Michael Marmot Passionately Delivers Yet Another Wake Up Call At Harvard About Inequalities In Health “Crisis”, “Calamity”, “Disaster” Are All Used To Describe Negative Changes In Life Expectancy Michael Marmot is Director of the Institute of Health Equality at the University College London Research Department of Epidemiology & Public Health and a well-known champion for social determinants of health. He delivered the annual Cutter Lecture in early May at the Harvard School of Public Health entitled “Social Justice, Health Equity, and the Social Determinants of Health.”
Life Expectancy As Index The cornerstone of Marmot’s cause for alarm described in the Lecture is the stall or fall in life expectancy in England in 2011 which until then had been increasing by one year every four years since the 1920’s. If you believe that health tells us something
Epidemiology Called “Loosey-Goosey Field”
June 2019
-3Epidemiology at Univ. Buffalo Celebrates 100th
- Marmot cont'd on page 2
Judge Postpones Trial And Appoints Mediator In Glyphosate Litigation Recent jury trials on whether or not glyphosate causes non-Hodgkins lymphoma have rendered verdicts in favor of plaintiffs with multi-million or even billion dollar awards against Monsanto, the maker of the wellknown Round Up, a glyphosate-based weed killer. Now a federal judge in San Francisco has postponed a pending federal trial and appointed an experienced mediator to help resolve the dispute between the parties.
In This Issue
According to the NY Times, that mediator is Kenneth Feinberg who has experience in mediating conflicts over the September 11th Victim Compensation Fund, the BP Deepwater Horizon oil spill, Volkswagen’s diesel emissions scandal, and the General Motors ignition switch litigation. It’s not clear what the judgment about the causal role of glyphosate, if any, will be. - Mediation cont'd on page 8 •
Volume Forty •
Number Six
-7New Epi Contest -10Notes on People -12Near Term Epidemiology Event Calendar -14Marketplace
-Marmot cont'd from page 1 The Epidemiology Monitor ISSN (0744-0898) is published monthly by Roger Bernier, Ph.D., MPH at 33 Indigo Plantation Rd, Okatie, SC, 29909, USA.
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Role of Money
fundamental about how well a society is meeting the needs of its population, said Marmot, then this is a “crisis” and the cause urgently needs to be uncovered. Using additional data, Marmot showed that life expectancy at birth is decreasing in some sections of the UK and is worse for the poorest women. Not only is this a “calamity”, he said, but the inequalities are getting worse and that this is a “disaster”. He went on to present similar data about life expectancy and inequalities in the US population.
Marmot also went on to describe how having more money or purchasing power does make a difference in life expectancy at birth in different countries, but only up to a certain threshold. Above the threshold, other factors play into the health determinants. For example, life expectancy in Costa Rica, Cuba, and Chile is similar to that in the US, however, the GDP per capita is much higher in the US. Something else is driving health in these situations besides purchasing power.
One cannot expect to continue gaining in life expectancy, according to Marmot, if inequalities are on the rise. He went on to suggest that the election of Donald Trump and the Brexit vote were not the causes of recent losses in life expectancy, but rather that underlying inequalities have led to both the health crisis AND the election of Trump and the Brexit vote.
Another way of illustrating this disparity is to note that poor persons in Baltimore with the same purchasing power as persons in Costa Rica have a life expectancy of only 63 years versus 77 in Costa Rica.
Amenable To Change Marmot then presented indirect evidence that heath inequalities can be reduced and life expectancy can be improved through government actions. He correlated changes in government administrations in the UK and US with changes in life expectancy and infant mortality, respectively, with populations faring worse with conservative or Republican administrations. These changes are correlated with the percentage of Gross Domestic Product being spent on social programs with the US ranking only 23rd among OECD countries.
Causal Model Marmot described both 1) structural drivers such as racism, economic systems, and cultural factors and 2) conditions of daily life such as early life experiences as having impact on health equity and leading a dignified life. An approach to health and well-being Marmot endorsed is one he uncovered in New Zealand’s Department of Treasury which states that “a well-being approach can be described as enabling people to have the capabilities they need to live lives of purpose, balance, and meaning for them.” Closing Observations “I believe that unarmed truth and unconditional love will have the final word in reality. This is why right, - Marmot cont'd on page 9
Influential Department Of Epidemiology At Buffalo Celebrates 100 Years Of Public Health Contributions Chair Jo Freudenheim Tells The Department’s Story In Our Interview Below The Department of Epidemiology and Environmental Health at the University of Buffalo is celebrating 100 years of contributions to the health of Buffalo, the region, the nation, and the world. We were surprised to learn about the long history of the Department and contacted Jo Freudenheim, the current chair of the Department, to get an insider’s view of the history and the events of the celebration. Here are our questions and Dr Freudenheim’s responses Epi Monitor: There are not many schools or departments of public health that are 100 years old. We know that Hopkins and Harvard are among the earliest to move in that direction, but I was surprised that Buffalo was in that category. Assuming I am correct, what do you think explains the creation of your department before many others? Are the factors the same or different than the other early departments that were founded? Freudenheim: That Buffalo was among the first to have a department focused on public health is not so surprising. When the department was founded in 1919, Buffalo was one of the largest cities in the US and it was a center of industry and innovation, including health innovation. Founded in 1846, the University at Buffalo was originally solely a medical school and was among the earliest medical schools in the US. The first cancer research center in the world was in Buffalo, founded in 1898, becoming what is today the Roswell Park Comprehensive Cancer Center.
The Roswell cancer hospital opened in 1913. In 1918, the Buffalo city hospital opened. Clearly the period around 1919 was a time of huge development in health and health delivery innovation in the region. In addition, there was at that time a history of epidemiology and public health in Buffalo. As early as the 1840’s, there was a published investigation of an outbreak of fever by Austin Flint, a UB faculty member. Flint’s research contributed to John Snow’s realization that water could transmit communicable disease and Snow referred to Flint’s work in his publication on cholera. Even before the department was created, there were courses in public health offered to the medical students and in 1913 a division of Hygiene and Sanitation was formed. When the department was founded, it was called the Department of Hygiene and Public Health, providing the nexus for public health for the medical school. While I am not certain what the motivation was for the formation of the department in 1919, it is likely that a contributing factor was the 1918 influenza pandemic. The outbreak in Buffalo was substantial, requiring a strong public health response including quarantines, and likely resulting in an increased appreciation of the importance of epidemiology and public health.
" As early as the 1840’s, there was a published investigation of an outbreak of fever by Austin Flint, a UB faculty member. Flint’s research contributed to John Snow’s realization that water could transmit communicable disease..."
Epi Monitor: What is some of the thinking that went into the decision to - Buffalo cont'd on page 4
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-Buffalo cont'd from page 3 celebrate the 100th anniversary? Is there a main anticipated benefit?
"This relatively small department has had a disproportionate impact on epidemiology and public health."
"... a disproportionate number of leaders in the field have been educated in Buffalo—including deans, chairs, leading government researchers, presidents of the major organizations."
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Freudenheim: We are celebrating the 100th because it will be a long time until we can have another such celebration! We think it is important to take a step back, to understand where we are coming from so that we have new perspective on where to go next. Putting together the history has been a great opportunity to see all that has gone on in Buffalo that has impacted health both in the region and more generally. We are hoping that this celebration is an opportunity for our alumni and all the faculty and staff who have been associated with the department to have a chance to reflect on all that has been accomplished. This relatively small department has had a disproportionate impact on epidemiology and public health. Epi Monitor: Your department has had multiple different names over the past 100 years. One that is particularly striking is going from the Social and Preventive Medicine Department to the Department of Epidemiology and Environmental Health. In years past it seems that Buffalo was most widely recognized for the Social component, but that element was dropped from the name. Can you comment on the change in name and the reasons for it? Freudenheim: There is a great deal of wonderful history attached to the previous name, Social and Preventive Medicine (SPM). We were SPM from 1967 until 2014 when we became the Department of Epidemiology and Environmental Health (EEH). As a department, we spent a lot of time and had many discussions in the course of changing our name. In the end, we decided that EEH was more
representative of who we are now and the focus of our work. We continue to have an interest in the topics that are included under the social and preventive medicine umbrella. However, there are now faculty doing work in a broader scope of epidemiology--molecular and genetic epidemiology focused work, for example. In addition, there are two additional divisions within the department—one in Environmental Health and one in Health Services Policy and Practice—and we wanted the name to better represent that diversity of focus. Epi Monitor: The information material about the anniversary event notes that several famous epidemiologists of the past had some affiliation with Buffalo. Names like Graham, Lilienfeld, Terris, Winkelstein and others. Has Buffalo been an above average magnet for epidemiologists or training ground for epidemiologists? If so, what reasons do you think might account for that? Freudenheim: As I mentioned above, our department has always been a relatively small one. Nonetheless, it has attracted major epidemiologists— outstanding faculty, researchers and students. In addition to the individuals you list, a disproportionate number of leaders in the field have been educated in Buffalo—including deans, chairs, leading government researchers, presidents of the major organizations. I would say, yes, Buffalo has been well above average as a magnet for faculty and as a training ground. I think that the attraction was the intellectual environment and the culture of innovation which attracted strong researchers to the work that was being done here. The outstanding - Buffalo cont'd on page 5
-Buffalo cont'd from page 4 leaders in the department have nurtured their mentees to do outstanding work and to take leadership in the field. Further, in the last 100 years, there has been important synergy of public health and epidemiology between UB and Roswell Park, both the surgeon by that name who founded the cancer center and also the cancer center itself. That relationship continues and increases in strength, as we continue to work together to educate the leaders of the future. Epi Monitor: Where does Buffalo rank today among a much larger universe of Schools of Public Health and what are the areas of greatest expertise or emphasis? Freudenheim: As noted above, we are a relatively small but very strong department. Research in the department still includes nutrition and on cancer, both long focus areas of the department. In addition, we are engaged in important research on cardiovascular disease, aging, particularly among postmenopausal women, eye disease, child growth and development, and pregnancy. In addition, there is research on global health, air pollution, heavy metal exposures, physical activity, health disparities, genetics, pesticides, the microbiome, health services and access to care. The department is thriving and growing in exciting new directions. Epi Monitor: The special lecture during your event will be the Saxon Graham Lecture. For persons unfamiliar with his work, can you give a brief account of why Dr Graham is is honored in this way?
Freudenheim: Dr. Graham was an internationally known cancer epidemiologist, best known for his groundbreaking studies on diet and cancer. He started those studies beginning in the 1950s, at a time when the prevailing wisdom was that it was not possible to include diet in an epidemiologic study. He was a longtime UB professor and was chair of the department from 1981-1991. Dr. Graham was an incredible mentor, providing guidance to a generation of epidemiologists as well as serving as a role model with his leadership in the field. He was an innovative thinker, for example, applying a thoughtful discussion of the science of creativity to epidemiology in his SER Presidential address in 1987. Dr. John Vena, Professor and Founding Chair of the Department of Public Health Sciences at the Medical University of South Carolina will give the Saxon Graham lecture this year. John received his PhD degree from our department and was a faculty member here 1981-2003. Epi Monitor: You are hosting a symposium as part of your celebration. Can you say a little something about the speakers and the topics that were chosen for this occasion? Is there a common underlying theme? Freudenheim: The focus of the celebration is on both epidemiologic research in the last 100 years and new directions for epidemiology for the future. As noted above, the celebration starts with the Saxon Graham lecture given by John Vena. For the symposium, Dr. Moyses Szklo will give a plenary talk. The symposium showcases some of the history of the research that has come out of the department as well as new directions for that research. Speakers will include - Buffalo cont'd on page 6
"... in the last 100 years, there has been important synergy of public health and epidemiology between UB and Roswell Park..."
" The symposium showcases some of the history of the research that has come out of the department as well as new directions for that research."
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-Buffalo cont'd from page 5
"I think that it is important to have a sense of the history of public health, to understand the factors that brought us to where we are today."
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Drs. Germaine Louis, Dean of the College of Health and Human Services at George Mason University, Brian King, Director of Research Translation, Office on Smoking and Health at CDC and Shauna Zorich, Clinical Assistant Professor in EEH at UB. All are EEH alumni. In addition, James Marshall, Professor Emeritus, Roswell Park Comprehensive Cancer Institute, a former EEH faculty member and Laura Smith, a current EEH faculty member, will give talks. Epi Monitor: What would you like colleagues at other Schools of Public Health to takeaway from your celebration event? Freudenheim: I think that it is important to have a sense of the history of public health, to understand the factors that brought us to where we are today. Some things have changed enormously in our field in the last several years—such as the ability to
handle extremely large data sets, the integration of molecular analyses with other epidemiologic data. Even these changes have roots in how we tried to improve the public health throughout the last 100 years. In addition, there are some things that have changed little—we are still concerned about the possibility of a major flu pandemic. We are still struggling with other infectious disease outbreaks such as the measles outbreak. We are still trying to understand how complex factors such as diet, the environment, physical activity, and access to care impact morbidity and mortality. Our view of public health is increasingly global as we better recognize how the health of populations everywhere impacts health throughout the world. It is extremely important to understand where we have come from and what we have accomplished as we look to the future to address these challenges and the ones that we cannot even yet imagine. ■
On The Light Side - New Contest Entries Received For 10 Commandments Contest Readers Encouraged To Enter Contest With Examples Below Last month we started a contest to identify 10 Mock Serious Commandments for epidemiologists to win a $500 prize. The contest rules are being republished here with examples of commandments submitted from our readers to encourage more readers to submit entries for our contest. Here are some examples of potential mock serious commandments for epidemiologists received from epidemiologists: Thou shalt not ignore confounders, measured or unmeasured. Thou shalt not entertain false evidence. Thou shalt not covet thy colleagues sample size. Thou shalt collaborate when thy sample size is insufficient. Thou shalt share thy data and analysis code. Thou shalt always construct and consult a DAG. Thou shalt not worship any false DAGs or other diagrams with bidirectional arrows.
Honor the weight of the evidence. Thou shalt not torture the data. Use your creative talents, send us your commandments, and get a chance to win $500.
Rules All entries must be received by July 31, 2019 at editor@epimonitor.net. If similar entries are received, the earliest received will have precedence. All entries must be original, created by the contestant, and not previously published elsewhere. The editor reserves the right to make the final selection of the contest winner, and all submissions become the property of the Epidemiology Monitor. Individuals may join together as a group and submit an entry or entries by department, school or other entity. A set must contain at least 10 commandments. We reserve the right to nullify the contest if too few entries are submitted, though we think this is unlikely given all the creative entries we have received from our previous contests!
"Thou shalt not worship any false DAGs or other diagrams with bidirectional arrows."
"Thou shalt not take the name of thy statistician in vain."
Thou shalt not have any alternative facts that come before Science. Thou shalt not take the name of thy statistician in vain. Remember to protect thy nights and weekends from thy work.
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-Mediation cont'd from page 1 Judge Reviews Evidence
"He called epidemiology 'a bit of a looseygoosey field' and found that the evidence implicating glyphosate was 'pretty sparse'."
"Did authors of new meta-study deliberately manipulate data or just botch their analysis?”
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The LA Times has reported that Vince Chhabria, the federal judge who postponed the pending trial this month, held pre-trial hearings before an earlier first trial last year. As a result of those pre-trial hearings, the LA Times described the judge as openly skeptical of some of the evidence. He called epidemiology “a bit of a loosey-goosey field” and found that the evidence implicating glyphosate was “pretty sparse”. According to the Times, he questioned how “an epidemiologist could conclude, in the face of all the evidence…that glyphosate is, in fact, causing non-Hodgkins lymphoma in human beings.” But he also questioned whether you could be sure it was safe and said “There’s at least a strong argument that the only reasonable conclusion one could draw right now is that we don’t know yet.” He allowed the first federal trial to proceed and the jury in that trial did make an award for $80 million. Now he has postponed a second pending trial and ordered the parties to mediation.
Glyphosate based herbicides and increased risk for Non-Hodgkins lymphoma.” Critique These findings have been scrutinized and found wanting by at least one epidemiologist. Geoffrey Kabat, who has focused in the past on identifying weak or flawed studies that are misleadingly reported by investigators and the media, presented a critique of the Zhang meta-analysis. It appeared on the website for the Genetic Literacy Project and was headlined “41% glyphosate-cancer increase claim under fire: Did authors of new metastudy deliberately manipulate data or just botch their analysis?” The key points he made in his critique were:
Zhang and the other researchers set out to combine the results of studies of drastically different quality. Yet they never question the appropriateness of conducting a meta-analysis, which, in this case, is the weighted average of one high-quality cohort study (Agricultural Health Study, AHS) with five casecontrol studies of much poorer quality.
Confronted with the choice of which risk estimate to select from the AHS, the researchers chose the highest RR of the 5 reported in the AHS, thus, ensuring that the resulting summary RR would reach statistical significance.
New Meta Analysis It appears that some of the controversy around glyphosate was reignited by the publication of a meta-analysis in Mutation Research earlier this year by Luoping Zhang and colleagues which reported an overall meta relative risk of 1.41, (95% CI 1.13-1.75). Combined with experimental animal and mechanistic studies, the authors concluded that “our current meta-analysis of human epidemiological studies suggests a compelling link between exposures to
- Mediation cont'd on page 9
-Mediation cont'd from page 8
In order to give their paper the appearance of academic rigor, the authors conducted a huge number of secondary analyses, varying different conditions, to convince us that the 41 percent increase in risk is a solid result that is not affected by varying different aspects of their analysis. But these “sensitivity analyses” and subtle statistical considerations are presented instead of addressing more basic issues that determined the results of the meta-analysis.
the opposing sides to work out an acceptable or just solution. Meanwhile, the truth of the matter, that is, the causal role of glyphosate, if any, is likely to take longer to settle, and the answer may arrive well after the legal settlements have been reached. ■
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The authors highlighted the 41% result, which they almost certainly realized would grab headlines and inspire fear.
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Dr Zhang, an adjunct professor of toxicology at Berkeley, was asked if she has responded to the Kabat criticisms but she did not respond to our inquiry. Role of Jurors The controversy around glyphosate not only raises questions about the causal role, if any, of glyphosate but also of the role of juries and mediators in sorting through conflicting scientific claims. Are the jurors as laypersons up to the task of evaluating conflicting scientific claims? Should the court seek an independent advisory group separate from the plaintiffs and defendants lawyers? Should the judge play a heavier hand in the final outcome? By appointing a mediator, the Judge Chhabria may be affirming the uncertainty and leaving it to the
" The controversy around glyphosate not only raises questions about the causal role, if any, of glyphosate but also of the role of juries and mediators in sorting through conflicting scientific claims."
-Marmot cont'd from page 2 temporarily defeated, is stronger than evil triumphant.” These words from Martin Luther King were invoked by Michael Marmot to parallel and encapsulate his own two-pronged strategy of using evidence-based policy (truth) in a spirit of social justice (love) to combat social inequalities. To listen to the Cutter Lecture, readers may visit: https://bit.ly/2x1ykBH
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Notes on People Do you have news about yourself, a colleague, or a student? Please help The Epidemiology Monitor keep the community informed by sending relevant news to us at this address for inclusion in our next issue. people@epimonitor.net
Died: Sarah Luna, age 31, in a plane crash in Metlakatla Harbor Alaska. She was a senior epidemiologist in the Liver Disease and Hepatitis Program of the Alaska Native Tribal Health Consortium and was traveling to the area in partnership with the Diabetes team. The Consortium described her as a person truly committed to the health and well-being of Alaska Native people.
Honored: Frank Tanser, with the Royal Geographical Society Back Award for pioneering the use of geographical information systems in the field of HIV epidemiology. Tanser is a research professor and senior faculty member of the Africa Health Research Institute (AHRI) at the University of KwaZulu-Natal. Tanser is credited by a colleague with making an amazing contribution to impoverished communities burdened with the HIV epidemic.
Honored: Nilka Rios Burrows, with the Public Service Award from the National Kidney Foundation. The award is for “someone who has dedicated their career to public service and has helped shape public policies or government programs that improve outcomes for kidney patients.� Burrows is an epidemiologist in the division of diabetes translation at the Centers for Disease Control and Prevention.
Sentenced: Tom Frieden, former CDC Director, to a conditional discharge after pleading guilty to a disorderly conduct violation. He was arrested last year following a groping allegation and faced charges for misdemeanor forcible touching and other sexual abuse and harassment charges possibly leading to jail time. According to the AP, the lesser disorderly conduct violation is not a crime, and the discharge will be dismissed and sealed in a year if Frieden does not get arrested in that time frame.
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- People cont'd on page 11
Notes on People - con't from page 10 Recognized: Beth Milius, as an "Unsung Hero" of state and local foodborne illness responses by the Washington State Food/Feed Rapid Response Team, a multiagency team that utilizes the Incident Command System and standardized procedures to quickly and efficiently respond to human and animal food incidents affecting Washington State. "She brings a calm, rational approach to the response while still keeping public health as the number one priority", said Randy Treadwell manager of the Rapid Response Team. "She's a true champion for public health in Washington", added Treadwell. A recent food safety magazine article featured unsung heroes among state and local public health officials who are innovating in conducting outbreak investigations without mentioning any of them by name. The Epidemiology Monitor requested further details and received this information about Beth Melius, who is a Foodborne and Enteric Disease epidemiologist in the Office of Communicable Disease Epidemiology in Washington. Readers are invited to send us information about other unsung heroes of epidemiology who are making important but unrecognized contributions to epidemiology and public health.
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Near Term Epidemiology Event Calendar Every December The Epidemiology Monitor dedicates that issue to a calendar of events for the upcoming year. However that often means we don't have full information for events later in the year. Thus an online copy exists on our website that is updated regularly. This year we will print upcoming events in the Monitor monthly. To view the full year please go to: http://www.epimonitor.net/Events
July 2019 July 1-3 https://bit.ly/2EoPaAe Short Course: Causal Inference in Epidemiology / University of Bristol / Bristol, England July 5 https://bit.ly/2UxLYaj Short Course: Statistical Methods for Mediation Analysis / University of Bristol / Bristol, England July 7-19 https://bit.ly/1LH3Qc6 Summer Program: Summer Institute of Advanced Epidemiology & Preventive Medicine / Tel Aviv University / Tel Aviv, Israel July 8-24 https://bit.ly/2RWT7iZ Summer Program: 11th Annual Summer Institute in Statistics and Modeling in Infectious Diseases (SISMID) / University of Washington / Seattle, WA July 8-26 https://bit.ly/2QnqkHv Summer Program: Summer Session in Epidemiology / University of Michigan / Ann Arbor, MI July 8-26 https://bit.ly/2SHoBtc Summer Program: UW Biostatistics Summer Institutes / University of Michigan / Ann Arbor, MI July 10-11 https://bit.ly/2Eg12Uk Conference: 7th World Congress on Public Health, Epidemiology & Nutrition / Global Public Health 2019 / Osaka, Japan July 10-12 https://bit.ly/2rwTFjW Short Course: Mendelian Randomization / University of Bristol / Bristol, England July 15-19 https://bit.ly/2Pzaq7A Short Course: Integrative Molecular Epidemiology / American Association for Cancer Research / Boston, MA July 27 - Aug 1 https://tinyurl.com/y7ttm7fq Conference: 2019 Joint Statistics Meeting / American Statistical Association / Denver, CO
- Calendar cont'd on page 13
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Near Term Epidemiology Event Calendar, con't from page 12 August 2019 August 12-16 https://bit.ly/2RTmaDL Short Course: Advanced Epidemiologic Methods: Rethinking Basic Epidemiologic Concepts / Berlin School of Public Health / Location TBA August 19-21 https://bit.ly/2G9aQlC Meeting: Science Policy: Improving the Uptake of Research into UK Policy / Wellcome Trust / Location TBA August 24-28 https://bit.ly/2UzGFHE Conference: 35th ICPE / International Society for Pharmacoepidemiology / Philadelphia, PA August 25-28 https://bit.ly/2UCxLsW Conference: ISEE 2019 - 35th Annual Conference / International Society for Environmental Epidemiology / Utrecht, The Netherlands August 27-29 https://bit.ly/2PwpHWM Conference: GEOMED 2019 / University of Glasgow / Glasgow, Scotland August TBA https://bit.ly/2QFJqbh Short Course: Primary and Secondary Prevention Research / Erasmus MC / Rotterdam, The Netherlands August TBA https://bit.ly/2C4bEEa Summer Program: Erasmus Summer Programme 2019 / Erasmus MC / Rotterdam, The Netherlands August TBA http://ecte.org/ Summer Program: European Course in Tropical Epidemiology / European Course in Tropical Epidemiology (ECTE) / Location TBA
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Ambitious Postdoctoral Epidemiologist / Biostatistician / Health Economist / Geographer wanted for cutting-edge HIV research (4 posts) We invite applications from ambitious postdoctoral epidemiologists, biostatisticians, health economists or geographers to join Professor Tanser’s research group at Africa Health Research Institute (AHRI) in Durban, South Africa. Training involves research in a mentored environment in the areas of population health, epidemiology, and behavioural science for cutting-edge HIV research in South Africa. The successful candidates will have access to one of the largest ongoing population-based HIV cohorts in the world - the Africa Health Research Institute’s population cohort in rural KwaZulu-Natal, which includes over 90,000 individuals, with individual-level sociodemographic, biological, and clinical record data as well as comprehensive genomics data. The projects will leverage the institute’s existing big data infrastructure, next generation viral gene sequencing platform, comprehensive geographical information system as well as the recently established research platform for tracking individual mobility patterns via smartphones and other on-going projects. POSITIONS: Epidemiologist/Biostatistician x1 Geographer/Epidemiologist x 2 Health Economist x 1 The successful candidates will be mentored by Prof Tanser and other leading scientists and Faculty Members at AHRI, who commonly publish in some of the top journals in the field (Science, Nature and Lancet). Successful candidates will receive a generous tax-free stipend for two years. Once appointed, the successful candidates will be supported to apply for externally funded personal fellowships and grants and develop collaborations/skills for their career development. Candidates will be based at our state-of-the-art laboratories in the beautiful city of Durban, which is a sub-tropical city on the Indian Ocean coast of South Africa, with support for flexibility of travel. The minimum qualifications and experience required for these research posts are: ♦
PhD in Epidemiology, Biostatistics, Bioinformatics, Econometrics, Mathematical Modelling, Spatial Analytics or a closely related quantitative field
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Several high-quality publications as a first author
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Ability to work in a multi-disciplinary team
Full Information on Each Position: http://epimonitor.net/2019-2814-Epidemiology-Job-Opening.htm How to apply To apply, email a detailed CV, cover letter indicating the position you are applying for and a research statement describing your research interests to Thulile Mathenjwa at Thulile.Mathenjwa@ahri.org before 12 July 2019. For more information you can contact Prof. Tanser at frank.tanser@ahri.org . AHRI reserves the right not to make an appointment. Please consider your application unsuccessful if you have not been contacted within four weeks of the closing date.
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