By Julie Engebretson
An estimated 440 million people worldwide suffer each day with hookworm disease, a debilitating parasitic infection that many, if not most, Americans have never heard of.
Four hundred and forty million.
Imagine the combined populations of the United States, the United Kingdom and France too sick to hold down a job, plagued by an insidious disease, with the world’s most capable health experts and pharmaceutical companies unable or without incentive to help. It sounds like the backdrop for Hollywood’s next apocalyptic thriller. A fiction.
But for the least among us in the world –– the approximately 1.3 billion people who live on virtually no money at all, including 1.65 million families in the U.S. who subsist on less than two dollars a day –– the ravages of hookworm and the 16 other conditions categorized as Neglected Tropical Diseases (NTDs) are an inescapable reality.
In a major step toward addressing these “diseases of poverty” and related challenges, Baylor University and its College of Arts & Sciences have been honored to welcome to campus this year two of the preeminent experts in the fields of global health, vaccinology and tropical disease –– Dr. Peter Hotez and Dr. Maria Elena Bottazzi, founding dean and associate dean of the National School of Tropical Medicine (NSTM) at Baylor College of Medicine (BCM) in Houston.
The pair, who have worked together for more than 15 years, are partnering with Baylor University by holding joint appointments to the faculties of both Baylor and BCM. At Baylor, Hotez serves as University Professor of Biology while Bottazzi is Distinguished Professor of Biology. This first-of-its-kind agreement represents a catalytic moment in the evolution of a number of initiatives —even dreams — rooted in Waco, in Houston and throughout the world.
“Just by their name, you can tell neglected tropical diseases have not been prioritized. Not all of them are killer diseases like Ebola,” said Hotez, who was interviewed repeatedly on major networks such as CNN and MSNBC during the 2014 Ebola virus disease outbreak. “Some [tropical diseases] are like Ebola, but many cause disability, shaving IQ points for children and affecting their future wage earnings. They make people too sick to go to work every day, they affect the health of girls and women and they affect the poorest people in the world.”
And when Hotez refers to the poor of “the world,” he includes the Americas as well. There is evidence of widespread NTDs across South Texas and in parts of Houston, including Chagas disease — a potentially life-threatening parasitic infection previously seen chiefly in Latin America and resulting in almost $1 billion in economic losses annually in the U.S., according to one estimate.
It is not difficult to extrapolate the effects on a family whose breadwinner cannot work due to the aforementioned hookworm disease or schistosomiasis, another parasitic worm infection afflicting an estimated 250 million people (equal to about 80 percent of the total U.S. population). For those of us who have not witnessed it firsthand, we can only imagine the poverty and economic depression shackling entire communities where rampant illness is a matter of course due to contaminated drinking water and soil.
Hotez and Bottazzi said that unfortunately, when it comes to developing vaccines to fight neglected tropical diseases, large multinational for-profit pharmaceutical companies accustomed to reaping billions for the products they manufacture have so far shown only modest interest in what would amount to pro bono vaccine development.
Advancing the mission
In the face of these realities, the fields of tropical medicine and global health in general are areas that are both essentially multidisciplinary and uniquely missional — an ideal fit for Baylor students and faculty living out the University’s stated mission of “worldwide leadership and service.”
“We do some work with Rice University [in Houston], sure,” Hotez said. “But one of the things that was so exciting about Baylor University was seeing its commitment to Christian mission in disease-endemic countries. We have Baylor undergraduates going all over the world, and they’re just captivated and fascinated by the culture and health issues affecting these countries. We actually developed the National School of Tropical Medicine Summer Institute in response to the demand from these undergrads.”
“The National School of Tropical Medicine recognized that Baylor is special because we’re so service-oriented and mission-driven,” said Dr. Kenneth Wilkins, divisional dean for sciences in the College of Arts & Sciences. “Instead of heading to the beach at spring break, our students might go to places such as Mexico or El Salvador to provide health services to those populations. That kind of student is a great match for a summer institute program that studies tropical diseases.”
The Institute, funded by the College of Arts & Sciences, is an intensive, two-week program held at BCM in Houston, designed to familiarize Baylor undergraduate students with the field of tropical medicine. In 2013 the Institute’s first cohort comprised 10 students and doubled to 20 the following summer.
“The summer institute provided me with a comprehensive understanding and humble appreciation for what it means to truly serve,” said Jolene Damoiseaux, who earned a BS with honors in biology from Baylor in May 2014. “I had the opportunity to work with raw data of a Chagas disease study during our epidemiology lectures, search for parasite eggs in fresh blood and fecal samples and visit the Sabin Vaccine Institute and Texas Children’s Hospital Center for Vaccine Development, which has vaccines for hookworm infection and schistosomiasis already in clinical trials.”
“From a broad perspective, the summer institute allowed me to dive into each aspect of public health to a deeper degree than I had before,” Gross said. “We got to look at public health in the U.S. as well as in developing nations. We learned about policy, epidemiology techniques and statistical decision-making behind each of these processes.”
Hotez and Bottazzi hope to see the summer institute expand in the coming years, inspiring even more Baylor undergraduates to orient their strengths and talents toward global health through one of the many avenues available.
“We also look forward to advising in terms of ‘hot topics’ in the sciences and forging more hands-on research collaborations between Baylor faculty and ourselves as well as other faculty at Baylor College of Medicine,” Bottazzi said. “All of this leads to more training and opportunity for the student body beyond the classroom, even expanding beyond the traditional sciences. I think Baylor is interested in an interdisciplinary approach [by] including the social sciences and other areas that create a broader circle around issues of global health.”
Dedicated disease fighters
The idea that the most effective strategies require more than laboratory scientists and physicians alone is not only reflected in NSTM’s four-fold mission — research, education, clinical activity and advocacy — it’s a conviction evident in both Hotez and Bottazzi’s résumés as well.
While trained as a microbiologist and clinical chemist, Bottazzi attended an MBA program at Temple University for a period immediately preceding her appointment to the faculty at George Washington University in 2001. The classes she took piqued an abiding fascination with “the business side of science.”
“My time at Temple led me toward spearheading the business of vaccine development in the nonprofit sector –– how do you gather and distribute resources to fund these programs which advance research, education and policy for NTDs?,” Bottazzi said. “It’s not as easy as garnering venture capital or getting Big Pharma involved as with for-profit models.”
Meanwhile, the efforts of Hotez, a pediatric physician and microbiologist, have included lobbying for changes and improvements to policy at the federal level since the late 1990s. Recently he authored “Blue Marble Health: A New Presidential Roadmap for Global Poverty-related Diseases,” a research paper emphasizing the role of the economically powerful G20 nations in controlling NTDs and reducing global poverty.
In January 2015, Hotez began serving as U.S. Science Envoy to Saudi Arabia and Morocco, advising the White House, the Department of State and the scientific community regarding potential opportunities for cooperation, and exploring joint vaccine development for NTDs affecting that region.
“Global health requires so many different skill sets,” said Stephanie Allen, who earned a BA in medical humanities and biology with honors from Baylor in 2013, an MS in reproductive and sexual health research from the London School of Hygiene and Tropical Medicine in 2014 and is currently a medical student at BCM. “One of the greatest aspects about global health, in my opinion, is that there is a place for everybody –– medicine, social work, law, vaccine development, policy, mathematics, epidemiology and so on. It’s something that’s so unique to the field and I hope these joint appointments will really fortify that idea for Baylor students.”
Benefits to Baylor
In Baylor’s Office of Prehealth Studies, program director Dr. Richard Sanker believes the addition of Hotez and Bottazzi to the biology department faculty will strengthen Baylor’s reputation as a leader in the area of biomedical research.
“Dr. Hotez directs an incredibly advanced research group, and he and Dr. Bottazzi are world-recognized leaders in global health and tropical disease medicine,” Sanker said. “As a consequence, that gravitas in this area is going to draw scholars and students who want to participate, engage and join the Baylor community. They bring that dimension.”
The joint agreement also provides the groundwork for a far-reaching and more reciprocal relationship between Baylor University and BCM — one that Sanker and others expect will offer new, collaborative experiences for current Baylor faculty, in addition to unique hands-on training opportunities for undergraduate prehealth students, particularly those in the premedical program.
“Many of the faculty working with students through the Baylor prehealth office are scientists,” said Sanker, who holds an undergraduate degree in biology and a masters and doctorate in education. “With some noted exceptions such as Dr. Lisa Baker and Dr. Lauren Barron, who are both physicians, most of us are biologists, chemists, neuroscientists and so on. We can engage our students in conversations about global health, but as a rule for our rather robust premed population we can’t generate the opportunities that Dr. Hotez, his colleagues and the greater BCM and Texas Medical Center network can help us cultivate and develop for our students.”
The interaction with Hotez and Bottazzi and the closer relationship with the NSTM will allow Baylor to build on significant research already being done by faculty in Waco to combat tropical diseases around the world.
Dr. Cheolho Sim, an assistant professor of biology who is a vector biologist and genomics expert, is developing vaccines designed to block transmission of the Brugia parasite, transmitted by mosquitoes. Molecular biologist Dr. Chris Kearney, associate professor of biology, is also doing research involving mosquitoes. He’s working on genetically engineered flowering plants known as impatiens that will kill mosquitoes carrying NTDs.
Meanwhile, Dr. Mary Lynn Trawick, associate professor in chemistry and biochemistry, is developing a new drug designed to attack the parasite in Chagas disease. The drug would kill the parasite by blocking a certain enzyme it requires throughout its lifecycle.
A new concentration
By taking advantage of expertise such as this already at Baylor and combining it with the new interface with Hotez and Bottazzi, Dr. Robert Doyle, chair and professor of biology, said Baylor has been able to launch a new concentration in tropical disease medicine available to undergraduate biology majors beginning in fall 2015.
“In the future, Dr. Hotez is very interested in developing a master’s degree program in tropical medicine at Baylor College of Medicine,” Doyle said. “We’ve developed this new concentration in tropical disease medicine so that later down the pipeline, when BCM’s tropical medicine school establishes their master’s degree, we’ll be able to prepare students with an inside track to success in that degree program.”
This new bridge between Baylor University and BCM would not have been possible without the help of Baylor’s president and chancellor, Judge Ken Starr.
“One thing that is very special about Baylor University in Waco is Judge Starr,” Hotez said. “He’s just a magnificent individual and was really fascinated by what we were doing. And of course, he’s on the board of BCM. Our new link to Baylor, in large part, reflects his personal involvement.”
“We’ve never had joint faculty appointments between Baylor University and BCM before,” said Dr. Lee Nordt, dean of the College of Arts & Sciences. “From the top down, starting with the Board of Regents, everyone has had a keen interest over the past few years in strengthening our relationships across all things Baylor — Baylor Healthcare in Dallas, BCM in Houston, Baylor University right here and Baylor Scott and White Health. Increasing faculty interaction between BCM and Baylor University is just one way to do that.”
With one eye ever fixed on the horizon, Hotez believes the strengthened institutional relationship and new joint appointments are foundations for a number of exciting changes.
“What I would love to see happen is a unique, iconic building at the Texas Medical Center that jointly houses Baylor University and BCM components, all devoted to diseases of poverty,” he said. “That would be the big vision.”
“The key word of the day is partnership,” Bottazzi said. “NSTM alone, Texas Children’s Hospital alone, BCM alone, Sabin Vaccine Institute alone, Baylor University alone — none of these organizations would be able to move alone in the way we can move together and tackle the global health problems caused by neglected tropical diseases. That’s why we value this partnership with Baylor. That’s the way to go.”
The entire Spring 2015 issue of Baylor Arts & Sciences magazine is available online.
©2015 Baylor University