Reducing the impact of infectious diseases in the Asia-Pacific

Associate Professor James TrauerMonash Public Health and Preventive Medicine's Associate Professor James Trauer was a finalist in the 2022 Eureka Prizes, some of the most prestigious prizes in Australian science. In 2021 he won a Victorian Young Tall Poppy Award, another significant achievement. Here we focus on the body of work that has led to this moment.

A/Prof James Trauer is a respiratory and public health physician with a passion for using modern software design to create models that help understand and predict the spread of disease through society, and the likely impacts of response strategies. He leads our Epidemiological Modelling Unit, a position he held from well before the pandemic launched epidemiological modellers into the celebrity realm.

"The pandemic really has pulled the work we do out of the shadows and into the limelight. It's been surreal to see the word 'epidemiology' bandied around so widely, and the level of media engagement I've undertaken in the last two years has skyrocketed," he says.

As a respiratory physician, James' initial work in epidemiological modelling initially focused strongly on transmissible respiratory infections, especially tuberculosis (TB).

"TB is still rife in many of our regional neighbours across the Asia-Pacific. As well as carrying a significant health burden for infected individuals, it's quite a complex disease. There are major challenges around drug resistance, case identification and latent infections, where people may remain asymptomatic for a long period of time before developing disease.

"To address these challenges, a few years ago my team and collaborators established the 'Australian Tuberculosis Modelling Network', which has been providing The Global Fund for Fight AIDS, Tuberculosis and Malaria and high-burden countries with the expertise to model the impact of specific TB control activities.

"Along with the Global Fund, we've also had significant funding from the Medical Future Research Fund, Australian government departments and the World Health Organization to guide TB elimination programs in our region, build local capacity among policy-makers, and support population screening programs."

COVID-19 has provided an even richer vein of research for A/Prof Trauer and his team over the last two years. Posing a more immediate threat to low- and middle-income neighbours than TB, the team have switched focus, applying their software to predict the path of the virus through those communities.

"We're really keen for other countries and populations to benefit from the software we've developed – the global threat of infectious diseases won't diminish for any of us until we have more equitable resources for controlling them.

"The modelling software we've created is adaptable, so we've spent time refining it for COVID, and have helped researchers across the Asia-Pacific region apply it to their own settings. It can help them understand how the virus may spread in their context, and they can use it to predict the effectiveness of interventions like school closures, local lockdowns and mask wearing.

"It's really important to understand the effectiveness of each of these on their own and combined, rather than utilising them as blunt instruments. As we've seen, the community only has so much tolerance for these interventions, so it's important to apply these strategically and for policy makers to be able to justify the rationale underpinning them.”

The pandemic has also seen James provide modelling data to the Victorian State Government, and become a familiar face on TV news shows.

"I honestly would never have thought I'd be a regular expert comment provider on the type of work I do! At the same time, I do really appreciate the opportunity. I think epidemiological modelling is such a useful resource for health at both a global and local level. It's really rewarding to see so many people engaging with it, and I hope I'm contributing to a shared understanding of infectious disease control."

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