Q&A with 2018 President Regina Rabinovich, MD

Posted 11 December 2017

2018 President Regina Rabinovich, left, accepts the gavel from 2017 President Patricia F. Walker on November 8 during the Annual Meeting in Balimore, MD.
Regina Rabinovich, MD, officially took the helm as 2018 ASTMH President on November 8 during the Annual Meeting in Baltimore, MD. She is a global health leader with more than 25 years of experience in the research, public health and philanthropic sectors, with a focus on strategy, global health product development, and the introduction and scale-up of tools and strategies resulting in impact on endemic populations.
Since 2012, she has served as the ExxonMobil Malaria Scholar in Residence at Harvard University. Prior to that she was Director of the Infectious Diseases at the Bill & Melinda Gates Foundation. She also has served as Director of the PATH Malaria Vaccine Initiative, worked on vaccine development at NIAID and was closely involved with the Children’s Vaccine Initiative.
We sat down with Dr. Rabinovich to discuss her interest in an ASTMH leadership role and her thoughts on challenges and opportunities in tropical medicine.

You’ve had a quite a career as a scientist and leader of major research initiatives. What attracts you to a position of leadership at ASTMH?

When I joined the Malaria Vaccine Initiative (MVI), it was a unique opportunity in part because it opened me up to a much broader world. It was unlike other areas where I had worked. I had worked in childhood vaccines, but in that world, the vaccine is the solution. For malaria, vaccines are just one of many solutions.
So the work at MVI and, later, at the Gates Foundation drew me into thinking more holistically about how you go about affecting health. It gave me an opportunity to work across a wide spectrum of initiatives and focus not just on research or product development challenges, but on barriers and systems critical to implementation as well.
That’s why today ASTMH is a great home for me.  It’s a society that is embracing a very broad, multifaceted global vision about what it’s required to confront and overcome the many infectious diseases that still loom as a major threat today.
When you look at the many challenges biomedical researchers face today, what stands out as some of the more difficult problems?
Obviously there are always funding challenges, but when I step back and think about other issues, one of the most difficult things scientists have to deal with today is information overload. How do people today tell the difference between what is real and what is not? How do they know the difference between a discredited scientist who is still speaking out against a measles vaccine, and the real facts about vaccines? How can ASTMH serve to rapidly bring the facts on imported infectious diseases, as we have done with Zika and, before that, Ebola?  And in that case, when something new strikes, how do we draw upon what is known, and acknowledge what needs to be worked out to help establish the next steps? ASTMH reflects a fellowship of experts with a variety of experiences globally, working from academia, government and civil society. 
Over the last few years there has been a surge of interest in global health in the U.S. due to the outbreak of Ebola virus disease in West Africa and then the Zika outbreak in the Americas. What other diseases should be on our radar screens?
I think there are many potential threats to be concerned about. There was the recent study regarding the H7N9 strain of avian influenza in China and whether it has the potential to become easily transmissible between humans. Another good example is TB, which is a disease that kills 1.8 million people every year. It has been with us for a long time, but there are drug-resistant strains circulating and we currently lack the tools we need to effectively control its spread. I’m worried about the unfinished agenda for TB.  
I also would like to see people looking at diseases where we have made significant advances and think about what can we do to go even farther. That is why we were so interested in having Dr. Anthony Fauci speak to us about the potential to end the HIV/AIDS pandemic. HIV is not one of the diseases we typically focus on within ASTMH, but given that it is a global pandemic, our community interfaces with that constantly. We don’t live in isolation – and the challenges range from access to drugs, differential diagnosis and drug interactions across therapeutic areas, just to name a few.  The impressive advances in HIV, and the strategies and end games being discussed about how to put HIV out of business, these can be very instructive across global health.
Where do you see opportunities today to make major strides against diseases that have long challenged tropical medicine researchers?
I thought the recent findings about the new triple therapy for lymphatic filariasis are amazing. I think it’s a bit surprising that it can actually prevent the adult worm from creating microfilaria, and that changes the feasibility of an endgame for LF and means we can start thinking about lymphatic filariasis as a credible target for elimination and eradication.
We are also really on the very edge of eradication with Guinea worm and polio, and that is quite exciting because when that happens, success can provide momentum for thinking about what’s next, and with a healthy dose of reality.  Both Guinea worm and polio took longer, and were more expensive, than originally estimated.  Other diseases, including measles and malaria, aspire to be a global target.  Malaria strategies are being created and the community is saying, “If this is the goal, then what tools are needed to get the job done?”  Clearly, the application of innovation, best science and novel approaches to deliver them will all be important.
Are there any changes that the Society should be thinking about for the Annual Meeting, which last year featured a compelling interactive exhibit on refugee health and this year featured virtual reality installations?
I think it can helpful for us to think about how to use mixed media and digital tools to enhance what we do because that is how the next generation is learning. Are there ways that we can enhance presentations at the Annual Meeting so that they are more accessible as teaching and learning tools? And we should think not only for those who attend the meeting, but for people who cannot travel to the U.S.
This year, we live-streamed the Alan Magill Symposium on Malaria Eradication. So not only did we have 600 people sitting and couple of hundred more standing, but we had this whole additional audience online, streaming it live and tweeting about it. I think that shows we have an ability to enlarge the audience for the rich array of discussions that take place at our Annual Meetings.  This is but one example of the work the Council will take on over the next year.