Joel Breman, MD, DTPH, FASTMH
Fogarty International Center, National Institutes of Health, U.S
The Society has been my main professional home since I joined in the 1970s. I was with the Centers for Disease Control and Prevention (CDC), resident in Guinea and Burkina Faso, and WHO, Geneva, fighting smallpox. In 1976, Karl Johnson, a former Society president, and I were in the Democratic Republic of Congo. We sent a recording to the meeting in Philadelphia sharing the description of the first epidemic of what we called Ebola Hemorrhagic Fever. This was my first Society meeting!
The Society can do more for members by helping decision-makers understand our mission and its benefits. Over the last five years our Society has grown by over 20%, to >4,000; our members have made notable scientific contributions and our management team has performed admirably. But we can do better. My priorities are: increasing funding, expanding our profile, increasing member services, promoting collaborations, and strengthening advocacy.
- Increasing funding. This requires strengthening our ties to Congress, foundations, and the private sector, and increasing public understanding of the importance of our work. While Congress and others respond to evidence, public opinion, personal contact and recognition for successes gain bipartisan support: PEPFAR (HIV/AIDS), the President’s Malaria Initiative, the Neglected Tropical Diseases initiative, and the response to epidemics (Ebola, Zika) are evidence of such support.
- Expanding the Society profile. We cannot get complacent. We must understand and address recent demographic, epidemiological, and technologic transitions. While the infectious diseases agenda remains at our core, chronic disease perils are emerging in low- and middle-income countries. Our global health and clinical subgroups are the perfect places for advancing these areas within the Society. Ever-looming zoonotic diseases and the One Health Initiative merit more attention.
- Increasing services to younger and foreign members. Everyone who comes to our great Annual Meetings should become a member and benefit from our training and job opportunities, grant offerings, scholarships, and website news. Developing leaders in science and global health requires aptitude in setting up and managing a laboratory, writing a successful grant, dealing with IRB and ethics issues, crafting great articles, and being a good mentor. We can do more training in these areas using distance learning, and at our meetings.
- Expanding our presence as the leading international scientific society. With globalization there is opportunity for more collaborative research in Asia, Africa, and Latin America. Supporting tropical medicine societies abroad is of mutual benefit. Providing more awards for scholars to present at our Annual Meeting is a priority. We will get more members - younger and of the highest quality.
- Advocating. I propose we strengthen our communications plan with op-eds, blogs, press releases, interviews, and articles to say what we do and why we do it. The Society Secretariat needs more resources; we need to define the best strategy to fill this need. Indeed, Council and subgroup members should have more responsibilities as Society advocates.
Summary of Volunteer/Member Roles in ASTMH
- Committees. As a Councilor (2007-2011), I worked actively on initiating the Fellow category. I remain a long-standing member of the Membership subgroup: we have worked on an equitable dues structure for foreign members and on polling members on the most important benefits they derive and desire from the Society.
- Meetings. Since 1981, I have attended virtually all Annual Meetings. I have presented talks and co-authored several posters on malaria. Starting in 1987, I co-organized symposia on malaria and pregnancy, the burden of malaria, poor quality drugs, leadership in tropical medicine (“The Fogarty at 40”), and moderated sessions on rectal artesunate and home treatment of malaria.
- Publications. Of my 195 publications and book chapters, and two co-edited books, 32 articles have been published in the AJTMH. I have been senior editor of three AJTMH supplements (2001; 2004 with Martin Alilio and Anne Mills; 2007 with Martin Alilio and Nick White) addressing “The Intolerable Burden of Malaria,” and one supplement titled “The Pandemic of Falsified Drugs: Laboratory and Field Innovations and Policy Implications” (2015, with Jim Herrington and Gaurvika Nayyar).
- Advocacy. I have visited Congressional members on behalf of the Society. I participated in a Congressional briefing arranged by our administrative and advocacy teams on the issue of poor quality drugs and represented the Society to the U.S. Pharmacopeia on the same topic. I have represented the Society at the American Association for the Advancement of Science and at Boston University speaking to the local student tropical medicine club.
- International Fellow nomination. I nominated one person, Dr. Jean-Jacques Muyembé-Tamfun of the Democratic Republic of Congo, as an Honorary International Fellow and he was so recognized in 2017.
After undergraduate studies at the University of California, Los Angeles, I was an artillery officer. Following post-bac, pre-med work, I trained at the Keck School of Medicine, University of Southern California, with an internal medicine residency at the Los Angeles-County-USC Medical Center. In the late 1960s, I lived in Guinea, as CDC-supported chief of project to eliminate smallpox and control measles in 20 West and Central African countries as part of the global smallpox program. With a career development award from the CDC, I was an infectious diseases fellow on the Harvard Medical Service, Boston City Hospital, followed by study at the London School of Hygiene & Tropical Medicine. In the mid-1970s, I worked with eight francophone countries to develop surveillance for epidemic diseases as Chief of Epidemiology at the Organisation de Coopération et de Coordination pour la lutte contre les Grandes Endémies, a regional African health organization based in Burkina Faso. There, I began research into the immuno-depressive effect of malaria on childhood immunizations.
In 1977, I became deputy chief of the Smallpox Eradication unit at WHO, Geneva. I was responsible for certifying eradication, decreasing the number of laboratories with variola virus, and, characterizing human monkeypox.
Returning to CDC in 1980, I began work on malaria full-time. The Malaria Branch had 15 persons in 1981. I became chief of the epidemiology and control activities and then deputy chief. During the 1980s and 1990s, we helped African countries define: antimalarial drug efficacy; the importance of malaria in pregnancy; and, the benefits of insecticide-treated bed nets. Our U.S.-based scientists partnered with those in 15 African countries doing research that was incorporated into national and international control guidelines. By 1993, we had 74 persons in our Branch.
I became Associate Director of the National Vaccine Program Office in Washington, DC in 1993 when my wife, a nurse and environmental lawyer, was offered a great job in the U.S. Department of Agriculture. I learned much about the way things work in Washington: networking, diplomacy, and money are key.
I came to the Fogarty International Center, NIH in 1995 to begin the emerging infectious diseases program. The only research training program we had focused on HIV/AIDS. Today, we have many extramural programs and work in over 100 lower-income countries. We have trained over 6,000 scientists. Building partnerships within NIH and from around the world has been extremely gratifying and productive. At the FIC, I have continued collaborative epidemiological research defining the burden of malaria and the pervasiveness of poor quality drugs.
I am still learning - by teaching at George Washington University, and consulting for the WHO, The Carter Center, the Gates Foundation, USAID, FDA, and the Multilateral Initiative on Malaria. I am Co-chair of the WHO International Commission for the Certification of Dracunculiasis Eradication and chair of an ad hoc group planning the celebration of the 40th anniversary since the World Health Assembly confirmed the eradication of smallpox.