Centre for Global Disease and Health

People living in low- and middle-income countries and communities experience risks from both communicable (infectious) and non-communicable diseases, which place them at increased risk of illness, poor health outcomes and early death.

Conditions which are common in higher income countries such as Australia (for example cancer, diabetes and heart disease) are also common in low-income countries, but available diagnostics and treatments are limited.

People in lower income settings may also face conditions that are relatively less common in wealthier settings. These include malaria, tuberculosis and other infections that cause a wide range of diseases such as diarrhoea and pneumonia; severe anaemia; risks to mother and baby during pregnancy; poor growth (stunting); and sub-optimal neurodevelopment.

Medical advances and improved access to health care have seen improvements in the health of people in low-income countries but progress remains slower than it should be. New threats such as the aftermath of the COVID-19 pandemic, climate change and food shortages threaten to reverse recent gains.

The WEHI Centre for Global Disease and Health aims to improve the health of people living around the world through discovery of basic mechanisms of disease and by finding solutions to optimise health.

1. To understand the biological basis for infectious and non-communicable diseases that particularly afflict people living in low and middle income settings.
2. To discover new ways of diagnosing, preventing, treating and even eradicating these diseases, and identifying ways to improve health and wellbeing for people living in low and middle income settings.
3. To translate our findings by influencing health policy through generating high quality evidence, to ensure people living in low and middle income settings have access to the best quality approaches to health care.
4. To train the next generation of researchers, including those from low income settings, to build future health and medical research workforce capability locally.
5. To establish and strengthen partnerships between Australian and international researchers, especially researchers based in the Asia-Pacific region, and develop these relationships to achieve our goals of improving health for people across the world.

The WEHI Centre for Global Disease and Health undertakes research to improve health and wellbeing for people and populations around the world using a multi-disciplinary approach that bridges basic, laboratory discovery science studies to well-designed cohort studies and global clinical trials.

A particular focus lies in leveraging cutting-edge genomic, immunological and neurodevelopmental assessment tools into population-based studies with the aim of making both high-impact discoveries about disease mechanisms, as well as providing evidence for interventions that aim to improve global health.

Our international studies involve deep collaborations with local partners and place high priority on local capacity building and training. Our highly-collaborative work involves the establishment of internal and external partnerships to meet specific research challenges.

We are committed to efficient scientific translation of new discoveries to novel treatments or prevention strategies. We also regularly contribute to World Health Organization policies by providing evidence and expert contributions to guideline processes.

Although the majority of the world’s population live in low- and middle-income countries (LMIC) and communities, their key health problems receive only a small proportion of research attention and investment.

Infectious diseases such as malaria, tuberculosis, HIV, or respiratory infections including COVID-19 continue to place a heavy burden, made worse by increasing antimicrobial resistance. But most LMIC populations have also seen a dramatic rise in non-communicable disease burden, such as nutritional deficiencies and cancer.

Addressing the biggest health challenges affecting the world’s poorest populations not only requires strengthening health systems and better application of existing interventions, but specific discovery research programs aimed at developing new, cost-effective tools targeted specifically at LMIC health problems.

The WEHI Centre for Global Disease and Health team comprises a multidisciplinary group of researchers with basic science skills in molecular biology, molecular parasitology, human immunology, drug discovery, genomics, epigenetics and microbiome analyses.

Our expertise also includes diagnostic test development, clinical and epidemiological studies including large randomised controlled field trials and cohort studies, as well as policy development with organisations such as the World Health Organization.

A blood test to detect recent malaria infections – Mueller Lab

We are developing serological markers of recent exposure to P. vivax malaria infections to aid elimination of this disease. Antibodies can detect not only current but also recent infections. People that have anti-P. vivax antibodies are thus likely to carry dormant parasites in their livers, which means they are at high risk of experiencing relapsing infection.

In samples from cohort studies conducted in various P. vivax endemic regions around the world, we have validated a signature of antibodies to a small panel of 4-8 antigens that can detect recent exposure with high sensitivity and specificity. This signature is the basis for the ongoing development of both high-throughput and point-of-care vivax sero-diagnostic assays.

The intention is to use these assays for a novel anti-vivax intervention called P. vivax Serological Testing and Treatment (PvSeroTAT), where people living in areas with risk of P. vivax transmission are screened using our sero-diagnostic exposure markers. If positive, they are then treated with a drug regimen that will effectively treat both asexual bloodstage and dormant liverstage parasites.

Our modelling studies predict that PvSeroTAT will result in significant reduction in P. vivax risk and thus could assist countries in accelerating towards P. vivax elimination. Clinical trials of PvSeroTAT are commencing in both Southeast Asia and Africa.

Project team

• Professor Ivo Mueller
• Dr Rhea Longley
• Dr Julie Healer
• Dr Ramin Mazhari
• Dr Emily Eriksson
• Kenneth Wu
• Macie Lamont

Early diagnostics to detect latent tuberculosis – Coussens Lab

Tuberculosis (TB) is the leading bacterial cause of death globally, with an estimated 10 million people developing TB annually, including 1 million children. Transmitted by aerosol, this slow-growing bacterium causes a chronic infection that can persist for many years without developing into disease (often called latent TB, estimated at 1.7 billion people in 2018). For roughly five to 15 per cent of infected people, TB develops into a chronic inflammatory disease, destroying the architecture of the organ it infects.

The lack of a diagnostic test that can identify who is currently infected and – most importantly – who will develop disease is a major challenge for TB control. This test is critical to target preventative therapy to those most at need and limit the cycle of transmission and disease.

We are combining the use of multiple high-resolution cellular profiling technologies (RNA-sequencing, spectral cytometry, DNA methylation profiling) to identify differences in immune cell function and the DNA changes which govern these differences, to guide the development of novel blood biomarkers of TB infection and disease risk.

Working with collaborators at the University of Cape Town in South Africa, we are analysing samples collected in two long-term studies tracking 450 adults and 1600 children living in communities with one of the highest rates of TB in the world. The research aims to identify individuals with early stages of infection and those who develop disease.

By identifying immune cell markers of infection and disease risk, our goal is to develop these into novel diagnostics that we can use to screen individuals in high-risk communities to receive preventive antibiotic therapies. Understanding the immune mechanisms that lead to disease risk we will also allow us to develop better long-term therapies for prevention as well as better treatments for patients to resolve TB disease and improve their long-term outcomes.

Project team

• Dr Anna Coussens
• Dr Dylan Sheerin
• Dr George Ashdown
• Rachel Evans
• Associate Professor Matt Ritchie
• Dr Quentin Gouil

Collaborators

• Wellcome Centre for Infectious Diseases in Africa (CIDRI-Africa)
• University of Cape Town
• University College London
• Boston University
• Queen Mary University of London

Improving maternal and child health – Pasricha Lab

Anaemia and undernutrition is very common in low and middle income countries, especially in pregnancy and in young children. We are undertaking a program of large randomised controlled trials in rural Bangladesh and Malawi to assess new solutions for anaemia control with the goal of improving maternal and child health, including pregnancy outcomes, maternal wellbeing, infection risk, and child growth and development.

The goal is to develop evidence (including health economic evidence) of the role for interventions in preventing anaemia and improving growth and neurodevelopment in low income settings, as well as to develop new insights into the physiology of iron metabolism in infancy and during pregnancy in people living in low income settings.

We are conducting two large trials of iron interventions in infants (BRISC, IRMA), which aim to discover if these therapies can improve child neurodevelopment and allow every child to reach their full potential. We are also leading three trials in pregnancy to assess whether modern intravenous iron formulations can improve maternal health and wellbeing (during pregnancy and in the postpartum), improve the safety of delivery and provide short and longer term benefits for the baby (REVAMP, REVAMP-TT and EDIVA).

These trials are undertaken in partnership with international scientists, including Professor Kamija Phiri at the Training and Research Unit of Excellence, Kamuzu University of Health Sciences, Malawi, and Dr Jena Hamadani, at the International Center for Diarrheal Diseases Research, Bangladesh.

Collectively these trials have recruited over 8000 mothers or infants across the two regions. Samples from these trials are also analysed using cutting-edge platforms including 16S rRNA gene sequencing and shotgun metagenomics for assessment of the microbiome, CyTOF and flow cytometry to assess immune development and function, and molecular characterization, for example using high throughput RNA sequencing, in order to make new discoveries about the health of mothers and babies living in low income settings, to help develop the next generation of solutions.

Project Team

• Professor Sant-Rayn Pasricha
• Sabine Braat
• Dr Ricardo Ataide
• Dr Rebecca Harding
• Dr Eliza Davidson
• Dr Alistair Mclean
• Naomi Von Dinklage
• Dr Louise Randall
• Dr Md Imrul Hasan
• Phoebe Fitzpatrick

• Aga Khan University, Karachi, Pakistan
• Armauer Hansen Research Institute, Addis Adaba, Ethiopia
• Eijkman Institute of Molecular Biology and Eijkman Oxford Clinical Research Unit, Jakarta, Indonesia
• Faculty or Tropical Medicine, Mahidol University, Bangkok, Thailand
• FIOCRUZ Rio de Janeiro, Brazil
• Foundation for Tropical Medicine Dr. Heitor Viera Dourado, Manaus, Brazil
• Institut Pasteur Cambodia, Phnom Penh, Cambodia
• Institut Pasteur Madagascar, Antananarivo, Madagascar
• International Center for Diarrheal Diseases Research, Bangladesh (icddr,b)
• PNG Institute of Medical Research, Papua New Guinea
• Training and Research Unit of Excellence, Kamuzu University of Health Sciences, Malawi
• Universidad Gayetano Herredia, Lima, Peru
• Universidad San Francisco, Quito, Ecuador
• University of Indonesia, Jakarta, Indonesia
• Wellcome Centre for Infectious Diseases in Africa (CIDRI-Africa), University of Cape Town