We are happy to announce the TEDMED 2020 Hive Program, which will feature inspiring entrepreneurs and their organizations.
As always, this year’s Hive class is made of Innovators representing early- to mid-stage organizations across 6 categories: 1) Life Sciences & Therapeutics 2) Med-Tech & Med-Device 3) Mobile & Digital Health 4) Health Systems, Care Delivery, and Reimbursement Models 5) Advancing Science 6) Public Health
New this year, the Innovators will be a part of an interactive onsite experience powered by TBWA\WorldHealth. Through this awe-inspiring experience that invokes wonder, Delegates have the opportunity to explore the power of asking “What if?” in fields from AI-driven mental health care, to novel drug discovery and development, to new models of human and animal genomics, and much more.
We hope you’ll join The Hive Innovators and the rest of our impressive Delegation in Boston, MA from March 2–4 for TEDMED 2020. If you have not signed up yet, register today.
This year’s Innovators were carefully selected from hundreds of organizations doing groundbreaking work in health and medicine. If you’d like to nominate an organization for next year’s Hive you can do so here.
The TEDMED 2020 theme is Make Way For Wonder, and we are looking forward to convening our Community and embracing the wonders of our times, the astonishing accomplishments, incredible possibilities, and extraordinary potential for the future. So, we were thrilled when the United States Pharmacopeia (USP) decided to celebrate its 200th Anniversary with TEDMED. After all, today’s wonders are built upon a strong foundation of scientific discovery. And, humanity is especially eager for those innovations that will help people everywhere live longer and healthier lives. In anticipation of USP’s presence at TEDMED in March, we talked with Ronald T. Piervincenzi, Ph.D., chief executive officer, about the organization’s history, its current work, and its approach to building trust in the future of medicine, supplements, and foods.
TEDMED: We’re excited to have you and USP join the TEDMED Community, especially on the occasion of such a monumental milestone – USP’s 200th anniversary.
Ronald T. Piervincenzi: Thank you. I’m thrilled to introduce USP to TEDMED’s audience and look forward to meeting attendees in Boston in March.
TM: What made you choose TEDMED to celebrate this milestone anniversary?
RP: Today, we are observing an unprecedented transformation in healthcare. USP’s 200-year legacy is built on trust and confidence in healthcare systems and anticipating and responding to emerging health challenges. Our founders joined together in 1820 to protect patients from a prevalence of poor-quality medical products. The backdrop today is different in scale, geography, modalities and many other factors. But the value of our work is the same. We are exploring how to build trust in future medical breakthroughs. There are many in the TEDMED community we can learn from and engage with as we imagine what the future holds.
TM: That’s exactly what TEDMED is all about! Let’s dive in. What is a pharmacopeia and what does USP do?
RP: Simply put a pharmacopeia is an official publication that includes a list of medicinal drugs and contains how those medicines are to be prepared, directions for their use, and assays to assess medicinal quality. The United States Pharmacopeia–National Formulary, which USP publishes, is the official quality standard for medicines marketed in the U.S. It is also used in over 140 other countries. USP is the leading independent scientific nonprofit organization that collaborates with the world’s top experts in health and science to develop quality standards for medicines, dietary supplements, and food ingredients. Through our standards, advocacy and capability building, USP helps increase the availability of quality medicines, supplements and food for billions of people worldwide. As the world gets smaller and more connected, quality issues affect everyone. Diseases travel. Drug resistance grows. Fake medicines kill. The foundation of quality we’re building helps address these and other global health challenges. Whether decreasing the prevalence of substandard and poor-quality medicines or helping to curb antimicrobial resistance, we’re there across 10 global sites working to protect the health of people all over the world.
TM: This seems like a very modern approach to medicine. Why did the U.S. need a pharmacopeia in 1820?
RP: Today, people trust U.S. medicines to be among the safest in the world but that wasn’t always true. In 1820, the U.S. was a new country. Medicines were made individually and differently by physicians or apothecaries. There were no regulations or more importantly, standards, to ensure that what you received in one city was the same as another. A medicine’s strength, quality, and even its identity varied widely depending on where it was made. Simply put, before our founding in 1820, there was no way to ensure that what was on the medicine label was what was actually in the bottle. Our founders—11 independent, forward-looking physicians— were concerned about this lack of uniformity and acted to protect patients from poor-quality medicines. Three of our founders were not only physicians, but also U.S. Senators—they were the voice that the U.S. needed to ensure the quality of medicines Americans used. They established the U.S. Pharmacopeial Convention, which published the first U.S. Pharmacopeia. A great deal has changed since our founding but the importance of having quality standards for medicines and other new therapies remains—now, our work is much more global.
TM: This year’s TEDMED theme, “Make Way for Wonder,” explores how medicine and healthcare is changing. Is that a theme that resonates with you?
RP: Absolutely. Wonder and scientific discovery makes medical breakthroughs possible. But trust makes them popular. More than 800 independent volunteer scientists contribute their expertise to develop and approve USP’s standards. They help to build trust by setting clear quality expectations for medicines, dietary supplements, and foods. In turn, USP standards help manufacturers worldwide bring more quality and affordable products to market, which benefits people everywhere. A recent Johns Hopkins University study found that on average, drugs with a USP public quality standard had approximately 50% more generic manufacturers compared with medicines without such a standard. The study also found that quality standards helped facilitate pharmaceutical competition and reduce prescription drug costs in the U.S.
TM: How does a 200-year-old organization prepare for the future?
RP: New technologies and treatments—precision medicine, digital therapeutics, 3D printing, immunotherapy, gene and stem cell therapies, and artificial intelligence—have arrived or are on their way. As we prepare for dramatic breakthroughs, we must work to ensure trust and quality are established as a part of these advances. Unfortunately, trust broadly is in a precarious position across sectors. Our history has taught us that for an innovation to become a widespread reality, both quality and trust are critical to its broad acceptance. USP together with hundreds of our stakeholder organizations and partners are already working to build confidence in future breakthroughs and to anticipate and address where the gaps will be. We know that when a USP public standard is available, we help manufacturers be better able to adopt the new technology, which is often a significant cost savings. In addition to conducting workshops and roundtables on topics such as cell and gene therapies and digital therapeutics, USP is working with the MIT Center for Collective Intelligence and more than 100 leaders from health and science worldwide to explore the developments and role that trust will play in shaping people’s health between now and 2040. We will explore the project’s findings from this “Trust CoLab” with the TEDMED 2020 Community.
TM: We’ll look forward to learning more about the Trust CoLab. Until then, what else should the TEDMED Community know about USP?
RP: I mentioned our volunteer scientists earlier. I invite TEDMED community members who are committed to making the world healthier, being scientifically rigorous, and working independently from politics or the private sector, to consider becoming a Champion of Trust. They can learn more by visiting our website or by stopping by the USP Lounge in the Social Hub at TEDMED. I also encourage everyone to also learn more about USP’s past, present and future and opportunities for other collaborations with us at www.usp.org/200.
TM: Thank you, Ron and very best wishes on the beginning of USP’s third century.
The 2020 TEDMED Editorial Advisory Board (EAB) is comprised of leading experts in fields spanning the spectrum of health and medicine. They have played an important role in helping to identify the topics, themes, Speakers and Innovators that will make up the TEDMED program this year. The members of the EAB are invaluable members of the TEDMED Community and are instrumental in shaping TEDMED 2020.
Given their unique role in helping to inform the TEDMED program, we wanted to know what they’re excited to experience at TEDMED this year and which speakers they are looking forward to meeting. Below are some of their responses – and we want to hear from you as well. Be sure to tag us in your responses on Twitter (@TEDMED), and on Facebook and Instagram (@TEDMEDcommunity).
Throughout the 2.5 days of TEDMED you will see the EAB in action, hosting Sessions, moderating Meetup Discussions, participating in Partner events, watching TEDMED Talks and enjoying the evening celebrations. If you haven’t registered yet for TEDMED 2020, join the EAB and the rest of the delegation before space runs out.
What are you most excited for at TEDMED 2020 and why?
“I’m excited for the energy and creativity that always sparkles from the TEDMED stage – and excited to see this wonderful program in its new Boston location!”-Pam Belluck, Health & Science Writer, New York Times
“As someone who grew up in ‘The Hub’, I have a ton of hometown pride and am thrilled for Boston to help forge the worldwide connections that form at TEDMED.”-Roxanne Khamsi, Independent Journalist
“Reconnecting with old colleagues and making many new friends!”- Sara Gorman, PhD, MPH, Director, High School Programming, Jed Foundation
Which TEDMED 2020 Speaker are you most looking forward to and why?
“Gokul Upadhyayula. Why?—biological sciences are in the midst of an imaging revolution and Gokul is leading the way; the machines he builds, the images he captures and the movies he creates are the very definition of wonder.”-Adam Goulburn, PhD, General Partner, Lux Capital
“Katherine Eban is one of the most amazing investigative journalists focused on medicine, the pharmaceutical industry and our modern quest for health. Her new book is fantastic — a must read for any TEDMEDer!”-Udaya Patnaik, Entrepreneur and Consultant
“Thjis Biersteker. This is the artist for our time. Combining data, technology and artistic installations to visualize the impact of climate change. Thjis proudly answers the common refrain of ‘I need to see it to believe it’ mentality. I’m so excited to see him talk about his vision, process and highlight the works he’s most proud of.”-Vanessa Ruiz, Creative Director, Wolters Kluwer Health; Founder, Street Academy
“Anne Basting—we are all aging.”-Howard Bauchner, MD, Editor in Chief of JAMA and the JAMA Network
We look forward to seeing you soon in Boston, MA. If you plan on joining us, be sure to register soon!
As we approach TEDMED 2020 we want to know what happens when you make way for wonder. We spent a lot of time earlier this year thinking about wonder—what it means and what creates wonder. Now we are contemplating what happens when we make way for it?
To help everyone begin to brainstorm what it means when they make way for wonder, we have compiled a few questions.
Have you had any transformative moments when you have taken the time to wonder?
What emotions or thoughts arise when you make way for wonder?
How has wonder impacted your work?
How would you describe wonder?
We also asked the members of our 2020 Editorial Advisory Board (EAB) what happens when they make way for wonder. You can see some of their answers below.
Now we want to hear from our larger TEDMED community! Tag us on Twitter (@TEDMED) and on Facebook and Instagram (TEDMEDcommunity) with your answers. Remember be creative, there is no right or wrong answer.
When I make way for wonder…
“People all over the world will benefit from better health.”- Sara Gorman, PhD, MPH, Director, High School Programming, Jed Foundation
When I make way for wonder..
“I think about if there is a way to reach consensus on health care delivery in the U.S. that works for the majority of the people.”-Howard Bauchner, MD, Editor in Chief, JAMA and The JAMA Network
When I make way for wonder…
“Discovery, innovation and progress exponentially accelerate.”-Adam Goulburn, PhD, General Partner, Lux Capital
Join us as we experience the power and possibilities that come to us when we make way for wonder this March 2-4 in Boston,MA. Register today!
TEDMED Delegate and President & CEO of Hopelab Margaret Laws lent her expertise as one of the official judges for the 2019 Astellas Oncology C³ Prize, which culminated in late October with a live pitch event awarding grants and resources to four inspiring winners. Just after C³ Prize winner Nanny Angel Network was awarded the Grand Prize, Margaret sat down with Leah Werry, a leading local champion for Nanny Angel Network, who pitched on behalf of the organization to discuss the winning idea. This interview was condensed and lightly edited for clarity.
Margaret Laws: I’m here with Leah Werry of Nanny Angel Network, a Canadian not-for-profit organization. Nanny Angel Network is the winner of the Grand Prize at today’s Astellas Oncology C³ Prize live pitch competition. Leah, would you tell us a little bit about yourself and about Nanny Angel Network?
Leah Werry: I am a volunteer and the Kingston Champion for our first branch outside of Toronto. Nanny Angel Network provides free, specialized, in-home childcare for moms who’ve been diagnosed with cancer.
ML: What is the origin story of Nanny Angel Network?
LW: Our founder, Audrey Guth, had a classic a-ha moment. She’s a mother of four and a cancer survivor. About 10 years ago, she was sitting in a waiting room for her own cancer treatment when she noticed a young mom struggling with a very fussy toddler, who was reaching up and grabbing her headscarf off her head. The mom was sitting there crying; she just couldn’t cope. Audrey started to wonder how this mom would be able to get to all of her treatments and get well for her child. That’s when Audrey realized she could do something about it, and Nanny Angel Network was born.
ML: Tell me a little bit about who the Nanny Angels are and their work with the families.
LW: Our Nanny Angels are volunteers with professional childcare experience, which gives moms peace of mind to know their kids are well cared for. These volunteers commit a minimum of six months, often a year or longer, to spend several hours a week with the family. We want to bring normalcy and consistency to these families’ lives, and so the same Nanny Angel supports a child or children throughout the mother’s cancer journey – from diagnosis through treatment and recovery, and if need be, through palliative and bereavement periods.
ML: Nanny Angel Network was the Grand Prize winner today, which means the organization took home a prize of $100,000. As you look ahead, what are some of the big milestones you anticipate, and how are you going to be taking this prize money and putting it to work?
LW: Winning means that we can accelerate our plans for the future. We’ve been developing our 10-year plan, and we’d like to open a new branch every year. We really want Nanny Angel Network to grow and help more families and more communities. Nanny Angel Network is very scalable, and we have to put building blocks in place to do that. That means investment in our backend support systems, our software programs, and building out our IT.
ML: I think the TEDMED community will have an incredible array of resources and people with ideas to help with that. It’s exciting to think about how you also might leverage the TEDMED community.
LW: Yes, it’s not just about the prize money, but about the support that we’ve been given. Winning the C³ Prize is such validation for what we’ve been doing, and it’s so motivating and inspiring. The help that the TEDMED folks have given us in this process; I just can’t believe what it’s bringing to the table for us in terms of resources.
ML: For this year’s C³ Prize, there were more 240 applications from people in 15 countries, with great depth and diversity. I’m sure it was exciting for you to be competitive in such an incredible global pool.
LW: This has really opened our eyes to what’s happening in cancer care overall, to really see that people are so passionate about finding solutions to problems that are beyond the grasp of traditional medical or technological interventions. There are such opportunities for synergy here to change the cancer journey for people.
ML: As one of the judges today, it was an exciting development to see the number of people who are out there tackling really hard issues, including social support and mental and emotional well-being. We do a lot of that work at Hopelab, which I lead, and it’s validating to understand what big issues these are in the cancer journey.
LW: You’re echoing how I feel exactly. It’s been so inspirational for us to see that human connection has to be part of the approach to helping families get through their cancer journey, because when a mom is diagnosed, it is the family’s cancer journey. It was really exciting to see the ideas to help people get through that process that go beyond the traditional way we think about cancer.
ML: What’s next for Nanny Angel Network? It’s bound to be an exciting year ahead.
LW: Nanny Angel Network is very scalable. We have a plan in place up until 2030, and now with the funding and support of Astellas and TEDMED and the whole team, we can accelerate our plans, and we’ll be opening our next branches and building our capacity to help more families.
ML: Looking forward to TEDMED 2020. Thanks a lot for talking with me today, and really excited to see you as this year’s Grand Prize winner. We’ll be looking to see what’s happened between now and March. To learn more about Nanny Angel Network and the other inspiring innovators who were selected for the 2019 Astellas Oncology C³ Prize, visit the C³ Prize website or follow #C3Prize on Twitter, Facebook and LinkedIn.
This TEDMED Partner Blog Post comes to you from TEDMED 2020 Partner, Astellas.TEDMED is excited to partner with Astellas Oncology on its C³ (Changing Cancer Care) Prize, a challenge that funds the best ideas beyond medicine to improve cancer care for patients, caregivers and their loved ones. The 2019 C³ Prize winners will join us at TEDMED 2020 as TEDMED Scholars, on March 2-4, 2020, in Boston.
We are excited to announce yet another group of speakers who will share their thought-provoking ideas, groundbreaking discoveries and extraordinary passions with us this March 2-4 in Boston, MA. You can learn more about our TEDMED 2020 speakers and their work here.
At TEDMED 2020, be inspired by community led cervical cancer prevention efforts in Rwanda. In the face of drug resistant infections and global epidemics, learn about a novel innovation that’s changing how we fight viruses. Celebrate how a musical visionary is helping us deepen our understanding of the profound impact music can have on all of us.
Scientific inquiry and investigative reporting will come together to help us better understand the global health risks presented by the generic drug boom. We will examine the potential consequences of the rise of accessibility to genetic data and how neuroscience can inform the law and decisions made around human behavior. And, explore how physicians are addressing climate change, one of the social determinants of health and how all of us, as consumers, have a role to play in influencing decisions involving the environment and our health.
We hope to see you in Boston, MA this March 2-4 for these and many other exciting speakers and topics. If you have not registered yet, now is your chance to secure your spot at TEDMED 2020.
Palliative care expert and TEDMED 2018 speaker, Steve Pantilat, is a leader in transforming the healthcare system and creating innovative programs to improve the care and quality of life of people living with serious illness and their families. Watch his Talk, “Why palliative care is essential in the face of serious illness” and read his blog post below to learn more about palliative care.
As people everywhere are living longer, they are likely to spend some portion of their lives, years or even decades, with a serious illness. Receiving a diagnosis of heart failure, dementia, cancer, Parkinson’s disease, emphysema or any of the other countless chronic and life-threatening illnesses is shocking. It can send you into a tailspin with the fear that your life is over. And yet, even in the face of serious illness it is possible to experience great joy, deep love, profound gratitude and strong hope. Finding the best care you can for your serious illness is an important first step. At the same time and right alongside that care, you should get palliative care. Unfortunately, myths about palliative care keep people from asking for it and getting it. Don’t let that happen to you or to someone you love. Here are the truths behind the myths. Bottom line: palliative care can help you live better, happier, and quite possibly longer.
Myth: People with serious illness have to choose between living well and living long.
Truth: Palliative care helps you live better and just as long.
Although many people think that there has to be a trade off between length of life and quality of life and that a path that includes or focuses on palliative care will result in shorter lifespan, rigorous studies show that palliative care can help people with serious illness live longer. In fact there is no study that shows that palliative care is associated with shorter lifespan. The truth is that studies demonstrate that palliative care helps people achieve a better quality of life, eases pain and depression, and reduces the chance that loved ones will experience depression or complicated grief after the person dies.
Myth: Palliative care is just end-of-life care, so if you are not dying now, it’s not for you.
Truth: It’s always the right time for palliative care.
Many people ask when is the right time for palliative care. The answer is that it’s always the right time for palliative care for someone with a serious illness. Of course, if we always wait for the “right time” for palliative care, then palliative care will come near the end of life and be seen as a marker of things going poorly. Don’t be fooled by this self-fulfilling prophecy. Ask for, demand, palliative care whenever you are diagnosed with a serious illness. Palliative care is also of great help to patients and their loved ones near the end of life. A palliative care team, or hospice, at the end of life can help you be comfortable, dignified, and peaceful at the end. And for times when the end of life is more chaotic than peaceful, as sometimes happens, having an experienced team to help out is even more important.
Myth: Palliative care can show you the right way to die.
Truth: There is no best or right way to approach serious illness and end of life.
There is no one right way to approach the end of life, just as there is no one right way to approach life. Decisions about the kind of care you want when faced with serious illness are very personal and based on many issues including your culture, religion, personal experiences and outlook on life. For all the talk about a good death, we can’t really make death good—it’s just sad and filled with grief and loss. Nothing good about that. But we can do our best to make the end of life peaceful, comfortable and dignified. Thinking about it in advance and facing it head on can make it more likely to be peaceful than chaotic. More important, we should focus on living, and making our lives, even with serious illness as fulfilling, meaningful, and good as possible. Palliative care can help.
My grandmother used to sign my birthday cards with the wish that I should live to one hundred and twenty. Moses lived that long and she wished that for me, too. As she got older, my grandmother changed it just a bit. In Hebrew, she changed just one letter and turned the wish upside down. Instead of writing, “live to one hundred and twenty” she wrote, “live to one hundred like twenty.” Live long and live well. My grandmother knew that a good life was as important as a long one. She would have told you to get palliative care, and she would have been right.
At TEDMED 2018 David Asch shared how he advances individual and population health by improving how physicians and patients make decisions in health care and in everyday life, including the use of medical treatments and personal health behaviors. Watch his Talk “Why it’s so hard make healthy decisions” and read his blog post below to understand more about the role irrationality and predictability play in decision making and why behavioral economics is such a powerful tool in health.
Health programs are more likely to be successful if they reflect how real people make real decisions.
If everyone did what was in his or her own best interest, no one would smoke, everyone would wear seatbelts, and most people would skip dessert. The simple observation that plenty of people do things that they know in their hearts isn’t good for them is partly a story about the limits of human willpower. It’s also a story about the trap of assuming that people are rational. We fall into that trap when we believe that helping people understand how to improve their health is enough to help them actually improve their health. Often it isn’t. We often do things that compete with our own best interest not because we don’t know what to do, but because even though we know what to do, we don’t do it.
Do any of these examples sound like you?
Sally is at an event where chocolate cake is served for dessert. Sally knows that the cake will throw her off her diet, but it is right in front of her, and it looks so luscious and, well, the diet can take a break until tomorrow…
Joe knows that regularly taking his high blood pressure medication is one of the best ways to avoid the kind of devastating stroke that dramatically changed his father’s life. But as he heads to bed for the evening and realizes he didn’t take his medication, he decides not to turn around and head back to the medicine cabinet…
Sally and Joe have present bias—meaning that they pay more attention to the outcomes that are right in front of them (like that chocolate cake) than the even-more-important outcomes that are in the future (like losing weight). They aren’t alone. I have present bias, and so do we all.
Reggie buys a lottery ticket on his way to work every day, and he always plays the same number. He dreams about what he’d do if he won, and although the odds are small, people win all the time. And he never misses a day because what if his number came up on just the day he missed buying a ticket!
Like Reggie, each of us sometimes overestimates small chances—focusing on the outcome rather than its likelihood. And each of us sometimes has regret aversion: we hate that feeling of missing out, that life would have been better if only we had done things differently. If only we had bought that stock when it was low. We all feel this way sometimes, just like we all overestimate small chances, and all focus too much on the present and not enough on the future.
Sally, Joe, and Reggie are not behaving in ways that best help them achieve their goals. But they are making the mistakes we all make.
So why do we continue to design tepid health programs based on a belief that people will do as they should? We do so because our first assumption is that people will behave with their own best interests in mind—that they will behave rationally. But often, we are irrational.
Behavioral economics is based on this recognition. We don’t always do what is in our own best interest. Our decisions are subject to emotion, to framing, to social context. But the key contribution of behavioral economics is recognizing we are irrational in highly predictable ways. It is the predictability of our psychological foibles that allows us to design strategies to overcome them. Forewarned is forearmed.
That’s why behavioral economics is such a powerful tool in health. For example, we can use behavioral economics to help people take their medications as prescribed. Perhaps we offer rewards to help them to do so—making the benefits of taking medicine seem relevant today, unlike the potential avoidance of a stroke years down the line. We can set up rewards in lottery formats because the difficulty interpreting small probabilities makes lottery incentives even more potent. We can make patients eligible for rewards only if they took their medicine the day before, harnessing the human tendency to avoid regret.
These approaches work because they see past how we would like people to make decisions and toward how they actually do so. They work because they hitch our health care wagon to the behaviors and mental approaches we already follow. They make the right choice the easy choice because they harness our own, predictable, irrationality instead of trying to compete with it.
We are thrilled to share another round of impressive speakers for TEDMED 2020 this coming March 2-4. These revolutionary thinkers are shaking up the status quo, from transforming how we care for our society’s most vulnerable populations to shifting our perceptions on aging and death, to using AI and crowdsourcing to revolutionize patient diagnosis. We’ll be fascinated by the possibilities of the bio-imaging revolution and discuss the art and the science behind a new platform focused on driving innovation that works toward preventing the next pandemic. The range of topics and ideas shared will inspire us all. You can learn more about the speakers and their groundbreaking work here.
Look out for another speaker announcement coming soon! Don’t miss your chance to register for TEDMED 2020 at our special Early Bird rate. Hope to see you there.
TEDMED: In your 2018 TEDMED Talk, you impart the importance of trying to stop pandemics before they start. You posit one way to begin to do this is to find patterns and test out new solutions for “everyday killer viruses” that can jump from animals to people, like rabies, but are not necessarily pandemics. What led you to choose to study rabies over another virus?
Daniel Streicker: In short, I followed the data and it led to rabies. Just consider the numbers— whereas many viruses jump into people or domestic animals only every few years or every few decades, rabies is transmitted from wild animals into new species every single day, probably hundreds of times over and governments around the world routinely carry out diagnostics on these cases. That means we get a high-resolution glimpse into the host jumping process: which hosts are involved, where it happens and when. The other thing that struck me about rabies was that we already knew so much about its basic biology. The decades of work done before me meant that I didn’t need to waste much time working out the fundamentals and could jump straight into what for me were the most exciting questions about anticipating and blocking transmission between species.
TM: Your research took you to the Peruvian Amazon to study rabies in vampire bats. You mention mudslides, power outages and stomach bugs among the challenges you encountered. What was the most difficult part of working in the field?
DS: I never worried too much about the uncontrollable things like getting sick or natural disasters. It was the things I thought I could control, but couldn’t and the things that seemed straightforward, but weren’t, that pushed me to the limit. In the first two years of the project in Peru, I tried to pack much more in than was humanly possible. Every time a key person arrived late, or our transportation didn’t show up, or bats were mysteriously difficult to catch, the realization that the day was lost stressed me out to no end. My solution was to work harder on less and less sleep. Looking back, I’m surprised the field team didn’t mutiny. After about 6 months, I remember walking down a street in Lima feeling like a sleep-deprived zombie, and suddenly realizing that no matter how much planning and wishful thinking I did, things would almost always go wrong in ways that I couldn’t predict. The only solution was to give myself a few extra weeks on both ends of every trip and go with the flow. That seems blindingly obvious now, but it took a lot of pain and frustration for me to get there.
TM: What impact has your research had on the communities you worked in that were facing a high prevalence of rabies transmittal?
DS: My longer term vision of preventing human and animal rabies by vaccinating bats is still a ways off, but I believe the road to getting there does provide tangible benefits. We have already made some progress with models that forecast rabies risk so this can potentially enable anticipatory vaccination before outbreaks begin, which would save lives. Beyond that, the nature of the work means we get exceptional access to remote communities in the Andes and Amazon that are typically underserved with respect to health access and education. This provides constant opportunities to talk to communities about the research we are doing and what actions they can take now to protect themselves and their animals (for example, using bed nets to prevent human bites or vaccinating livestock). I’d also like to think seeing us capture, handle and collect samples from mysterious animals like bats inspires some natural curiosity in younger generations and might even let them see science as a career possibility.
TM: You shared that you and your team have used genomics to forecast outbreaks and are working on an edible self-spreading vaccine that can “get rid of viruses at their source before they have a chance to jump to people”. What other creative or innovative tactics have you and your team employed in your efforts?
DS: One of my favorite things about science is that you occasionally get the chance to chase unconventional ideas. One of those was a recent project where a few colleagues and I became convinced that it might be possible to use machine learning to mine the genome sequences of viruses to predict what host they came from. This was a major challenge since when new viruses emerge, it’s almost always from a non-human animal, but it can take years or even decades of experiments and surveillance to find the culprit and while all that research is happening, the disease is free to emerge again. Although there’s still a lot of work to do in this area, we ended up developing algorithms published in Science that when provided, just a single viral genome can instantaneously predict which kinds of animals the virus came from. That effectively narrows the short list of animals for researchers to consider and in some cases could even guide how outbreaks are managed in real time to limit onward transmission.
TM: What do you see for the future of virus control/eradication?
DS: I think right now is an incredibly exciting time for disease control. We have technologies at our fingertips that just a few years ago were almost unimaginable. Transmissible vaccines are the example I discussed in my Talk, but other approaches like engineering pathogen resistance into hosts or using natural enemies or symbionts to control human pathogens like malaria or dengue within the mosquito vectors that transmit them are also taking off and show great promise. More and more the scientific question is not whether these tools work in the lab (we know they do), but how to apply them in the real world. That creates an interesting interdisciplinary challenge that will need to involve collaborations among the laboratory scientists developing the technologies, the field biologists who understand the natural systems, the epidemiologists who can project the outcomes on disease transmission, and the social scientists who can evaluate the economic costs and acceptability to the public. That last challenge is crucial since interventions in natural systems, particularly those involving genetic engineering of hosts or vaccines, are bound to be controversial. My view is that it’s vital to recognize in these situations that inaction costs lives. Rational, evidence-based assessment of the risks and benefits of these technologies will be increasingly important so we can actually realize the potential that new technologies have to transform human and animal health.