Gillings Around the globe

Six students received funding to attend the 2019 Triangle Global Health Annual Conference on One Health: Creating Our Shared Future — Humans, Animals, and the Environment. Here are their reflections on the day!

Madelaine Katz, MPH student:

My experience at TGHC 2019 conference was wonderful. I had the chance to learn a lot about an area of global health that I am not as well versed in, in the form of environmental health, which was a major topic on panels and plenaries due to the theme of the One Health conference. I was particularly engaged with Dr. Dennis Carroll’s keynote on major globalized trends and their impact on health. I’ve had a lot of opportunities to learn about climate change in general, but the trends such as population change, land use change, and transformative technology were fairly new perspective to me. The fact that the world’s population will be increasing so rapidly over the next 80 years has so many alarming implications for health, especially since people will also be living longer. I am motivated to try in my career to encourage programming that incorporates knowledge of these trends, perhaps most importantly by focusing on the sustainability of health interventions and policy, so that it has overreaching positive impact on future generations wherever possible.

Having the opportunity to present my poster was also very exciting. My poster was based on research of menstrual hygiene policy on a global scale, and suggestions of how it can be more frequently incorporated into policies and guidelines such as the Sustainable Development Goals. Quite a few people came by to speak with me about my poster, it was encouraging to hear from people who wanted to discuss the importance of menstrual hygiene in this multidisciplinary space. It was a great opportunity to practice my research presentation and dissemination skills, and I received some great feedback for future work in this area from other professionals, and was even able to make a few new connections!

I’m so grateful that Gillings provided funds that made it possible for me to be a part of the event, and that I received a chance to share my work on menstrual hygiene policy in this arena. I’m looking forward to following up on the new professional connections I have made, and attending future global health related events in the area.

Brandon Adams, MPH student:

I thoroughly enjoyed the content and wide range of scientific ideas and projects at the conference. For me, the most memorable talk of the day was surprisingly at the beginning. Dr. Dennis Carroll touched on the future state of the world and discussed subjects such as population growth, climate change, and advanced technology. From his discussion, he emphasized the immediate need for change and collaboration across disciplines, specifically in the form of One Health, where professionals that specialize across a range of fields of human health, animal health, and environmental health need to work together to solve the issues that are plaguing this world.

Overall, the experience was certainly a memorable one and a formative point in the development of my career interests and professional goals. In addition, it was great to contextualize the material I learn from the program courses at Gillings and apply it to findings and discussions in the real world from both a global and local context.  As an added note, this was my first professional STEM/global health conference, and I would never be able to attend it without the financial support that I received. I would like to thank the UNC Gillings School of Global Public Health and the respective departments for awarding me this rare and important opportunity.

Kris Sladky, MPH student:

On October 16, I had the privilege of attending the 2019 Triangle Global Health Annual Conference under the theme of One Health: Creating Our Shared Future – Humans, Animals, and the Environment. The format of the conference consisted of morning, lunch, and afternoon plenary sessions, a late morning and afternoon breakout session, and morning and afternoon mingle/poster/tabling sessions. With a variety of breakout panel topics and rooms at each session, over 45 poster presentations on various One-Health-Related topics, and a variety of organizations tabling, this format proved conducive to allowing participants agency in what exhibits, topics, and discussions they engaged in. As for the plenary sessions, each had a keynote speaker, panel, and storyteller, as well as an award presentation. While I thoroughly enjoyed both of the keynote speakers, Dr. Dennis Carroll’s talk in the morning entitled “Six Mega-Trends and Their Implications on Global Health in the 21st Century” really caught my attention. Flowing through statistics on six major areas that are currently experiencing rapid change including population, disease profile, urbanization, climate change, land use change, and transformative technologies, Dr. Carroll explicated how the “globe” is not ready to handle the magnitude of change coming by 2100 in all of these areas, which was frankly frightening. He urged us as public health practitioners to venture out of our “professional silo’s” and bridge the gaps among them in order to work toward solving, or managing many of these coming changes together in an interdisciplinary fashion.

For the morning breakout session, I attended Pathways to One Health Research in Vector Borne Disease. I was most intrigued by Dr. Natalie Bowman’s research on Chagas disease in Peru, and the socio-cultural aspects that contribute to spread of the disease from its triatomine, “kissing bug” vector to humans. In some of the periurban villages in Arequipa, Peru Dr. Bowman worked in, people like to live wall to wall with their domestic animals, which brings humans close to another source of food for the “kissing bugs.” Thus, the bug is drawn to the area of the homes with both their human and animal food sources, making it likely to bite, and infect humans, whereas animals do not show symptoms of the disease. Further, she discussed the difficulty of possible interventions including spraying and using physical barriers in the area, making prevention more challenging. As a trained anthropologist, and One Health enthusiast, I enjoyed connecting some of the more “micro” aspects of the disease covered by Dr. Bowman of an insect-vector-borne illness to the human and environmental challenges in the area.

The lunch plenary consisted of a “Company Showcase” for AgBiome, Locus Biosciences, and Sentinel Biomedical. As a pet lover and owner of multiple cats and dogs over my lifetime, essentially all of whom have passed away from cancer, this company provided incredible insight into their primary mission of advancing animal health by understanding the biological and environmental influences of canine cancer. As a kid, several of our homes were sprayed regularly with Round-Up weed killer, either by outside, private, landlord-hired companies, or by my father. With our cats and dogs constantly outside and exposed to these chemicals, my father (an exotic animal veterinarian and professor at UW-Madison School of Veterinary Medicine) and I have been discussing a theory that maybe exposure to these chemicals (among others on the ground in parks, on pathways, etc.) ultimately caused the cancer in our pets. Matthew Breen, the founder of the company, delineated what the company does specifically, and how they have been using surveillance, and dog tracking systems to keep in touch with the diseases animals come down with. Importantly, Breen made an excellent connection to humans as our pets’ counterparts, bringing up the point of possibly beginning to sequence, and gain more insight on the connections between animal and human cancer. As a cat/dog/animal lover in general, I thoroughly enjoyed Mr. Breen’s presentation, and appreciated his One Health connection, which was the most evident of all of the speakers over lunch.

For the afternoon breakout, I followed my passion for writing and communication and attended the “Reach the People: How to Communicate Global Health Issues and Solutions” session. The panel, mediated by Editor in Chief of Global Health NOW from JH Bloomberg School of Public Health, included Matthew Chamberlin (Director of Communications and Marketing from Gillings School of Global Public Health), Lisa Braziel (Senior VP Ignite Social Media), Leoneda Inge (Race and Southern Culture Reporter for NC Public Radio), and Gavin Yamey (Professor, Duke University). I thoroughly enjoyed Gavin Yamey’s speech. He was engaging and laid out insightful lessons about effectively communicating public health information, including making sure to know your audience. Further, at the end of this session, we discussed the difficulty, as public health professionals and academics, of communicating the results and important messages from our research to laypeople and other academics alike.

The final plenary of the day featured keynote from Dr. Linda Birnbaum focusing on environmental issues and their impacts on human and animal health, as well as a panel entitled “Trouble in Paradise – One Health in the Galapagos Islands.” This panel mixed human anthropology, nutrition, microbiology, environmental science, and veterinary medicine to discuss the conditions affecting humans, animals, and the environment in the Galapagos Islands. The flash talks covered consequences of ocean warming on the Galapagos biome, anti-microbial resistance, the dual burden of nutrition, the threat to sea turtles and marine ecosystems with climate change and human disruption, and the marine environment and how it affects human settlement. Having been interested in the Galapagos Islands since I was a kid, I really enjoyed this panel, and felt it provided the most comprehensive coverage of factors that play into One Health (biology and microbiology, environmental and marine science, anthropology, nutrition, socio-political issues, animal and ecosystem health, etc.).

I am extremely grateful to have been able to participate in this conference. I have developed a passion for One Health throughout my life based on my family background, academic endeavors, love for animals, and concern for the environment, and hope to carry this focus into my future career as a physician, public health practitioner, and professor. Every opportunity to gain knowledge from experts in such a variety of fields, especially in such a welcoming, interdisciplinary setting, should be embraced.

Stephanie Cleland, MSPH student:

Today, 23% of global deaths are linked to the environment, accounting for 12.6 million deaths annually. By 2100, 5 of the 10 most populous countries will be in Sub-Saharan Africa, resulting in increased urbanization, ambient air pollution, and non-communicable diseases. Currently, 9% of terrestrial species are threatened with extinction by 2050, caused by land-use change driven primarily by agriculture related to livestock production.

These are just a few of the alarming facts presented by speakers at the 2019 Triangle Global Health Conference. The speakers used this information to emphasize the importance and complex interconnectivity of the growing field of one health, a concept that extends beyond the health of humans, animals and the environment and into energy, trade, and urban planning. The conference was an incredible opportunity to learn more about one health and connect with students and professionals doing important global health work in the Triangle area. During my poster presentation, I discussed my research on the air quality and acute health impacts of wildfires with Linda Birnbaum, the former director of the National Institute of Environmental Health Sciences. Receiving feedback and guidance from one of the most notable scientists in environmental health is an experience unique to a setting like the Triangle Global Health Conference.

The plenaries and breakout sessions during the conference were particularly impactful for me because they highlighted that the future of one health belongs to youth, the current students and future workers. Speakers emphasized that with collaborative engagement, technical competence, and an enabling environment, we will be able design the next generation of multi-sectoral, community-level solutions to address increasingly complex one health challenges. After attending this conference, I am more motivated than ever to join the growing workforce of one health professionals, where I can lead by example, emphasizing that global health is local health and that developing solutions to complex one health challenges requires flexibility and adaptability.

During the panel on climate change, Juli Trtanj from NOAA made a comment that has stuck with me since the conference. She noted that we observe so much environmental data, from satellites to temperature to land use. Given this extensive access to data, she posed the question: “Why are we still surprised by outbreaks, both human and animal?” She emphasized the importance of leveraging the available environmental data to better predict and prevent outbreaks. Moving forward into my career in environmental health I believe this question will motivate much of the work I do.

Lein Soltan, MPH student:

Dr. Dennis Carrol set the scene for the day’s proceedings with his talk titled “The Future is Coming, Are We Prepared? Six Mega Trends and Implications for Global Health”. He described these six trends as population change, changing demographics, urbanization, climate change, land use change, and transformative technologies. The moral of his story: by 2100, this world will look entirely different. He poignantly preached how we must shift our paradigm from thinking about the world we were born into to the world those born of us will inherit. The major takeaways: Africa will be the center of these global trends and solutions will need to be multi-sectoral. We must revolutionize artificial intelligence to tackle the issues we have been unsuccessful at preventing. While I and likely the majority of the room felt an impending sense of doom at the close of his talk, Dr. Carrol reminded us: Do not panic! It was a wonderful introduction to a day of One Health filled presentations. What I found most sticking about Dr. Carrol’s talk was his insistence that we need to expand One Health to include energy, trade, urban planning, and financing in addition to animals, environment, and people.

Dr. Carrol’s introduction was followed by Rob Salerno from DAI who shared with us “Three Lessons for Moving into Journey”. We must lead by example, recognize that complex problems require flexible and adaptive management approaches, and we must measure impact, performance, and progress. While we are not expected to share the same views on how best to tackle these “wicked” problems, we must move unison towards the same goals.

The climate change panel offered insights into the critical need to advance and streamline disaster related research which is often delayed or missed due to difficulties in funding, slow review protocols by the IRD, lack of ready to go research tools and protocols, lack of inclusion of community stakeholders, and no formal way to coordinate research. The first panelist argues that research must prioritized as part of the public health emergency response in order to answers these two critical questions about disaster efforts: Is it safe? Did our efforts help? He shared how the NIEHS developed a pre-reviewed protocol in May 2015 that would be ready to launch during an emergency. This protocol was used after Hurricane Harvey blasted through Houston and allowed research efforts to commence within two weeks.

We also learned that while sugar beets and sugar cane benefit from increasing levels of carbon dioxide, most other crops suffer and we are seeing yields consistently declining. The panel wrapped up with a discussion on how ocean species are sentinels for climate change. We are not untouched by the issues we see in the ocean as was demonstrated by the recent salmon die off in Alaska and the increasing incidence of cholera and vibrio outbreaks.

After a brief poster session break, I attended the advocacy workshops led by two member of FHI 360. They shared FHI 360’s nine steps to developing an advocacy strategy. We focused on step three: identifying target audiences and participated in stakeholder analysis and power mapping activities using Zika in Puerto Rico as a case study. The major takeaways from this workshop were that you need to be flexible and systematic in your advocacy approach.

Throughout the rest of the day, I learned about the methods of tick surveillance in North Carolina, how we can use dogs as sentinels for human health, and finally, about One Health in Galapagos. In this panel, Dr. Adrian Marchetti shared the four major threats to ocean environments (climate change, invasive species, marine pollution, and over-exploitation of marine resources), Dr. Amanda Thompson enlightened us on the dual burden of disease among Galapagos residents (obesity and malnutrition), Dr. Jill Stewart alerted us to increasing antimicrobial resistance in the waters of the Galapagos, and Dr. Greg Lewbart virtually gave us insight into sea turtle wrangling to look for ingestion of plastics.

Dr. Linda Birnbaum closed out the day and shared her forty years of expertise on environmental air quality and predictive toxicology – that is utilizing organisms with common biological pathways to predict responses in humans. Here, we learned that 92% of deaths in low income countries are pollution related and that a healthier environment could prevent the deaths of 1.7 million children under five years of age.

Thank you UNC Gillings for allowing to engage in this wonderful day of learning how to tackle some of Earth’s most challenging and salient issues. It is truly exciting to see the how the One Health movement is at play across various disciplines!

Lilly Smith, MPH@UNC student:

Attending the Global Health Triangle Consortium annual conference expanded my knowledge of public health and excited me for a future career in this field. I found out about the conference through the UNC MPH email newsletter when the topic of the conference caught my eye: One Health. My interest in public health comes from the veterinary medicine field and previous studies had lead me to learn about this framework of looking at how the health of humans, animals, and the environment interact. Speakers at the conference came from a variety of disciplines but are all working towards improving global health. 

One of the keynote speakers, Dennis Carrol, laid the foundation for the conference by discussing six mega-trends and their implications for global health in the 21st century. I enjoyed the breakout sessions I attended on “Strengthening Human and Zoonotic Disease Surveillance in Burkina Faso, Mali, and Sengal” and “One Health Efforts Are Likely to Fail Unless Partnerships Are Gained with Agricultural Industries and Food Animal Veterinarians”, which both touched on areas in which I would like to work in the future. I learned about companies working on exciting new techniques such as using data collected on cancers in dogs in order to learn more about cancers in humans and using CRISPR techniques to kill bacteria as an alternative to antibiotics. 

I enjoyed reading posters about public health research and talking to students who have performed a variety of research. The conference afforded great opportunities to network with professionals and other students. As an online MPH student, it was exciting to meet a few of the other UNC students!