In this interview, Dr. John Amuasi, MBChB, MPH, MS, PhD discusses the impetus and hopes for the African Researchers' Small Grants Program - an effort supported by the African Research Network for Neglected Tropical Diseases (ARNTD), the U.S. Agency for International Development (USAID) and the Coalition for Operational Research on Neglected Tropical Diseases (COR-NTD).
As ARNTD's Executive Director, Dr. Amuasi led the charge for the creation of the new funding program, which supported the work of six early and mid-career researchers based in Africa to tackle barriers to the control and elimination of neglected tropical diseases, or NTDs, in their home countries. The selected researchers are based in Cameroon, Nigeria, Tanzania and Togo, and their work focuses on all five of the NTDs addressed by preventive chemotherapy, or PC-NTDs.
This interview took place on November 4, at the fifth annual COR-NTD Meeting in Baltimore, Maryland.
- Small Grants, Big Impact: Dr. Humphrey Mazigo, Mwanza, Tanzania
- Small Grants, Big Impact: Dr. Regina Ejemot-Nwadiaro, Cross River State, Nigeria
- Small Grants, Big Impact: Dr. Pythagore Fogue, Dschang, Cameroon
- Small Grants, Big Impact: Dr. Monique Dorkenoo, Lomé, Togo
- Small Grants, Big Impact: Dr. Mabula Kasubi, Muhimbili, Tanzania
- Small Grants, Big Impact: Joy Chikwendu, Makurdi, Nigeria
Photo: Dr. John Amuasi poses with four of the six inaugural winners of the African Researchers' Small Grants Program and Dr. Isaac Osei, Scientific Officer for ARNTD, at the 2017 COR-NTD Meeting in Baltimore, MD. From Left: Dr. John Amuasi, Dr. Humphrey Mazigo, Dr. Regina Ejemot-Nwadiaro, Dr. Monique Dorkenoo, Dr. Mabula Kasubi and Dr. Isaac Osei. NOT PICTURED: Dr. Pythagore Fogue and Joy Chikwendu. MACKENZIE BATES/NEGLECTED TROPICAL DISEASES SUPPORT CENTER
The Small Grants Program (SGP) from ARNTD and USAID is giving the opportunity for researchers in several countries to expand on their work with neglected tropical diseases (NTDs). How did this initiative to have this grant available to these six individuals come up?
The small grants is a culmination of discussions that started about two years ago with Emily (Wainwright), Joe (Shott), Pat Lammie and a bunch of others who I and a couple of others approached with the idea of support for African researchers to engage in operational and other research which would be useful or informative to the entire NTD community and especially towards the elimination agenda. The initiative stems from the belief that there is a lot of potential among researchers on the African continent, but many of them just haven’t had the opportunity to put their skills to the test or to the greatest use that they could because of the relatively limited opportunities that African scientists have to lead some of the important research that informs policy and other decisions toward elimination and control of NTDs. So Pat, Emily and Joe and others bought in to this idea and that kickstarted the move towards the Small Grants Program.
Could you take me through the process of selecting these researchers that earned the SGP opportunity? How many applied?
We tried to make this process as rigorous and transparent as possible, especially for us at ARNTD, because this is the first ever of its type. We appreciate the faith and the confidence that USAID and COR-NTD have imposed in us to give us this opportunity so we wanted to make this as right as possible. We started by launching an online call. There was an online form which was created in application form that collected all of the applications. The applications, as you know, were open to all African-focused NTD researchers. The applications came in close to 100 of them and we screened the applications for the meeting the criteria of the call - which was that the application must be focused on the PC-NTDs and focuses on the exclusions that they have to be there because of federal government regulations. We screened and then we came up with about 60 and then we screened further and we developed a review of criteria. The ARNTD management board, which also serves as a scientific review board, did the first round of the reviews of the applicants. We had a scoring system so we developed a review guide to score all of these. All of those who met the minimum score were then forwarded for a second round of reviews at the USAID and COR-NTD level and that resulted in the choice of six (individuals).
Those decisions could not have been easy.
No. It was certainly not easy. But I think it was a good process to go through and the right thing to do. I think we got the best out of the lot paired with the criteria that we set.
How proud are you of each of the six SGP recipients?
We’re very proud for many reasons, of course certainly of all researchers who work in Africa, but again for two important reasons with the distribution. We have three females and three males. For me I think that’s great. There wasn’t really any gender bias but it was based on the quality of the submissions. The other thing is the distribution from across the continent. We have folks from West Africa, Central Africa and East Africa as well. I think that’s also a great representation, also.
Your background in medical science spans the globe. You’ve earned degrees in Ghana and the United States. What were the challenges, if any, that you faced while pursuing your career?
It was in my third year of medical school. In Ghana (that’s where I did medical school), we do seven years of medical schools straight for the first degree and then you continue and they do the clinical years so all together it’s seven years. So, in my third year of medical school, that’s when I had decided quite firmly that I was going to pursue a career in public health. At the time, that was pretty uncommon and still is that one would decide not to pursue a specialty, but go straight in to public health. So I applied and got in to the University of Minnesota after my two years practicing as a doctor in a teaching hospital. I got a good funding package from Minnesota and then I came back and I realized I needed to go further and do a PhD because I wanted to get in to research and public health. I went back and got a good offer again from Minnesota. I got a good offer from Johns Hopkins right in here in Baltimore, they offered me a PhD in international health, but Minnesota gave me a better offer and I knew the place so I went back there. After my Master’ when I came back to Ghana, I was actually placed at a lower level from my colleagues because I hadn’t pursued a traditional career pathway. So, I was actually earning lower than my colleagues but that didn’t bother me too much because I knew exactly what I wanted to do. Many people also realized that I had accomplished a lot within a short space of time. This was sometimes a challenge because some people have known you since you were much younger and some are able to accept their achievements and take the worth of it and others have a hard time dealing with it. Those were some of the challenges. Albeit, it’s been never a dull moment. The challenges are what make it exciting.
The ultimate goal for anyone in the public health field is to not only control and eliminate NTDs in not just Africa, but the entire world.
This is definitely one of the objectives to make sure that these diseases no longer have the level of negative impact that they have. For me, the key thing which I always like to remind everyone of is the fact that these are the diseases of the poor. It’s the poorest of the poor who on the account of the social status are so vulnerable to these diseases. It’s not so bad if someone goes on a hike in a forest or camps out somewhere and gets bitten by some black flies and ends up with one of these NTDs, but that’s a different kind of scenario as opposed to somebody living their normal lives and because of their social status and they want to live normal lives, they cannot because these diseases are in so close proximity to them. Eliminating that connection between poverty in these diseases is really at the heart of this fight.
You’ve worn many hats throughout your profession. You’ve worked with organizations such as the WHO, ICTSD, the DNDi among others. How do you balance those obligations while still conducting your own research?
It’s always a challenge balancing all of these. I teach, I run ARNTD and many things. But one I would say is, I have been working like this practically all of my life ever since I was in medical school, balancing many things at the same time. The kind of experience I’ve had as well as education I’ve had has set me up for this kind of thing. I do biomedical research as well as field research. I have a good number of people with whom I work who are very efficient, helpful and who support in many ways the kind of work I do. I do a bit of consulting here and there for different organizations. Yesterday, Cathy Roth came to speak about DFID’s contribution. I didn’t know Cathy was involved in this because last week I was with her in Geneva discussing something completely different – related to bio banking for Ebola. I was in a small meeting with Cathy and I didn’t know she was also going to be here. So many of us wear many, many different hats. When I was coming here on the flight, I spent a good part of the eight-hour flight just working on my student’s thesis, you know, marking it up. So, it’s many things and ultimately if I can chip in here, because I’m a faith person, the grace of God has really brought me this far. This is really, for me, at the heart of it.
With you being the Executive Director of ARNTD, the mission, “To support evidence-based control and elimination of NTDs from Africa by empowering current and future generations of African researchers” is something you take great pride in trying to accomplish. How has your organization kept this undertaking going while hoping Africa one day will be NTD-free?
For us, I think this Small Grants Program is evidence of us pursuing this mission. The Small Grants Program is essentially an opportunity for African researchers to do research that they themselves believe is important - an agenda which is set by them, pursued by them. The interesting thing about this, is that it includes the junior researcher component which is really the future generation of African NTD researchers. So, we’re giving them the opportunity to experience what it means to write a competitive proposal, to get a grant, manage it and do the research and come up with the result and publish it, hopefully. So, I think this Small Grants Program is clear evidence of us staying true to our mission. And this is why I keep knocking on the doors of potential collaborators to really join in this kind of effort. I think it’s noble in many ways, and it’s a win-win for all of us in this NTD fight.
In the process of putting these Q&As together for all six SGP recipients, they don’t see this a small grant. They see this as a big opportunity to help further their research and help their respective countries. That must be very exciting from your perspective.
You’ve hit the nail right on the head. The only thing that’s small in these grants is the money. But the visibility, opportunity in itself, the spring it gives us is not small. There’s nothing small about this except the money and even that, one can argue in the relative scheme of things. We make all of it small in relation to the cash, but in every other way, it’s not small.
What have you been most proud in your time at ARNTD?
I think there have been many exciting moments, aside from the Small Grants Program, which is more continuous kind of exposure I would say I’m very, very proud of. Maybe the one, single blip or event which I’ll call, one very thing I’m proud of was when I was asked to represent ARNTD to address the German Chancellor during the third Geneva International Forum this year in February. So I addressed the German Chancellor on NTDs on behalf of the whole NTD community in the world. I think that for ARNTD and for me was one of our proudest moments.
In your article to the G20 Foundation, you called NTDs a, “complex constellation of diseases.” You’re trying to shed even more light on how these threats are serious not only in Africa, but across the world. With Africa at the forefront of the control and elimination of NTDs, how much feedback and help have you received since the article was released and what has been done to help with this cause?
That article I think is one of those which will always be a reference that one can use to leverage legitimacy, support and commitment from different quarters. The article just came out a couple of months ago during the G20 Summit in Hamburg, Germany. And what I’ve done is to forward this far and wide for the potential to collaborate. We featured it on our website and we publicized in different forums here and there. There are a number of applications we’ve put in which we have referenced this article. So, I think we’ve yet to reap the full benefit of that article and that exposure, but it’s coming along.
What has ARNTD learned from its counterpart, the European Foundations Initiative for NTDs (EFINTD) that has been successful in Africa? In what areas have you improved?
The EFINTD was a one-time activity which the (Volkswagen) VW foundation and a bunch of others put together with the objective of training African scientists. The good thing is, a lot of the EFINTD members have gone on to become very prominent NTD researchers. Many of them are actually here at COR-NTD. Some of them are working with [WHO's Expanded Special Project for Elimination of Neglected Tropical Disease, or] ESPEN now and a lot of them are doing really great, great work. So, it’s that model of bringing people up, give them opportunities and make them beneficial to many others, which led to the formation of ARNTD. For us to have been able to galvanize the success of these individuals, bring others who are not necessarily with EFINTD, in to the ARNTD fold and then together with COR-NTD and USAID to create this opportunity for grants, I really think that’s an expansion of something that started small. This is why again I’ll reiterate that call for support from others to increase the quantity of money so that we can attract even more prestigious African researchers to do work with ARNTD, COR-NTD and USAID and others.
This interview is being conducted on the second day of COR-NTD meeting in Baltimore. Having four of the six SGP winners here, what are you hoping they get out of this meeting?
That question strikes a chord. What really prodded me going in to public health was an exposure I had, an opportunity. This was in the days of the Global Forum for Health Research which doesn’t exist anymore. It was sort of absorbed Council on Health Research for Development (COHRED) in Geneva. So I applied and was invited to attend the 5th Global Forum for Health Research. That exposure, hearing research from all over the world, hearing about disparities, hearing about research methodology and approaches to addressing issues related to poverty and how that impacts public health and health outcomes changed my way of thinking. I do not downplay the opportunity to expose people. It’s exposure that generates thinking. Exposure, just like in a disease, you get exposed to pathogens. You develop antibodies and the body responds in a certain way, good or bad. Exposure always elicits responses. This is a good exposure. It will elicit a response, which can be of immeasurable magnitude down the line.
The funding partners with ARNTD, USAID and COR-NTD, it could not have been accomplished without their help.
Absolutely. I have spoken to a few of the partners and I can tell you that some of them tell me quite bluntly, “Well, we’re watching how this goes and then we’ll see what we do.” So, there are many on the sidelines to see if this goes well, they’ll be happy to jump in. I do not take for granted at all the faith that COR-NTD and USAID have placed in us to make this work. Not every funder will be willing to take a perceived risk of this sort. We’re really eager to make this work and very cognizant of the effort that COR-NTD and USAID have put in to this. They really didn’t have to. But I think it comes from a fundamental belief in the principle of giving African researchers the right opportunities to do what they want to do.
Inline Photo: Dr. John Amuasi conducts research while in Ghana - AFRICAN RESEARCH NETWORK FOR NEGLECTED TROPICAL DISEASES