Professor Greg Fox is a respiratory doctor and clinical trialist at the University of Sydney and Director of the Sydney Vietnam Institute who is contributing to the momentum towards tuberculosis (TB) elimination. Professor Fox received the 2021 NHMRC David Cooper Clinical Trials and Cohort Studies Award, recognising the highest ranked recipient in the Clinical Trials and Cohort Studies scheme.
Read on to find out more about Professor Fox’s research, in his own words.
Tuberculosis (TB) is an airborne infectious disease that affects 10 million people each year, worldwide. Only COVID-19 causes more infectious deaths. The vast majority of TB cases in Australia occur among migrants from high-burden countries where TB is common. Hence, any attempt to eliminate tuberculosis in Australia requires effective TB control efforts in our region. Unfortunately, the investment in research into TB has been very limited, a stark contrast to the rapid investment provided to address COVID-19.
Twenty years ago, I was confronted by the devastating impact of TB during a medical student placement in Malawi, Africa. This was at the height of the African AIDS epidemic, and TB was a common cause of death – particularly for those who were HIV-infected. The contrast with Australia, where TB was rarely fatal, couldn’t have been starker. My experience in Africa convinced me that TB was a neglected global health problem, and that I wanted to be a part of the solution.
In 2009, I moved to Vietnam to undertake a PhD focusing upon the early detection of TB. I saw first-hand the effects of TB upon both the wealthy and the poor. Not only did people with TB have to contend with the effect that the infection had on their bodies, but the disease was also highly stigmatised. This frequently resulted in social exclusion and catastrophic economic loss. Drug-resistant TB made their outcomes even worse.
Over the past decade, my research group has undertaken a program of research to improve the early detection, the prevention and the treatment of TB. Much of this work has been conducted in Vietnam, where over 100,000 people have participated in our clinical trials.
Our clinical trials team from the Woolcock Institute of Medical Research in Vietnam has partnered with researchers, clinicians and policy-makers across the world to conduct this research. We have demonstrated the effectiveness of community-based interventions to rapidly reduce the prevalence of TB and tested the effect of medications to prevent drug-resistant TB. The knowledge that we have gained through our research has impacted national and international TB control policies.
We are motivated by a vision of eliminating TB globally – an ambition to which the global community have committed. However, over the past decade, limited progress has been made towards achieving this goal. Our research is helping to test new tools, treatments and public health strategies in Vietnam, a high TB burden country at the heart of the global epidemic.
The unprecedented global response to COVID-19 has proven that rapid progress can be made with sufficient innovation and investment. The global TB pandemic requires the same level of commitment. Our team is contributing to the momentum towards TB elimination, and taking the evidence we are generating and translating it into policies that can save millions of lives.