Mathematical modelling to move science on schistosomiasis forward

The researchers want to know whether two decades of mass drug administration with a single drug can result in drug resistance among school-going children in Zanzibar, an island located off the coast of East Africa. A medical doctor and epidemiologist, Dr. Coffeng's research focuses on mathematical modelling to explore the transmission cycles of endemic neglected tropical diseases such as visceral leishmaniasis, soil-transmitted helminths, and schistosomiasis.

Sustainability has always been important to him and is perhaps even more critical in the current funding climate. He has worked to firmly embed this schistosomiasis project within the Laboratory, where government-funded infrastructure and human resources already exist. His team has aligned with the Ministry of Health’s schedule for data collection, integrated data systems and requirements, and trained local staff whose participation in the project helps them to master new techniques. To fellow researchers, he emphasises that working within local partner systems is not without its challenges. 'Don't expect that you know anything…the reality is much more complex than you think and people have no reason to trust you... but it is key to work together with a local partner.' Luc also encourages humility. By taking a step back and allowing the other partners, who had a prior relationship with the government, to play a leading role, he was able to prevent potential antagonism. Dr. Coffeng advises junior researchers to primarily seek funding from sponsors that have experience working in low-resource settings, as there can be considerable difficulties in setting and managing expectations related to sustainability. 

Dr. Coffeng's work is not immune to the recent cuts in development aid. The Task Force for Global Health, which ran the Coalition for Operational Research in NTDs and funded several operational research projects, ceased to exist. Without this operational research, the results from his work, which inform policy and guideline development, cannot be tested in field settings. However, he believes framing research as "moving science forward" rather than aid could be key to continued engagement with funders.

For early career researchers, whether from the Netherlands or other parts of the world, he has noted the lack of formal training in modelling for guideline development and policy evaluation. Therefore, a large part of his work involves one-to-one training and mentorship, and he encourages these researchers to "work with someone that inspires you".

Looking back, Dr. Coffeng is most proud of his contribution to revising infectious disease modelling methodology, notably the use of individual models. These models simulate a population with a finite number of people, each with life courses and characteristics evaluated independently, in contrast to earlier models that relied on simplified population averages. These models, widely applied during the COVID-19 pandemic, better capture the substantial heterogeneity related to age, social groups, disease course, and access to services.

Dr. Coffeng now looks forward to establishing a collaborative project in East Africa examining the transmission and control of visceral leishmaniasis.