” seeks to apply smaller successes to the whole population, using early, enhanced drug treatment both to treat the sick and to keep the virus at levels low enough to reduce transmission, with the hope of choking off the pandemic.

Treatment as prevention has been gaining sway in the global AIDS community in recent years. In 2011, then-Secretary of State Hillary Clinton hailed it as a possible route to “an AIDS-free generation,” and it was included in the State Department’s 2012 blueprint toward that goal. But whether it can actually work to reduce infection at the community level remains an open question.

Essex, who is the head of HAI and the Mary Woodard Lasker Professor of Health Sciences, has joined with a group of collaborators on a massive trial to test the strategy scientifically. The trial is needed to confirm that a strategy proven successful in smaller, targeted groups will work in the general population. It is also needed to provide the kind of solid scientific footing required to persuade governments to fund a major expansion of drug treatment worldwide.

The Botswana Combination Prevention Project —“Ya Tsie” in Setswana, the country’s dominant language — is an enormous undertaking. It involves partners from HSPH, the Botswana Ministry of Health, the Botswana-Harvard Partnership, and the U.S. Centers for Disease Control and Prevention, and is funded through the U.S. government’s PEPFAR program. After two years of preparation, it is in the process of enrolling more than 100,000 people, age 16 to 64, living in 30 villages across the country.

“It’s a big trial, obviously,” Essex said, “and it’s part of an approach most people recognize as important in the future, using treatment interventions as prevention.”

The trial villages are paired with control villages getting the current standard of care, though with the latest in medical record-keeping and improvements in medical equipment and supplies. The villages where treatment as prevention is being tested will receive a combination of several established strategies that researchers hope will prove more effective together than the sum of their parts. Among the strategies: in-home counseling and testing, mother-to-child interventions, and voluntary circumcision of uninfected men.

The key intervention, however, will provide anti-retroviral drugs according to two measures, rather than just the one used as the current standard. The current standard is a measure of HIV’s destruction of immune cells, called “CD4 counts,” which have become medical shorthand for measuring progression of the disease. Counts below 350 CD4 cells per microliter of blood are a common threshold — and the one used in Botswana — at which anti-retroviral therapy starts.

Essex thinks that if lowering infectivity is a key goal, then the standard should reflect infectivity, not how sick a person is. The best measure of that, he believes, is viral load, which tallies the number of copies of the virus in the bloodstream. That has direct bearing, he said, on how easy it is to infect a sex partner, and can be high even before CD4 counts fall enough to prompt government-funded antiretroviral drug therapy.

“There’s pretty good evidence that viral load is the best correlate of transmission,” Essex said. “People without high viral load don’t transmit.”

Those enrolled in the Ya Tsie trial will begin drug therapy when viral load tops 10,000 copies per milliliter of blood or when their CD4 counts drop below 350 cells per microliter.

“There’s some overlap between CD4 and viral load, but there’s a significant number of people with high viral load but with CD4 even above 500,” Essex said. “We’re targeting people with high viral load but who are above the standard of care.”

Victor De Gruttola, the chairman of HSPH’s Biostatistics Department and the Henry Pickering Walcott Professor of Biostatistics, said faculty and students have devoted years to refining statistical methods to aid in design, monitoring, and analysis of the trial. A key element is genetic tracking of the virus in study participants, which will provide insight about the extent to which viral strains circulate within and across villages, an important consideration in evaluating the success or failure of the intervention.

“What we’d really like to know is what would happen if you rolled out the intervention to an entire sexual network,” De Gruttola said. “What we’re finding out is what actually does happen to HIV incidence in a village receiving the intervention that is surrounded by nonintervention villages. But studying viral genetic linkage provides a basis for estimating what the intervention’s effect would be if all nearby villages received the intervention.”

De Gruttola said that is just one issue that statisticians and others involved in the study design have been considering. Another is the likelihood that participation in the trial won’t be equal — some groups, particularly young men, are more difficult to enroll than others.

Data collection for the trial is expected to last four years, Essex said, followed by about a year of analysis before major findings can be released. Secondary analysis of the data will likely continue for years afterward, he said.

Essex is hopeful that treatment as prevention can provide another tool to fight the AIDS pandemic, which even with significant progress in recent years still has an enormous impact, infecting some 24 percent of adults in Botswana. He is cautious, however, about the chances for a home run against the disease.

Even if the intervention proves effective, it would still have to gain political backing to be included in government health programs, with cost a key factor — another reason Essex has decided to explore viral load as an indicator of when therapy should start, rather than just beginning therapy as soon after infection as possible, as other trials are investigating. Though the latter approach would doubtless have a dramatic effect on the disease’s spread, it would likely also be expensive enough to make rallying the necessary political support difficult. An expansion of treatment to just a subset of the population, one with a high likelihood of infecting others but not yet sick enough to qualify for drug treatment, may be more politically palatable.

“We’ve had unbelievable progress with drugs since the early to mid-’90s, both from the standpoint of saving lives of people who’ve already progressed to disease and preventing mother-to-child transmission,” Essex said. “[But] convincing everyone that they can and should [support a new intervention] from the standpoint of resources, of policy … is never easy.”

By Alvin Powell, Harvard Staff Writer

Support on the cutting edge: Bernard Lemos receives Star Family Challenge Award

Bernando“Jamie Star challenges and enables us to do something important, without being prescriptive about how it’s done,” Douglas Melton, the Xander University Professor and Thomas Dudley Cabot Professor in the Natural Sciences, said Tuesday about the Star Family Challenge for Promising Scientific Research.

At the inaugural awards ceremony for the challenge, Melton, who chairs the committee behind it, related an important dinner conversation with its founder, James A. Star ’83. Melton said the two discussed the need to fund interdisciplinary research, and the result was a clear target.

“We want to fund research which would not otherwise be funded, research that would be new, and that would have large potential impact,” Melton said. “This kind of research often happens when you look between fields.”

The challenge was established by Star and funded at his direction with a $10 million grant. Given biannually to Harvard faculty members, the awards range from $20,000 to $200,000 and are determined by a committee of senior FAS members.

At the ceremony in a packed University Hall, this year’s four winners presented research with jaw-dropping potential. Charles Lieber, the Mark Hyman Jr. Professor of Chemistry at the School of Engineering and Applied Sciences (SEAS), is researching ways to use nanoscale technology to create electronics that could be injected into the brain and become fully integrated with neural networks. The results could someday be used to treat diseases and traumatic injuries, Lieber said, citing epilepsy and Parkinson’s disease. Such “injectable electronics” would be much less invasive than surgery.

Lieber also described his “ultimate dream”: “injectable closed-loop systems for the detection, monitoring, and treatment of diseases.”

Richard Lee, a professor of stem cell and regenerative biology at Harvard University and professor of medicine at Harvard Medical School, said a simple question lay at the heart of his research: “Can DNA tell time?” He followed with another: “Why is it that a dog keeps track of time seven times longer than we humans do?” The mechanism by which DNA tracks time is “one of the great unsolved mysteries of science,” said Lee, and the answers could help fight disease.

Lee noted that people with muscular dystrophy die at about age 20, and those with cystic fibrosis die at about 30. “We’d like to extend this time,” he said. “Could we slow down time within the muscles of MD patients or within the lungs of CF patients?” He added in a later interview, “I am a physician, so thinking about patients with diseases is all that I do. I dream about being able to slow down diseases, or delay their onset.”

Conor Walsh, an assistant professor of mechanical and biomedical engineering at SEAS, is developing wearable technology — “soft wearable robots” that could someday help people with limited mobility walk with their normal gait. His interdisciplinary research combines robotics, engineering, and biomechanics.

Bernardo Lemos, assistant professor of environmental epigenetics at Harvard School of Public Health, studies the extraordinary resilience of microanimals called tardigrades. “These organisms can be boiled, frozen, desiccated, sent into space, subjected to radiation, and yet still remain alive,” Lemos said. His research has potential in biotechnology, materials science, and public health. “Those of us in public health worry about pollution, lead paint, heavy metals, and how all the toxicity they spread impacts us. Well, tardigrades are barely impacted at all by these things,” and knowing why could advance research, he said.

After hearing from the four winners — selected from more than 60 submissions — Star said, “These were phenomenal presentations. I’m so glad to be supporting such cutting-edge research.”

The challenge will continue to encourage submissions from both the natural and social sciences at Harvard, and work to help close the funding gap faced by researchers.

By Chuck Leddy, Harvard Correspondent

Why Public Health? Anthony Covarrubias

In our video series “Why Public Health?” we ask Harvard School of Public Health students and alumni to talk about what drew them to the field. Anthony Covarrubias, a doctoral student in the Biological Sciences in Public Health program, talks about growing up without health insurance, and his new determination to understand and make an impact on obesity from a molecular level.

Click here to watch the video.

A passion for science—and fighting malaria

Perrine-Marcenac-470x313Before Perrine Marcenac even enrolled at Harvard School of Public Health, the institution changed her life.

During an interview for the PhD Program in Biological Sciences in Public Health, Marcenac found herself fascinated by her faculty interviewers’ work on the malaria vector and parasite, and by the time she said good-bye, she’d found her research calling.

“I remember thinking ‘Wow! That’s really interesting,’” recalls Marcenac, now a second-year doctoral student. “During these 30-minute conversations with them, I just instantly knew. They asked me the right questions. They challenged me. I could see their passion. I don’t think picking up a paper and reading it could have given me nearly the same desire to work in the field.”

That desire has stayed with her. These days, the 27-year-old Marcenac is absorbed in research on mosquito biology and how malaria spreads. In particular, she is exploring the interplay between reproduction and immunity in Anopheles gambiae, the primary mosquito vector responsible for the transmission of malaria in most of sub-Saharan Africa. Highlights of her work to date include field research in the West African nation of Burkina Faso, which she describes as incredibly demanding but also exhilarating.

“It’s really critical to test in the field with natural populations of mosquitos—to see if our results are the same there as they are in the lab,” she explains. “It was a month of the hardest work I’ve ever done, but it was so awesome. I was very lucky to get into the field my first year, and I hope to go back.”

As a PhD student, Marcenac is hosted by Harvard’s Graduate School of Arts and Sciences, but her work is primarily carried out through Harvard School of Public Health, where she conducts research in the Department of Immunology and Infectious Diseases. The opportunity to do scientific research within a school of public health is tremendously valuable, she says.

“Because I’m interested in answering questions relevant to international health, it’s important to have people working in that context here at the population level. It’s exciting to think about the possibility of collaborating with epidemiologists and biostatisticians as well as other laboratory scientists.”

As the child of two globe-trotting chemical engineers, Marcenac developed her international perspective early on. Before attending Boston University, she had lived in France, Michigan, Singapore, and Indiana and had traveled extensively through some of the world’s poorest regions. Those experiences ultimately led to an undergraduate internship with Doctors Without Borders and continue to fuel her commitment to global health. “I saw a lot of injustice relating to health access, and it’s something that I’ve carried with me,” she says.

Another enduring legacy of Marcenac’s childhood is her conviction that gender should have no bearing on her research career. In an era when the shortage of women in STEM (science, technology, engineering, and math) professions, including academia and research, continues to spark concern, Marcenac feels fortunate that her scientific pursuits took root in fertile soil. “My parents were both scientists. To me there was never a difference between my dad’s ability and my mom’s ability. I was lucky to be raised in an environment where no one ever suggested that girls weren’t good at science.”

In her advisor, Flaminia Catteruccia, Marcenac now has both a role model and source of guidance and support. “Perhaps a female scientist at her level understands the roadblocks that someone in my position might encounter along the way,” Marcenac says. “She has definitely pushed me to do things I might not have done—like giving a talk at a conference. Her awareness helps me move forward. It’s really good.”

— Amy Gutman

photo: Kent Dayton

Chagas Disease Cure for “Silent Killer” Remains Elusive

Barbara_Burleigh-copy1Barbara Burleigh, associate professor of immunology and infectious diseases, studies Chagas disease, a leading cause of infectious heart failure. The disease is a major health and economic burden in Latin America, where it’s endemic, with roughly 8 million people infected and another 100 million individuals at risk of infection, mostly in rural, resource-poor settings.

How does Chagas disease cause infectious heart failure, and does it affect many people in the U.S?

Chagas is one of a group of so-called “neglected tropical diseases”—diseases that mainly affect the poorest countries and that have typically been overlooked because of the world’s focus on the “big three” diseases with the highest mortality rates: HIV/AIDS, malaria, and tuberculosis.In people with Chagas disease, it takes decades after the initial infection for severe symptoms to appear—which is why the disease is sometimes referred to as “the silent killer.” Symptoms include heart failure as well as severe swelling of the esophagus and/or colon, which greatly interferes with digestion. Chagas appears in people chronically infected with Trypanosoma cruzi, typically transmitted via contact with the feces of a blood-sucking insect called the triatomine, or “kissing bug.” Although triatomine bugs are found in the U.S.—mostly in the southern half of the country—people here have rarely been infected through bug bites, because the bugs thrive mainly in cracks and holes in houses made of mud or adobe or thatch—the kind of housing you’ll find in poorer countries. So, in the U.S., Chagas infections come mostly from infected blood or from mother-to-baby transmission, and are on the rise because of new immigration from Latin America. About 300,000 are infected in the U.S., and it’s estimated that Chagas-related health care costs top $100 million annually. While insect control measures in Latin America and donor blood screening both there and in the U.S. have helped lower the incidence of new cases of Chagas disease, more needs to be done. There’s no vaccine for the disease and the two Chagas drugs available—nifurtimox and benznidazole—can provide a cure only if taken very soon after the initial infection. That means that costs will continue to rise for those with Chagas disease, who are often infected as children, develop heart failure at relatively young ages (40s and 50s), and who may require extensive cardiac care, including heart transplants.

What sparked your interest in studying this “neglected” disease?

Since I was a graduate student, I have gravitated toward parasitic diseases that impact populations in the developing world. It is the fascinating biology of the Chagas disease parasite, T. cruzi, that attracted me initially, but the fact that this is a neglected disease afflicting millions motivates me to find ways to combat it. There is still so much to learn about how this pathogen establishes and maintains infection that persists for decades, and about the cellular and metabolic processes involved. Gaining insights into these processes at the molecular level will have significant implications for the understanding and treatment of chronic Chagas disease.

How close do you think we are to finding an effective way to combat this disease?

It’s hard to say. For a long time, Chagas was neglected because pharmaceutical companies don’t see poverty-stricken populations as a market. Now, with increased emphasis on developing drugs to combat neglected tropical diseases—supported by the U.S. government, the World Health Organization, and other nongovernmental organizations and nonprofits—the Chagas disease agenda has gained traction. While some new compounds look promising, recent clinical trials in humans have been disappointing. These failures suggest a complexity associated with persistent human infection that we do not understand. It’s possible that the parasite is able to adapt in order to avoid harm from the medications being used. By studying this possibility at the molecular level, we might be able to pinpoint the mechanisms at play in Chagas disease—which could lead to the development of more effective drugs to fight it.

Karen Feldscher

Harvard hosts symposium to encourage more minority students to pursue Ph.D.s

031414_Ivy_Plus2_60512014 Ivy Plus Symposium

The second Ivy Plus Symposium attracted 130 undergraduates and 19 program directors from across the country. The event was aimed at giving them the chance to get an up-close-and-personal view of graduate student life; to network with nearly 60 faculty members, including 20 Harvard faculty, alumni, and administrators; and to get to know each other.

For any student, the decision to pursue a Ph.D. represents a major academic challenge and a multiyear commitment.

For students from under-represented groups, however, the challenges don’t always end at the classroom door. From combatting racial and gender preconceptions to justifying to family and friends the decision to pursue a Ph.D. rather than a professional degree, many face hurdles that can dissuade them from even applying to graduate school in the first place.

In an effort to dispel the notion that graduate school and careers in academia at elite institutions can be beyond the reach of minority students, Harvard last week co-hosted the second Ivy Plus Symposium.

With support from the president’s office and the deans of the Business School, Law School, Kennedy School of Government, and the School of Public Health, the weekend event, co-hosted with the Massachusetts Institute of Technology and co-sponsored by a group of Ivy Plus institutions, attracted 130 undergraduates and 19 program directors from across the country, and was aimed at giving them the chance to get an up-close-and-personal view of graduate student life from current Ph.D. candidates; to network with nearly 60 faculty members, including 20 Harvard faculty, alumni, and administrators; and to get to know each other.

“We and other top universities suffer from the perception that pursuing a graduate degree at our institutions is an unattainable goal,” said Sheila Thomas, assistant dean for diversity and minority affairs, who, along with Stephanie Parsons, helped to organize the symposium.  “The sponsoring institutions conceived of this symposium to break down this wall.  We wanted to provide an opportunity for our faculty and the students attending to engage with each other around their scholarship.”

While increasing diversity at the graduate-school level is a national priority, the symposium is just the latest of Harvard’s efforts to attract greater numbers of minority students.

When he was appointed in 2008, then-Dean Allan M. Brandt made increasing diversity among graduate students a priority, and led the transformation of the recruitment, admission, and retention efforts at Harvard’s Graduate School of Arts and Sciences (GSAS).

Brandt was instrumental in enhancing student experiences at Harvard, through the adoption of best practices in graduate advising and mentoring, increases to the funding package offered to graduate students, and the creation of programs that help graduate students navigate a challenging academic job market.

“The recent Ivy Plus Symposium is but one example of Harvard’s ongoing efforts to assure the great diversity of our graduate programs,” Brandt said. “We have found that diversity is essential to the excellence of our programs, which are committed to preparing the next generation of researchers and scholars, pushing the frontiers of knowledge across the globe.”

Under the leadership of current GSAS Dean Xiao-Li Meng, the Whipple V.N. Jones Professor of Statistics, that commitment has been continued as faculty have been encouraged to engage in practices designed to give students — particularly those whose academic background may be unfamiliar to faculty — equal footing during the admissions process.

In recent years, practices like those have paid large dividends. In the three years since Thomas’ position was created, the number of minority students admitted to GSAS has steadily increased, and the percentage of incoming students who are under-represented minorities has more than doubled, from 5 to 11 percent of the students matriculating and from 7 to 16 percent of U.S. students entering GSAS.

“One of the goals of this symposium is to bring together these potential future applicants with the faculty from all our Ivy Plus schools,” Thomas said. “Whether they apply to Harvard or not, this is about allowing them to gain a different perspective on this place, and for our faculty to get a different perspective on students who attend schools they may not recognize.”

Equally important, Thomas said, the symposium offered a chance for program directors from a host of universities to connect with faculty and administrators.

“It’s important for our faculty to have those conversations with program directors, and vice versa,” Thomas said. “We want program directors to feel comfortable advising their students to apply to our schools. But it’s also important for our faculty to understand what students are learning as undergrads, and what kind of research experiences they’re having. It’s that exchange of information that builds important relationships.”

While Harvard has made supporting a diverse student body a priority, those efforts aren’t limited to the students on campus.

In an effort to encourage undergraduates to consider pursuing a Ph.D., Harvard has developed two programs aimed at giving students hands-on research experience: the Summer Research Opportunities at Harvard (SROH), a 10-week research internship for non-Harvard undergrads in life sciences, humanities, and social sciences; and the GSAS Research Scholar Initiative, a post-baccalaureate program that provides up to two years of individualized research and academic training for people who are considering a Ph.D., but are not ready for admittance.

For students such as Kyrah Daniels, a fourth-year Ph.D. candidate in Harvard’s Department of African and African American Studies who took part in a question-and-answer session with prospective graduate students, the opportunity to attend the conference was too important to pass up.

“I think it’s tremendously important for Harvard to host events like this,” she said. “I wish I had something like this, because I felt so alone in my own grad-school-application process. I felt like I didn’t have anybody to look up to with regard to what the actual nuts and bolts of the process would be like. So I’m grateful I have the opportunity to meet young students who are interested in grad school, because they’re going to be my colleagues one day. And I’m also excited to meet people who want to push research further.”

While Harvard has made strides in efforts to recruit greater numbers of minority students into the graduate ranks, Thomas said there is still more to do to dispel the notion that grad school remains off limits to all but a few.

“In the context of Harvard, we have an even higher bar to clear,” Thomas said. “From our point of view, Stanford, Yale, and the other Ivies are our peers. But from the outside … there is still a perception that Harvard is at a different level, so it’s even more important for us to make it seem like this is a place that you can come. If you decide this is a place you want to be, if this is the place for you, you can be here.”

By Peter Reuell, Harvard Staff Writer

Click here to see the original article in the Harvard Gazette.