P³ | #10 Spring - Summer 2020

#10 2020

SPRING-SUMMER

THE FOCUS SHOULD BE ON WELLBEING

LENKA BEŇOVÁ, PROFESSOR OF MATERNAL HEALTH

NL

COLOPHON Responsible Publisher Marc-Alain Widdowson Editor-in-Chief Ildikó Bokros Eline Van Meervenne Editorial Coordination Ildikó Bokros Editorial Committee Ildikó Bokros Nico Van Aerde Eline Van Meervenne Catie Young Louise O’Connor Layout Toech communicatiebureau Photography Astrid Bultijnck, Jessica Hilltout *P³ - ITM’s essence captured in one letter We work to improve health worldwide by conducting and applying science.

Our innovative and interdisciplinary work focuses on Pathogens (Department of Biomedical Sciences), Patients (Department of Clinical Sciences) and Populations (Department of Public Health).

ITM researchers improve our understanding of tropical diseases, and develop better methods for their diagnosis, treatment and prevention. Others study the organisation and management of health care and disease control in regions where means are limited, but needs are huge. We also focus on the health of animals and the diseases they spread to humans.

Translations Serv-U Contact communicatie@itg.be +32 (0)3 247 07 29

#10 2020

SPRING-SUMMER

Dear Reader, There it is: you are looking at the tenth edition of P³! We started this magazine five years ago with the mission to showcase ITM’s wide scope of activities: education, research and medical services through human stories. In the past five years we have covered exciting stories ranging from surviving Ebola to a large-scale leprosy project, from parasite hunting in the Amazon to global health. In this spring-summer anniversary edition we put maternal health in the focus through the work of our new full professor, Lenka Beňová.

This issue is packed with novelties. We present you Wanda - our brand new travel app for smartphones. Wanda is here to help travellers stay up-to-date with information about health risks at their country of destination. You can also learn about ITM’s newest master’s course: the Master in Tropical Medicine, which will start with the first batch of students in September 2020.

Are you able to tell a real tiger mosquito from its lookalikes?

After reading ‘The List’, you definitely will be! Further, you can discover more about ITM’s work on HIV in the 1980s and about researcher Temmy Sunyoto’s fight against leishmaniasis, one of the neglected tropical diseases. On the last page, Minister of Finance and Development Cooperation Alexander de Croo explains his connection to ITM. Enjoy the read.

The Editorial Committee

# EDITORIAL

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ITM NUMBER COVER STORY: “THE FOCUS SHOULD BE ON WELLBEING” INTERVIEW WITH PROF LENKA BEŇOVÁ A TRAVEL APP CALLED WANDA DEEP DIVE WITH AN OCEAN VIEW PHOTO STORY: CONNECTING THE DOTS AT THE 60TH ITM COLLOQUIUM REWIND: ONLY THE STIGMA REMAINS: THE ITM - HIV CONNECTION PORTRAIT: TEMMY SUNYOTO THE LIST: THE TOP 3 TIGER MOSQUITO LOOKALIKES ITM AND I: ALEXANDER DE CROO

© The contents of this publication may not be reproduced in whole or in part without the express consent of the publisher. Images in this report were taken with full understanding, participation and permission of the people portrayed. The images truthfully represent the depicted situation and are used to improve public understanding of our work. # TABLE OF CONTENTS

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# ITM NUMBER

11 TRIALS

Last year, the Clinical Trials Unit (CTU) of the Institute coordinated 11 trials with patients or healthy volunteers around the world. In these trials, our scientists investigate new or improved treatment methods or vaccination schedules for

infectious diseases. In addition, the CTU participates in several (inter)national consortia and provides support in clinical project management, data management and/or statistics related to the set-up, conduct and reporting of trials.

THE FOCUS SHOULD BE ON WELLBEING ILDIKÓ BOKROS We sit down with Lenka under the old pear tree in the charming garden of ITM’s Campus Rochus. It is one of the (maybe unusually) warm October days, when many colleagues occupy the garden chairs, happily soaking up what feels like the last rays of sunshine before the winter. Lenka joined ITM’s Unit of Maternal Health in early 2018, and on 1 November, 2019 she was appointed full professor. P³ talked with her just days before she officially started in her new function.

What is your background? How did you arrive at maternal health?

My background is actually business administration (laughs)! I am originally from Slovakia but went on to study in the US, after which I headed the development of a network at a start-up company in eldercare in the US and worked as project coordinator with Médecins Sans Frontières in Nigeria, Palestine and South Sudan. I got my Master’s degree in Middle East studies in Egypt in 2007, where I lived for two years and learned Arabic. Since 2010, I had been studying and working at the London School of Hygiene & Tropical Medicine (LSHTM), which is also where

I completed my Master’s in Demography and my PhD. During my doctoral studies I focused on socio-economic inequalities in health in Egypt: why do poor people tend to have worse health outcomes? We know they access healthcare less, preventively and curatively. As I set out to study this, I discovered that the best data that can be analysed to understand the chain of events capture maternal and child care. There are large, nationally representative surveys called Demographic and Health Surveys, which are openly accessible. While at LSHTM, we developed a harmonised dataset of all demographic health surveys ever conducted in sub-Saharan Africa, and initiated several collaborations with colleagues around the world to help them answer relevant maternal health questions from these data.

Broadly speaking, as a quantitative social scientist, I enjoy thinking about meaningful indicators for measuring the progress we are making in maternal and newborn health.

# COVER STORY

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I enjoy thinking about meaningful indicators for measuring the progress we are making in maternal and newborn health.

What brought you to Antwerp, and to ITM? There are two main reasons I am very excited to be here, one of them is the legacy of Professor Emeritus Vincent De Brouwere’s work, who was the Head of the Unit of Maternal Health until his retirement last year. The way he approached capacity building and cooperated with the partners in such a respectful manner is a true example. On our future projects, we will work together with Dr Jean-Paul Dossou and Professor Alexandre Delamou from our partner institutions (Centre de Recherche en Reproduction Humaine et en Démographie, Benin and Centre National de Formation et Recherche de Maferinyah, Guinea, respectively) and they already feel like old friends!

The second thing that attracted me to ITM is the Institute’s and our department’s expressed and conscious focus on vulnerable populations. The most neglected women, adolescents, slum-dwellers, high-parity mothers – those are the populations we have in mind when we conduct research and engage with partner institutions.

At this point in history, women are the least likely to die of maternal health causes, ever. But there is still a fairly large amount of mortality and morbidity remaining. We will focus comprehensively on the burden of ill-health associated with being pregnant and giving birth, on the concept of well-being or quality of life.

What will you be working on as a professor or ‘ZAP’, to use the official Flemish terminology?

I have two big projects that are starting soon. One is a Horizon 20201 project called ALERT, which aims to empower and strengthen midwives as leading providers of childbirth care. We will be focusing on hospitals in Benin, Malawi, Tanzania and Uganda. The project is led by the Swedish Karolinska Institute. We at ITM will be working on two aspects: a realist evaluation, which asks how and why this project works, if it does, and economic evaluation: basically, how much it costs.

Second, for the past years we have focused on how to intervene between labor starting and the baby being born, to prevent maternal mortality. We have assumed that the biggest challenge was to get women to come to facilities to give birth, and we have achieved tremendous success there. But what happens after, in postpartum care? We have recently found – and these findings have been published in two papers – that while women come to health facilities to give birth, they stay for a very short time, in some settings only a matter of hours, and even routine checks are not carried out. We do not have a good understanding of why the basic protocols for postnatal monitoring are not followed.

In our other, FWO-funded (Research Foundation – Flanders) Senior Postdoctoral Fellowship, I will try to find the answer to this. I will be reviewing postnatal care in health facilities worldwide, and

# COVER STORY

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Lenka in Guinea in 2019, with local health centre staff: midwife Martine Louamou, attendant assistant for delivery Mamata Camara, nurse Abou Bangoura, MD and research assistant Yamoussa Bangoura. In the white shirt is ITM PhD student Bienvenu Camara from Maferinyah

exploring the barriers and enablers to providing postnatal care monitoring to women before and after discharge from health facilities in Tanzania and Guinea.

We have seen unparalleled success in the uptake of antenatal care and the proportion of births happening in health facilities. But this has also resulted in these facilities becoming more crowded, which is especially a problem in fast-growing cities. There are often shortages of staff, skills or equipment. In a big hospital more than 100 babies may be born per day. How do the teams working there structure routine postnatal checks and pre-discharge procedures? To follow

women and babies and make sure that they are fine is what drives me.

What is a marker of success for you?

Our results will hopefully better enable countries and health facilities to implement new postnatal care recommendations and thus make substantial advancements in maternal survival and well-being. In 2013 the World Health Organization (WHO) published its recommendations on postnatal care of the mother and newborn. They are now in the process of updating these recommendations for which they are looking at the most recent evidence and we aim to inform their guidelines with our re-

search – especially our FWO project will be linking with this. Firstly, I am trying to understand how different countries organise the postpartum period: how does the follow-up of mothers happen in various countries, what is the scope of possibilities. Secondly, in Tanzania and Guinea we will try to see why, if guidelines exist, they are not being followed, what are the specific obstacles from the women’s and the health workers’ side.

As I mentioned, one of my other passions is making use of secondary data, particularly the Demographic and Health Surveys. These datasets are collected in dozens of countries and are available for anyone to use. However, a large percentage of the papers written from these data is led by Western and Northern academics. I hold writing retreats and workshops for people from the South to learn how to analyse and publish about their own countries from their own data and gain the data analysis skills. We held one in Uganda and one in Guinea last year and we really hope to continue them on an annual basis, facilitated by experienced researchers from the South. This is a very rewarding part of my job.

1 Horizon 2020 is the biggest EU Research and Innovation programme ever with nearly €80 billion of funding available over 7 years (2014 to 2020).

BIO » Senior Postdoctoral Research Fellow, ITM (2019-ongoing) » Assistant Professor, lead of Secondary Data Analysis for Generating New Evidence (SAGE) team, London School of Hygiene and Tropical Medicine (20142018) » Researcher on a conditional transfer programme in Egypt (2008-2010) » Coordinator with Medecins Sans Frontieres in Nigeria, South Sudan, Palestine (2004-5, 2007) » BSc Business Management (Suffolk University, Boston), MA in Middle East Studies (American University in Cairo), MSc Demography & Health and PhD in Population Studies (London School of Hygiene and Tropical Medicine)

Lenka with midwife Martine Louamou at the Kaback Health Centre # COVER STORY

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A TRAVEL APP CALLED WANDA NICO VAN AERDE The numbers speak for themselves: ITM’s travel clinic is becoming ever more popular among globetrotters.

Almost 20,000 people visited the clinic for travel advice and vaccinations in 2018 – 3000 more than in 2016.

Since the end of 2019, these travellers can carry a world of health information in their pocket because the Institute has developed a new smartphone

application that keeps them up-todate with information about health risks at their destination.

The app is called Wanda and is available in Dutch, French and English. Besides developing this new app, ITM has also given its travel medicine website a complete makeover.

P³ talked to Dr Mieke Croughs, the Wanda project leader.

Why was the travel medicine website thoroughly revamped?

The information on the old website focused on doctors and less so on travellers.

We concentrated primarily on the medical aspects. Wanda is made specifically for the traveller. We have completely revised all information and tailored it to the needs of users who have no medical knowledge. We also wanted to improve the user experience of the travel medicine platform and I think we succeeded: the website navigation is more logical, and the search function has become more efficient.

Why did you add an app?

Previously, travellers who attended a travel consultation received the brochure ‘How to travel and stay healthy’. In practice, however, we noticed that our patients often did not read this brochure, let alone take it with them on their journey.

However, these days, almost everyone has a smartphone, and once you have installed the app, you have the information constantly at hand, even when there is no internet. A second advantage is that the app can give much more information than a brochure. And finally, we can use the app to send travellers an alert when there is an outbreak in their country of destination.

So, when I download the app, I will find all the information I need about healthy travel?

A face-to-face consultation with a doctor – your GP or an ITM doctor - is still preferred. After all, the app only contains general information. We cannot take account of individual risk factors because we are not familiar with the person’s medical history and the way in which he or she travels. Wanda is not intended to replace face-to-face medical consultations.

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We can use the app to send travellers an alert when there is an outbreak in their country of destination.

Did you already receive positive feedback?

We did! Travellers are very enthusiastic.

We even receive feedback from abroad, including from the Netherlands, where the ‘GGD reist mee’ app is available. We also know that NGOs recommend the app to members of their staff who are regular travellers.

What is the advantage of this app over similar apps?

Any idea how many times the app has been downloaded?

I don’t think there is a similar app that is so extensive. The Netherlands have the ‘GGD reist mee’ app, but it contains far less data and is only in Dutch. Wanda is trilingual, all information is available in Dutch, English and French.

During the first two months, the app was downloaded nearly 10,000 times. A pleasing result.

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Do you have any plans for the further development of this app?

We will certainly be adding new topics, such as air pollution or bed bugs. We are also considering whether we can use the app to support scientific studies. For example, we could ask travellers to tell us (voluntarily) via the app if they have a fever. It would help our research into trop-

ical diseases and illnesses. We also want to create a new platform for doctors, to ensure that the information that could previously be found via our website remains easily accessible.

Heidi and her daughter Sofie will soon be travelling to The Gambia. They recently made an appointment at ITM: “We have been to Africa before, but realised that we might need additional vaccinations. I visited The Gambia page on Wanda and learned that this was indeed the case. We received yellow fever, tetanus and hepatitis A and polio vaccinations.�

DEEP DIVE WITH AN OCEAN VIEW CATIE YOUNG With pride, ITM launched a new master’s programme this year giving students a choice out of three Master of Science programmes – in Public Health, in Tropical Animal Health and now in Tropical Medicine.

Leveraging our rich scientific and research expertise, the new Master of Science in Tropical Medicine invites students from all over the world to take a deep dive into tropical medicine choosing either from our clinical or biomedical science orientation.

ITM’s interdisciplinary approach to advance science and health for all is to bring together pathogens (biomedical sciences), patients (clinical sciences)

and populations (public health).

This unique aspect of our Institute is instilled in the new master: along with the deep dive into their chosen field of clinical or biomedical science, students also get an ‘ocean view’ – equipping them with contextual and relevant research skills in tropical medicine from all three disciplines so that they can have a real impact on the larger health care ecosystem.

P3 talked to course co-directors Prof JeanClaude Dujardin, Head of Department of Biomedical Sciences, and Prof Lut Lynen, Head of Department of Clinical Sciences, to discover more.

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Can you please tell us how the new master’s took shape?

Lut: We have so many diverse and eager students coming to ITM taking short courses and postgraduate certificates in public health, clinical and biomedical sciences in the context of tropical medicine. We’re pleased and flattered to see that most of them want to come back. But we realised we lacked a path for students who want to deepen their knowledge and research skills and gain a master’s accreditation in the clinical and biomedical areas of tropical medicine.

Jean-Claude: Indeed, importantly the new master’s answers these student

needs, and also a demand from a research and employer perspective: NGOs, research institutes and industry are all seeking highly skilled clinicians and biomedical professionals in tropical medicine, especially with our globalised world where tropical diseases, pathogens and their vectors go well beyond the borders of the ‘tropics’.

What can students expect?

Lut: Connection would be my answer – to a close-knit community of experts with whom they can learn and co-create. Connection to ITM professors and research staff with vast field experience, and of course connection to our strong 19-coun-

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Want to know more about ITM’s new MSc in Tropical Health?

Visit www.itg.be/mtm

try partner network and a formidable alumni group active in NGOs, public health and industry.

This connection is strengthened through our cosy, student-centred campus in Antwerp that allows professors to tailor-make programmes to meet particular student research and thesis needs. We are also a very democratic place, so hierarchies are flat with a very participatory learning style. Students can also look forward to lots of hands-on simulations that teach the realities of fitting highly developed science into low-resource settings.

Jean-Claude: This learning environment, which is unique to ITM, is underpinned by a course structure reflecting ITM’s holistic approach. To start, all students acquire a basis in international health, they will then move into either a biomedical or a clinical cluster. After acquiring a basis in this cluster, they can then choose electives to best suit their needs: this can be from ITM or from other institutions.

For their master’s thesis, students can integrate laboratory or fieldwork and can also gain international experience as they answer an open research question in tropical medicine. They also have supervisors and input from all three areas of ITM expertise – pathogens, populations and patients – so that, along with going deep vertically in their chosen field of expertise, they can really make the most of this horizontal, holistic approach. As a biologist I see this as going from gene to ecosystem - an approach I was able to gain at ITM. This was really apparent through my fieldwork in Peru and Bolivia for example, where I was able to combine

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The new master’s course further increases an already strong educational activity.

my research in molecular biology with clinical and ecological insight. The new master’s programme enables us to share this combination of perspectives with students.

Also from my departmental viewpoint, the new master’s course further increases an already strong educational activity in our department and concretises our contribution to this interdisciplinary approach further - which I am very happy for, as it also allows ITM research to grow richer in many ways.

You say ITM also grows richer, how so?

Jean-Claude: Well as a researcher, your findings are only of use when they are shared as widely as possible and can be used as authority and input for further research. Educating others is a unique and expansive way of disseminating and further developing our research. At the heart of it, it’s what academia is all about.

Lut: I totally agree; I get a lot of energy from teaching because, yes, students learn from us professors but it’s a reciprocal process. Every time I teach, I learn a great deal from students and the interactions that we have. And with each student who succeeds in our programmes I feel really proud that I’ve added another person to my own and to ITM’s network; another person who I know is capable and ready to move ahead in finding real solutions to real problems in health care all over the world.

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PHOTO STORY

CONNECTING THE DOTS AT THE 60TH ITM COLLOQUIUM ITM colloquia bring together experts from all continents to discuss the most pressing scientific questions in tropical medicine and international health. The 60th edition built on this tradition by addressing the current challenges of global health, with a specific focus on migration, climate change and technological innovation.

Infectious diseases specialist Diana Pou Ciruelo gave a talk about migration through the Mediterranean. She urged researchers to fight the rumours that refugees bring infectious diseases, and to show the world that they are healthy individuals fleeing from awful conditions, looking for a better life.

They mostly suffer from psychological trauma.

Keynote speaker Ngozi Erondu called for the decolonization of global health, by dismantling the ‘global health’ system that advantages the North, by reversing colonial legacies e.g. public health to protect the west, and by ending imperialistic approaches that prevent local research leadership and data ownership.

Her Majesty the Queen of the Belgians inaugurated the Colloquium. In her speech she was advocating for breaking the silence on mental health matters.

Christian Seelos, Director of the Global Innovation for Impact Lab at the Stanford University Center on Philanthropy and Civil Society gave a fiery speech about innovation: “Don’t expect success from innovation, but radical learning.”

Africa CDC Director and ITM alumnus John Nkengasong emphasised the importance of external partners aligning their efforts with the African Union’s health strategy: Agenda 2063, the Africa we want.

Nuno Faria, Associate Professor from the University of Oxford, talked about his innovative research in tracking the genomics of arboviruses. He highlighted the importance of moving towards a coordinated and global genomics-informed surveillance of viral pathogens.

# PHOTO STORY

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REWIND

ONLY THE STIGMA REMAINS The ITM - HIV connection LOUISE O’CONNOR Every year World AIDS Day pays special attention to the plight of people living with HIV and AIDS. The impact of ITM’s HIV-research can hardly be overestimated since scientists from the Institute helped lay the foundations of global research in the field. This is why ITM puts the spotlight on the disease on World AIDS Day. Last year’s event was accompanied by a ‘bye-bye stigma’ campaign. Staff wrote encouraging messages on paper T-shirts and hung these on clothes lines throughout the ITM buildings. Although HIV medication has turned this deadly disease into a chronic condition, the stigma associated with the virus remains strong.

A room in the clinic of ITM in the 1980s

In the early 1980s, ITM’s Dr Peter Piot and Dr Henri Taelman reported similar symptoms in people from Central Africa visiting them in Kinshasa, to those of a mysterious disease affecting gay communities in US cities. With Dr Kapita of the Hopital Mama Yemo in Kinshasa, they were the first to make the link with AIDS in Africa. At the same time, a team of ITM researchers, including Dr Marie Laga, investigated venereal diseases in sex workers in the slums of Nairobi. They too examined whether this same disease was spreading in Kenya. Their findings were shocking. As many as half of the female sex workers were found to be infected with the virus. It meant that HIV, branded as the ‘gay plague’ until then, was no longer just a gay disease. The news that

ITM’s Peter Piot, Bob Colebunders and Marie Laga with Congolese colleagues of Project SIDA in Kinshasa

HIV could also be transmitted through heterosexual contact, however, met with a lot of resistance and initially a number of scientific journals even refused to publish these new findings.

In the meantime, the Institute took care of the first generation of HIV patients, the majority of whom were Belgian gays.

Sexuality, particularly homosexuality, was still a big taboo in Belgium in the 1980s leading a double life; they were often married and had children. Moreover, the disease was fatal to most and as a result many HIV-positive Belgians faced a double stigma: being gay and infected with HIV. ITM staff did their best to offer psychological support, a listening ear.

The treatment of patients in other hospitals was not always straightforward. For example, in some facilities medical staff did not even dare to bring food into a patient’s room but left it at the door.

Fortunately things have changed over the last 40 years since the discovery of HIV/AIDS. In the mid-1990s the combination of different antivirals proved to be an effective treatment and led to a dramatic drop in the mortality rate. The disease was no longer a death sentence but a manageable condition. But living with HIV is not easy and even today sufferers continue to face a lot of prejudice.

Many people are reluctant and anxious when confronted with HIV/AIDS. It remains difficult, for example, to tell a new partner that you are infected with HIV and those who are infected often face discrimination, rejection and exclusion.

The stigma associated with the disease continues to be a harsh reality for people living with HIV and often results in fear and isolation. Through the ‘bye-bye stigma’ campaign ITM staff wanted to highlighting the impact of this stigma.

# REWIND

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PORTRAIT

“ACCESS TO CARE IS TOO OFTEN OVERLOOKED FOR LEISHMANIASIS” ELINE VAN MEERVENNE After her medical studies in Indonesia, ITM researcher Temmy Sunyoto started working for Doctors Without Borders (MSF). During her 10 years at MSF, Temmy remained connected to ITM through several courses including the Postgraduate in Tropical Medicine and International Health, and the Master in Public Health.

Eventually, she started working for ITM in 2015 and completed her PhD in 2019 as a Marie Curie fellow. Without ITM, she says, she would not be who she is today: a passionate researcher working on neglected diseases.

“When I had just graduated from medical school, I didn’t feel like doing a specialisation or working in a private practice. At MSF I found my calling. During the first two years, I worked in several regions of Indonesia on various projects about HIV, tuberculosis, and responded to emergencies such as the tsunami of 2004. Just before my first mission abroad in 2006, I took a postgraduate training in Tropical Medicine and International Health at ITM. That was one of my first acquain-

tances with the Institute and I immediately liked it very much. My first mission abroad was to South Sudan. The region had been plagued by conflict for years, and we tried to re-establish basic health services in a hospital. It was tough; but very rewarding. I worked hard and with few resources but I learned a lot,” says Temmy. She also came to realise that working at MSF is not a job but a lifestyle - her missions took her to Darfur (Sudan), Ethiopia, Kenya, and India. Gradually her roles also expanded to medical referent and medical coordinator.

Triggered by the challenges she experienced in the field, Temmy wanted to improve her skills in public health and epidemiology. She went back to ITM to complete the Master in Public Health in 2009 and wrote her master’s thesis on leishmaniasis. “Leishmaniasis is a topic close to my heart. When I worked as a doctor for MSF, these patients I saw in Somalia often had to travel great distances to get to our centre, and these sick children had to be treated with the only available drug requiring painful injections for a month. After doing my master’s at ITM, I ran a leishmaniasis project in India, and I continued to be intrigued by the com-

plexity and diversity of the disease. As a neglected disease, lack of effective control tools remain an issue especially in Africa where the context is challenging.

Furthermore, access to care is too often being overlooked,” says Temmy.

“When I had the chance to do a PhD on leishmaniasis, I jumped at this opportunity. I carried out my PhD within the framework of Euroleish, a Marie Sklodowska Curie Innovative Training Network, with Prof Marleen Boelaert as my promoter and mentor. In my doctoral thesis, I explored the factors that impede access to treatment and found a myriad of problems. Understanding the disease burden better is crucial, especially in contexts such as Somalia or South Sudan, where availability and accessibility of care is limited.”

This means she also examined access issues relating to market failure of leishmaniasis drugs, barriers from supply chain and health system and perceptions of the community. “Very rarely is the population’s voice being heard, and that’s what I try to do in Sudan and Ethiopia: making their voice heard in the effort to prevent and control this disease,” says Temmy.

Temmy remains passionate about leishmaniasis and access to care in general.

“After I finished my PhD, I started working on a project to improve control tools for leishmaniasis, this time an innovative vector control method for cutaneous leishmaniasis in Morocco. My research concentrates on the balance between innovation and access: new tools are useless if they do not reach the people who need them most,” Temmy concludes. # PORTRAIT

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Temmy moderates a group discussion with the seasonal workers ©Pieter-Jan Claessens

TEMMY AND THE DOCU-SERIES Temmy Sunyoto and her leishmaniasis research feature in the documentary series screened on the Belgian television channel Canvas later this year. The camera crew followed Temmy all the way to Abdurafi in Ethiopia and they give us a glimpse of the leishmaniasis problem among seasonal workers on large sesame farms. Temmy talked to many health workers and seasonal labourers to better un­ derstand the challenges from their perspectives.

Seasonal workers on their way to the sesame fields ©Pieter-Jan Claessens

THE LIST

TOP 3 TIGER MOSQUITO LOOKALIKES LOUISE O’CONNOR In 2019, our researchers once again found eggs, larvae and adults of the tiger mosquito in Belgium. Early detection and monitoring of exotic mosquitoes is crucial to control populations and estimate the risk of disease transmission. ITM’s Unit of Entomology (a.k.a. the mosquito experts) receives a multitude of questions,

photos and phone calls from alert citizens every week. However, until now the spotted specimens always turned out to be lookalikes of the tiger mosquito. Here we list the top 3 species which are most often confused with tiger mosquitoes – so that next time you think you found one, you can try to identify it yourself!

Spotted in » Europe, Turkey, North Africa, Southwest Asia » Common in Belgium Characteristics » 7-9 mm » Dark brown » Dark and light brown ringed pattern on legs » Spotted wings Difference with tiger mosquito

Culiseta annulata Also known as Banded house mosquito

» Larger than tiger mosquito » Dark brown with pale stripes on legs, the tiger mosquito has a black and white striped pattern » Spotted wings, unlike the tiger mosquito

# THE LIST 23

Spotted in » Worldwide » Common in Belgium Characteristics » 5-15 mm » No proboscis (syringe-like mouthpart) » Males have large feathered antennae » Protruding legs in resting position Difference with tiger mosquito

Chironomidae Also known as Non-biting midges

» Larger than tiger mosquito » No proboscis » Striped, but will never have black and white striped pattern like the tiger mosquito

Spotted in » Worldwide » Common in Belgium Characteristics » 7-35 mm » No proboscis » Long legs, wings and abdomen Difference with tiger mosquito » Larger than tiger mosquito » No probosicis » Patterned, spotted or coloured wings, unlike the tiger mosquito Tipulidae Also known as Crane flies

THE REAL DEAL – THE INFAMOUS TIGER MOSQUITO

Banded house mosquito

Asian tiger mosquito

Spotted in » East Flanders, Hainaut, Namur, Luxembourg Characteristics

Aedes albopictus

» The Asian tiger mosquito is very small (see photo comparison with one eurocent) » Contrasting black and white stripes on body » Black and white striped legs with white tips » White stripe down its back » The proboscis (part that pierces the skin) is white at the end

Also known as Asian tiger mosquito # THE LIST

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Our goal is to eliminate sleeping sickness.

ITM AND I

ALEXANDER DE CROO It has been five years already since I became Minister of Development Cooperation. It has been, without a doubt, an exceptionally exciting period. We carried out a whole series of reforms in order to update the Belgian development policy. For example, Belgium fully endorsed the new Sustainable Development Goals (SDGs), the UN proposals to end extreme poverty by 2030. Partnerships are vital if we want to succeed.

It was therefore one of my priorities to build bridges between traditional and not so traditional development partners and actors and the private sector. A government or the traditional development sector alone can no longer achieve the ambitious agenda of the SDG. “L’union fait la force” — working together makes us stronger. We Belgians know that all too well.

ITM laid the foundation of the related research through the development of new rapid tests, the deployment of more effective fly traps, advanced digital data processing and more efficient population research. The Belgian Development Cooperation and the Gates Foundation provide the necessary funding.

Belgium has been recognised internationally as a pioneer in the fight against sleeping sickness for years, partly as a result of the world-renowned scientific expertise of ITM and the Belgian efforts in the DRC. This new collaboration receives international acclaim as well. It is not a coincidence that the new Congolese president Tshisekedi insisted on visiting ITM during his first foreign visit. ITM has every reason to be proud!

One of the new partnerships that I am most proud of and which I helped set up three years ago is that between ITM, the Belgian Development Cooperation and the Bill & Melinda Gates Foundation. Our goal is to eliminate sleeping sickness. Every year there are several thousand cases of sleeping sickness in Africa, particularly in the Democratic Republic of Congo (DRC). Without treatment, the disease is always fatal.

# ITM & I 27

CALENDAR 17 Mar

The Battle of the Scientists Antwerp

26 Apr

Antwerp 10 Miles

2 Jul

Master in Public Health (MPH) graduation ceremony

28 Nov

Flemish Science Day

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