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International Health

From the Chair

Malnutrition and infectious diseases each cause substantial disease burden in low- and middle-income countries, but in combination are especially deadly. I am very thankful that Professor Keith West arranged for the 3rd Graham Lecture to be a full symposium that both recognized the first comprehensive review of this synergistic relationship 40 years ago by Scrimshaw, Taylor and Gordon and addressed the current state of the science on this important topic.

In the last 40 years, the interactions of nutrition and infection have received ever increasing attention and our department has been on the forefront of this research and application in programs. Faculty and students, in collaboration with colleagues in many countries, have described nutrition and infection relationships in community-based epidemiologic studies and in clinical and field trials. Over the last several decades this work has resulted in seminal contributions on the following:

Current work is breaking new ground on the role of vitamin D deficiency in the risk of pneumonia and other infectious diseases, while efforts continue to understand both the risks and benefits of iron supplementation in settings with high rates of malaria and other infectious diseases.

Characteristic of the department, faculty have a strong commitment to implementation of their findings in programs that improve global health. From the mid-1960s—even before his review on the interactions of nutrition and infection was published in 1968—Prof. Carl Taylor was leading the Narangwal Experiment in India to assess the possible synergistic effects of integrated nutrition support, infectious disease control, and health care for reducing child mortality. More recently, faculty not only conducted the pivotal research, but also drove the actions that have led to global programs of vitamin A supplementation and the use of zinc for treatment of diarrhea.

Looking to the future, there are many new aspects of the nutrition and infection interactions to explore. Even adult chronic conditions that have strong nutritional origins, such as cardiovascular diseases, are suspected of having an infectious and inflammatory component. With now strong evidence that human selenium deficiency contributes to microbial evolution toward more virulent Coxsackie and influenza viruses, a role of nutritional deficiencies in emergence of possible pandemic infections needs urgent attention. Important questions continue to arise and new laboratory methods to study the immune response will add to our understanding of the nutrition and infection relationships.

Finally, I would like to congratulate the master’s and doctoral graduates of the Department of International Health and those of other departments. The momentum to improve global health is growing, and as leaders you must capitalize on that energy. Best wishes for your future career challenges and opportunities.