The power of biology

[soundcloud url=”https://api.soundcloud.com/tracks/324452287″ params=”auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false&visual=true” width=”100%” height=”450″ iframe=”true” /]

See transcript

{***Pause/Music***}

{***Noah Leavitt***}

Coming up on Harvard Chan: This Week in Health…

The power of biology

{***Deepali Ravel Soundbite***}

(For students to really understand that understanding biology means understanding their own bodies and decisions they’re going to make is very important)

In this week’s podcast, you’ll meet doctoral student Deepali Ravel—a malaria researcher and an advocate for science education.

We’ll learn about the challenges scientists face in eradicating malaria—and why she believes that teaching basic biology at an early age is so critical.

{***Pause/Music***}

{***Noah***}

Hello and welcome to Harvard Chan: This Week in Health. It’s Thursday, May 25, 2017 and I’m Noah Leavitt.

This week the Harvard Chan School is celebrating Commencement, and so we’re sharing another student profile.

Last week you heard from Pedro Lamothe-Molina an HIV researcher and aspiring physician-scientist.

This week, we’re sharing an interview with Deepali Ravel, a doctoral student in the Department of Immunology and Infectious Diseases.

Deepali studies the biology of the malaria parasite—which affects more than 200 million people each year—and kills more than 400-thousand.

In addition to her work in the lab, Deepali is also an advocate for the importance of science education for children and teenagers—particularly basic biology.

I spoke to her about the challenges scientists face as they work to eradicate malaria—but also why teaching biology at a young age can help kids lead healthier lives.

I started our conversation by asking Deepali what initially drew her to public health.

DEEPALI RAVEL: So I came to public health from really a science background. So I’d always been really interested in science from a young age, really excited about the natural world and very curious. And then over the years, I also became very interested in global problems and human inequity in different settings. And so I realized that biology and science could be a really important tool for addressing those inequities. And then over time, I really sort of honed in on this idea of health inequities. And so that was where public health came in.

NOAH LEAVITT: So that’s an interesting mix, kind of like having the kind of, like, lab science, but also kind of the inequities parts. So I guess where did that interest stem from?

DEEPALI RAVEL: So when I was in college, I got to learn a lot about biology and biological engineering. And so while studying those technical things, I also had the chance to work with some more international focused programs that were thinking about how we use technology to address developing world problems. And so I got to work on a health project in Nicaragua and started realizing how powerful biological tools could be for these things. And so I decided I wanted to go to grad school somewhere where I could keep really focusing on biology and biological tools but then understand the public health context of things and start understanding the delivery systems that are involved in deploying biological interventions.

NOAH LEAVITT: And so you’re are working in the Department of Immunology and Infectious Diseases. You’re working on malaria. I guess kind of a two part question– what drew you to want to study malaria and what specifically have you been working on?

DEEPALI RAVEL: From a biology perspective, malaria is, I think, a really interesting pathogen. It is a parasite that infects humans but also goes through a mosquito vector. And so t has a really complex life cycle. And there’s this constant interplay, sort of– we’ll call it an arms race of the parasite evolving and then the host evolving, ways to control it.

And so I think purely from a scientific standpoint, it’s a very interesting problem and felt like an area that could be a really powerful setting to learn about human and microbial biology. And then I think more than just that though, I really knew I wanted to work on something that was a globally relevant pathogen. I was very interested infectious disease and malaria has, of course, the known sort of mortality toll. But I was also very interested in how infectious disease affects societies at an economic and social level.

And so it really tied together a lot of those different things. And I think because I knew I wanted to learn about public health, malaria was something that clearly was going to eventually, to be eradicated, require a combination of biological tools and political tools and economic tools. And so all of those things that play into public health I think this is a good lens for. And so it gave me the chance to explore science but also really deeply explore a lot of other areas that I hadn’t been exposed to yet.

NOAH LEAVITT: And so I do want to talk about the biology portion in a minute, but I wanted to just kind of follow up on something you said there with, like, you know, the goal of eradicating malaria. And so what are some of the challenges when it comes to eventually reaching that goal of eradication?

DEEPALI RAVEL: So there’s a few different levels, I think, of major challenges. So the ones that we think about the most in our department are really sort of biologically based barriers to eradication– so thinking about how effective our current tools are actually going to be over time. So right now, much of the progress in the last several years that’s made in controlling and beginning to eliminate malaria has come through new drugs that have been deployed– so the drugs as well as insecticides and the insecticide treated bed nets that you hear about.

And something we’re finding is that in this sort of parasite and intervention arms race that the parasite is– parasites globally are developing resistance to a lot of drugs. Mosquitoes are developing except insecticide resistance. And so there’s this major concern that the current tools that have really allowed us to make a lot of progress in eliminating the malaria are going to start not being effective anymore.

So that’s sort of one component of this. And then also malaria is something that is a very complex disease with this complex life cycle that means that if you’re going to eliminate it, you have to be able to target parasites in humans. You have to be able to target parasites in the mosquitoes and the mosquito population.

And so that requires a lot of resources. It requires really good planning in a health system across all of these different levels. And so I think the political capital that you need for that, the educational infrastructure you need for that, the economic resources you need for that are quite a challenge and something that I think many countries are making progress on. But still, there’s a long way to go.

NOAH LEAVITT: And you talk about the parasite and you mentioned, you know, you’re working on finishing up your dissertation. So what has your research here focused on?

DEEPALI RAVEL: Yeah, my research has focused on looking at the blood stage phase of malaria parasite. And the labs that I’ve been in have focused on how the parasite develops in the blood and then also how it creates a new stage that gets picked up by mosquitoes and transmits the infection. And so I focused both on that stage that develops in the blood and causes symptoms as well as that transmission causing stage.

And so I very specifically looked at how the parasite remodels the red blood cell while it’s living inside of it. So in order to hide from pressures, from things like the spleen in the human as well as the immune system, parasites have to renovate the surface of the red blood cell and other parts of the red blood cell. And so I focus on a very specific family of proteins. And so what we see is that if we disrupt this set of proteins, we get major changes in the remodeling of the parasite, and we think that if there is a way to target these proteins or at least understand their function better, we can start understanding how to eliminate them in a new way that’s different than how current drugs or vaccines work.

NOAH LEAVITT: So in a sense, you’re kind of trying to– like, you’re trying to understand how the malaria parasite works and then seeing if you can- I guess the goal is to change how it works.

DEEPALI RAVEL: Yeah, so right now, there are a lot of proteins or enzymes in the parasite that current drugs target directly. And as we sort of get to the point where we realize some of our current tools aren’t working, there’s been this sense in the community that we need to step back and just better understand the basic biology and a lot of different pathways [INAUDIBLE] the parasite to basically uncover whether some of these other pathways could be things to target with new drugs. And so my research is really at the very early stage of things– so trying to understand what this family of parasite proteins does. And then perhaps in some way at some point, they could be targeted with a new class of drugs or interventions.

NOAH LEAVITT: So hearing you talk is interesting because it seems like I’m guessing one of the challenges with malaria is you kind of talk up this arms race where the parasite itself is kind of evolving. But I think as everyone knows, I mean, scientific research takes a long time. I mean, there are no kind of easy solutions. I mean, is that kind of attention that scientists have to deal with that? You have to try to make discoveries quickly while the parasite is kind of still evolving in real time?

DEEPALI RAVEL: If you look at different drugs that have been deployed, I mean, there haven’t even been drugs where in the same year or two years that a drug was finally approved and put into use in communities, resistance to that drug actually started emerging. And so it really is quite a quick time scale. And so I think part of this idea is that if we have new drugs that are starting to hit the clinics right now, we can’t stop at that and we to still have the basic biology in other areas going so that there’s something in the pipeline at all times.

NOAH LEAVITT: And so you mentioned you’ve had the chance to kind of go into South America, like, do fieldwork. How did that fieldwork kind of change at all, like, how you view malaria?

DEEPALI RAVEL: I had actually never really spent time in a clinical environment and certainly not somewhere where malaria was a problem. It was something that from family in India and other places, I did understand the community level toll to some extent. But this I think really gave me a very personal handle things.

And so when I was actually in Brazil for a field project was in the midst of this general malaria transmission but also a Zika outbreak that was starting there. And so it was a chance to really much better understand the way a health system can be mobilized and think about sort of the toll of all of these different vector borne diseases in that particular area. And in addition to getting to see some of the health system, I also had the chance to work with really fantastic students and professors in that hospital department there. And so I actually got to learn a lot from them about the species of malaria that they work on and start to think about the parallels it has to my own work and then had the chance to do some teaching and really take a set of tools that we worked on in our lives and make them into something that they could use there.

NOAH LEAVITT: And so I wanted to follow up on the teaching aspect because we were just talking before the interview about biology education kind of in general. So why has that kind of become an important focus for you?

DEEPALI RAVEL: In addition to always really loving science, I’ve also really loved teaching. I think teaching has been a part of my family in a lot of ways and also something that I’ve really enjoyed and found that I’m strong at. And so over the course of just being here at the School of Public Health and learning about health systems in different places and things that are challenges for malaria in particular, I learned a lot about the need for capacity building in different places and then also just how core education and understanding disease and health is for a person to make informed decisions about their own health and then also to have medical practitioners and public health practitioners and scientists in a community that can really focus very locally on making progress with public health.

And so something I’ve seen is that in many places, there just haven’t been the resources or the curriculum focus that allow that type of really rigorous biology education to happen. And so I’ve been very interested in what the role of scientists and public health practitioners is in actually shaping biology education in a very targeted ways– so saying what do we feel people need to understand better to make decisions better. And so I’m starting to look at how I could take sort of my background in biology and in public health but also my love for teaching and combine that in a way that can focus on education in an international context. But then also I think those same problems of biology education and health decision making are certainly a problem here in the US. And so I’ve also been interested in how I can be involved in things more locally.

NOAH LEAVITT: And so, like, what would be an example, I guess, maybe here in the US of kind of how biology education could kind of affect health decision making?

DEEPALI RAVEL: So I think that biology, when it’s just taught in a classroom, can often feel like a very esoteric thing. It’s such a tiny microscopic scale of things going on and can seem like a lot of memorization and a lot of facts sometimes. And I think for students to really understand that understanding biology means understanding their own bodies and decisions they’re going to make is very important.

So I think if you’re trying to think about how you make people understand the importance of a lot of preventative measures– so things like cigarette control, for example– I think that at least to me and a lot of students that I’ve had the chance to teach, if you really understand on a very molecular level the effect of carcinogens on your own cells and understand how cancer can occur, it really starts to make you appreciate the fact that these are real things and that making very small lifestyle changes is actually having a real impact. If these pathways are so small and components are so small that you can never see them, then if you don’t really understand how they work, I think it can be hard to really make the commitment to make lifestyle changes. So I think from that perspective, it’s important.

I also think that if we look in the US and in a lot of places, a lot of our health disparities in specific communities I think can stem from the fact that there’s very few people from those communities that are actually empowered to go to school or work in a way that lets them come back and work on health issues. And so I think that as soon as you can start to have people from different communities or groups go to med school, for example, or have time in a public health environment like this and then actually go back to their community or be working on a national scale to advocate for the problems in those communities, you can actually start to have a lot of transformative change.

{***Noah***}

That was our interview with Deepali Ravel, a doctoral student here at the Harvard Chan School.

If you’d like to see more student stories, you can check out our “Why Public Health?” video series. We’ll have a link to that on our website, hsph.me/ThisWeekinHealth.

That’s all for this week’s episode.

Coming up next week: The anti-vaccine movement in the United States.

Minnesota is now in the midst of its worst measles outbreak in decades, after anti-vaccine groups targeted Somali immigrants, leading to a drop in vaccination rates among children.

We’ll speak to an expert on childhood vaccines about the outbreak in Minnesota, the importance of immunizations for children, and strategies to combat messaging from anti-vaccine groups.

In the meantime you can always listen to this podcast by subscribing on iTunes or Stitcher, or listen any time at soundcloud.com/harvardpublichealth. 

May 25, 2017 — Deepali Ravel, PhD ’17, studies the malaria parasite and believes biology can be a powerful tool for addressing global health problems. In this week’s podcast we speak with Ravel about the challenges scientists face in eradicating malaria—and why she believes that teaching basic biology at an early age is so critical.

You can subscribe to this podcast by visiting iTunes, listen to it by following us on Soundcloud, and stream it on the Stitcher app.

Watch more student stories in the playlist below: