Q&A: The challenges of improving global child health

Infectious Disease News recently spoke with Robert E. Black, MD, MPH, professor of international health at Johns Hopkins Bloomberg School of Public Health, about his career researching and reducing the leading causes of childhood mortality and morbidity. In this interview, Black discusses the challenges of strengthening health research capacity in developing countries, the most pressing global health threats, and the link between nutrition and infectious diseases in children, among other topics.

Robert E. Black

Black was the recipient of the 2016 Jimmy and Rosalynn Carter Humanitarian Award, which was given by the National Foundation for Infectious Diseases (NFID) in recognition of his work to improve the survival of children around the world.

To submit nominations for the NFID’s 2017 awards, visit nfid.org/awards. The deadline is Thursday, June 30.

What has been the single greatest achievement in the fight against infectious diseases in your lifetime, and how has it impacted global health?

That’s a tough one. I would say smallpox eradication. Probably not a surprising answer. I think it showed what the collective will of countries and international agencies could do in eradicating a disease, and I think that really provided the impetus for immunization programs more generally.

Currently, what is the greatest infectious disease threat globally, and how is it being addressed?

Childhood pneumonia. Er, sorry — pneumonia is the answer. Childhood pneumonia is very important, but so is adult pneumonia. I think it’s being addressed in part by immunizations and more available vaccines, but also has to be addressed by prevention of disease in other ways, for example improving nutritional status, and has to be addressed by antibiotic treatment or by treatment in general.

What are the most significant challenges to strengthening health research capacity in developing countries?

I would say institutional stability and institutional capacity. There are certainly a lot of good, smart well-trained people in developing countries, but many don’t stay because the institutions where it would be appropriate for them to be based and do research have many limitations of resources, salary, laboratory capability and competing commitments for other things.

Much of your work has focused on global child health. Can you describe the interaction between infectious diseases and nutrition in children?

Sure. I think we know it’s a bidirectional relationship. Children who are undernourished with a variety of definitions of that — including vitamin and mineral deficiencies — are more susceptible to infectious diseases. They have more severe infectious diseases and higher mortality from infections. On the other side of that, we know that infectious diseases contribute to undernutrition — part of the causal pathway for undernutrition.

What has been the single greatest achievement in your career as a researcher?

I would say the discovery that zinc deficiency is a major contributor to the severity of infectious diseases, and that providing additional zinc in the form of supplements can reduce diarrhea, pneumonia and child mortality.

Disclosure: Black reports no relevant financial disclosures.