Front Line Science: Smith Lab Plays Part in Fighting Neglected Tropical Diseases

On many afternoons, the corridors outside Professor Steven Williams’ office in Ford Hall are stacked high with boxes.

The cartons—full of syringes, alcohol swabs, sample tubes and containers for medical sharps, among other supplies—are destined for countries trying to eliminate neglected tropical diseases (NTDs).

The shipments are part of critical sample-collection-and-analysis efforts led by Williams, Smith’s Gates Professor of Biological Sciences, who has spent decades researching the molecular biology of parasites that cause neglected tropical diseases. More than 1.4 billion of the world’s poorest people now suffer from at least one of 17 such diseases—including chronic, debilitating illnesses such as elephantiasis, hookworm and river blindness.

Prof. Steven Williams (top row, far right) and employees of the Smith College Gates Reference Lab recently organized the largest ever shipment of disease testing supplies to South Sudan.

Last month, Williams and his colleagues in the Smith College Gates Reference Laboratory organized what is believed to be the largest shipment of disease testing supplies to South Sudan—just over a ton.

They have also sent more than 30 tons in 100 shipments of supplies to Ethiopia, Ghana, the Republic of Congo and 40 other countries where NTDs are widespread. Each shipment costs in the neighborhood of $30,000 for the transport alone, Williams says.

The Smith lab is now the primary site for testing thousands of blood and mosquito samples sent in by other countries for signs of neglected tropical diseases.

“It’s a huge program,” says Williams, whose lab is supported by a five-year grant from the Bill & Melinda Gates Foundation. “We are working with the Task Force for Global Health, which is now managing 100 such projects in 70 countries.”

The task force, based in Decatur, Ga., supports the World Health Organization’s goal of eliminating several neglected tropical diseases by 2020.

Williams says the effort holds promise thanks to drug donations from major pharmaceutical companies and prevention and testing work supported by the Gates Foundation and the U.S. Agency for International Development.

“Progress has been substantial,” Williams says. “Over the past decade, the incidence of lymphatic filiariasis, for example, has been cut in half, from an estimated 300 million to 150 million people.” The disease, also known as elephantiasis, causes massive swelling of the limbs and other body parts, as well as other debilitating symptoms.

Williams says the campaign to eliminate NTDs has also been aided by recent advances in mapping and testing technologies—some of which his lab has helped to develop.

“The strategy is known as mass drug administration: everyone in the areas where we’ve found these diseases gets treated, not just individuals who are infected,” he explains. “One of the important questions we are trying to answer through our testing work is when can we stop treatment? Some countries have been able to stop. There’s real momentum there.”

Patrick Lammie, who directs the task force’s neglected tropical disease efforts, credits Williams with helping to keep that momentum going.

“Steve’s work has been instrumental in developing new molecular diagnostics for testing people and mosquitoes,” says Lammie, who is a senior scientist with the federal Centers for Disease Control. “And his team from Smith has ended up being an essential support for providing diagnostic tools supplies” to countries developing NTD programs.

Williams’ working relationship with the Task Force goes back to a sabbatical year he spent with the nonprofit organization in 2007. As the fight against neglected tropical diseases has ramped up in recent years, so has the importance of the Smith lab, Lammie says.

“One of the key aspects of Steve’s work in this area is his ability to connect all the different players—researchers, people in the field and the drug companies,” Lammie says.

Lammie likened current disease-fighting efforts to an airport where planes are stacked up waiting to land. Similarly, he says, the global health community is poised to eliminate a number of neglected tropical diseases as the distribution of those diseases is defined and treatment barriers are removed.

Among the hurdles is getting supplies to health workers in countries where there is armed conflict, Williams says.

“South Sudan is not terribly safe right now,” he notes. “People doing the field work and collection are working at risk.”

Climate change also makes the fight against neglected tropical diseases more urgent, Williams says.

“The tropics are actually getting bigger, and the mosquito population is growing,” he says. “That’s why it’s important to eliminate these diseases now.”

The next step in the Task Force strategy is to set up labs in countries where NTDs are endemic, Williams says.

“There is also a lot of work going on to develop tests that can be done in the field so we don’t need a high-tech lab,” he adds.

In the meantime, the number of samples being sent to the reference lab at Smith has been rising. Some 6,000 samples recently arrived from three health districts in the Democratic Republic of Congo alone, Williams says.

How can the lab keep up?

“We’ll get back to you on that,” quips Nils Pilotte, a research associate and one of three full-time Gates employees at the Smith lab.

“It’s important not to let up on the gas, or things could start going in the other direction with these diseases,” Pilotte emphasizes.

Williams says Smith will continue to play a role in efforts to eliminate neglected tropical diseases, which impoverish families and entire villages in many parts of the world.

“We are the only small college represented in the Global Programme for the Elimination of Lymphatic Filariasis,” Williams notes. “To meet the goal of eliminating such diseases, we will need to keep doing this work for many more years.”

Research associate Weam Zaky analyzes blood samples for signs of neglected tropical diseases at Prof. Steven Williams' Gates Reference Laboratory at Smith. Photo by Isabella Casini '17.