"Infectious diseases cannot be studied from one discipline alone"

Why is mobility such an important theme for infectious diseases right now?

JOHAN: Mobility has always been important for infectious diseases. But the global landscape is changing very rapidly, which makes this particularly relevant today. We see major changes in the financial landscape, climate change and increasing human mobility. Mobility is also a broad concept. It is not only about people moving: pathogens move, vectors move, and ecosystems change. All these components interact.

ENDALAMAW: Globalisation and human movement can accelerate the physical spread of pathogens, while climate change can alter their natural habitats and the distribution of vectors. Pathogens themselves also change, including in their genetics and drug susceptibility. Antimicrobial resistance is a clear example of this.

But the health system and the policies around it also influence these dynamics. How medicines are used, how people access and adhere to treatment, and how health systems respond can all contribute to changes in pathogens and the spread of resistance.

The question is therefore not only how pathogens are moving, but also how health systems can adapt to this changing landscape. Can we develop responsive policies? Can we use new technologies such as AI to better track these changes? And, in the context of a changing global funding landscape, how can countries in the Global South strengthen the resilience and sovereignty of their health systems?

Will AI play a major role in the conference?

JOHAN: AI is an important emerging tool that will probably have an impact on all parts of society, including research in infectious disease. But it is still a new tool, so we need to discuss how to maximise its benefits while remaining critical. What data are available? How good are those data? And to what extent are they relevant in different contexts? Infectious diseases emerge in very different settings, and some contexts are much better represented by data than others.

ENDALAMAW: We also need to think about how AI and other digital health tools can be used ethically, and how to make sure that the Global South has equal access. Otherwise, there is a risk of digital exclusion.

At the same time, the potential is enormous. These tools can help us understand pathogens and identify patterns in research data that may otherwise be difficult to see. In computational biology and pathogen evolution, for example, digital tools could significantly advance our understanding of how pathogens change and spread.

This will be particularly relevant in the session on surveillance for populations in motion. How do we use data to improve surveillance while making sure that systems remain accountable, equitable and responsive to the people they are intended to serve?

How does mobility feature in your own research on leishmaniasis?

JOHAN: Visceral leishmaniasis, the second-largest parasitic killer in the world, is a good illustration of why mobility matters. In Ethiopia, for example, people may move seasonally from the highlands to the lowlands for agricultural work. Their mobility affects their exposure to the Leishmania parasite.

There are also highly mobile communities in southern Ethiopia. Where people move can influence their exposure, but it also creates a challenge for providing continuous healthcare.

Climate change adds another layer. Historically, cutaneous leishmaniasis, which affects the skin, was more associated with the highlands and visceral leishmaniasis with the lowlands. With climate change, these patterns can start to overlap. That can have consequences for the epidemiology of the disease.

GADISA: My recent research focuses increasingly on marginalised and hard-to-reach communities, including mobile populations. We look at how we can improve access to and the quality of healthcare for these communities: how they understand health risks, how they respond to them, how they perceive the health system and how acceptable and accessible that system is to them.