Menzies School of Health Research Postal address: Location: Phone: (+61) 08-8922 8196 PO Box 41096 John Mathews Building (58) Fax: (+61) 08-8927 5187 Casuarina NT 0811 Nightingale Road Website: www.menzies.edu.au Australia Royal Darwin Hospital Campus Tiwi NT 0810 Australia
Our mission To improve the health of people of northern and central Australia and regions to the near north through multidisciplinary research and education by: Promoting a broad understanding of health that reflects underlying socioeconomic, environmental, health system and biological factors as determinants of health and disease. Conducting high-quality multidisciplinary research, research training and public health education with a focus on Indigenous, remote and tropical health. Advancing the local, national and international application of research findings to improve health. Advocating for research that will contribute to better health for people of the region. Building strong partnerships with community groups, service providers, policy-makers, and other academic organisations.
Our logo The Menzies School of Health Research logo reflects the School’s broad research agenda. The warm and fluid circle shapes symbolize both the sun — representing the School’s physical location — and a human cell, the building block of life and the basis of MSHR’s work. The rhythmic edge of dots suggests the School’s many Indigenous clients and collaborations. The precise lines underscoring the ‘m’of Menzies illustrates MSHR’s rigorous scientific standards. Menzies School of Health Research 2003 Annual Report
2003 has been a year of success, opportunity, challenge and change. We have continued to strengthen and grow at an exciting rate and have been increasingly recognised as a leader in PHOTO COURTESY GALIWIN’KU PHOTO MSHR LIFESTYLE PROJECT, HEALTHY Indigenous, remote and tropical health issues and education — both nationally Contents and internationally. Our 2003 Annual Report highlights In Celebration of Excellence: 2003 Highlights ...... 2 areas of research excellence, giving a Chairperson’s Report ...... 4 brief overview of our research priorities Director’s Report ...... 5 and achievements, our mutually MSHR: Leaders in Indigenous, remote and tropical health research ...... 6 supportive training and education Infectious Diseases Division ...... 7 programs, and our strong governance Ear & Respiratory Health ...... 8 Skin Health ...... 9 practices for the year ending Malaria & International Health ...... 10 31 December 2003. Melioidosis & Emerging Infectious Diseases ...... 12 We encourage you to visit our website Tropical Toxinology ...... 12 www.menzies.edu.au to view detailed Population Health & Chronic Diseases Division ...... 13 information on our work and Chronic Diseases ...... 14 operations. Comprehensive reports Environmental Health & Health Services ...... 16 available online include: Foetal and Early Life Origins of Chronic Disease ...... 17 Social Determinants of Health ...... 18 2003 Research & Education Community-based Interventions ...... 19 Report: detailed listing of MSHR Education & Training Division ...... 20 research projects and education Indigenous Forum ...... 22 programs Corporate Services Division ...... 23 2003 Financial Statements: Collaborations & Major Partners ...... 24 complete audited financial Governance ...... 25 statements Patrons & Members ...... 27 MSHR Honorary Appointments ...... 27 Publications ...... 28 Research Funding ...... 31 Financial Overview ...... 32 For Further Information ...... inside back cover in celebration of excellence:
Grants & fellowships Awards & recognition Assoc Prof Nick Anstey was awarded Prof Kerin O’Dea was $3.1 million over five years from the awarded a Centenary Medal Wellcome Trust and NHMRC for for services to research in collaborative work with the Australian Indigenous health. Indonesian Ministry of Health in The medal was created to Papua and the University of PNG on honour those who have made studies to reduce morbidity and Australia’s first hundred mortality from malaria in Papua and years as a federal nation a PNG. This is the largest grant ever success and those who have awarded to MSHR, and one of only laid solid foundations for eleven projects to receive funding in Australia’s future. an initiative which aims to help Dr Alan Cass and co-authors won the Prof Kerin O’Dea and Dr Sandra improve the health of people prestigious Medical Journal of Eades were honoured in this year’s throughout the Asia–Pacific region. Australia/Wyeth Award for the best Australia’s 100 Smartest People in research paper published in the MJA International Health team was the October edition of The Bulletin during 2002. awarded $1 million over five years magazine. They were chosen for their from the US National Institutes of extraordinary contributions to MSHR Indigenous researcher (and TV Health to work with the Indonesian research in the area of Indigenous chef!) Geoffrey (Jacko) Angeles was Ministry of Health in understanding health. invited to be a member of the how and why people get severe editorial board for the US-based Dr Malcolm McDonald’s rheumatic malaria, with a focus on continuing Pimatziwin Journal, a publication fever project won the top Heart our Papuan field studies on the role highlighting Aboriginal and Foundation award for ‘Best Project’. of nitric oxide. Indigenous community health. Menzies researcher, Dr Sandra Eades, NHMRC awarded MSHR research Dr Allen Cheng, PhD student at was honoured with an appointment team, led by Assoc Prof Joan MSHR, was awarded the Murray-Will to the NHMRC’s prestigious Research Cunningham and Assoc Prof Ross Fellowship for Rural Physicians by Committee. Bailie, a $2.4 million research grant the Royal Australasian College of to improve research into the health Dr Peter Morris was awarded the Rue Physicians. Wright Memorial Award for his study of Indigenous Australians. Dr Graeme Maguire was awarded ‘Additional training in recommended Assoc Prof Ross Bailie was awarded Best Public Health Paper at the hygiene practices for the prevention an NHMRC Senior Research Thoracic Society of Australia and of bacterial cross-infection and Fellowship to commence in January New Zealand (TSANZ) conference respiratory illness in Australian child 2004. held in Adelaide in April. care centres: A randomised PHERP (Public Health Education and controlled trial’ at the Annual Assoc Prof Joan Cunningham and Research Program) funding was Scientific Meeting of the Royal Dr Amanda Leach both received granted for our Master of Public Australasian College of Physicians. NHMRC Career Development Awards. Health course for a further two PhD student, Yin Paradies was MSHR research projects involving years. During 2003, MSHR had 65 awarded a Fulbright Scholarship for scabies and skin health, and research students enrolled each semester in one year’s study at the University of into reversing Indigenous renal the MSHR Public Health Coursework California, Berkeley, USA. failure, were highlighted as examples program. of projects that made it ‘From Bench to Bedside’ in the December 2003 edition of the Medical Journal of Australia.
2| 2003 Highlights | Menzies School of Health Research 2003 Annual Report 2003 highlights PHOTO COURTESY PRIORiTI PROJECT, MSHR COURTESY PRIORiTI PROJECT, PHOTO
Special events Important visitors & partnerships The new look Menzies School of MSHR formed a historic partnership International Expert on climate Health Research website with Charles Darwin University (CDU) change, Professor Tony McMichael, (www.menzies.edu.au) was launched to strengthen the health research Director of the National Centre for in May in a ceremony featuring and education capacity of CDU. The Epidemiology and Population Health dancers from the Galiwin'ku relationship allows Menzies to retain at the Australian National University, community. The website is an its autonomy, while at the same time was invited to teach students innovative interactive framework to being a Foundation School within enrolled in MSHR’s Public Health communicate with researchers, Charles Darwin University’s Institute Coursework program. research participants, policy-makers, of Advanced Studies. Prof Paul Zimmet, renowned service providers, students and the Renewed Commonwealth funding of international diabetes expert, who general community. $23 million over seven years for the was in Darwin for the launch of the The Menzies School of Health new Cooperative Research Centre for DRUID project, presented a seminar Research Building was officially Aboriginal Health (CRCAH) has which delivered a powerful message named in honour of inaugural MSHR allowed us to enhance our strategic on diabetes to a packed audience. Director, Prof John Mathews AM, in alliances with other organisations Dr Barbara Starfield and Dr Neil appreciation of his leadership in with an interest in Indigenous Holtzman from John Hopkins building nationally and internation- health. University, USA, presented seminars ally recognised health research Signing of a Memorandum of on ‘Achieving Equity in Clinical capacity in the Northern Territory. Understanding with the University of Practice’ and ‘Genetic Myths of The ceremony held in August was Queensland to facilitate the Social Class and Race’. The officiated by then Commonwealth recruitment of high-quality research presentations were co-hosted by Minister for Health and Ageing, students. MSHR and Charles Darwin University. Senator The Hon Kay Patterson. The International Health team As one of his last official The DRUID study, a study to renewed their Memorandum of appointments, The Hon John determine the prevalence of diabetes Understanding with their principal Anictomatis, Administrator of the and related conditions in an urban partner, Indonesia’s National Northern Territory, visited Menzies Indigenous population, was launched Institute of Health Research and School of Health Research in October in September. Fifteen new staff, Development in Jakarta. The Director to meet staff and tour our facilities. including 11 Indigenous people, were and the Secretary of NIHRD signed employed to work on the project. the five-year MOU during a visit to Darwin in June 2003, enabling collaborative malaria and tuberculosis health research and OPPOSITE PAGE: MSHR officially named training to continue in Papua its research facilities ‘The John Mathews province, with the potential to Building’ at a ceremony in August. Left expand to other communicable and to right: MSHR Director Prof Kerin non-communicable diseases. O’Dea, inaugural MSHR Director Prof John Mathews AM, Federal Minister for Health & Ageing Senator The Hon Kay Patterson, and MSHR Chairman Mr Richard Ryan AO. THIS PAGE: Left: Torres Strait Islander dancers featured in the launch of the DRUID study in September, weaving through the crowd.
Menzies School of Health Research 2003 Annual Report | 2003 Highlights | 3 chairperson’s report
n my final year as Chairman of the has retained its independent Act of MSHR Board, I am honoured to Parliament which guarantees MSHR’s I present this Annual Report which autonomy into the future. The changes highlights the achievements of the to MSHR’s status, which came into Menzies School of Health Research, an effect from 1 January 2004, will, in the organisation which continues to be at medium- to long-term, ensure MSHR the forefront of remote, Indigenous and gains the benefits of increased access tropical health research. to funding for research infrastructure I am also proud to say that this Annual from the Commonwealth. The changes Report is the first of a new format have also meant the establishment of a where MSHR has implemented its new Governing Board. commitment to utilising technology by I would like to acknowledge the using the MSHR website in conjunction continuing support of the Menzies with the printed Annual Report. There Foundation and the Northern Territory are many highlights in this report and Government, whose ongoing financial on the website (www.menzies.edu.au). commitment to MSHR allows the I urge you to take the time to read organisation to have a stable core further about the health research and funding base. Thanks also to the former education which is carried out at Minister for Health and Community MSHR. Services, The Hon Jane Aagaard MLA 2003 has been a year of challenge and and her successors late in the year, The great success. Under the leadership of Hon Dr Peter Toyne MLA and The Hon Director Prof Kerin O’Dea and other Marion Scrymgour MLA. talented staff, the number of research I would also like to thank my fellow projects continues to grow. Highly Board members, the Director of MSHR, competitive national and international Prof Kerin O’Dea, and all the staff and funding has been awarded across a students for their hard work, broad range of medical research, commitment and support for the including scabies, rheumatic fever, organisation through this challenging tuberculosis, diabetes, malaria, kidney period of change whilst continuing to disease, lung disease and melioidosis, as achieve significant research success. well as research into a variety of social and economic factors affecting Whilst I have finished my term as Indigenous health. Chairman of the MSHR Board, I look forward to maintaining contact with 2003 has also brought many challenges MSHR in a different role. I know the as discussions took place around a organisation is in good hands and is controlled entity model to formalise destined for further future success. I links between MSHR and Charles also wish the new Board well in its Darwin University (CDU). Both the endeavours. Board and staff were involved and consulted during this process. MSHR Richard Ryan AO
4| Chairperson’s Report | Menzies School of Health Research 2003 Annual Report director’s report
Among this success, Assoc Prof Joan I am grateful to those MSHR academic Cunningham and Assoc Prof Ross Bailie and administrative staff who were were awarded an NHMRC Capacity- actively involved during the extensive Building Grant of $2.4 million over five negotiations with Charles Darwin years to build capacity in policy University and the Northern Territory relevant to quantitative, social analysis Government. I would also like to thank t is no secret that the health of and research in Indigenous health. In the MSHR Board for their support Indigenous Australians is among the addition, the NHMRC awarded Assoc during this challenging time. poorest in the country. Indigenous Prof Ross Bailie a prestigious NHMRC I Whilst 2003 has been a year of populations suffer enormous social and Senior Research Fellowship. economic disadvantage. In both remote significant research success for MSHR, and urban Indigenous communities the MSHR has also increased its our challenge is to maintain this people are affected by chronic and commitment to international health momentum. We are determined to infectious diseases and general poor research and a number of international improve our fundraising capacity so as health related to a range of factors, collaborations have been fostered to better support our hardworking and including poverty, overcrowded living during the year. The MSHR International talented researchers and maintain our conditions, and inadequate nutrition. Health team, led by Assoc Prof Nick position as a national leader in Anstey was awarded $3.1 million from Indigenous, remote and tropical health Australia’s awareness of these the Wellcome Trust and NHMRC for research and education. important issues continues to grow and collaborative work with the Indonesian This 2003 Annual Report features our governments, as well as funding bodies, Ministry for Health and the University research progress, and highlights a year are now firmly acknowledging the vital of PNG to undertake research to help of exciting new grants, prestigious importance of improving Indigenous prevent and treat the most severe forms awards and recognitions, and numerous health. MSHR is the only independent of malaria. This is the largest grant ever special events and visitors. medical research institute in Australia awarded to MSHR. with a primary focus on Indigenous I hope you enjoy the Annual Report in I am pleased to report the MSHR health. Since being established in 1985, its new format and I urge you to also Education and Training Division was a major goal of MSHR has been to visit our website for a closer look at the successful in gaining Commonwealth conduct research and education that work carried out at the Menzies School funding for a further two years to makes a difference to people’s lives, as of Health Research. well as promoting new findings which support the Master of Public Health course though the PHERP program. influence health policy and practice. Professor Kerin O’Dea Sixty-five students were enrolled at 2003 has been a very successful year MSHR each semester in 2003 and this for MSHR as staff and students have course continues to attract high-quality built on past success and obtained students who are interested in a career significant funding for several new in public health. major research projects in Indigenous and tropical health. 2003 also saw the introduction of legislation to formalise links between During the year, MSHR was awarded MSHR and Charles Darwin University almost $10 million in NHMRC funding (CDU) with the primary incentive for for project grants, scholarships and MSHR being access to future fellowships which will commence in Commonwealth research infrastructure 2004. This is a new record for MSHR funding. Notwithstanding this new link and demonstrates the institution’s with CDU, MSHR retains an reputation for excellence in research. As independent Act of Parliament which Director, I am very proud of this preserves MSHR’s autonomy and achievement. independence.
Menzies School of Health Research 2003 Annual Report | Director’s Report | 5 MSHR | leaders in indigenous, remote & tropical health research
uring 2003 there has been much health of Indigenous people and our media attention on the state of neighbours to the near north in D health of Australians and the countries such as Papua New Guinea, health system within Australia. It is not East Timor and Indonesia. Located on enough that Australians are living the Royal Darwin Hospital Campus in longer than ever — we now expect to Darwin’s northern suburbs, MSHR also live long and healthy lives. operates small units in Alice Springs and Gove. Yet, while most Australians can reasonably expect to live well into their Since commencing operations in 1985, seventies and eighties, Indigenous MSHR has developed a successful track Australians, and those living in remote record in producing high-quality communities, cannot expect such research spanning infectious and non- longevity. communicable diseases, the social and and remote communities to ensure environmental determinants of health, research projects are of priority and In the words of an Indigenous young health systems and information relevance. Through our Indigenous person featured in an article by systems. Forum, Indigenous staff and colleagues journalist Philip Adams: at MSHR are invaluable in ‘Superannuation is irrelevant to We recognise the greatest health gains communicating health priorities and Indigenous people. We don’t live that are to be made through exploring the values of Indigenous people to non- long.’ (The Weekend Australian intersections between priority heath Indigenous researchers, facilitating Magazine, May 24-25, 2003) issues, determinants of health, and research projects in a culturally translation of research into practice and With our focus on Indigenous, tropical appropriate manner, and determining policy. and remote health, MSHR is uniquely how research findings can be taken positioned to conduct research which MSHR prides itself on its ability to work back to the communities in the form of can underpin improvements in the in close partnership with Indigenous practical health benefits.
Governing Board
Director
Executive Executive Officer Administration Officer
Corporate Population Health & Tropical & Emerging Education & Indigenous Staff Forum* Services Division Chronic Diseases Division Infectious Diseases Division Training Division
Operations Research Programs Research Programs Chronic Diseases Ear & Respiratory Health Finance & Accounts Social Determinants of Skin Health Health Malaria & International Early Life Origins of Health Information Technology Chronic Disease Melioidosis & Emerging Community-based Infectious Diseases Human Resources Interventions Tropical Toxinology * Indigenous Forum staff are Environmental Health employed across all divisions & Health Services
Research Administration
6| MSHR: Leaders in Indigenous, Remote & Tropical Health Research | Menzies School of Health Research 2003 Annual Report infectious diseases division
he Infectious Diseases Division comprises five
PHOTO COURTESY PRIORiTI PROJECT, MSHR COURTESY PRIORiTI PROJECT, PHOTO T research programs investigating health issues important for our region.
Studies are targeted at improving prevention and treatment of specific illnesses, generally through seeking a better understanding of the underlying disease processes. Epidemiology, clinical observations and basic laboratory work are involved, with evidence-based approaches undertaken when possible.
The emphasis for the division is on collaboration with local health colleagues and experts outside the Northern Territory, in addition to cooperation between disciplines and across professional and cultural boundaries.
Division Leader | Professor Bart Currie
Menzies School of Health Research 2003 Annual Report | Infectious Diseases Division | 7 Ear & Respiratory Health The Ear and Respiratory Health program 25% of these children presented is made up of researchers from a variety with perforated eardrums, and only of backgrounds, including Aboriginal 7% of children were identified as health workers, doctors, nurses, having normal middle ear status. In laboratory scientists, and postgraduate 2003 that rate had only fallen to students committed to researching 21%, despite pneumococcal causes, methods of prevention and conjugate vaccination. treatment of severe respiratory It is not clear how many Aboriginal conditions, particularly middle ear adults suffer significant hearing infections and chronic lung disease. loss, (estimates range up to 40% in Middle ear infections (otitis media) some communities), but childhood are common among children in all middle ear infections from populations. While the World Health pneumococcal bacteria are Organization indicate that ear drum considered the main cause. emphysema) is a progressive disease, perforation greater than 4% represents Ongoing trials into the effectiveness of with limited treatments available once a massive public health problem, the a new pneumococcal conjugate vaccine lung damage becomes severe. rate in most remote Aboriginal to prevent middle ear infection are communities is dramatically higher. currently an important focus of the Ear Although smoking, overcrowding and Team’s work. Several research projects growth in early life are recognised In these children middle ear infection evaluating the impact of the vaccine factors contributing to COPD, repeated follows nasopharyngeal colonisation Prevenar™ are continuing in Aboriginal bacterial respiratory infections may also and persists throughout childhood, communities from Central Australia to be an important, preventable factor in often progressing to perforation of the Katherine West, East Arnhem Land and the establishment and progress of COPD ear drum. Up to 60% of Aboriginal the Tiwi Islands. within Aboriginal communities. babies have perforations in the first year of life. Research conducted in 2001 Chronic obstructive pulmonary disease ABOVE: Certainly not shy, young Marie by our Ear Team, spanning 29 (COPD) affects nearly 15% of Aboriginal Assumpta shows the Menzies PRIORiTI communities in the Northern Territory, Australians living in remote Ear Team how saliva swabs should be revealed further alarming results in communities. COPD (often used to taken! (Photo courtesy PRIORiTI Project, children aged six months to 2.5 years: describe chronic bronchitis and MSHR)
Key achievements A Territory-wide surveillance project wide controlled trial in a study communities in the diagnosis and has been established to monitor drug evaluating the best treatment for management of middle ear infection. resistance to antibiotics traditionally Aboriginal children diagnosed with Instigated community consultation used to treat pneumococcal middle ear infection — single dose and preliminary research in an infections. The study will also Azithromycin versus seven days Arnhem Land community in a project measure antibiotic prescription rates Amoxycillin. to gain a local perspective of how to and pneumococcal conjugate Completed our second Territory-wide make tuberculosis (TB) control vaccination uptake. survey of ear disease as part of our intervention programs more Commenced a study to determine if studies investigating the impact of effective. The aim of the project is to antibiotic treatment or vaccine the new 7-valent conjugate reduce the incidence of TB infection effectiveness is compromised by high pneumococcal vaccine Prevenar™. in this community where periodic TB levels of respiratory bacterial Completion of the first phase of an outbreaks still occur. It is also pathogens. The first phase of this assessment of herd immunity anticipated this project will help project has confirmed important following infant vaccination increase local capacity to deal with differences in the density (or (pneumococcal vaccine Prevenar™) other public health problems in concentration) and diversity of on pneumococcal carriage within an Aboriginal communities. bacteria carried in the noses of entire Aboriginal community. children with severe ear disease. Developed a ‘Train the Trainer’ MSHR 2003 Research & Education Report Successful randomisation of over workshop for the Ear Video training provides detail on all research projects and 150 children in our first Territory- package to assist Aboriginal is available online at www.menzies.edu.au
8| Infectious Diseases Division | Menzies School of Health Research 2003 Annual Report TOP: Phase contrast micrograph of an adult male Sarcoptes scabiei collected Skin Health from an agile wallaby in the Northern Territory. Skin infections are quite common, and although they can cause unsightly, BELOW: The scabies mite burrows under inconvenient and uncomfortable health the skin, causing intense itching which results in open lesions and allows a problems, they are usually treatable with point for infections to enter the body. readily available medications. (Photos courtesy of Skin Health Program, Skin infections in Indigenous populations MSHR) are far more insidious. Up to 60% of children in remote Aboriginal communi- ties in northern and central Australia, are Key achievements estimated to be infected with scabies — Forty-three thousand scabies mite outline of immune responses a skin disease caused by a tiny mite. The cDNA clones have been sequenced important in normal scabies and to scabies mite burrows under the skin and so far from a goal of 50,000 in an assess differences in those with breeds, often transmitted to others ongoing gene discovery project that severe infestation (crusted scabies). before diagnosis. aims to significantly advance the Recent studies reveal tea tree oil Scabies cause intense itching, resulting limited amount of molecular could be used as a new topical in open skin lesions. These sores often information available about the treatment for scabies. Results become infected with group A strepto- scabies mite. demonstrated that tea tree oil was coccus (GAS) — a group of bacteria that Molecules of interest identified so highly effective in killing the scabies thrive in the tropical environment of the far include similarities between mite in the laboratory. Northern Territory and cause a massive scabies mite and house dust mite MSHR research team, in range of diseases, including pharyngitis allergens, potential vaccine collaboration with international (strep throat), rheumatic fever, glomeru- candidates, genes associated with researchers in America, England and lonephritis (a major kidney disease) and drug resistance and potential drug Germany have demonstrated that invasive diseases such as streptococcal targets in therapeutic studies. the group A streptococcus toxic shock syndrome. Extended research using DNA population in tropical Northern The Skin Health program focuses on fingerprinting techniques continued Australia is more diverse than researching skin infections and infesta- to identify the biological species elsewhere in the temperate world. tions endemic to Indigenous communi- classification of the scabies mite. An important study to determine if ties in the NT, such as scabies and topi- Previous studies suggest a single group A streptococcus (GAS) skin cal streptococcal infections, and their gene pool, however, our molecular infection leads to acute rheumatic relationship to kidney disease and rheu- study demonstrated genetic fever (ARF) is under way in two matic fever. This relationship is of inter- differences between mites obtained Aboriginal communities. est as some remote communities in the from northern Australian dogs and Northern Territory suffer the highest those on people. This discovery had GAS throat infections are rates of rheumatic fever and kidney dis- important implications in scabies traditionally thought to be the only ease in the world. control programs for Aboriginal cause of ARF. However, GAS is communities. uncommonly found in the throat of Our Skin Health team are also involved in Indigenous people in the NT, even an innovative collaboration with the Further clarification of genetic though Aboriginal communities Cooperative Research Centre for variation and understanding of the suffer the highest reported rate of Aboriginal Health (CRCAH), in a number of interbreeding between mite ARF in the world. Results of this laboratory, clinical and public health proj- populations is important for disease study could therefore have ects known as the Healthy Skin initiative. and resistance control. important implications for Publication of seven papers and an prevention and vaccine development additional two invited reviews in of ARF around the world. press resulting from our study into Exciting preliminary results suggest antigens, allergens and immune new diagnostic blood tests may responses to normal and crusted improve the accuracy of diagnosis of scabies. rheumatic fever. Recent developments leading to expression and purification of scabies mite recombinant antigens MSHR 2003 Research & Education Report now provides an exceptional provides detail on all research projects and opportunity to obtain a clearer is available online at www.menzies.edu.au
Menzies School of Health Research 2003 Annual Report | Infectious Diseases Division | 9 Malaria & International Health
Each year, malaria affects over 300 and the Indonesian Ministry of Health’s million people internationally, with up to National Institute of Health Research two million deaths. Children and and Development. This collaborative pregnant women are particularly program addresses the prevention and vulnerable. Malaria is a major cause of management of tropical diseases of morbidity and mortality in Eastern importance to the region, with a number Indonesia and Papua New Guinea. of studies being undertaken in Eastern The social consequences of this tropical Indonesia. A new collaboration has also disease are enormous. In countries been established with Papua New where malaria occurs, the burden Guinea. extends beyond the individual and their Our research aims to improve the family, it impedes economic diagnosis, treatment and prevention of development. malaria and tuberculosis. Skills An international health collaboration exchange and training are an important was established in 1996 between MSHR part of the research.
LEFT: MSHR International Health Program Clinician Dr Enny Kenangalem explains lung function testing to a patient with severe malaria at RSMM Hospital, Timika, Papua. BELOW: Mimika TB Program Director Dr Ardian Muhammad demonstrates his X-ray reading skills to (from left) Dr Graeme Maguire (MSHR), Assoc Prof Nick Anstey (MSHR), Dr Paul Kelly (MSHR), Pak Erens (Depkes Timika) and Dr Tjandra Handojo (RSMM). (Photos courtesy of International Health Program, MSHR)
10 | Infectious Diseases Division | Menzies School of Health Research 2003 Annual Report Key achievements