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Allen School News Message from the Director

Message from the WSU Senior Director of Global Health

Sitting around a campfire in Ndutu in northern Tanzania while enjoying a cold beverage was, perhaps, an unlikely “think tank” location. Having spent the day with our rabies vaccination team in the Serengeti District, Bryan Slinker, dean of the WSU College of Veterinary Medicine, WSU alumnus and veterinarian Dr. Kyle Frandle, Dr. Kathy Richmond of the Paul G. Allen Family Foundation, and I brainstormed about how to get the needed grassroots involvement by people in developed countries to make rabies elimination a reality. The primary challenge is that rabies is truly a neglected disease and its burden in Africa and Asia is largely unrecognized in the United States and other developed countries. The outcome of the discussion was the incredible opportunity represented by the over 60,000 veterinarians in the United States engaged in companion animal health care. Each doctor is an expert in rabies vaccination and collectively they serve 180 million pets, providing the focal point to spread the message about the burden of rabies and that it can be eliminated. The “big idea” aside, it was critical to learn how to work with private practice veterinarians to capitalize on their expertise and public engagement without interfering in their dayto-day clinical work. Veterinarians and their staffs jumped in and worked with our communications and development teams to create a process that met these goals. Remarkably, these veterinarians took it on to financially support the elimination campaign by donating funds every time they vaccinate for rabies in their own clinics. You can read more about two of these leaders, Drs. Tim Kraabel and Beth Fritzler, in this newsletter. They are emblematic of the numerous veterinarians who have made this mission their own. Five years after the campfire discussion, the number of participating veterinarians continues to grow—each one bringing our collective goal of eliminating human suffering due to rabies ever closer. Thank you from all of us at the Allen School, and especially on behalf of the people their support protects against rabies.

Guy Palmer
Creighton Endowed Chair and
WSU Senior Director of Global Health

Message from the WSU Senior Director of Global Health

Our encompassing goal is to improve public health and catalyze human opportunity through research, teaching, and outreach. To achieve this goal, it requires committed individuals. In October, we celebrated professor Kariuki Njenga who was elected to the National Academy of Medicine. It is described as “one of the highest honors in the fields of health and medicine and recognizes individuals who have demonstrated outstanding professional achievement and commitment to service.” Read more at go.wsu.edu/Njenga. This richly deserved recognition adds to the national and international reputation of the Allen School faculty. All of WSU’s National Academy of Medicine members are Allen School faculty, six are fellows of the American Association for the Advancement of Science, and six are members of the Washington State Academy of Science, including professors Doug Call and Jon Yoder who were elected earlier this year. Election to these bodies reflects not only the highest levels of scholarship, but also a commitment to serving society through science. As impressive as these achievements are, they are in many ways only the “tip of the iceberg.” The Allen School has an outstanding group of young faculty, already widely recognized among their peers for their accomplishments, who will undoubtedly emerge as the next generation of nationally and internationally recognized fellows and academy members. I look forward to seeing how they help meet our goals to improve health and opportunity for everyone, everywhere.

Guy Palmer
Creighton Endowed Chair and
WSU Senior Director of Global Health

Message from the WSU Senior Director of Global Health

The Allen School, and the broader global health programs at WSU, would not exist today without the support of Paul G. Allen and the over 300 individual donors who continue to invest in our mission. This support catalyzed the University’s subsequent investment in the Allen School and has dramatically changed the global health landscape at WSU. Over the past four years, our federal research support, principally from the National Institutes of Health and the Centers for Disease Control and Prevention, has increased more than 300 percent, demonstrating the multiplier effect of initial philanthropic support. Perhaps more impactful than this catalytic effect, donor support drives innovation in ways that state and federal support cannot. Multidisciplinary research such as demonstrating the linkage between livestock vaccination and secondary school education for girls in rural Kenya, highlighted by National Public Radio for its innovation, falls outside any funding agency’s remit. Similarly, current research on drivers of antibiotic resistant microbes in Guatemala and how to reduce the emergence and spread of this resistance requires strong international partnerships between universities and indigenous communities—all made possible with philanthropic support. But the greatest impact of donor support, independent of size, is the confidence placed in the faculty, staff, and students in meeting our mission of improving public health. We take your support to heart and pledge to ensure it makes a difference in human health and opportunity.

Guy Palmer
Creighton Endowed Chair and
WSU Senior Director of Global Health

Message from the WSU Senior Director of Global Health Summer 2017

“Build a better mousetrap and the world will beat a path to your door.” Ralph Waldo Emerson’s famous aphorism may apply to mousetraps, but certainly not to all inventions, even those with potential to markedly improve lives and livelihoods. To the contrary, one of the great challenges in global health and development is to understand what determines whether a technology—such as a new vaccine, water collection system, or improved crop variety—is adopted and used. While the Allen School is heavily engaged in the discovery and development of new disease prevention and treatment tools, we are also mindful that these advances are only impactful if they are adopted. As you will read in “Notes from the Field,” interdisciplinary doctoral student Zoe Campbell is conducting research in Tanzania to understand why households decide to vaccinate their chickens, a critical nutritional and economic resource for smallholder families in east Africa,
against the leading cause of poultry death, Newcastle disease. While research has shown the vaccine is highly effective, use among rural households remains low. By understanding what factors lead a household to adopt the vaccine and those constraints that limit adoption, we can develop strategies to overcome the barriers to widespread use and ensure the full benefit of the vaccine. Importantly, women most commonly make the decisions on household chicken production. Understanding how women in low income and vulnerable communities make decisions is critical to improving health, not only in Africa, but here in the United States. In collaboration with WSU’s School of Economic Sciences, the Allen School has successfully recruited a new faculty member with specific expertise in female gender decision-making and the impact on health. Dr. Shanthi Manian will join WSU in August, strengthening our capacity to not only discover and develop new technologies, but to ensure they have the impact on health and opportunity that is central to the Allen School’s mission.

Guy Palmer
Creighton Endowed Chair and WSU Senior Director of Global Health

Message from the WSU Senior Director of Global Health Spring 2017

Who would even think to investigate whether there’s a link between cattle vaccination rates and girls’ high school attendance, asked National Public Radio. We would. As you will read in this newsletter, Dr. Tom Marsh, who is jointly appointed in the School of Economic Sciences and the Paul G. Allen School for Global Animal Health, led an interdisciplinary research team to learn how households decide whether to vaccinate for East Coast fever, a leading cause of cattle illness and death in East Africa. The team quantified the economic benefits of vaccine adoption, but took it one step further to estimate how those financial gains were then used for broader societal goals, including investment in childhood education. This study, which is ranked in the top 5 percent of all research outputs ever tracked by Altmetric, exemplifies two of the founding principles of the Allen School. First, that innovative technology such as the vaccines and drugs that our scientists research only makes a difference if used. Thus, understanding the decisions that drive people to adopt (or not adopt) these products is essential for ensuring our innovation has real-world impact. The second principle is our commitment to interdisciplinary approaches and the integration of social and economic sciences with biomedical research. Meeting our goal of improving public health and enhancing human opportunity requires the expertise found in a comprehensive research university. The work by Marsh and colleagues demonstrates the impact when disciplines work on a common challenge.
Guy Palmer
Creighton Endowed Chair and WSU Senior
Director of Global Health

MESSAGE FROM THE WSU SENIOR DIRECTOR OF GLOBAL HEALTH

Educating the “next generation” of leaders across the full spectrum of global health—from basic research that discovers new solutions to translating these discoveries into practice and policy—is central to the Allen School mission. The opportunities created by our faculty have attracted an incredibly international graduate student body: 65 percent of our students come to the program from outside the United States, representing over 20 different countries. Last year we initiated a new program with support from the Bill & Melinda Gates Foundation that provides doctoral training for an integrated cohort of students from the United States, United Kingdom, and several African countries. By training side by side, students will develop a professional network that will extend long past their graduate education as they emerge as global health leaders. Importantly, the research takes place in east Africa, allowing the full cohort to develop the skills required to discover, develop, and implement solutions in the regional context. As you read in this issue’s “Notes from the Field,” Ashley Railey describes a day conducting eld research on foot and mouth disease in northern Tanzania. Her story illustrates the highly interdisciplinary research and the opportunities to study in a unique and challenging environment. That these challenges and opportunities are shared among all the students in the cohort provides a common understanding and a framework that will increasingly pay dividends as these individuals emerge as the next generation of leaders.

Guy Palmer
Creighton Endowed Chair and WSU Senior Director of Global Health

Message from the WSU Senior Director of Global Health | Fall 2016

Early next year the Allen School will celebrate its 10th anniversary. We are starting the festivities early with the appointment of Dr. Tom Kawula as the new director. Tom brings a rare combination of talents including internationally recognized scholarship, educational leadership, and a commitment to the humanitarian values, which are central to the school’s mission. As a renowned infectious diseases scientist, Tom adds to the breadth and depth of expertise in zoonotic diseases within the faculty. But it is his record of innovation in graduate education and his dedication to mentoring students, fellows, and young faculty that caught the attention of the search committee. Allen School students engage in multiple graduate programs at WSU, reflecting the diversity of disciplinary expertise needed to address global health problems, and conduct research in multiple global sites as well as in the Allen Center’s state-of-the-art laboratories. Innovative global health education, especially in equal partnerships with institutions in developing countries where demand is rapidly increasing, will be a challenge and an opportunity for WSU and the Allen School. Tom’s experience and expertise will be an ideal fit. In terms of timing, Tom’s arrival comes as an exciting chapter unfolds at WSU with the development of the new Elson S. Floyd College of Medicine. Tom spent most of his career in the University of North Carolina School of Medicine, but also has experience at two colleges of veterinary medicine, a combination that will help guide WSU in maximizing our collective impact to improve health for everyone, everywhere. On behalf of the faculty, staff, students, and our incredible network of donors, we welcome Tom and can’t wait to see what the next 10 years brings.

Guy Palmer
Creighton Endowed Chair and WSU Senior Director of Global Health

Message from the WSU Senior Director of Global Health | Summer 2016

Close to one billion children worldwide are infected by soil-transmitted helminths, better known as worms. Infected children are nutritionally, physically, and cognitively impaired—robbing them of their full human potential.

There are multiple global efforts to eliminate this burden, primarily by mass drug treatment. Logically, these treatment efforts focus on administering medication at schools to reach a large number of children at one time. But for pastoralist families, who are often semi-nomadic, there are large gaps in coverage. These hard to access children are critical to global campaigns for their own health and to eliminate a source that can later reinfect already treated children.

Fortunately, the Allen School has worked for several years with pastoralist communities in connection with our partners in the Serengeti Health Initiative. Dr. Felix Lankester developed a strategy to link rabies vaccination of dogs in the pastoralist communities with mass drug treatment to eliminate worms. At first glance, these two efforts, vaccination of dogs and drug treatment of children, may appear incongruous, however Dr. Lankester knew that years of rabies vaccination campaigns had gained the trust of the pastoralist communities and that this would allow unique access.

With funding from the Bill & Melinda Gates Foundation, Dr. Lankester has implemented this program with the goals of increasing coverage for both the drug treatment and the rabies vaccination—and to save costs by combining transport and personnel costs. This effort illustrates the Allen School’s faculty commitment to not only implement, but to lead through innovation. As always, on behalf of the Allen School faculty, staff, and students, our global partners, and, most importantly, the people we serve, thank you for your continued support.

Guy Palmer
Creighton Endowed Chair and WSU Senior Director of Global Health

Message from the WSU Senior Director of Global Health | Spring 2016

When people say “it takes a village,” they are saying that the power of many is greater than the power of one. Collectively, we can accomplish goals that are beyond our individual reach. Meeting the goal of eliminating rabies as a cause of animal and human suffering by 2030 will indeed take a village. But it also takes leadership. Drs. Tim Kraabel (’87 DVM) and Beth Fritzler (’91 DVM) and their medical staff at Lien Animal Clinic in West Seattle exemplify this leadership. Even though 90 percent of the human deaths from rabies occur in Africa and south Asia— halfway around the world from Seattle—the compassion of the clinic’s staff and clientele for both pets and people led them to act locally for change globally. Roughly 59,000 people die each year from rabies; about half are children. But with the knowledge that human rabies deaths can be eliminated through dog vaccinations, the Lien Animal Clinic donates a monetary portion of each rabies vaccination they give to dogs at their clinic to support village-wide dog vaccinations in Africa. Lien’s clients have also joined this effort with individual donations. Through their generous support, an additional 1,000 dogs will be vaccinated by March 2016. We are grateful for the leadership they have taken to help protect these pets and their families and for bringing us closer to our goal to end rabies worldwide.

Guy Palmer
Creighton Endowed Chair and
WSU Senior Director of Global Health

Message from the WSU Senior Director of Global Health | Winter 2015-16

How does a disease outbreak start? It’s a simple question that doesn’t have a simple answer. Pathogens that cause infectious diseases can remain inactive, safely cocooned in an animal or environmental reservoir, until the conditions are ideal for emergence and rapid spread. Ongoing research in the Allen School illustrates our efforts to find answers to this critical question. The plague is one of the oldest recorded epidemic diseases and was responsible for the Black Death, which reduced Europe’s population by half in the mid-1300s. Today the plague still remains a serious public health threat in endemic regions–those where the disease occurs with some regularity– globally and here in the United States. From April to August 2015, six U.S. states, predominately in the southwest, reported cases of the human plague. Where the responsible pathogen, Yersinia pestis, “hides” between outbreaks is unknown. Recent research by Allen School professor Dr. Viveka Vadyvaloo showed that pestis can infect amoeba, which are single-cell organisms that can live in the soil. Her findings are critical because plague foci are associated with specific soil types. In this scenario, the plague bacterium remains silently inside the amoeba in rodent burrows and then emerges to infect resident rodents and then humans. Understanding what factors trigger emergence can allow targeted surveillance for future outbreaks before they happen. Targeted surveillance is already being used successfully for Rift Valley fever, a highly fatal viral disease of humans and livestock. Similar to the plague, Rift occurs episodically and is linked to climatic changes that favor its mosquito-borne transmission. Professors Kariuki Njenga and Terry McElwain are lead investigators on a new CDC supported effort to increase surveillance in at-risk areas in Kenya—a country previously hard hit by Rift. Given the increased risk in an El Niño year, surveillance, diagnosis, and reporting efforts are currently being ramped up. These approaches allow limited resources to be strategically employed where they will be most effective, supporting our mission to improve public health and human opportunity everywhere.

Guy Palmer
Creighton Endowed Chair and
WSU Senior Director of Global Health