Millions of people in low-income countries live with debilitating diseases such as schistosomiasis caused by parasitic worms. But despite having impacts similar in scale to malaria and tuberculosis, treatment of these neglected tropical diseases (NTDs) caused by parasites receive much less funding for treatment and research.

A new initiative led by Imperial College of London researchers‎ will leverage state-of-the-art technologies and new computer simulation techniques to test a more comprehensive set of interventions to break the transmission of these parasites in rural Ethiopia. If successful, this work could provide a model for similar initiatives in rural communities around the world. 

If you want to do this kind of globally-impactful research for communities that need it most‎, the online Global Master of Public Health degree lets you work alongside Imperial College faculty from anywhere in the world. 

A Comprehensive Package of Interventions

‎The Imperial College-led research initiative is being conducted in the Wolayita zone in south-east Ethiopia, home to 2 million people.‎ In Ethiopia, as elsewhere, current national programs rely almost exclusively on drug treatments to attempt to mitigate the impacts of parasitic infections.

Mathematical models developed by Imperial researchers suggest that  there is potential to break the transmission of these infections by combining drug treatments with other types of interventions.‎ in collaboration with local non-government organizations and the Ethiopian Ministry of Health, the project team will implement additional provision of water, sanitation, and hygiene (WaSH) resources and related behavior change communications alongside the distribution of deworming tablets. 

This project will be the first attempt to implement this package of interventions at scale in a low-income country, but it is also groundbreaking because of the monitoring technologies used. Researchers are using biometric fingerprint technology from Simprints to identify and track 200,000 participants over the course of the five-year project. By creating a verifiable register of those living in Wolaita who are complying with the treatment, researchers will be able to develop a robust dataset that can be analyzed to provide insights for parasite control policies.

‎Think Global, Collaborate Local

The London Centre for Neglected Tropical Disease Research at Imperial College London is heading up this research, providing the mathematical modeling underlying the project as well as technical support and capacity-building for their collaborators at the Ethiopian Public Health Institute. Ethiopia’s Federal Ministry of Health will be responsible for distribution of the deworming treatments, and World Vision Ethiopia will lead on WaSH infrastructure and associated behavior change communications activities.

This kind of close collaboration with government and non-government institutions alike is characteristic of Imperial College’s global approach to solving pressing public health challenges at the local level. If this aligns with your goals for your public health career, the online Global Master of Public Health degree gives you an opportunity to work with Imperial faculty from wherever you are.

Second-hand smoke kills over 880,000 people every year globally, and a quarter of those deaths are among children 14 years or younger. These sobering statistics have helped drive smoking bans in public places in many countries, but these bans still cover just 20% of the world’s population.

A new study led by Dr. Thomas Hone of Imperial College of London’s School of Public Health has strengthened the case for expanding of these measures by examining the effects of public smoking bans on infant and neonatal mortality in Brazil. The results have already caused a stir, with coverage in major Brazilian media outlets like Agência Brasil and Globo.

This research adds to Imperial’s track record of impacting public health debates in countries around the world – and now, students anywhere in the world can be a part of this high-profile work by enrolling in Imperial’s 100% online Global Masters of Public Health program.  

Impacts of Different Types of Smoking Bans

Exposure to second-hand smoke can have significant, lasting health impacts on children. In the womb, second-hand smoke can negatively affect fetal development and increase risks of pre-term birth and low birth weight, and infant exposure can increase the risk of sudden infant death syndrome (SIDS), lower respiratory tract infections, and asthma.

Brazil has established itself as a leader in tobacco control internationally, beginning with a 1996 law implementing a partial smoking ban allowing smoking in separate and/or ventilated spaces, which helped reduce smoking prevalence from 34.8% in 1989 to 14.7% in 2013. A comprehensive federal ban took the next step in 2014 by completely prohibiting smoking in all enclosed public places, with no exceptions for separate smoking sections or ventilation (which is often ineffective in preventing second-hand smoke exposure).

Brazil is also a particularly interesting country to study because the national smoking ban was preceded by state-level activity, including 9 states introducing comprehensive smoking bans and 17 states strengthening partial smoking bans. This “natural experiment” helped researchers isolate the impacts of the different types of bans from 2000-2016 using a combination of municipal-level data and telephone surveys.

• Comprehensive bans were associated with a 5.2% reduction in infant mortality and a 3.4% reduction in neonatal mortality.

• Partial bans were associated with a 3.3% reduction in infant mortality, but no change in neonatal mortality.

Overall, strengthening smoking bans were estimated to have avoided over 15,000 infant deaths in Brazil, with the majority in the São Paulo and Rio de Janeiro owing both to their large populations and early implementation of comprehensive smoking bans. Notably, benefits were also greatest in municipalities with lower educational attainment and higher poverty rates, indicating significant equity benefits of these policies as well.

International Collaboration for International Impacts

While this research was led by Imperial College of London’s Dr. Hone, the study was a truly international effort. Co-authors hailed from Brazil’s National Cancer Institute and Ministry of Health and the University of São Paulo, the University of Rotterdam in The Netherlands, the University of Edinburgh in Scotland, and the International Union Against Tuberculosis and Lung Disease.

This study was published on the World Health Organization’s World No Tobacco Day, and the goals of this research are similarly international. While the risks of second-hand smoke have led to comprehensive smoking bans in many high-income countries, lower- and middle-income countries (LMICs) have lagged behind – an issue that is often compounded by higher rates of smoking and second-hand smoke exposure.

With one-third of developing countries lagging behind the UN’s Sustainable Development Goal 2030 targets for neonatal mortality, this study of the impact of smoking bans in Brazil could thus be an important catalyst for progress in other LMIC contexts around the world. Public health students and professionals aspiring to make similar global impacts can join Imperial through the online Global Masters of Public Health degree.  

Cardiovascular disease, including heart attacks, strokes, hypertension, and a wide range of other illnesses affecting the heart and blood vessels, is perhaps the biggest public health challenge in the United States. It causes about 800,000 deaths and 6 million hospital admissions every year, and it is a particularly urgent priority for policymakers because it disproportionately impacts lower income groups.

Dietary factors are one of the leading causes of heart disease, and a new study indicates that about 230,000 deaths could be prevented through 2030 in the U.S. with a combination of several specific food policy interventions. The international research team was led by  Dr. Jonathan Pearson-Stuttard of Imperial College London’s School of Public Health, whose new online Global Masters in Public Health degree is making this kind of impact possible for students anywhere in the world.

Comparing Different Food Policy Approaches

Researchers used the US IMPACT Food Policy Model and probabilistic sensitivity analyses to evaluate several potential policy pathways to reduce U.S. cardiovascular disease (CVD) incidence through 2030. Options studied included:

• 10% tax to increase the costs of sugar-sweetened beverages (i.e. a soda tax)
• 10% subsidy to reduce the cost of fruits and vegetables
• 30% subsidy for fruits and vegetables for Supplemental Nutrition Assistance Program (SNAP) recipients
• A national mass media campaign aimed at increasing consumption of fruits and vegetables

In terms of overall benefits, the 10% nationwide subsidy on fruits and vegetables had the biggest modeled impact by far, with about 150,500 CVD deaths prevented or postponed by 2030. By comparison, the 30% subsidy for only SNAP recipients would save 35,100 lives, a 10% soda tax would save 31,000 lives, and a one-year mass media campaign would save 25,800 lives. Altogether, a combination of these policies could save 230,000 lives by 2030.

In addition to looking at overall CVD morality, the study also examined the extent to which these approaches reduced the socio-economic disparities in CVD impacts. While the media campaign and the national subsidy and tax policies had no impacts in this regard, the targeted 30% fruit and vegetable subsidy for SNAP recipients (who are, by definition, low-income households) could reduce the disparity of CVD mortality by about 6%.

Thus, while implementing all of these policies could have the best outcome, the study suggests that fiscal strategies to target the price of fruits and vegetables vs sugary beverages would have a much greater impact than public education and awareness strategies. Moreover, it should be possible to shrink the disproportionate burden low-income communities suffer from heart disease by targeting more aggressive subsidies towards these households.

International Collaboration

While this research was focused on the U.S. context, it was conducted by a team spanning a number of institutions spread across multiple countries. Co-authors of the report hailing from the eastern side of the Atlantic include Dr. Pearson-Stuttard of Imperial College London as well as researchers from the University of Liverpool and the Medical University of Gdansk, Poland.

U.S. institutions were also very well represented, with researchers from Tufts University, the Montefiore Medical Center, Birgham and Women’s Hospital, and the American Heart Association. Collaboration between Imperial College and U.S. researchers is very common; U.S. researchers were the co-authors for nearly 8,000 papers published by Imperial researchers from 2015 to 2017, more than any other country! Additionally, the report drew on support from a grant from the National Institute of Health, part of the U.S. Department of Health and Human Services.

If you’re interested in making this kind of impact on public health and public policy in the US – or anywhere else in the world – the Global Master of Public Health degree from Imperial College gives you a chance to collaborate globally online and on your schedule from wherever you are.