Identifying local-to-global "win-win" solutions for human health and sustainability through infectious disease control

史无前例的传染病出现速度、到2100年养活110亿人的需要、普遍的贫困和环境的迅速退化是21世纪一些最可怕的生态和公共卫生问题。由于健康经常推动全球的政策，并经常与生态联系在一起，它可以成为确保发展中国家可持续未来的关键杠杆，在发展中国家，疾病、贫困和人口增长最为猖獗，解决这些问题的资源最为有限。该研究小组调查了从地方到全球的疾病控制战略如何造福人类和环境健康。这项研究的基础是，地球上超过15亿被蠕虫感染的人类消耗的每一卡路里的一部分被浪费在喂养或抗击这些蠕虫上，治疗蠕虫感染的大规模药物管理(MDA)是廉价和经济有效的，以及冲刷农田的化肥助长了水媒蠕虫感染并降低了水质。减少对寄生虫的食物浪费将为人类提供更多的食物，减少自然区域向农业的转变，同时减轻疾病、饥饿、贫困、气候变化和生态系统服务赤字。具体地说，研究小组通过移除栖息着蜗牛的水生植被来测试控制血吸虫病的效果，蜗牛是感染人类的蠕虫的来源。这项实地工作是在塞内加尔进行的，是传染病管理如何促进全球可持续发展的原型。这个项目具有变革性，因为它创新性地整合了生态学、疾病生物学和社会经济学的原理，以制定缓解战略和政策建议，以解决全球生态和公共卫生问题。该项目为博士后研究人员以及本科生和研究生提供了研究机会，包括来自服务不足群体的个人，并促进了与塞内加尔科学家的国际合作。该项目的第一个目标是进行全球生物经济分析，全面量化丙二醛治疗人类蠕虫的实质性经济效益，这反过来又应该更广泛地促进丙二醛的使用，不仅减少疾病，而且减少营养不良、贫困和环境危害。该项目的第二个目标是使用随机对照临床试验来评估收获水生植物并将其用作堆肥、牲畜饲料或用于生产气体的生物消化器的燃料是否可以减少人类水媒疾病和贫困，通过回收植物中捕获的氮和磷来减少水污染，并增加利润、开放水域获取以及食品和能源生产。该项目的第三个目标是利用遥感技术开始整合、转换和扩大这些创新，以绘制出水生植被的丰富度和村庄的偏远程度。该项目中使用的生物经济学实验和数学方法在结构上是通用的，提供了该项目理论方面的广泛概括性，超越了具体的寄生虫和实证工作的地点。这使该项目成为一张蓝图，说明如何：1)破坏贫困-疾病陷阱；2)设计和测试以社区为主导的维持公共健康福利的激励措施；3)预测环境变化对其他寄生虫传播的影响；4)协同整合社会经济和环境系统，开发同时改善人类健康和可持续性的创新。这项研究的结果将通过同行评议的出版物、美国和塞内加尔的公共研讨会系列以及塞内加尔研究中心的研讨会进行传播。该奖项反映了NSF的法定使命，并通过使用基金会的智力优势和更广泛的影响审查标准进行评估，被认为值得支持。

The unprecedented rate of infectious disease emergence, the need to feed 11 billion people by 2100, widespread poverty, and rapid degradation of the environment represent some of the most formidable ecological and public health problems of the 21st century. Because health often drives policies across the globe and is regularly linked to ecology, it can be a vital lever for securing a sustainable future for the developing world, where disease, poverty, and human population growth are most rampant, and resources to address these issues are most limited. The research team investigates how disease control strategies at local-to-global scales benefit human and environmental health. This study builds on the facts that part of every calorie that the more than 1.5 billion worm-infected humans on the planet consume is wasted on feeding or combating these worms, that mass drug administration (MDA) to treat worm infections is cheap and cost-effective, and that fertilizers that wash off an agricultural field fuel waterborne worm infections and reduce water quality. Reducing food wasted on parasitic worms would provide more food for humans and reduce the conversion of natural areas to agriculture, simultaneously mitigating disease, hunger, poverty, climate change, and ecosystem service deficits. Specifically, the research team tests the efficacy of controlling the disease schistosomiasis by removing aquatic vegetation that harbors the snails that are the source of the worms that infect humans. The fieldwork is carried out in Senegal and serves as a prototype for how the management of infectious diseases can promote sustainability across the planet. This project is transformative because it innovatively integrates principles of ecology, disease biology, and socio-economics to develop mitigation strategies and policy recommendations to address global ecological and public health problems. The project provides research opportunities for a postdoctoral researcher and undergraduate and graduate students, including individuals from underserved groups, and it promotes international collaboration with scientists in Senegal. The first aim of this project is to conduct a global bioeconomic analysis to holistically quantify the substantial economic benefits of MDA to treat human helminths, which, in turn, should more widely promote the use of MDA to reduce not only disease but also undernutrition, poverty, and environmental harm. The second aim of this project is to use randomized control clinical trials to evaluate whether harvesting aquatic vegetation and using it as compost, livestock feed, or fuel for gas-producing biodigesters will decrease human waterborne diseases and poverty, reduce water pollution by recycling nitrogen and phosphorous captured in the plants, and increase profits, open water access, and food and energy production. The third aim of this project is to begin to integrate, translate, and scale these innovations using remote sensing technology to map the abundance of aquatic vegetation and village remoteness. The bioeconomic experimental and mathematical approaches used in this project are general in their construction, offering broad generalizability of the theoretical aspects of this project beyond the specific parasites and locations of empirical work. This allows the project to serve as a blueprint for how to i) disrupt poverty-disease traps, ii) design and test incentives for community-led maintenance of public health benefits, iii) predict the effects of environmental change on the transmission of other parasites, and importantly, iv) synergistically integrate socio-economic and environmental systems to develop innovations that simultaneously improve human health and sustainability. The results from this study will be disseminated through peer-reviewed publications, a public seminar series in the U.S. and Senegal, and workshops at Senegalese research centers.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.