Although there?s no denying that much of the excitement in modern science is to be found in the world?s molecular biology labs, often the scientists who work there are ?part of a very big group, doing one technique or working on gene X, and it is very routine,? points out Professor Roy Anderson, head of the Department of Infectious Disease Epidemiology at Imperial College, London. ?We need to make careers more attractive,? he continues. ?The attraction in our project is that it is a mixture of science and humanitarianism that will appeal to some of the best.?
The project in question is the Schistosomiasis Control Initiative ( SCI), a partnership involving Imperial College, the World Health Organisation, and the Harvard School of Public Health, funded to the tune of £20 million by the Bill and Melinda Gates Foundation.
The impact of the parasitic worm Schistosomiasis on health in developing countries is tremendous. The parasite spreads through fresh water, making it difficult for people who have to rely on lakes and rivers for their water supply to avoid infection. Once the parasite has entered the human body through the skin, the centimetre-long worm takes up residence in the blood vessels surrounding the bladder and intestine for years. Female worms lay many eggs, which return to the water during urination and defecation. In the case of heavy infections, thousands of eggs escape daily, causing heavy blood loss. Remaining eggs are trapped in the liver, hampering its ability to filter out poisons and leading to stunted growth and early death.
School-age children, women, and those in contact with fresh water through their work are most at risk--and the numbers are staggering. More than 200 million people are currently affected, with 600 million who live in tropical regions with inadequate water supplies and sanitation in danger of contracting the disease.
And yet, ?the misery and ill health caused by Schistosomiasis is so unnecessary,? says Dr Alan Fenwick, director of SCI. A drug--praziquantel--that has all the qualities of an ideal candidate for the large-scale control of Schistosomiasis is readily available. It is safe, effective, and its price has fallen by 80% since its introduction, making it more affordable. ?The challenge now is to deliver the treatment to places like sub-Saharan Africa, where the drug has never been available,? adds Fenwick.
?Making a difference on the ground is our philosophy,? says Anderson. The project aims to implement the delivery of the drug in four developing countries, expecting them to take over the running of the programme in the longer-term. These countries will be selected according to how badly they are affected by Schistosomiasis and how committed their governments will be to the programme. The first country likely to benefit from the programme is Uganda. Meanwhile it is hoped that the example given by the selected countries will inspire other nations afflicted by the disease.
Research has an important role to play in supporting the implementation of drug delivery. First, hot spots of infection must be identified in the selected countries to determine which regions the programme should target initially. Then, the effectiveness of the implementation will be evaluated in terms of reduction in the prevalence and intensity of infection as well as improvement in the nutritional status, school attendance, and cognitive ability of the treated children. ?We also need to be very careful about monitoring drug resistance and to make sure that the drug doesn?t have interactions with [other] drugs commonly used? in the area, says Anderson.
About 10 scientists are to be recruited at the graduate, PhD, and postdoc level over the next several months, and the range of backgrounds the project is expected to draw on is very broad. ?We need scientists with skills in biology, epidemiology, statistics, ecology, geography, and public health,? says Anderson. But most importantly, scientists should have ?a high degree of flexibility ? not be scared to turn their hands to lots of different things,? and ?be enthusiastic and good at solving problems on the ground?. Anderson points out that suitable applicants may not always be the most academic scientists. ?They must also have practical and social skills? that will be necessary to generate an atmosphere that empowers local scientists to take on and run the project long term. Scientists from the developed world may be recruited to the project for between 1 and 3 years and must be prepared to travel to Africa, although they will not have to live there for extended periods. Most importantly, ?as this project is oriented to Africa, we would hope African people will become involved,? says Anderson.
If you would like to join SCI, send a paragraph about your interests along with your CV to the Department of Infectious Disease Epidemiology, Imperial College.