Advertisement

EcoHealth

, Volume 2, Issue 4, pp 258–272 | Cite as

All Hands on Deck: Transdisciplinary Approaches to Emerging Infectious Disease

  • Margot W. ParkesEmail author
  • Leslie Bienen
  • Jaime Breilh
  • Lee-Nah Hsu
  • Marian McDonald
  • Jonathan A. Patz
  • Joshua P. Rosenthal
  • Mazrura Sahani
  • Adrian Sleigh
  • David Waltner-Toews
  • Annalee Yassi
Original Contributions

Abstract

The increasing burden of emerging infectious diseases worldwide confronts us with numerous challenges, including the imperative to design research and responses that are commensurate to understanding the complex social and ecological contexts in which infectious diseases occur. A diverse group of scientists met in Hawaii in March 2005 to discuss the linked social and ecological contexts in which infectious diseases emerge. A subset of the meeting was a group that focused on “transdisciplinary approaches” to integrating knowledge across and beyond academic disciplines in order to improve prevention and control of emerging infections. This article is based on the discussions of that group. Here, we outline the epidemiological legacy that has dominated infectious disease research and control up until now, and introduce the role of new, transdisciplinary and systems-based approaches to emerging infectious diseases. We describe four cases of transboundary health issues and use them to discuss the potential benefits, as well as the inherent difficulties, in understanding the social–ecological contexts in which infectious diseases occur and of using transdisciplinary approaches to deal with them.

Keywords

transdisciplinary social–ecological systems emerging infectious diseases HIV SARS Nipah virus 

Notes

Acknowledgments

Ideas for this article were developed during a working meeting on social–ecological systems and emerging infectious diseases, hosted by the Asia-Pacific Institute of Tropical Medicine & Infectious Diseases and the East-West Center (March 9–11, 2005), supported by NIH Research Grant #R13 TW007300, and funded by the Fogarty International Center and Office of Behavioral and Social Sciences under the NIH Roadmap initiative “Research Teams of the Future.” We acknowledge the efforts of the meeting organizers, and also those who have supported the writing of the article, including Elizabeth Sowatzke and Jeff Marks. Special thanks to Carolyn Annerud, John M. Kobayashi, Conor Kretsch, Heather McMillen, and Jean Lebel for their valuable contributions to the working group discussions.

References

  1. Aguirre AA, Ostfeld RS, Tabor GM, House C, Pearl MC (2002) Conservation Medicine: Ecological Health in Practice, New York: Oxford University PressGoogle Scholar
  2. Albrecht G, Higginbotham N, Connor L (2001) Transdisciplinary thinking in health social science research: definition, rationale, and procedures. In: Higginbotham N, Albrecht G, Connor L, (editors), Health Social Science: a Transdisciplinary and Complexity Perspective South Melbourne: Oxford University Press, pp 70–89Google Scholar
  3. Ali SH (2004) A socio-ecological autopsy of the E. coli O157:H7 outbreak in Walkerton, Ontario, Canada. Social Science & Medicine 58:2601–2612CrossRefGoogle Scholar
  4. Amerasinghe FP (2003) Irrigation and mosquito-borne diseases. Journal of Parasitology 89(Suppl):S14–S22Google Scholar
  5. Banken R, (1999) From concept to practice: including the social determinants of health in environmental assessments. Canadian Journal of Public Health/Revue Canadienne de Santé Publique 90:S27–S30Google Scholar
  6. Barcellos C, Sabroza P (2001) The place behind the case: leptospirosis risks and associated environmental conditions in a flood-related outbreak in Rio de Janeiro. Cadernos de Saúde Pública. Reports in Public Health 17:59–67Google Scholar
  7. Ben-Shloma Y, Kuh D (2002) A life course approach to chronic disease epidemiology: conceptual models, empirical challenges and interdisciplinary perspectives. International Journal of Epidemiology 31:285–293Google Scholar
  8. Berkes F, Colding J, Folke C (2003) Navigating Social-Ecological Systems. Building Resilience for Complexity and Change, Cambridge, UK: Cambridge University PressGoogle Scholar
  9. Birn A-E (2005) Gates’s grandest challenge: transcending technology as public health ideology. The Lancet 366:514–519CrossRefGoogle Scholar
  10. Breilh J (1991) Epidemiologia: Economía, Politica e Saude, Sao Paulo, Brazil: UNESP-HucitecGoogle Scholar
  11. Breilh J (1995) Epidemiology’s role in the creation of a humane world. Social Science and Medicine 41:911–914Google Scholar
  12. Breilh J, (2003) Epidemiología Crítica: Ciencia Emancipadora e Interculturalida, Buenos Aires: Lugar EditorialGoogle Scholar
  13. Brown V, Grootjans J, Ritchie J, Townsend M, Verrinder G (2004) Sustainability and Health—Supporting Global Ecological Integrity in Public Health, London: Allen and UnwinGoogle Scholar
  14. Bunch MJ (2003) Soft systems methodology and the ecosystem approach: a system study of the Cooum River and environs in Chennai, India. Environmental Management 31:182–197CrossRefGoogle Scholar
  15. Chapin M (2004) A challenge to conservationists. WorldWatch Nov/Dec 2004:17–31Google Scholar
  16. Chua K (2003) Nipah virus outbreak in Malaysia. Journal of Clinical Virology 26:265–275CrossRefGoogle Scholar
  17. Chua K, Chua B, Wang C (2002) Anthropogenic deforestation, El Nino and the emergence of Nipah virus in Malaysia. Malaysian Journal of Pathology 202:15–21Google Scholar
  18. Clennon J, King C, Muchiri E, Kariuki H, Ouma J, Mungai P, et al. (2004) Spatial patterns of urinary schistosomiasis in a highly endemic area of coastal Kenya. American Journal of Tropical Medicine and Hygiene 70:443–448Google Scholar
  19. Collins AE, (2003) Vulnerability to coastal cholera ecology. Social Science & Medicine 57:1397–1407Google Scholar
  20. Colwell R, (1998) Balancing the biocomplexity of the planet’s living systems: a twenty-first century task for science. Bioscience 48:786Google Scholar
  21. Commentaries (1998) Journal of Epidemiology and Community Health 52:612–618 (various authors)Google Scholar
  22. Davies S, Unam L (1999) Smoke-haze from 1997 Indonesia forest fires: effects on pollution levels, local climate, atmospheric CO2 concentration, tree photosynthesis. Forest Ecology & Management 124:137–144CrossRefGoogle Scholar
  23. Daszak P, Cunningham AA, Hyatt AD (2000) Emerging infectious diseases of wildlife: threats to biodiversity and human health. Science 287:443–449CrossRefGoogle Scholar
  24. De Plaen R, Kilelu C (2004) From multiple voices to a common language: ecosystem approaches to human health as an emerging paradigm. EcoHealth 1:S8–S15CrossRefGoogle Scholar
  25. du Guerny J, Hsu L-N, Chitna S (2002) A Development Strategy to Empower Rural Farmers and Prevent HIV. UNDP South East Asia HIV and Development Project, Bangkok. Available: http://www.hiv-development.org/publications/HESA.asp [accessed August 10, 2005]
  26. Erikson K (1991) A new species of trouble. In: Communities at Risk: Collective Responses To Technological Hazards, Couch SR, Stephen Kroll-Smith J (editors), New York: Peter Lang, pp 11–29Google Scholar
  27. Evans RG, Marmor ML Theodore R (1994) Why Are Some People Healthy and Others Not?: The Determinants of Health of Populations, New York: A. de GruyterGoogle Scholar
  28. Field H, Young P, Yob J, Mills J, Hall L, Mackenzie J (2001) The natural history of Hendra and Nipah viruses. Microbes and Infection 3:307–314CrossRefGoogle Scholar
  29. Foley JA, DeFries R, Asner GP, Barford C, Bonan G, Carpenter SR, et al. (2005) Global consequences of land use. Science 309: 570CrossRefGoogle Scholar
  30. Follér M-L, (2001) Interactions between global processes and local health problems. A human ecology approach to health among indigenous groups in the Amazon. Cadernos de Saúde Pública. Reports in Public Health 17:115–126Google Scholar
  31. Funtowicz SO, Ravetz R (1994) Uncertainty, complexity and post-normal science. Environmental Toxicology and Chemistry 13:1181–1885Google Scholar
  32. Gamage B, Moore D, Copes R, Yassi A, Bryce E, et al. (2005) Protecting health care workers from SARS and other respiratory pathogens: a review of the infection control literature. American Journal of Infection Control 33:114–121CrossRefGoogle Scholar
  33. Gerberding JL (2004) Women and infectious diseases. Emerging Infectious Diseases 10:1965–1967Google Scholar
  34. GFHR (2004) 10/90 Report on Health Research 2003–2004, Global Forum Health Research, Geneva, SwitzerlandGoogle Scholar
  35. Gloster M, (2000) Approaching action research from a socioecological perspective. Systemic Practice and Action Research 13:665–682CrossRefGoogle Scholar
  36. Gu Y, Xia L, Li Z, Zhao M, Yang H, Luo Q, et al. (2001) Study on schistosomiasis control strategy in Ertan reservoir. Chinese Journal of Parasitology and Parasitic Diseases [Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi] 19:225–228 (in Chinese, with English abstract)Google Scholar
  37. Gross Stein J, Stren R, Fitzgibbon J, MacLean M (editors) (2001) Networks of Knowledge: Collaborative Innovation in International Learning, Toronto: University of Toronto PressGoogle Scholar
  38. Holling C, (2001) Understanding the complexity of economic, ecological and social systems. Ecosystems 4:390–405CrossRefGoogle Scholar
  39. Horlick-Jones T, Sime J (2004) Living on the border: knowledge, risk and transdisciplinarity. Futures 36:441–456CrossRefGoogle Scholar
  40. Hotez P, Remme J, Buss P, Alleyne G, Morel C, JG B (2004) Combating tropical infectious diseases: report of the Disease Control Priorities in Developing Countries Project. Clinical Infectious Diseases 38:871–878CrossRefGoogle Scholar
  41. Howard J (2004) Workshop on Ecosystem health in medical, veterinary, and other professional curricula. EcoHealth 1:S1–S2Google Scholar
  42. Howard J, Rapport D (2004) Ecosystem health in professional education: the path ahead. EcoHealth 1:S3–S7Google Scholar
  43. Hsu L-N, du Guerny J, Guest P (2000) Early Warning Rapid Response System: HIV Vulnerability Caused by Mobility Related to Developmen, Bangkok, Thailand: UNDP South Asia HIV and Development ProgramGoogle Scholar
  44. Hsu L-N, du Guerny J, Guest P (2003) From Early Warning to Development Sector Responses against HIV/AIDS Epidemics. A summary of two Early Warning Rapid Response System workshops 13th–14th June 2002, Bangkok, Thailand and 16th October 2002, Kunming, China. Bangkok, Thailand: UNDP South Asia HIV and Development ProgramGoogle Scholar
  45. Hsu L-N, du Guerny J, Guest P (2004) A Manual for Early Warning Rapid Response Systems for HIV/AIDS, Bangkok, Thailand: UNDP South Asia HIV and Development ProgramGoogle Scholar
  46. Hunter J, Rey L, Chu K, Adekolu-John E, Mott K (1993) Parasitic Diseases in Water Resources Development: the Need for Intersectoral Negotiation, Geneva: World Health OrganisationGoogle Scholar
  47. Institute of Medicine (IOM) (editor) (2005) Microbial Threats to Health: Emergence, Detection and Response, Institute of Medicine of the National Academies. Washington, DC: National Academies PressGoogle Scholar
  48. Jantsch E (1972) Inter- and transdisciplinary university: A systems approach to education and innovation. Higher Education 1:7–37CrossRefGoogle Scholar
  49. Jobin W (1999) Dams and Disease: Ecological Design and Health Impacts of Large Dams, Canals and Irrigation Systems, London: E & FN SponGoogle Scholar
  50. Kaufman GE, Else J, Bowen K, Anderson M, Epstein J (2004) Bringing conservation medicine into the veterinary curriculum: the Tufts example. EcoHealth 1:S43–S49CrossRefGoogle Scholar
  51. Kay J, Regier H, Boyle M, Francis G (1999) An ecosystem approach for sustainability: addressing the challenge of complexity. Futures 31:721–742Google Scholar
  52. Klein JT, Grossenbacher-Mansuy W, Häberli R, Bill A, Scholz R, Welti M (2001) Transdisciplinarity: Joint Problem Solving Among Science, Technology and Society, Basel, Switzerland: Birkhäuser VerlagGoogle Scholar
  53. Krieger B (1994) Epidemiology and the web of causation: has anyone seen the spider? Social Science & Medicine 39:887–903CrossRefGoogle Scholar
  54. Krieger N (2001) Theories for social epidemiology in the 21st century: an ecosocial perspective. International Journal of Epidemiology 30:668–677Google Scholar
  55. Lam S (2003) Nipah virus—a potential agent of bioterrorism? Antiviral Research 57:113–119CrossRefGoogle Scholar
  56. Lashley FR (2004) Emerging infectious diseases: vulnerabilities, contributing factors and approaches. Review of Anti-infective Therapy 2:299–316Google Scholar
  57. Lattuca LR (2001) Creating Interdisciplinarity: Interdisciplinary Research and Teaching among College and University Faculty, Nashville, TN: Vanderbilt UPGoogle Scholar
  58. Lattuca LR (2003) Creating interdisciplinarity: grounded definitions from college and university faculty. History of Intellectual Culture 3(1). Available: http://www.ucalgary.ca/hic/website/toc/tableofcontentsvol3.html [accessed August 10, 2005]
  59. Lebel J (2003) Health: an Ecosystem Approach, Ottawa: International Development Research CentreGoogle Scholar
  60. Lebel J (2004) Ecohealth and the developing world. EcoHealth 1:325–326CrossRefGoogle Scholar
  61. Lewis ND (2005) Is the social-ecological framework useful in understanding infectious diseasis? The case of HIV/AIDS. EcoHealth 2 (DOI: 10.1007/s10393-005-8477-x, this issue)Google Scholar
  62. McDonald M, Anker M, Deal C, Mawle A, O’Connor S, Slaughter L (2004) International Conference on Women and Infectious Diseases. Emerging Infectious Diseases 10:1963–1964Google Scholar
  63. McDonell G (2000) Disciplines as cultures: towards reflection and understanding. Transdisciplinarity In: Somerville MA, Rapport D, (editors), Recreating Integrated Knowledge, Oxford, UK: EOLSS Publishers, pp 25–38Google Scholar
  64. McMichael AJ (1999) Prisoners of the proximate: loosening the constraints on epidemiology in an age of change. American Journal of Epidemiology 149:887–897Google Scholar
  65. McMichael AJ (2000) Assessing the success or failure of transdiciplinarity. In: Somerville MA, Rapport D, (editors), Transdisciplinarity: Recreating Integrated Knowledge, Oxford, UK: EOLSS Publishers, pp 218–220Google Scholar
  66. McMichael AJ (2002) The biosphere, health and “sustainability.” Science 297:1093CrossRefGoogle Scholar
  67. Merrifield J (1993) Putting scientists in their place: participatory research in environmental and occupational health. In: Park P, Bryden-Miller M, Hall B, Jackson T (editors), Voices of Change: Participatory Research in the United States and Canada, Westport, CT: Bergins Garvey, pp 65–84Google Scholar
  68. Mertens F, Saint-Charles J, Mergler D, José Passos C, Lucotte M (2005) Network approach for analyzing and promoting equity in participatory ecohealth research. EcoHealth 2:113–126CrossRefGoogle Scholar
  69. MMWR (2005) Health concerns associated with disaster victim identification after a tsunami—Thailand, December 26, 2004—March 31, 2005. Morbidity and Mortality Weekly Report 54:349–352Google Scholar
  70. Mohd Nor N, Gan C, Ong B (2000) Nipah virus infection of pigs in peninsular Malaysia. Revue Scientifique et Technique de l’Office International des Epizooties 19:160–165Google Scholar
  71. Mohd Shahwahid H, Othman J (1999) Malaysia. In: Glover D, Jessup T (editors), Indonesia’s Fires and Haze: the Cost Catastrophe, Singapore: Seng Lee Press, p 160Google Scholar
  72. Moore D, Gamage B, Bryce E, Copes R, Yassi A, Group. aomoTBIRPS (2005) Protecting health care workers from SARS and other respiratory pathogens: organizational and individual factors that affect adherence to infection control guidelines. American Journal of Infection Control 33:88–96CrossRefGoogle Scholar
  73. Motavalli J (2004) Connecting the dots: the emerging science of conservation medicine links human and animal health with the environment. E-magazine 15:Nov/Dec. Available: http://www.emagazine. com /index.php?toc&issue=73&src= [accessed April 15, 2005]
  74. O’Fallon LR, Dearry A (2002) Community-based participatory research as a tool to advance environmental health sciences. Environmental Health Perspectives 110:155–159Google Scholar
  75. O’Ryan M, Prado V, Pickering L (2005) A millennium update on pediatric diarrheal illness in the developing world. Seminars in Pediatric Infectious Disease 16:125–136Google Scholar
  76. Parkes M, Panelli R (2001) Integrating catchment ecosystems and community health: the value of participatory action research. Ecosystem Health 7:85–106CrossRefGoogle Scholar
  77. Parkes M, Panelli R, Weinstein P (2003) Converging paradigms for environmental health theory and practice. Environmental Health Perspectives 111:669–675CrossRefGoogle Scholar
  78. Patz JA, Daszak P, Tabor GM, Aguirre AA, Pearl M, Epstein J, et al. (2004) Unhealthy landscapes: policy recommendations on land use change and infectious disease emergence. Environmental Health Perspectives 112:1092–1098CrossRefGoogle Scholar
  79. Provincial SARS Science Committee (PSSC) (2003) Guidelines for the Acute Management of the Patient with SARS in the Hospital Setting, May 9, 2003 Available: http://www.bccdc.org/downloads/pdf/epid/reports/SARS_Appendix-n-Guidelines_jun19-03.pdf [accessed June 30, 2003]
  80. Ravetz J (2005) The No-nonsense Guide to Science, Toronto and Oxford: New Internationalist PublicationsGoogle Scholar
  81. Real LA (1996) Sustainability and the ecology of infectious disease. Bioscience 46:88–97Google Scholar
  82. Sapiro V (2004) Interdisciplinary and Collaborative Teaching at the University of Wisconsin–Madison: Overcoming Barriers to Vitality in Teaching and Learning. Available: http://www.polisci.wisc.edu/users/sapiro/papers/interdisciplinary.pdf [accessed August 10, 2005]
  83. Salter L, Hearn A (editors) (1996) Outside the Lines: Issues in Interdisciplinary Research, Montreal and Kingston: McGill-Queen’s University PressGoogle Scholar
  84. Sleigh A, Jackson S (2001) Dams, development, and health: a missed opportunity. Lancet 357:570–571CrossRefGoogle Scholar
  85. Smith KF, Dobson AP, McKenzie FE, Real L, Smith DL, Wilson ML (2005) Ecological theory to enhance infectious disease control and public policy. Frontiers in Ecology and the Environment 3:29–37Google Scholar
  86. Sokunthea N (2002) Mobilization and Empowerment of Rural Communities Along the Asian Highway (Route 5) in Cambodia to Reduce HIV Vulnerability: The Empowerment of Farmer Life Schools. Srer Khmer, Funded by UNDP HIV Southeast Asia Project. Project UNDP-FAO/RAS/97/202. Available: http://www. communityipm.org/docs/Farmer_Life_Schools.doc [accessed April 10, 2004]
  87. Somerville MA, Rapport D (editors) (2000) Transdisciplinarity: Recreating Integrated Knowledge, Oxford, UK: EOLSS PublishersGoogle Scholar
  88. Taylor LH, Latham SM, Woolhouse ME, et al. (2001) Risk factors of disease emergence. Philophical Transactions of the Royal Society of London. Series B 356:983–989Google Scholar
  89. Turner BL II, Kasperson RE, Matson PA, McCarthy JJ, Corell RW, Christensen L, et al. (2003) A framework for vulnerability analysis in sustainability science. Proceedings of the National Academy of Sciences USA 100:8074–8079Google Scholar
  90. UNAIDS (2004) UNAIDS 2004 Report on the Global AIDS Epidemic. 4th Global Report, UNAIDS/04.16E, Geneva: Joint United Nations Programme on HIV/AIDSGoogle Scholar
  91. Varia M, Wilson S, Sarwal S, McGeer A, Gournis E, Galanis E, et al. (2003) Investigation of a nosocomial outbreak of severe acute respiratory syndrome (SARS) in Toronto, Canada. Canadian Medical Association Journal 169:285–292Google Scholar
  92. Vinetz JM, Wilcox BA, Aguirre A, Gollin LX, Katz AR, Fujioka RS, et al. (2005) Beyond disciplinary boundaries: Leptospirosis as a model of incorporating transdisciplinary approaches to understand infectious disease emergence. EcoHealth 2 (DOI: 10.1007/s10393-005-8638-y, this issue)Google Scholar
  93. Waltner-Toews D (2001) An ecosystem approach to health and its applications to tropical and emerging diseases. Cadernos de Saúde Pública. Reports in Public Health 17:7–36Google Scholar
  94. Waltner-Toews D (2004) Ecosystem Sustainability and Health: a Practical Approach. Cambridge, UK: Cambridge University PressGoogle Scholar
  95. Waltner-Toews D, Kay J, Neudoerffer C, Gitau T (2003) Perspective changes everything: managing ecosystems from the inside out. Frontiers in Ecology and the Environment 1:32–30Google Scholar
  96. Waltner-Toews D, Neudoerffer C, Joshi DD, Tamang MS (2005) Agro-urban ecosystem health assessment in Kathmandu, Nepal: epidemiology, systems, narratives. EcoHealth 2:155–164CrossRefGoogle Scholar
  97. Weiss R, McMichael A (2004) Social and environmental risk factors in the emergence of infectious diseases. Nature Medicine 10:S70–S76CrossRefGoogle Scholar
  98. WCD (2000) Dams and Development: A New Framework for Decision-Making. The Report of the World Commission on Dam, UK: Earthscan, 404 ppGoogle Scholar
  99. WHO (2003) WHO issues global alert about cases of atypical pneumonia: cases of severe respiratory illness may spread to hospital staff. Available: http://www.who.int/mediacentre/ releases/2003/pr22/en/print.html [accessed June 30, 2003]
  100. Witten K, Parkes M, Ramasubramanian L (2000) Participatory environmental health research in Aotearoa/New Zealand: constraints and opportunities. Health Education and Behaviour 27:371–384CrossRefGoogle Scholar
  101. Wilcox BA (2005) Emerging infectious diseases: bridging the divide between biomedical and bio-ecological paradigms. EcoHealth 2:167–169Google Scholar
  102. Wilcox BA, Aguirre AA (2004) One ocean, one health. EcoHealth 1:211–212Google Scholar
  103. Wilcox BA, Colwell RR (2005) Emerging and reemerging infectious diseases: biocomplexity as an interdisciplinary paradigm. EcoHealth 2 (DOI: 10.1007/s10393-005-8961-3, this issue)Google Scholar
  104. Yassi A, Bryce E, Moore D, Janssen R, Copes R, Bartlett K (2004) Protecting the Faces of Health Care Workers: Knowledge Gaps and Research Priorities for Effective Protection against Occupationally-Acquired Respiratory Infectious Diseases, Vancouver, Canada: Report to the Change FoundationGoogle Scholar
  105. Yassi A, Moore D, FitzGerald JM, Bigelow P, Hon C-Y, Bryce E, et al. (2005) Research gaps in protecting healthcare workers from SARS and other respiratory pathogens: an interdisciplinary, multi-stakeholder, evidence-based approach. Journal of Occupational & Environmental Medicine 47:41–50Google Scholar
  106. Yassi A, Noble M, Daly P, Bryce E (2003) Severe acute respiratory syndrome—guidelines were drawn up collaboratively to protect healthcare workers in British Columbia. BMJ 326:1394–1395CrossRefGoogle Scholar
  107. Zerhouni E (2003) The NIH roadmap. Science 302:63–72CrossRefGoogle Scholar

Copyright information

© EcoHealth Journal Consortium 2005

Authors and Affiliations

  • Margot W. Parkes
    • 1
    • 2
    Email author
  • Leslie Bienen
    • 3
  • Jaime Breilh
    • 4
  • Lee-Nah Hsu
    • 5
  • Marian McDonald
    • 6
  • Jonathan A. Patz
    • 7
  • Joshua P. Rosenthal
    • 8
  • Mazrura Sahani
    • 9
  • Adrian Sleigh
    • 10
  • David Waltner-Toews
    • 11
  • Annalee Yassi
    • 12
  1. 1.Global Health Research ProgramUniversity of British ColumbiaVancouverCanada
  2. 2.Asia-Pacific Center for Infectious Disease Ecology, Asia-Pacific Institute of Tropical Medicine and Infectious Disease, John A. Burns School of MedicineUniversity of HawaiiHonolulu
  3. 3.Leslie BienenMissoula
  4. 4.Centro de Estudios y Asesoria en Salud (Health Research and Advisory Center)AsturiasEcuador
  5. 5.Health Systems Program, International Health DepartmentJohns Hopkins Bloomberg School of Public HealthBaltimore
  6. 6.Office of Minority and Women’s Health, National Center for Infectious DiseasesCenters for Disease Control and PreventionAtlanta
  7. 7.Global Environmental Health Program, Nelson Institute for Environmental Studies, Center for Sustainability and the Global Environment (SAGE)University of WisconsinMadison
  8. 8.Division of International Training and Research, Fogarty International CenterNational Institutes of HealthBethesda
  9. 9.Environmental Health Research CenterInstitute for Medical ResearchJalan PahangMalaysia
  10. 10.National Centre for Epidemiology and Population HealthAustralian National UniversityCanberraAustralia
  11. 11.Department of Population Medicine, Ontario Veterinary CollegeUniversity of GuelphGuelphCanada
  12. 12.Institute of Health Promotion Research, Department of Health Care and Epidemiology, and Department of MedicineUniversity of British ColumbiaVancouverCanada

Personalised recommendations