Meningitis, malaria and malnutrition are the biggest health challenges for the Sahel region – a geographical area just below the Sahara desert that encompasses portions of 10 African countries.
In January, the Epicentre Medical Day in Niamey, Niger, brought together researchers, public health experts and government officials to discuss best practices and ongoing issues for the country and the Sahel region. Epicentre Africa serves as the research and training arm of Médecins Sans Frontières (MSF), or Doctors without Borders, with centers in Paris, Uganda and Niamey.
I sat down with Prof. Yap Boum II, Regional representative for Epicentre Africa, and John McConnell, Editor-in-Chief of The Lancet Infectious Diseases, who shared their views on creating inclusive multilingual research systems; opportunities and challenges in health research; and emerging trends in the field.
Can you share your thoughts on multilingualism in health research, and francophone research in particular?
YB: Multilingualism in health research is one solution to address the challenge of exclusion of researcher to global health because of their language. Francophone researchers, for example, have no or limited access to global health because they do not speak English. This happens not only for the scientific publications that they cannot read or publish but they are also excluded from the international scientific conferences where they cannot interact, and lastly from the funding call they cannot apply too. Therefore translation plays a huge role in ensuring that no one is left behind because of their language.
JM: The dominance of English as the language of scientific communication can be a barrier to researchers from non-English speaking countries who are not bilingual. The language barrier limits the ability of researchers to get published, to have their research disseminated and discoverable, and to read the scientific literature.
John, please tell us more about The Lancet’s multilingual abstracts project.
JM: As a first step in tackling this issue, The Lancet journals are offering to publish translated abstracts of research articles in the language of the country from which the article originates. The translation will be provided by the authors of the paper and published as an online appendix. Although I doubt journals will ever have the resources to publish full-text translations in multiple languages, improvements in translation technology might eventually break down language barriers.
During the current coronavirus outbreak, we are offering to make available Chinese translations of entire articles (not just the abstract) if authors are able to provide these.
Yap, do you envision technology playing a significant role in enabling multilingualism in research in the future?
YB: During our Medical Day in Niamey, the use of a translator ensured that all our non-francophone guests could contribute. Similarly, the automatic translation using machine learning will be a game-changer in the access to health research without any barrier. Though there will be some adjustment needed, automatic translators will catalyze great initiatives such as the one taken by The Lancet journals to publish abstracts in French with the original English manuscript as a supplementary annex. With time, we will put a bit of order in this health research Tower of Babel!
On local solutions
What is the importance of stimulating and supporting high quality health research in low- and middle-income countries? Arguably, both the approach and results could be more relevant to the issues and practice in those communities.
JM: Every country has its own unique health challenges, many of which can be shared with other countries in the same region and at the same level of economic development. In the long-term, the health challenges of low- and middle-income countries cannot be solved by parachuting in expertise and technology from high-income regions — human and technological resources, along with a research-friendly environment, need to be stimulated, developed and maintained in the places where they are needed. In this regard, an encouraging aspect of the Chinese-built ultra-modern hospital in Niamey that I had the opportunity to visit during the Epicentre Medical Day is that it provides a place for expert local healthcare professionals to practice and apply their skills locally – as well as to train others.
YB: The aim of health research is to provide evidence that can improve health toward better quality of life. Considering that the South carries the highest burden of disease, they are the most in need for homegrown and innovative solutions that can improve their healthcare system. These regions need local research that can address global health issues – to find effective local solutions.
Can you share some examples of homegrown solutions with us?
YB: At the Epicentre Niger Research Centre, we assessed the efficacy of a Rotavirus vaccine that targets diarrhea – a disease quite common in the Sahel region. We found that this vaccine remains highly efficient even after exposure of high temperature (35°-40°C) during more than three months. This is the kind of evidence that changes the fight against diarrheal diseases in countries where temperatures rise beyond 40°C during the dry season. Similarly, we need to find evidence for the new generation of Meningitis Vaccine for children below 2 years. With that evidence, the 22 million children born yearly in the African countries, and affected by meningitis, will be fully protected.
On future trends
John, what are shifts and trends that you see emerging, especially within infectious diseases field? Do you see research becoming more interdisciplinary?
JM: As the current coronavirus outbreak that started in China is showing, the pace of research in infectious diseases can move incredibly quickly. Much of this speed of action I put down to developments in molecular biology over the past 30 to 40 years, which allowed identification of the causative coronavirus, development of diagnostic tests, and sequencing of entire viral genomes, all in a matter of days. And an internet-connected world allows the instant spread of information. Molecular biology is also a vital aid in diagnosis and understanding of disease processes across all fields of healthcare. It’s arguable whether this new world of digital health information has yet had a profound impact on disease prevention and treatment, but it can only be a matter of time.
Yap, in terms of moving from research to practice, do you see new research trends become more relevant, or more rapidly applicable, for emergency response on the ground?
The future of health research will include the use of AI in different levels of the healthcare system. The use of AI in diagnosis, for example, will allow more accurate screening of disease at the lowest levels of the healthcare system and in the most remote places. It will have a critical impact on disease surveillance and therefore speed up the response to an outbreak. Because of the low- and middle-income countries suffer from a lack health resources, there is more need to find accurate ways to care for patients in the most remote places. The use of AI in diagnosis and e-medicine will need to be assessed and validated to avoid unforeseen adverse effects, but it is quite an attractive development nonetheless.
Yap Boum II, MPH, PhD
Regional Representative for Epicentre Africa, Co-Founder of Kmerpad and iDocta
Prof. Yap Boum II is the Regional Representative for Epicentre Africa, the research arm of Medécins sans Frontieres (MSF), also known as Doctors Without Borders. He is currently based in Yaoundé, Cameroon.
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From 2009 to 2014, Dr, Boum headed the Epicentre’s research base in Mbarara, Uganda, leading research projects on tuberculosis and malaria among others. He was in charge of the Coordination for the use by MSF of the vaccine against Ebola, VSV-ZEBOV, during outbreaks in West Africa and more recently in Democratic Republic of Congo.
Dr. Boum teaches Public Health and Microbiology at Mbarara University of Sciences and Technology (Uganda), where he has a professorship, and at the Universities of Virginia (UVa), Yaoundé I and Douala (Cameroon). He has held an array of leadership and advisory positions on national and international scale. Presently, Dr. Boum serves on the editorial boards of the Journal of Health and Human Rights and the Public Library of Science (PLOS) and BMC Infectious Diseases.
Boum is also co-founder of Kmerpad, a nonprofit that developed washable sanitary pads to empower women, allow them to fully participate in their education and limit the waste generated by the use of non-reusable sanitary pads. He also co-founded iDocta, a digital platform that take healthcare services to the community.
In all his work, Dr. Boum is inspired by the vision of a healthy and wealthy Africa. As an Archbishop Desmond Tutu Fellow, he aims to promote the creation of a critical mass of young Africans to find homegrown and innovative solutions to address the social and public health challenges Africa faces.
Editor-in-Chief, The Lancet Infectious Diseases
John McConnell was the founding editor of The Lancet Infectious Diseases in 2001.
He gained a degree in clinical microbiology and parasitology from the University of East London, before spending six years researching septic shock-related topics at the Royal Postgraduate Medical School, Hammersmith Hospital, in London.
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John joined The Lancet in 1990. He was a peer-review editor for several years, and in 1996 was the first editor of the journal’s website. In addition, he was a member of the organising committees for conferences on influenza in Singapore and Beijing, on healthcare-associated infections in London and Beijing, on mass gatherings medicine in Jeddah, on HIV in San Francisco, on viral hepatitis in Shanghai, and chaired the organising committee of the 2016 Royal College of Physicians of Edinburgh Infectious Diseases Symposium.
John has authored research papers, editorials, and commentaries, and delivered lectures on academic publishing and infection-related topics. John has appeared as an expert commentator on BBC, ITV, Channel 4, Sky News, Al Jazeera, CNBC, CNN, and CCTV America, on regional and national radio, and in national newspapers.
In 2011 he was awarded Fellowship of the Royal College of Physicians of Edinburgh.
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