ITM Annual Report 2016 by Institute of Tropical Medicine in Antwerp

ANNUAL REPORT 2016

ITM Annual Report 2016

Excellence & Relevance Tropical diseases, HIV/AIDS, tuberculosis and inadequate health care influence the lives of billions of people worldwide. The Institute of Tropical Medicine in Antwerp, Belgium, promotes the advancement of science and health for all, through innovative research, advanced education, professional services and capacity building of partner institutions in the South. For us, scientific excellence and social impact are two sides of the same coin.

OUR VISION:

Integrity

Equal chances at a healthy life for all.

Ethical standards, academic freedom,

OUR MISSION:

scientific creativity and critical sense are integrated in all our activities.

Scientific progress in tropical medicine and public health.

OUR CORE TASKS:

Specificity We focus our activities on our scientific niche, and seek for the unique added

Scientific research; higher education;

values that are complementary to that of

medical and scientific service provision.

other knowledge institutes.

OUR VALUES:

Respect

Excellence

We respect human equality, diversity,

We pursue the highest possible quality

solidarity, welfare and self-development.

in our research, education and service programmes.

Efficiency We engage our resources in an optimal and sustainable way in function of our objectives.

ITM Annual Report 2016

4 Foreword by the Chair

8 Our partners worldwide

Directorâ&#x20AC;&#x2122;s note

10 The Institute at a glance

OUR CORE TASKS

12 Research

Education

28 ITM figures

20 Medical services

24 Development cooperation

ITM Annual Report 2016

Foreword by the Chair

The Board of Governors was pleased to monitor the excellent performance of ITMâ&#x20AC;&#x2122;s units, departments and management in 2016, described further in this report. In addition, it followed up on the recommendation of the newly established audit committee to review its own governance principles. For once, I will therefore focus this foreword on the Board itself. Cathy Berx

The legal format of ITM is a Foundation of

utory General Assembly, composed of

Governor of the Province of Antwerp

Public Utility, in which by law all powers

the current members complemented by

Chair of the Board of Governors of ITM

are vested in the Board of Governors. As

representatives of staff, students, alumni

the current Board is largely composed of

and partners. The General Assembly will

representatives of collaborating universi-

also determine the profiles of the Board

ties and funding ministries, conflicts of

members of which there shall be 8 to 12,

interest may arise. In addition, the large

and who should be knowledgeable in one

size of the Board with 21 members and the

or several of ITMâ&#x20AC;&#x2122;s fields of expertise.

preponderance of the executive Bureau are not ideal in terms of equal participation

As stakeholder convention, the General

and decisiveness. On the other hand, vital

Assembly will ensure that ITM remains

stakeholders such as staff, students and

faithful to its vision, mission and values.

alumni, or partner institutions are not

To that end, and notwithstanding the legal

(fully) represented.

powers of the Board of Governors, it will provide compulsory and hard-to-ignore

Following a more general trend among

advice on strategic decisions, including

Belgian Foundations, the Board therefore

governance charters, internal regulations,

decided to transform itself into a stat-

long-term policy or budget plans, and

major covenants with authorities and

This fundamental transformation of ITM’s

external partners.

governance will not affect its organisation and operations overnight. On the longer

In addition, the statutory goal of ITM was

term, however, it will adjust the checks and

reformulated in function of its updated

balances between external stakeholders,

mission and strategy with, among others,

board, management and staff. The align-

emphasis on its academic mandate and

ment of all partners contributing to ITM’s

the integration of the veterinary expertise

mission is indeed vital to confront the mo-

into human health.

mentous changes and challenges ahead. ■

The current Board of Governors approved the new statutes unanimously on 14 December 2016. After the completion of the legal requirements at the level of the federal and Flemish governments, they will enter into force at the end of 2017.

“As ‘stakeholder convention’, the General Assembly will ensure that ITM remains faithful to its vision, mission and values.”

ITM Annual Report 2016

Director’s note

“ITM and its partners around the world must be ready to stand against the tide, sticking to academic excellence as their most powerful tool.”

Prof. Dr. Bruno Gryseels Director Institute of Tropical Medicine Antwerp

Ground-breaking publications, world-

challenge. They led their departments

the tide, sticking to academic excellence

class conferences, flattering assessments of

through highs and lows, and grew ever

as their most powerful tool.

our master’s courses, innovative projects

stronger in their institutional role as

against sleeping sickness, the submission

members of the management committee.

of a new five-year capacity strengthening

A prime occasion to take stock of scientific and societal impact will be the

programme to the Ministry of Development

The transition that lies behind us has

10th edition of the European Congress

- these are just a few highlights that kept us

prepared ITM for a rapidly changing

on Tropical Medicine and International

busy and utterly motivated over the past

world. In fact, some of the assumptions

Health (ECTMIH), which will be hosted

year. Read all about it on the following pages

of our initial “ITM2020+” reform plan

by ITM in Antwerp on 16 - 20 October

and our brand new website www.itg.be.

have already been surpassed by reality,

2017. We foresee an exciting programme

for example the changes in the realm of

in a magnificent venue, close to all the

At the same time we look back at a period

development cooperation and the in-

delights of glorious Antwerp. Do have

of strategic reorientation and restructur-

creased competition for scarce scientific

a look at www.ectmih2017.be and join

ing. I wish to thank wholeheartedly all

funds. The same forces of globalisation

us at this premier gathering on tropical

staff for their critical loyalty throughout a

have also led to electoral and political

medicine and international health in

demanding but fascinating time in which

consequences that challenge interna-

Europe. I promise you will not regret it. ■

we outlined the future of ITM. I am par-

tional solidarity as well as science-based

ticularly grateful to the department heads

rationality. ITM and its partners around

who, back in 2011, took up a formidable

the world must be ready to stand against

ITM Annual Report 2016

Board of Governors (Composition since 19 October 2016)

Chair

Co-opted members

• Ms. Cathy Berx, Governor of the Province of Antwerp

• Mr. Luc Bertrand, Ackermans & van Haaren

Vice Chair • Mr. Karel Baert, partner at Egon Zehnder International • Mr. Herman Van Goethem, Rector of the University of Antwerp

Members • Mr. Nicolas Antoine-Moussiaux, Chambre des Universités de

• Ms. Anne Chapelle, BVBA 32 and Atelier Haider Ackermann • Mr. Ajit Shetty, Janssen Pharmaceutica • Ms. Elies Van Belle, Memisa

Observers Government Commissioner • Mr. Johan Dhondt

l’Académie de Recherche et d’Enseignement supérieur Conseil interuniversitaire de la Communauté française • Ms. Yolande Avontroodt, Belgian Ministry of Health • Ms. Linda De Kock, Flemish Ministry of Education

Secretary • Mr. Jean-Christophe Donck, Institute of Tropical Medicine in Antwerp

• Ms. Kathleen D’Hondt, Flemish Ministry of Science • Mr. Fons Duchateau, City of Antwerp

ITM staff representation

• Mr. Bruno Gryseels, Institute of Tropical Medicine in Antwerp

• Mr. Bart Criel

• Mr. Jan Phillippé, Ghent University

• Ms. Titania Van De Velde

• Mr. Jo Robays, Belgian Ministry of Science • Ms. Anne Van Autreve, Flanders Department of Foreign Affairs • Mr. Bruno Van der Pluijm, Belgian Ministry Development Cooperation • Mr. Chris Vander Auwera, Flemish Ministry of Public Health • Mr. Johan Van Eldere, KU Leuven

ITM Annual Report 2016

The Institute at a glance Prof. Dr. Bruno Gryseels

Supporting Services

Director Institute of Tropical Medicine Antwerp

General Manager: Jean-Christophe Donck

MISSION: to provide optimal support to the departments and governing bodies, to partner constructively with our stakeholders, to contribute to ITM’s scientific excellence and relevance, to safeguard compliance, sustainability and transparency, to promote staff satisfaction and well-being.

9 Units

123

Staff members

Clinical Sciences

Head of Department: Prof. Dr. Lut Lynen

Research units

Management unit

132

Medical units

Staff members

MISSION: to generate and disseminate clinical knowledge and to improve patient care by research, training and reference services in the field of tropical and global infectious diseases. SPEAR POINTS: • Febrile illnesses in the tropics and in travellers

Education unit

Ongoing PhD projects

• Tropical bacterial infections • Antibiotic resistance and stewardship

• Neglected tropical diseases

• Sexually transmitted infections

• Emerging and epidemic infectious

• HIV & co-infections (tuberculosis,

diseases

leishmaniasis, hepatitis C)

ITM Annual Report 2016

Public Health

Head of Department: Prof. Dr. Anne Buvé

Research units

MISSION: to generate, disseminate and manage scientific knowledge relevant to

Management unit

public health in developing countries through research, postgraduate education and service delivery.

Education unit

Staff members

Ongoing PhD projects

SPEAR POINTS: • Evaluation of complex and integrative health interventions

• Reproductive health, including HIV • Non-communicable diseases

• Evaluate and improve interventions

• Health policies and health financing

for the control of tropical diseases

Biomedical Sciences

Head of Department: Prof. Dr. Jean-Claude Dujardin

Research units

Management unit

105

Education unit

Staff members

MISSION: to generate, disseminate and apply scientific knowledge on pathogens and vectors of tropical infectious diseases, and to develop tools for their diagnosis, surveillance and control. SPEAR POINTS: • Pathogen diversity, using different ‘omic’ approaches

Ongoing PhD projects

• Molecular basis of pathogen adaptation and evolution strategies • Tools for diagnosis, surveillance and control of disease

• Dynamics of pathogen transmission • Ecological basis for sustainable control or elimination of diseases

ITM Annual Report 2016

Our partners worldwide LATIN AMERICA

• Post-Graduate Medical School, Universidad Mayor de San Simon (UMSS), Cochabamba, Bolivia • Instituto Nacional de Higiene, Epidemiologia y Microbiologia (INHEM), Havana, Cuba

• Instituto Pedro Kourí (IPK), Havana, Cuba

• Institute of Public Health, Pontificia Universidad Católica del Ecuador (PUCE), Quito, Ecuador • Instituto de Medicina Tropical “Alexander von Humboldt” (IMTAvH), Universidad Cayetano Herredia, Lima, Peru

AFRICA

• Laboratoire de Référence de Mycobactéries (LRM), Cotonou, Benin

• Clinical Research Unit of Nanoro (CRUN), including Centre Muraz, Burkina Faso

• Institut National de Recherche Biomédicale (INRB), Ministère de la Santé Publique, Kinshasa, DRC

• Programme National de Lutte contre la Trypanosomiase Humaine (PNLTHA), Kinshasa, DRC • École de Santé Publique (ESP), Université de Lubumbashi, Lubumbashi, DRC

• College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia

• Centre National de Formation et Recherche de Maferinyah, Guinea

• École Nationale Supérieure de Statistique et de Economie Appliquée (ENSEA), Abidjan, Ivory Coast

• École Nationale de Santé Publique (ENSP) Rabat, Morocco • Instituto Nacional de Saúde (INS), Maputo, Mozambique

• Laboratoires de Virologie, Bactériologie et Parasitologie, Université de Dakar, Dakar, Senegal • Laboratoires de Virologie, Bactériologie et Parasitologie, Université de Dakar, Dakar, Senegal • School of Public Health, University of Western Cape (UWC), Cape Town, South Africa

• Department of Veterinary Tropical Diseases (DVRD), University of Pretoria (DVTD), Pretoria, South Africa • School of Public Health (SPH MUCHS), Makerere University College of Health Sciences, Kampala, Uganda

ASIA

• Sihanouk Hospital Center of HOPE (SHCH), Phnom Penh, Cambodia

• National Centre for HIV/Aids, Dermatology and STD’s (NCHADS), Phnom Penh, Cambodia • National Centre for Parasitology, Entomology and Malaria Control (NMC), Phnom Penh, Cambodia • Institute of Public Health (IPH), Bangalore, India

• Center for Tropical Medicine, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia

• B.P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal • National Institute of Malariology, Parasitology and Entomology (NIMPE), Hanoi, Vietnam

ITM Annual Report 2016

Institutional capacity building supported by Belgian Development Cooperation Institutional capacity building supported by Flanders Alliance of education and exchange

ITM Annual Report 2016

OUR CORE TASKS

304 papers in scientific journals

Research

The mission of ITM is to advance and apply the sciences in the fields of tropical medicine and international health. ITM’s academic triad of research, education and service provision places research at the forefront. In 2016, our researchers once again left their mark in the laboratory, at the bedside and in the field.

New scientific insights Over

3.000

In 2016, ITM researchers published 304

The EU-funded Ebola-Tx consortium

papers in highly ranked scientific jour-

also demonstrated the feasibility of con-

nals. Below we provide a selection illus-

ducting a high-quality trial, which both

trating the scope and quality of our work.

respects international ethical and safety regulations and is

women in Burkina Faso, Ghana, Malawi and Zambia were involved

The results of a

in the PREGACT trial

complex and demanding clinical trial with convalescent plasma as

grounded in com-

“Community-based clinical trials in developing countries are no easy undertaking”

munity participation, in the midst of an outbreak. As such, this group

DO YOU WANT TO KNOW MORE ABOUT PREGACT?

treatment for Eb-

VIMEO.COM/157585442

in the New England

gency trials and

Journal of Medi-

interventions.

ola were published

provided a model for future emer-

cine. Prof. Johan van Griensven and an international group of experts showed that

Prof. Kevin Ariën and his team devel-

adding convalescent plasma to standard

oped a new diagnostic test for Ebola and

treatment does not significantly improve

published their findings in the Journal of

the chances of survival for Ebola patients.

Infectious Diseases.

WOMEN PARTICIPATING IN THE PREGACT TRIAL, NAZOANGA, BURKINA FASO

The New England Journal of Medicine

Community-based clinical trials in devel-

Prof. Chris Kenyon described and an-

also published the findings of PREGACT,

oping countries are no easy undertaking,

alysed the different rates of decline of

a large clinical trial on malaria during

as described extensively by the EU-funded

syphilis around the world in PLOS Ne-

pregnancy coordinated by Prof. Umberto

research consortium NIDIAG under the

glected Tropical Diseases. The discovery

D’Alessandro, currently the director of

direction of Prof. Marleen Boelaert. In

of penicillin in the first half of the 20th

the MRC Unit The Gambia). PREGACT,

seven articles published in PLOS Neglected

century has led to a sharp decline of

for PREGnancy Artemisinin-based Com-

Tropical Diseases, the international group

syphilis worldwide, except in Africa.

bination Treatments, involved over 3000

of researchers analysed specific challenges

women in Burkina Faso, Ghana, Malawi

and possible solutions, as well as proposed

Prof. Jean-Claude Dujardin and col-

and Zambia. The four-year study showed

guidelines for quality-assured clinical field

leagues reconstructed the genetic ge-

that four available antimalarial treat-

research on neglected tropical diseases.

nealogy of Leismania donovani in the →

ments are safe to use in pregnancy. A multidisciplinary group led by Prof. Marc Coosemans investigated whether the widespread use of mosquito repellent at community level can help to beat ma-

FLEMISH SCIENCE DAY: CATCH A DISEASE

laria. In The Lancet Infectious Diseases, they

In November 2016, the Institute of

toms and treatment in their quest

described how failure to ground malaria

Tropical Medicine opened its doors to

to identify their disease. Back in the

control strategies on human behaviour is

the public on the occasion of Flemish

art deco main building, the public

one of the greatest obstacles to a successful

Science Day. Both children and adults

took a closer look at different kinds

intervention. Remarkably, despite 70% of

took part in an exciting geo-catch

of mosquitoes with the help of our

the nearly 50.000 participants in Ratana-

around the Institute where they each

entomologists. Children were also

kiri, Cambodia having reported daily use,

caught a disease. Participants were

invited to create their own insects in

anthropological studies showed that only

quizzed about prevention, symp-

an “Insectorama” drawing workshop.

8% effectively used the repellent.

ITM Annual Report 2016

RESEARCH

OUR CORE TASKS

40 YEARS EBOLA CONFERENCE: REBECCA JOHNSON (L) AND PETER PIOT

Indian subcontinent stretching back to

in Yambuku, DRC in 1976. Prof. Jean-

his colleagues organised two seminars

the 19th century. Their results, published

Jacques Muyembe, the first scientist on

dedicated to “complexity”, addressing

in eLIfe, perfectly matched the historical

site and a long-standing partner of ITM,

the need for a paradigm shift in the field

records of British physicians in India.

joined Belgian Ebola pioneers Guido van

of research and evaluation of health

der Groen and Peter Piot to share their

interventions.

Non-communicable, chronic diseases

experiences. Since October 2016 ITM takes part in

such as diabetes place an ever-growing burden on ill-equipped health systems in

In May, ITM also hosted the 13th edition

ZikaPLAN, a new EU-funded research

low-income countries. Dr. Josefien van

of the conference series on Molecular

consortium created in response to the

Olmen showed in the Journal of Clinical

Epidemiology and Evolutionary Genet-

Zika virus epidemic that struck Latin

and Translational Endocrinology that

ics of Infectious Diseases (MEEGID).

America in 2016. ITM will contribute

mobile health interventions - though a

This top conference on the molecular

to developing new diagnostic tools and

welcome addition to already well-func-

evolution of pathogens gathers dedicated

to investigating sexual transmission. ■

tioning programmes – are not the game

scientists from various fields of expertise.

changer that many experts assume.

In the run-up to the conference, ITM

Bringing top experts together In September 2016, ITM brought to-

organised a two-week course teaching hands-on applications of molecular tools in infectious disease research.

gether leading experts to discuss lessons learned from the unprecedented Ebola

Public health interventions are mostly

outbreak in West Africa from 2014-

composed of several interconnected ac-

2016. The meeting also marked the 40th

tions. Hence, they are popularly referred

anniversary of the first Ebola outbreak

to as “complex”. Prof. Bruno Marchal and

WANT TO KNOW MORE ABOUT OUR RESEARCH? 2016.ITG.BE/RESEARCH

PORTRAIT

How an untreatable ailment turned curable

months recommended

Until recently, patients with multidrug-resistant tuberculosis (MDR-TB) faced a very long and difficult treatment period, which many failed to complete. That was until ITM’s TB expert, Dr. Armand Van Deun, developed a shorter and more effective combination treatment that simplifies the clinical management and control of MDR-TB enormously. Dr. Van Deun, a clinical bacteriologist, specialised in tuberculosis while working in control programmes in Tanzania, Rwanda and Bangladesh for the Damien Foundation in the 1980s-90’s. During this time, he witnessed the spectacular rise of drug resistance, but refused to accept that patients could not be cured. In 1999, Van Deun joined ITM’s Mycobacteriology Unit while continuing to work closely with the Damien Foundation, The International Union against Tuberculosis and Lung DR. ARMAND VAN DEUN

Diseases, MSF and the WHO. After many

→

TB PATIENT IN BANGLADESH

Each year, nine million people develop

years of research and shuttling between

tuberculosis, a bacterial infectious disease

Bangladesh and Antwerp, Van Deun was

that is increasingly unsusceptible to availa-

able to fine-tune his “Bangladesh regimen”

ble antibiotics. Until recently, patients with

in 2006. He showed that the combination

TB that is resistant to more than one drug

of seven medicines ‘only’ needs to be

required two years of treatment, including

taken for nine months instead of 18 to 24

second-line drugs with toxic side effects,

months. “In the following years, several

such as deafness. Many patients did not

studies in other countries confirmed the

complete this taxing therapy and only

effectiveness of his treatment.

half of the patients were actually cured.

©DAMIEN FOUNDATION

The WHO’s adoption of Van Deun’s comIn May 2016, the World Health Organi-

bination therapy for MDR-TB crowns a

zation (WHO) adopted the combination

lifetime dedicated to research excellence

therapy that ITM’s Dr. Armand Van Deun

in service of the world’s most vulnerable

had developed and tested as the new

populations. ■

worldwide standard.

ITM Annual Report 2016

OUR CORE TASKS

Education In response to the needs of today’s students in our fast-paced, globalised world, ITM has been working intently towards building flexible, modular programmes and expert short courses that focus on active dialogue and mutual learning and integrate e-technology. “De-localisation brings education closer to where people bear the burden of tropical diseases and poor healthcare”

Take our Master of Science programmes in

Every eight years, higher education pro-

Public Health and Tropical Animal Health,

grammes in Flanders face an accreditation

for example. Regarded as international

process. In 2016 it was our turn. Both the

points of reference for decades, thousands of

MSc in Tropical Animal Health and

alumni around the world treasure the life and

the MSc in Public Health received the

study experience they gained in Antwerp.

green light – you can read more about

But as the world evolves, so too must our

the glowing assessment in the portrait

programmes if they are to remain relevant.

section on page 19. The MSc in Public Health has three orientations, among

110

on-going PhD’s at ITM

DO YOU WANT TO KNOW MORE ABOUT EDUCATION AT ITM? WWW.ITG.BE/EDUCATION

In January 2016, the revamped MSc in

them the newly accredited International

Tropical Animal Health programme,

Health orientation, which is flexible and

comprised of 24 animal health profession-

affiliated with the international higher

als, launched with an induction workshop

education partnership, tropEd. Studying

in the field. Purposefully located at the

part-time and learning from different

border of South Africa’s Kruger National

experts at various institutions is a very

Park and the Mnisi community, students

attractive feature of the programme. Not

got a taste of health at this model point

surprisingly, this orientation has seen

of exchange between humans, animals

rapidly increasing interest from both

and the environment. The master’s, now

European and third country candidates,

a joint venture with the Department of

which has led to this year’s decision to

Veterinary Tropical Diseases (DVTD) of

raise the admittance quota.

the University of Pretoria, South Africa, is a blended course offering a combination

Brand new

of e-learning and face-to-face modules

2016 saw many changes in our short expert

with a special emphasis on One Health.

courses. “De-localisation”, where the course

The programme draws on the comple-

is organised outside of ITM walls, is one

mentary research expertise of Pretoria

of these. This shift has brought education

and Antwerp, which cultivates a fertile

closer to where people bear the burden

environment for the development of high

of tropical diseases and poor healthcare.

quality training modules.

One such example is our short course on

600

students in 2016

MASTER’S STUDENTS IN DISCUSSION

Qualitative and Mixed Methods in Inter-

Antibiotic Resistance” was organised at

In the run-up to the 13th International

national Health Research. This intensive

ITM for the first time in June 2016. An-

Meeting on Molecular Epidemiology

one-month course provides students with

tibiotic resistance can only be controlled

and Evolutionary Genetics of Infectious

a comprehensive theoretical background

through a multidisciplinary approach,

Diseases (MEEGID XIII), ITM organised

and the methodological skills required to

which was specifically addressed in the

a two-week course on “Applied molecular

have greater insight into qualitative and

course. During the course, participants

epidemiology of infectious diseases” in

mixed methods research in order to better

(a mix of medical doctors, nursing staff,

May 2016. This first edition in Antwerp

understand human behaviour and local

pharmacists, biomedical and social sci-

built upon the experiences from a test

socio-cultural settings in international

entists and laboratory staff) developed

edition that took place in 2013 within the

health. For the first time since its launch,

a specific containment strategy to be

framework of the institutional collabo-

the 6th edition took place in The Gambia, in

implemented back home. Evaluations of

ration between ITM and the Institute of

close collaboration with ITM’s institutional

the course were highly positive and an

Tropical Medicine Alexander von Hum-

partner, the Medical Research Council Unit

extended three-week long second edition

boldt in Peru. The 15 participants worked

The Gambia. This edition attracted many

will follow in 2017.

on targeted computing skills and received →

European students, with the number of self-financing participants also noticeably increasing. The student mix and opportunity to carry out field work in a setting relevant for international health themes provided enriched exchanges in the course. Antibiotic resistance is a fast-growing problem worldwide, and is considered a major threat to public health by the World Health Organization. As a targeted response to the growing need for highly skilled professionals in the containment of antibiotic resistance in low-resource settings, a two-week course on “Hospital-Based Interventions to Contain SHORT COURSE ON ANTIBIOTIC RESISTANCE

ITM Annual Report 2016

EDUCATION

OUR CORE TASKS

EMERGING VOICES IN VANCOUVER

EMERGING VOICES

FOR GLOBAL HEALTH IN VANCOUVER Joining forces in course development is a notable trend in an

in Bangalore (India), ITM, and a globally representative

array of ITM programmes. For instance, Emerging Voices

Emerging Voices governing team. Emerging Voices 2016,

4 Global Health is a DGD-funded multi-partner blended

which was organised just before the 4th Global Symposium

training course directed at young health systems researchers

on Health System Research in Vancouver, brought together

from the South with the mission to empower a new gener-

40 young and promising health system researchers and

ation of global and local change makers. In 2016, the fifth

professionals, who were coached to actively participate in

venture was co-organised by the Institute of Public Health

and feature their work at the Symposium.

expert training in advanced molecular

institutions in Europe and worldwide host

tageous. Although LINQED has come

techniques to be applied in their own

15 PhD students who receive training in

to an end, the networking activities will

research on leishmaniasis, malaria or

disciplines ranging from parasitology,

continue and even be expanded under a

tuberculosis. Afterwards, the participants

molecular science, genetics, epidemiology

different umbrella. An international part-

were provided with ample opportunities

to strategic interventions. ITM is proud to

ner meeting in August 2016 identified the

to interact with each other and meet in-

host three of these students who are com-

need to initially focus on strengthening

ternational top experts of the field during

pleting the multi disciplinary programme

students’ research skills, on developing

the MEEGID conference, which is part

that bridges basic and applied research.

distance education as well as on organis-

of a prestigious Elsevier series.

Unique PhD programmes

Joining forces

ing staff exchange and jointly developing curricula. With the support of the Belgian

In 2016, the LINQED project - the net-

Development Cooperation, we are setting

Apart from the 103 regular PhD students,

work connecting ITM with institutional

up a broader educational alliance with

ITM is a proud partner in two innovative

partners with a focus on quality assurance

our academic partners in the South and

training programmes in which 7 students

in international health higher education

other interested institutions. ■

are completing (parts of) their doctoral

- concluded its final year. Its last annual

studies at the Institute. The first, the Trans

workshop took place in Kampala, Ugan-

Global Health programme, is part of

da, in May with 30 participants from

the highly competitive Erasmus Mundus

11 LINQED member institutions from

Joint Doctorate Programme. This trans-

Asia, Africa, Latin America and Europe.

disciplinary programme enables PhD

The workshop themes were ‘Cooperative

students to receive a double degree from

Learning, Critical Thinking in Higher

two partner institutes in two European

Education and Improving Education

countries. The second, EUROLEISH.NET,

Leadership and Research’. LINQED suc-

a Marie Sklodowska-Curie – Innovative

ceeded in proving that mutual learning on

Training Network, is a programme in

didactics and quality assurance through

which a selection of academic and private

networking is both feasible and advan-

WANT TO KNOW MORE ABOUT EDUCATION AT ITM? WWW.ITG.BE/EDUCATION

PORTRAIT

ITM Annual Report 2016

A course excellent in relevance

According to the NVAO, the Accreditation Organisation of the Netherlands and Flanders, ITM’s Master of Science in Public Health (MPH) achieves its societal objectives with distinction and continues to maintain the highest degree of academic excellence. Master’s student Rita Zawora Yao Zizien from Burkina Faso could not agree more. health career, a clear understanding of the

careers resulting from obtaining their

analytical approaches and interpretation

diploma, they form a strong professional

of data are must-haves.”

network and contribute to other influential networks for advocacy, capacity building

RITA ZAWORA YAO ZIZIEN

As with all master programmes in Flan-

and policy change.’ Indeed. Rita first heard

ders, the MPH must be re-accredited every

about the course from an alumnus: “my

eight years based on a thorough external

very first Regional Director of Health, Dr

assessment. In the latest assessment report

Robert Kargougou, who is currently the

published in August 2016, the NVAO once

Secretary General of the Ministry of Health

again designated this master’s-after-mas-

of Burkina Faso recommended the course

ter’s training programme as ‘excellent’,

to me. He told me about the great quality

which is quite impressive considering that

training he received and urged me to apply

only one other programme in Flanders has

to the institute once I obtained the necessary

ever received a similar appraisal. Among

field experience.”

other aspects, the report praised the lecturing staff for its extensive and varied

However, consistent excellent evaluations

ITM’s MPH turned 50 in 2014. This

international professional experience,

by no means give us the license to simply

long-standing programme is geared to-

which made their perspectives both keenly

rest on our laurels. Rather, this drives ITM

wards experienced health professionals

relevant and interesting for the students.

to think of innovative ways to keep our

in low- and middle-income countries

The report, likewise, made note of the rich

master’s programme excellent and relevant.

with the aim of strengthening health care

variety of teaching methods, high level of

In the coming eight years, we will work

in developing countries. The course has

interaction and up-to-date course material.

towards a course with a more diverse stu-

two study orientations: health systems

Rita could only second this opinion: “The

dent population in terms of professional

management and policy, and disease

most valuable for me in the course are the

background and originating from low-,

control. Rita Zawora, who is the head of

lecturers with immense field experience

middle-, but also high-income countries.

a district hospital where she combines

and the quality of the lectures they give

We will integrate an even greater variety of

clinical work and management, knows

us. The diversity of the assignments is

teaching methods, increasingly emphasize

that having experience in both is crucial:

also noteworthy – they always shed light

collaboration with an international and

“As a health district manager responsible

on a new dimension I have not previously

multidisciplinary teaching staff and will

for programme implementation, I was

thought about. I feel challenged!”

broaden our flexible modules organised in

faced with the difficulty of having to use

Antwerp or overseas by experienced staff

and analyse data to improve the perfor-

According to the NVAO assessment,

mance of my district. For a successful public

alumni ‘make clear steps forward in their

from partner institutions in the South. ■

ITM Annual Report 2016

OUR CORE TASKS

35.563

Medical services

consultations in 2016

The polyclinic is probably ITM’s best-known branch among the Belgian public, as it provides high-quality care to tens of thousands of travellers, migrants and people with HIV or other sexually transmitted infections (STIs) every year. The pre- and post-travel clinic, HIV centre, and STI clinic are supported by ITM’s dedicated expert laboratories that also serve as reference laboratories in Belgium and beyond. The polyclinic is part of our Department of Clinical Sciences, hosting academic units, medical units and reference laboratories.

Medical services include: Pre- and post-travel medicine ■ HIV/STI clinic ■ Helpcenter ■ Reference laboratories

ITM Annual Report 2016

Top 5 vaccinations 1. Yellow fever 2. Hepatitis A 3. Polio 4. Typhoid 5. Tetanus + Diphteria

QUICKER AND EASIER VACCINATION SCHEMES FOR RABIES

Belgium has been rabies free since 2001. However, in

ITM recommends preventive vaccination - which offers

Africa and Asia, this disease remains extremely common,

partial protection, but revaccination is required after a bite

claiming more than 60.000 lives a year, mostly among

- for those planning adventurous travels or regular visits

young children. Strikingly, it is a disease that is prevent-

to risk countries (like in Africa or Asia). However, rabies

able through the vaccination of children and dogs. The

preventive vaccination is currently not simple requiring

World Health Organization wants to eradicate rabies

three shots at three different times to build up protection

globally by 2030 and ITM actively supports this objective

against the disease (day 1, day 7 and day 28). Due to poor

by researching how to improve vaccination schedules.

health infrastructure, it is not easy to implement such a difficult scheme in the countries where the disease claims

If bitten, bite wounds should be washed thoroughly with

most lives. Since 2011, ITM and the Ministry of Defence

soap and water for 15 minutes, as the virus is extremely

have been jointly carrying out research into easier and

sensitive to detergents, followed by treatment with disin-

shorter rabies vaccination schedules to help eradicate this

fectants. Medical attention for further care and possible

disease worldwide.

post-exposure prophylaxis (vaccination after the risk contact) should be sought out as soon as possible.

ITM Annual Report 2016

MEDICAL SERVICES

OUR CORE TASKS

Zika cases among Belgian travellers:

2.956 of diagnostic tests

This distinct ITM model bridges patient

settings. A new audit and certification

care and medical research, placing the

programme was introduced as part of

patient at the heart of the departments’

restructuring within the WHO and ITM’s

and institution’s missions. Our clinics

HIV/STI laboratory was one of the first

and laboratories collaborate closely with

to be confirmed for a new mandate as

other centres in Europe and across the

WHO testing laboratory.

130

confirmed cases

globe, for example in the development and validation of diagnostic tests, the surveillance of import diseases and the

Our reference laboratories

implementation of multi-centre clinical

1. National Reference Centre for arbo-

studies and trials.

viruses 2. National Reference Centre for sexu-

In total, fourteen of ITM’s medical and

ally transmitted diseases (Treponema

research laboratories are recognised na-

pallidum, Chlamydia trachomatis,

tional or international reference centres.

Neisseria gonorrhoeae, Mycoplasma

Our HIV/STI and immunology labora-

genitalium)

tories have yet again been accredited

3. National Reference Centre for Rickett-

as WHO-collaborating centres up to

sia and Anaplasma (consortium with

2020, and continue to provide advice

Koningin Astrid Militair Hospitaal)

and develop guidelines in support of

4. National Reference Centre for Coxiella

international programmes. So far, they

burnetti and Bartonella (consortium

have also assessed more than 250 different

with UCL Saint-Luc et CODA)

rapid tests for the WHO and/or WHO

5. National AIDS Reference Laboratory

member states. The green light of our

6. WHO Collaborating Centre for HIV/

laboratories is required before new tests

AIDS Diagnostics and Laboratory

can be marketed or utilised in endemic

Support

WANT TO KNOW MORE ABOUT OUR MEDICAL SERVICES? WWW.ITG.BE/E/MEDICAL-SERVICES

7. National reference laboratory for infectious and tropical diseases 8. WHO Collaborating Centre for the Diagnosis and Surveillance of Mycobacterium Ulcerans Infection 9. Supranational Reference Laboratory (SRL) for Drug-Resistant Tuberculosis 10. World Organization for Animal Health Reference Laboratory for Surra 11. WHO Collaborating Centre for Research and Training of Sleeping Sickness Diagnosis 12. National Reference Laboratory for Trichinellosis, Echinococcosis, Sarcosporidiosis and Anisakiasis 13. FAO Reference Centre for Livestock Trypanosomiasis 14. OIE-Reference Centre for theileriosis

PORTRAIT

ITM Annual Report 2016

Zika: headline story of 2016 The Zika virus epidemic in Latin America put physician Ralph Huits, molecular biologist Lieselotte Cnops and their colleagues from ITM’s medical services to the test in 2016. With Ebola barely under control, our expertise in tropical fever was once again solicited by the public and the authorities.

after the acute infection phase had passed. In a matter of weeks, our virology unit and clinical laboratory developed and implemented new tests, which detect antibodies specific to the virus, even when the body has recovered from the infection. “Each day, we received returning travellers with questions about exposure to the virus. Especially for pregnant women or couples with a wish to become pregnant, knowing whether or not they had been infected was

LIESELOTTE CNOPS AND RALPH HUITS

crucial,” said Huits. In the course of 2016,

Belgian travellers have always had a weak

Lieselotte Cnops had already developed

ITM’s clinical laboratory tested over 2000

spot for Latin America’s popular holiday

molecular diagnostic tests for many vi-

returning travellers, confirming over 100

destinations. In 2016, they were joined

ruses, including chikungunya, which

Zika cases. Our experts also responded to

by thousands of athletes and supporters

had also caused a large outbreak in Latin

countless media requests about the Zika

attending the Rio Olympics in Brazil, the

America in 2014. When, in 2015, the first

virus epidemic.

country most severely hit by the Zika

Zika virus reports arrived from Brazil,

virus outbreak.

Cnops anticipated the need to develop

The situation remains far more pressing

another test. “We knew that, in case of

in some of the over 60 endemic countries,

According to Ralph Huits, who in 2010

a large outbreak, it was only a matter of

some of which have been confronted

began research in Aruba on dengue, a

time before we were going to deal with

with millions of cases. ITM does joint

virus very similar to Zika, “Even though

this rapidly spreading virus in our travel

research with a fertility clinic in Trinidad

Zika virus infection had been considered a

clinic,” said Cnops. ITM confirmed the first

and Tobago and is a member of the large

mild flu-like illness, the link between Zika

Belgian Zika case in January 2016 using

European Union funded research network

virus and microcephaly put a relatively

an in-house developed molecular test.

ZikaPLAN, which aims at fighting Zika

mild and unknown virus high up on the

today and at building long-term outbreak

health agenda”. As early as January 2016,

From 2015, ever more scientific evidence

response capacity in Latin America. In

ITM began advising pregnant women or

was published about congenital malforma-

ZikaPLAN, our researchers are charged

couples who wished to conceive, to avoid

tions and the possibility of sexual trans-

with investigating sexual transmission

travelling to areas where the Zika virus

mission. However, no reliable diagnostic

and developing more rapid diagnostics

was endemic.

test was yet at hand to confirm an infection

for Zika virus infections. ■

ITM Annual Report 2016

OUR CORE TASKS

ITM-DGD Framework Agreement ended in 2016

Development cooperation

With generous support from the Belgian Ministry and Directorate-General for Development (DGD), ITM runs an extensive programme of individual and institutional capacity building in the South. Under the motto “Switching the Poles”, partner institutes gradually take charge of the collaboration in order to develop the scientific and medical expertise most relevant for their country as well as the world. The third framework agreement between ITM and DGD, which kicked off in 2008, came to an end on 31 December 2016 having received an annual budget of no less than € 15.500.000. DENGUE CAMPAIGN WORKERS MILAYDIS AND RAFAELA INSPECT A WATERTANK IN LA LISA NEIGHBOURHOOD HOME, CUBA

The ITM-DGD framework agreement includes 10 country programmes in Benin, Burkina Faso, Cambodia, Cuba, Democratic Republic of the Congo, Ethiopia, Guinea, Peru, South Africa and Vietnam. See also the map on page 10.

VISIT OF MINISTER ALEXANDER DE CROO

“ Whenever health issues come up in my discussions, ITM gets a positive mention” ALEXANDER DE CROO BELGIAN DEPUTY PRIME MINISTER AND MINISTER OF DEVELOPMENT COOPERATION

“Whenever health issues come up in my discussions, ITM gets

also met with students and researchers from the South cur-

a positive mention,” said Belgian Deputy Prime Minister

rently being trained at ITM thanks to support from DGD.

and Minister of Development Cooperation Alexander De Croo about our reputation when visiting our Institute in

Minister De Croo received a special briefing on the sleeping

November 2016. The Minister and ITM’s management

sickness programme in DR Congo and encouraged ITM

committee discussed the past, present and future of the

to set ambitious goals for the elimination of this long-time

relationship between ITM and the Ministry. The delegation

affliction.

A changing political context

Uganda, where our partners had largely

programmes range from diagnostics, treat-

In recent years, DGD has focused its

reached their development goals. We

ment and control of neglected tropical and

“bilateral” (country to country) cooper-

strive to continue these partnerships in

infectious diseases to health systems with

ation increasingly on the least developed

joint research and education initiatives.

specific attention to reproductive health,

countries, fragile states and post-conflict

fragile contexts and socio-economic and

zones, mainly in Africa. While this policy

A new framework programme

is not compulsory for NGOs and other

In September 2016, ITM submitted a

access to care or acceptance of interven-

“indirect actors” such as the universities

proposal to DGD for a fourth ITM-DGD

tions. Guinea-Conakry is a new partner

and ITM, these bodies concluded an

framework programme for the period

country and we will begin to collaborate

agreement with DGD to limit their number

2017-2021. The new programme in-

with the “Centre National de Recherche et

of partner countries with a similar, be it

cludes collaboration with 10 country

Formation en Santé Rurale” and the NGO

less exclusive, focus. As a consequence,

programmes in Benin, Burkina Faso,

“Fraternité Médicale Guinée” to train health

countries such as India or Indonesia,

Cambodia, Cuba, Democratic Republic

professionals and to rebuild the national

where ITM has enjoyed long-standing

of the Congo, Ethiopia, Guinea, Peru,

health system in the post-Ebola era.

partnerships, are no longer eligible for

South Africa and Vietnam. In each coun-

DGD support. We narrowed our coun-

try, we will collaborate with one to four

Also part of the programme is a special

try portfolio further by winding down

partner institutes to strengthen national

ITM initiative in DR Congo aimed at ad-

our institutional capacity building in

capacity for health research, training and

vancing innovative technical and strategic

Ecuador, Bolivia, Morocco, Senegal and

service delivery. Thematically, the country

approaches to the control and elimination →

anthropological determinants, such as

ITM Annual Report 2016

DEVELOPMENT COOPERATION

OUR CORE TASKS

“ Country programmes range from diagnostics, treatment and control of neglected tropical and infectious diseases to health systems”

ESTHER NAKKAZI, 2016 JOURNALIST-IN-RESIDENCE

of sleeping sickness (Human African Trypanosomiasis), receiving matching support from the Bill & Melinda Gates and Cargill Foundations. The new ITM-DGD framework agreement also allows us to develop and strengthen a global “Alliance” programme of education, training and exchange in institutional partner countries and beyond. Other initiatives in the coming five-year programme are fellowships for ITM’s expert, master’s and PhD training; expert and policy support from ITM experts to DGD; the coordination of Be-cause health (the platform

JOURNALIST-IN-RESIDENCE 2016

of Belgian actors in international health, www.because-health.be) and networks on international health policy (www. internationalhealthpolicies.org) and the

Since 2014, the Institute has been

can science journalists in Uganda

quality of medicines (www.quamed.org).

inviting a journalist from Africa,

and beyond. Esther maintains an

Public awareness initiatives on tropical

Asia or Latin America each year to

active blog called ‘Uganda ScieGirl’

and global health are also foreseen.

reside here for several weeks. After

where she writes about science and

deepening their understanding

health. At ITM, Esther contrib-

In a similar but separate programme,

of tropical medicine and glob-

uted to our International Health

funded by the Flemish Ministry of Inter-

al health issues in Antwerps, the

Policy newsletter, increasing her

national Affairs, ITM supports the work

journalists-in-residence are better

knowledge about health policy.

of the National Public Health Institute in

equipped to report about these

She also reported about the 2016

Maputo, Mozambique. ■

issues. Ugandan science journalist,

Ebola conference held in Antwerp

Esther Nakkazi, was selected from

in September, which reflected on

a range of candidates as ITM’s Jour-

the latest outbreak and commem-

nalist-in-Residence 2016. Esther is

orated the 40th anniversary of the

a freelance reporter specialised in

first Ebola outbreak in Yambuku,

science and technology. She teaches

DRC in 1976.

media training and mentors Afri-

WANT TO KNOW MORE ABOUT DEVELOPMENT COOPERATION? SWITCHINGTHEPOLES.ITG.BE

PORTRAIT

ITM Annual Report 2016

Better health for all in India

In 2008, ITM started working with the Institute of Public Health (IPH) in Bangalore within the framework of its institutional capacity building programme funded by the Belgian Development Cooperation. Founded in 2005 by ITM alumnus Dr. N. Devadasan, IPH has since made a noticeable impact on improving access to quality health care in India through research, capacity building and advocacy. international peer-reviewed journals, all this within a period of eight years”. 2017 marks a new chapter in the relationship between ITM and IPH. Due to a changing political agenda, IPH Bangalore will not be formally included in ITM’s 2017-2021 capacity building programme, but both parties DR. N. DEVADASAN, DIRECTOR OF INSTITUTE OF PUBLIC HEALTH, BANGALORE, INDIA

are determined to continue collaboration. (see also the main text on this page).

India has a mixed public/private healthcare

services, looking at financial constraints

system. When people become ill they often

in government structures. They also in-

It has also recently come to light that these

turn to private practitioners believing

vestigate why people do or do not visit

plans might be complicated by India’s Home

they will receive better and quicker care.

public facilities, in order to identify areas

Ministry’s decision to deny IPH, as well as

However, this is not always the case, as

of improvement for the public sector.

many other NGOs, permission to continue

actors in the unregulated private sector

receiving foreign funds. It is difficult to see

often authorise unnecessary treatments

In 2015, IPH also took over the coor-

this decision apart from the important con-

motivated by financial incentives. Currently,

dination of ITM’s “Emerging Voices for

tribution IPH has made, through research

seventy percent of medical expenses in

Global Health”, an innovative multi-partner

and advocacy, to a recent anti-tobacco law

the country come from out-of-pocket

blended training programme aimed at

in Karnataka, a state of about 65 million

payments, which forces around 60 million

empowering young researchers from the

people. Despite these setbacks, ITM is

people into poverty each year. This is where

South by providing intensive skills training

thrilled with IPH’s achievements and is

IPH comes in, taking equitable access to

and facilitating their participation in a

eager to continue joining forces to promote

health care to heart.

global health conference.

better health in India and beyond.

ITM has helped IPH to set up a pioneering

In other words, IPH Bangalore has come

“Today, IPH is considered as a credible

e-learning programme on public health

a long way in a decade. “ITM has helped

academic institution and its faculty are on

management for health professionals, and

us to grow as an institution. Our relation-

various government committees. We hope to

the two institutes collaborate on several

ship is built on mutual respect and shared

continue our efforts to strengthen the Indian

joint research projects, which feed into

priorities,” said Dr. N. Devadasan. “Today,

health systems, so that the most vulnerable

policymaking. For instance, researchers

we have trained more than 1.800 students

get access to quality health care and can lead

from both institutes examine district health

and published more than 100 articles in

a healthy life,” said Devadasan. ■

ITM Annual Report 2016

ITM figures Research

2016

2015

2014

Papers in scientific journals

304

332

330

SCIENTIFIC EXCELLENCE AND IMPACT Innovative research projects running with the support of Flanders OPEN GLOBAL CAMPUS

New international research projects

ITM IN THE INTERNATIONAL RESEARCH AREA International research consortia led by ITM Clinical trials coordinated by ITM

Education MASTER

Master’s students

Master’s students Public Health

Master’s students Tropical Animal Health

Nationalities

Belgian

Non-EU countries

121

122

121

ostgraduate Certificate in Tropical Medicine and P International Health

Belgian

Non-EU countries