Recap of the ASTMH 2024 Annual Meeting

See original article on LinkedIn here

Advancing Science - Building Community - Together

The 2024 Annual Meeting of the American Society of Tropical Medicine and Hygiene (ASTMH), held in New Orleans from November 13–17, drew over 4,000 participants. Global health experts, researchers, and clinicians gathered to explore advancements and challenges in tropical medicine and global health.

The meeting included more than thousand presentations, covering a wide range of disease topics and methodologies. These not only contributed to advancing scientific knowledge but also fostered new connections and strengthened existing ones.

Initially skeptical about attending yet another conference this year, I was glad that I had the opportunity to go, to get new food for thought from presentations, to engage in session and poster discussions, and, of course, to network especially in the field of neglected tropical diseases (NTDs) and malaria.

Now, nearly four weeks later, and with thoughts already turning to 2025: What insights to carry forward, what to keep doing/improve, and what to do differently next year? - Recap from the scientific sessions at ASTMH.

1. Advancing Science

With so many sessions, it is futile to try to capture the full breadth of advanced tools and scientific achievements. Instead, below are some highlights across 5 sessions with links to related websites or author publication on the topics to obtain further details and information.

Getting the Dose Right

The translation of findings from animal models to humans, alongside strategies for validating these translations remains a challenge. Given the urgent need to advanced treatment options for NTDs and other diseases, approaches to optimize human drug dosages using data from preclinical studies and animal models are highly relevant. The talks covered topics of scaling from pre-clinical to clinical trials, combination of PK/PD and PB/PD modelling for malaria treatment dosing, the use of human challenge models for treatment optimization, pharmacokinetic considerations for pregnant and breastfeeding mothers, and pharmacometrics in global health. Software spotlight: Monolix, PK-Sim.

Measures for Control and Elimination of Neglected Tropical Diseases I and II

Qualitative study results from the DeWorm3 project on factors influencing scale-up of community-wide MDA for soil-transmitted helminths across study sites in Benin, Malawi and India identified six key themes influencing the future scalability of community-wide mass drug administration (cMDA), including community preference for door-to-door delivery, strong support for scaling but also concerns about feasibility and the importance of community sensitization among other. After 15 years of MDA in Bangladesh, researcher found persisting high STHs prevalence among school-aged children as well as coverage challenges especially in hard-to-reach populations. Moving from STH to Onchocerciasis, a study in Ethiopia found that enhanced ivermectin MDA in the Wudi Gemzu hotspot reduced blackfly infectivity however revealed persistent Ov16 seropositivity in children hence concerns about potential reintroduction or recrudescence of transmission exist and may necessitate resuming MDA in the surrounding post-treatment surveillance areas. Preliminary results from a longitudinal survey in Northern Ghana suggest potential interruption of onchocerciasis transmission, meeting criteria for stopping mass drug administration (MDA) based on a less stringent 2% Ov16 seroprevalence threshold. Continued monitoring over the next three years will assess recrudescence. Overall, there was the note to move towards an essential package of care to provide to the communities and people, rather than siloed campaigns. Related session: “Innovative Tools for the Control of NTDs. How to Achieve Impact through Access Beyond Drug Donations”, also featuring Moxidectin, a new tool to complement ivermectin’s achievements to eliminate onchocerciasis, and also effective against Lymphatic Filariasis. Software spotlight: ESPEN IU Planner

Implementing Perennial Malaria Chemoprevention across Africa: Converging to Consensus?

Several PMC pilot implementation studies are ongoing in ten African countries including the MULTIPLY project (3 countries), The PLUS project (4 countries), GiveWell/Path (1 country) and the Malaria Consortiums PMC Effect study (1 country), with varying schedules. The session’s focus was on the findings of the operational research studies and lessons learned on acceptability, uptake, data management and reporting. In addition, the concomitant roll-out of PMC and the malaria vaccine was a specific question. Overall results were promising, showing high acceptability of PMC and reaching high coverage during the first year of life with challenges reported for the second year of life. Many of the studies nearing the end of follow up and study results on PMC effect are expected for 2025.

Reaching the last Mile: Innovations and Implementation Approaches to Ensure Community based malaria for all

Approaches mentioned in that session included expansion of community case management to all ages (mCCM in Malawi, mCCM in Madagascar), proactive visit of CHWs as part of a comprehensive primary care package (ProCCM Trial in Mali, ProCCM, PAMO Plus in Zambia), modelling to optimize geographic expansion of CHWs (Cameroon). (Software spotlight: recent published article on OpenStreetMap mapping and route optimization algorithms, different research group though).

Global Health: Use of Modeling, AI and Other Advanced Methods to Study Disease Epidemiology and Impact of Climate Change on Global Health

An Dengue forecasting model was updated to explicitly accounts for the interacting effects of temperature, drought and excessive wetness on dengue outbreaks. The model was adopted for the recently launched climate-integrated dengue early warning system in Barbados. In another talk on dengue, researcher projected a “massive global impacts of climate change on dengue transmission”, estimating a 20% increase based on data from 21 countries. At the end of the session, two talks from IDM researcher highlighted advancements in the use of AI for a) Enhanced Qualitative Data Analysis in Global Health (example on Vaccine Surveys in DRC) and b) AI for interacting with dynamic infectious disease model, using an example of the CMS software (Having used CMS before and knowing some struggle of validating the ‘emodl’ files, I found this talk particularly fascinating). Software spotlight: all linked above.

Examples of other sessions

• End-to-End Development of a Lassa Fever Vaccine Program
• Exploring the protective potential of intranasal vaccines for the deadly Marburg virus
• Smallpox to a Global Mpox Outbreak: How Did We Get Here and How Do We Regain Control?
• Generating Durable Protective Immunity with Malaria Vaccines
• Asymptomatic Malaria in Pregnancy: An Urgent Problem to Resolve
• Innovative Local Solutions and Novel Data Use Toward Last Mile Efforts in Eliminating Neglected Tropical Diseases
• Earth Observation for Health: Integrating Novel Data Streams in Decision-Support Systems for Climate Sensitive Infectious Diseases
• The Next Chapter of Progress: Integrating New Tools, Strategies and Partnerships to Beat Malaria

2. Building Community

Conferences are as much about the formal sessions as they are about the informal interactions, such as lunch meetups and side meetings. Two of those that I can highlight are the Applied Malaria Modeling Network AMMnet Lunch get together and the Global Institute for Disease Elimination GLIDE side meeting. Those meeting triggered some insightful and relevant discussions and allowed participants to meet others in person, for some for the first time.

The role and success stories of communities and collaborations were emphasizes throughout the sessions, as effectively summarized by the powerful closing talk “Future of public health depends on breaking down silos” (Paulin Basinga, Director Africa BMGF). Future of public health depends on breaking down silos and on multisectoral approaches that include communities. After all, as emphasized in the closing words of the conference:

"infectious disease do not accept borders, solutions should neither".
Marburg in Rwanda was mentioned as an example how everyone came together to quickly act. Other examples mentioned were the New Nets Project to tackle insecticide resistance, and the Project to Accelerate New Treatments for Tuberculosis (Pan TB), among other. On that note, ASTMH members were invited to join Africa research Connect, a 'community that is dedicated to increasing the visibility and impact of African research on the global stage'. Moreover, the development of the Africa Clinical Trial Network was highlighted as a significant step forward to advance excellent science and innovation.

3. Together

In the opening keynote: “Decolonizing Science to Benefit All: Reflections of an African Researcher on the Frontlines” (Monique Wasunna, DNDi Africa Ambassador) emphasized the importance of decolonizing science to make it beneficial for everyone and highlighted the progress made by African-led initiatives in health research. In addition, she reflected on her own career path and provided inspiration for the younger generation of African scientists.

"I am where I am today because someone supported me" 
View abstracts and browse through 2024 ASTMH sessions here.

ASTMH blog posts: [ASTMH blog post, Global Health NOW at ASTMH, malarianomore blog news, PATH at ASTMH, GSA ASTMH, MESA malaria session compilation].

This article was originally published on LinkedIn on December 8, 2024, go to article.