PLOS Pathogens at 10 Years

Editors-in-Chief Kasturi Haldar and Grant McFadden highlight 10 years of PLOS Pathogens research in celebration of past accomplishments and future endeavors.

As PLOS Pathogens turns 10, we are excited to assemble a collection of primary research articles that reflects the high quality and breadth of original research published over the journal’s first decade. The strength of PLOS Pathogens remains its vibrant community of editors and authors, its high standard of peer review, its collective vision and commitment to publish and make available immediately and universally, outstanding original articles that significantly advance the understanding of pathogens and how they interact with their host organisms. Over 60 PLOS Pathogens Section Editors—experts on viruses, bacteria, prions, fungi, oomycetes and parasites of animals and plants—were invited to select articles they believe represent the very best exemplars from their respective fields. From this nomination process emerged 42 articles that were chosen for their scientific excellence, diversity, and sheer influence on pathogens research and human health.

A significant proportion of these chosen research articles from the past decade focus on the molecular resolution of the diverse complex machineries built at the interface of pathogen-host determinants (indeed, more often both) and poised at critical junctures of infection or disease. These articles have all been hard-won windows into the internal mechanics of pathogenesis. They show how in response to environment, changes in molecular structure and function result in a pathogen’s ability to become a deadly silent infection, a seasonal threat, a chronic public health concern despite herculean control efforts, antagonistic or synergistic with other pathogens, or a threat to our food supply.  The underlying rationale at PLOS Pathogens has been to develop evidence-based strategies that translate into improved pathogen detection and the stimulation of new avenues for the treatment of infection and disease. Some studies utilize powerful -omics tools to scan both pathogen and host genetic material, physiology, and intermediates in between to exploit “Achilles heels” using targeted smart therapies capable of selectively disrupting the pathogen but not the host networks. Sometimes, paradoxically, the strategy has been to strategically disrupt host infection prevention processes, which minimizes drug-selected antimicrobial resistance and can also be responsive to rare but nonetheless terrible infectious outbreaks or mixed infections, since all are escalating problems in the treatment of modern disease.

The PLOS Pathogens vision of publishing research of interest across the wide spectrum of pathogens ensures work of broad interest reaches the public as well as those whose work is impacted by novel findings. Indeed, there are several instances where research in one pathogen system actually stimulated research in a vastly different disease area, sometimes not even of infectious etiology. These shared principles unify not just the outstanding research studies but also the community of editors, authors and readers bound by mutual interest in molecular pathogenesis and Open Access. We are deeply indebted to this community and hope you will enjoy perusing this 10th Anniversary Collection, will celebrate the successes of the last decade with us, and will continue to support the highest level of research publication and its unhindered dissemination at PLOS Pathogens.

To check out both the 10th Anniversary Collection of articles, as well as the new Research Matters Collection, visit here.
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Health and the Sustainable Development Agenda: Leaving No One with Disability Behind

On the eve of the UN summit on Sustainable Development goals, Alarcos Cieza of the WHO reminds us that disability is part of the human experience contributing to human diversity.

A young man, who has been affected by polio, enjoying the beach in Benguela, Angola  Image credit: WHO/Bernard Franck

A young man, who has been affected by polio, enjoying the beach in Benguela, Angola
Image credit: WHO/Bernard Franck

On September 25-27 the United Nations Member States will meet in New York to agree on an ambitious post-2015 Development Agenda as the next phase of the Millennium Development Goals. For health professionals, the natural focus will be on Sustainable Development Goal 3: Ensure healthy lives and promote well-being for all at all ages. As the United Nations specialized agency for health, The World Health Organization (WHO) stands committed to the targets of SDG, which focus on reducing premature mortality from diseases and injuries, and to progressively achieve universal health coverage with high quality interventions that people need.

One of WHO’s messages in New York will be about the need for the health community, and all other stakeholders, to rethink disability in the context of the SDGs.  “No one must be left behind” is the commitment being made, with the universality of this message paramount.

Disability is often thought of as a serious misfortune that befalls a minority of people, fundamentally limiting their well-being and requiring substantial societal investment in health and social services.

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Category: Global Health, Mental Health, Policy, WHO | 1 Comment

“Don’t just do something, Stand there!”: Highlights from PODC 2015

Jack O’Sullivan (@JackOSullivan3) recounts highlights from the third Preventing Overdiagnosis Conference, hosted last week by U.S. National Cancer Institute.

Image credit: Dr.Farouk, Flickr

Image credit: Dr.Farouk, Flickr

Fifteen hundred years BC, the Ancient Egyptians recognised the potential harms of overtreatment – ‘tumor against the god Xenus, do thou nothing there against’. Millennia later, at the National Institutes of Health, the third Preventing Overdiagnosis Conference again provided much debate around medicine’s fundamental paradox: the harms of too much medicine.

Hosted by the National Cancer Institute (US), Oxford University’s Centre for Evidence-Based Medicine, Bond University, The Dartmouth Institute, Consumer Reports and the British Medical Journal (BMJ) clinicians, patients, academics and policy makers enjoyed a full three days of academic reflection.

Cancer, and the difficulty in delivering the appropriate diagnosis and treatment at the appropriate time, was extensively covered. Cancer screening is perhaps the most contentious example, with breast, cervical, prostate and thyroid discussed in detail. Fundamentally, where a significant increase in cancer incidence with no change in mortality is observed over time, there is a strong suspicion that the increased incidence represents cancer of no clinical significance. This argument is particularly compelling where the introduction of a new screening test coincides with a rapid increase in incidence. South Korea’s thyroid cancer ‘epidemic’(paywall), presented by Hyeong Sik Ahn of the Korea University School of Medicine, was perhaps the most striking example of this.

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Category: Cancer, Conference news, Global Health | 2 Comments

PLOS NTDs co-Editor-in-Chief Serap Aksoy and Associate Editor Dan Masiga conduct a Manuscript Writing Workshop at University of Nairobi, Kenya.

By Serap Aksoy and Joel Ochieng

An important goal for PLOS Neglected Tropical Diseases (PLOS NTDs) is to develop global capacity in publication practices in low- and middle-income countries, given that NTDs disproportionately affect people living in these areas. Accordingly, almost one-half of the PLOS NTDs Deputy or Associate Editors are based in institutions outside of North America and Europe. Attracting papers from Disease Endemic Country (DEC) authors remains a high priority. Thus, disseminating information on Good Writing Skills and Manuscript Publication processes is essential to allow authors from these countries to succeed in getting their works accepted through the peer-review system.

Image Credit: Emma Burns

Image Credit: Emma Burns

On June 18, 2015, co-EIC of PLOS NTDs Serap Aksoy, and PLOS NTDs Associate Editor Dan Masiga held an Editor Workshop in Nairobi to discuss issues essential for the publication process. Drs. Joel W. Ochieng, Senior Research Fellow and Leader of Agricultural Biotechnology Programme and George Obiero, Director of Centre for Biotechnology and Bioinformatics at the University of Nairobi, hosted the workshop. Over forty senior scholars, postdoctoral fellows, and graduate fellows, as well as several undergraduates attended the meeting. Among the topics discussed was the Open Access movement and the leadership of PLOS in this effort. Following the presentation made by Dr. Aksoy, the group discussed issues related to publication ethics and concerns related to plagiarism and data manipulation. Dr. Aksoy addressed questions related to the manuscript submission as well as peer-review process and the rights and responsibilities of authors through this process. The slide-set can be accessed on the PLOS NTDs website. Dr. Masiga discussed the Article-Level Metrics resources and their benefits. Many in the audience were unaware of the Article-Level Metrics used at PLOS, which allows for research articles to be primarily judged on their individual merits, rather than on the basis of the journal in which they are published. capture the manifold ways in which research is disseminated and can help users determine the value of an article to them and to their scientific community.

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Category: Global Health, Neglected Diseases, Open Access, Peer review | 1 Comment

Update to Blue Marble Health Collection

This week sees a major update to the PLOS Collection “Blue Marble Health: the mismatch between national wealth and population health” with the addition of 50 new papers, including two new editorials published today in PLOS Medicine and PLOS Neglected Tropical Diseases.

Blue Marble Health signals a shift in current thinking about global health, highlighting that the stark contrasts associated with health in developing and developed countries may no longer ring true and urging that health outcomes must no longer be defined by simplistic and generalised geographical or economic boundaries.

Blue Marble Health

Blue Marble Health

Writing in PLOS Neglected Tropical Diseases, Editor-in-Chief Dr Peter Hotez cites recent data from the World Health Organization (WHO) to support the hypothesis that neglected tropical diseases (NTDs), long associated with low-income countries, are becoming common afflictions of the world’s poorest people in wealthier countries also. Dr. Hotez notes that the Group of 20 (G20) countries which, together with the nation of Nigeria, represent 86% of the global economy, account for approximately half of the world’s parasitic worm infections, as well as most cases of dengue fever and leprosy.  He concludes that “the global economy could improve significantly through the lifting of the bottom segment of the G20 economies out of poverty,” and that an orientation towards Blue Marble Health at the G20’s 2016 summit could drive “a major breakthrough in global health.”

In the second editorial published today Dr. Larry Peiperl, Chief Editor of PLOS Medicine,  and Dr Hotez examine recent WHO data on years of life lost from non-communicable diseases (NCDs), which include heart disease, diabetes, and most types of cancer.  While such diseases have long been seen as the scourge of wealthy countries, Drs. Peiperl and Hotez argue that their distribution within the G20 countries and Nigeria suggests that the poor living among the wealthy disproportionately share the global burden of NCDs.

This analysis suggests that NCDs may be joining NTDs in following the Blue Marble Health pattern of geographical redistribution with convergence on the world’s poorest people, with adverse implications for human development.  “Strong economies must take responsibility for population-wide preventive action that embraces vulnerable populations now living in extreme poverty.”

The poor living among the wealthy.

Major areas of poverty in the G20 nations and Nigeria, where most of the world’s NTDs occur.

Other additions to the collection provide more evidence to support the Blue Marble Health concept. This includes research into cardiometabolic diseases in rural Uganda, diabetes care in GuyanaLeishmaniasis in Saudi Arabia and the economic burden of Dengue in Mexico, and a Policy Forum calling for national childhood cancer strategies in low- and middle- income countries.

PLOS Medicine and PLOS Neglected Tropical Diseases encourage the community of biomedical and social scientists, humanists, health economists, healthcare professionals, and public health workers to submit papers that highlight health disparities among the poor and otherwise disadvantaged populations, those who are often forgotten in the world’s middle- and high-income countries.

Category: Cancer, Collections, General, NCDs, Neglected Diseases, Open Access | Comments Off on Update to Blue Marble Health Collection

Hello, We’re Open

Karin Purshouse (@karinpurshouse), a clinical and academic junior doctor in Oxford, invites you to join the conversation with other early career researchers at the next OpenCon Community Call, this Wednesday, July 29.

It is not always easy, as a junior researcher, to stick your head above the parapet and stake your commitment to Open Access. As a junior doctor and early career researcher myself, I find speaking about OA with even my peers can feel controversial. But finding the courage to be an OA advocate as junior researchers through talking and listening is exactly what the OpenCon Community Call is all about.


OpenCon 2014. Image credit: Aloysius Wilfred Raj

The OpenCon Community Call was born after a group of 150 students, librarians and early career researchers met at OpenCon2014 in Washington, D.C. in November last year, bringing together an international community of people interested in Open Access, Open Data and Open Education. From every continent bar Antarctica, we represented fields as diverse as Slavic Languages and Literature to Computational Neuroscience and pretty much everything in between. As conferences go, we all agreed it had been epic – from the peers we had connected with to the caliber of senior figures we were able to both lobby and learn from, it had been a game-changer of a conference for all of us in appreciating our pivotal role in the OA movement. A key concern we shared was how to continue and develop our open community. We wanted to continue to learn from and support each other in striving for open-ness, as well as provide a platform for those new to Open Access to join the conversation. With that, the OpenCon Community Call was conceived.

The formula is simple – we talk about all things Open in a ‘safe’, low pressure environment, keep up to date with OA developments and support each other with new projects and initiatives to promote OA in our environments. Hosted monthly, each call is one hour of structured news sharing and discussions via a teleconference call, and the agenda and minutes are continuously updated and available. Everyone is free to contribute to the call or the agenda/minutes, and we have a coordinating team who provide the structure for the call. Around 20-25 participants representing both familiar faces as well as new ones have been attending each call. We’ve had everything – discussions about developing OA policies at universities and other academic institutions, guest speakers such as Kevin Smith from Duke University who spoke to us about Elsevier’s recent press release on a new sharing policy, or individual quandaries, such as how Ebola research can be made OA or how to get local initiatives off the ground.
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Category: General | 1 Comment

Simple but elusive – why are we still talking about HIV drug delivery?

Ahead of the International AIDS Society (IAS) Conference held in 2015 in Vancouver, Canada (July 19-22), Helen Bygrave of MSF discusses her frustrations with the lack of implementation of simple, programmatic strategies for improving HIV care.

My main memory of the last IAS conference I attended, held in Vienna in 2010, was a resounding standing ovation for a presentation (including this video) by one of my colleagues working in Mozambique. In a situation where antiretroviral therapy (ART) had not been extensively decentralised, and where drug supply limitations meant people had to attend a clinic every month to pick up their drugs, a simple idea had transformed the way that patients received their HIV care. In short, people living near each other had got together and agreed to take it in turns to pick up each other’s drugs. This resulted in less time spent at the clinic and lower transport costs for patients and an immediate reduction in workload for clinic staff.

Simple, no? So why are people living with HIV/AIDS still queuing up all day every month (or couple of months if they are lucky) outside a clinician’s door to pick up their ART? Many of them feel well, their CD4 counts are fine, and some now even know that their viral load is undetectable. There must be a more efficient way to deliver medications to these patients.


Community ART group in Zimbabwe; image credit: Helen Bygrave

How we deliver ART as a chronic medication has become a hot topic of debate. Examples range from facility-based fast-track through to adherence clubs, community ART groups (CAGS), and, finally, some examples of community-based pharmacies are appearing. These strategies have been variously named alternative-refill strategies, community models of care, and differentiated models of ART delivery. Whatever the title, the strategy must be patient-centred, ie responsive to patients’ needs, and context-adapted – since what might work in a busy clinic in Johannesburg may not work in rural Zimbabwe. My dream is to be able to offer patients a range of options to choose from when collecting their repeat drug refills. Some of the community strategies may even provide opportunities beyond easing drug supply, such as strengthening community engagement with the aim of mobilising local communities, reducing stigma, and enhancing their link with health-care systems.

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Category: Conference news, General, HIV | 3 Comments

Dismantling gains in global health?

As the Third International Conference on Financing for Development begins in Ethiopia, Áine Markham of Médecins Sans Frontières warns that basing funding decisions on country-level finance indicators could be a step backwards for global health, especially in middle-income countries. 

This month signals a critical moment for the future of global health financing as high-level political representatives meet in Addis Ababa for the Third International Conference on Financing for Development to discuss how the new Sustainable Development Goals (SDGs) will be funded. Current trends in stagnating spending on aid and a finance-driven rhetoric risk abandoning the achievements of recent decades.


Sunset on Addis Ababa; image credit: Jean Rebiffé, Flickr

Arguably, some of the greatest gains in global health during the past 15 years can be attributed to initiatives such as the Global Fund to fight AIDS, Tuberculosis and Malaria. The Global Fund, with its well-focused goals and multi-stakeholder governance mechanisms, created results-orientated funding that prioritised effectiveness, improved health outcomes and positively influenced national and international policies. Importantly, its inclusion of civil society as a national ‘watch-dog’ safeguarded the pertinence of health interventions in recipient countries. The Global Fund and other initiatives such as Gavi, the vaccine alliance, broke with tradition and funded critical interventions including recurrent costs such as health staff, drugs and renewable medical commodities. These initiatives, which have stemmed from the Millennium Development Goals (MDGs), galvanised global attention and funding on fighting killer diseases and ill health.

These important advances are now being eroded. The continued use of gross national income to allocate official development assistance (ODA), which includes development assistance for health, has potentially catastrophic effects for over 70% of the world’s poor who live in the 105 countries classified as middle-income. The risk with the current moves by donors to change modalities and channels of assistance to countries in this bracket could see the health needs of people living in these countries deprioritised with national health expenditure unable to replace external support. Over 50% of the humanitarian medical programmes of Médecins Sans Frontières (MSF) are in ‘middle-income’ countries such as, Sudan, Kenya and South Africa and we are alarmed by the disparity between global rhetoric and the reality faced by the populations we serve.

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Category: General, MSF | Tagged | 2 Comments

Lessons and Challenges for Developing and Delivering HIV Programs for Sex Workers

Today sees the addition of an important paper to the PLOS Collection Focus on Delivery and Scale: Achieving HIV Impact with Sex Workers; published in PLOS Medicine, David Wilson of World Bank looks at lessons learnt and challenges for developing and delivering HIV programs for sex workers.

The burden of HIV is heavily disproportionate in sex workers, where the high rates of partner change in their work and their vulnerability increase the likelihood of sexual transmitted infections. The Collection, writes Wilson, “challenges AIDS researchers and practitioners to initiate a new generation of comprehensive sex worker HIV prevention programs for a changing sex work context”.

Other articles featured in the collection highlight the cost effectiveness of community mobilisation efforts in improving the uptake of services and influencing transmission of HIV and other STIs. Evidence shows the impact of HIV programmes with sex workers – such as those in Thailand and India – when they are implemented at a sufficient scale. Countries in Africa such as Benin, Burkino Faso and Nigeria have also executed effective and feasible interventions, but analysis of these show that funding in these programmes remains inadequate and, as a result, the large scale responses that are required do not exist.

Image Credit: Rebecca Selah,; PublicDomainPictures,; alkautsar eddiejakoeb,; hdptcar,

Image Credit: Rebecca Selah,; PublicDomainPictures,; alkautsar eddiejakoeb,; hdptcar,

With the increased burden of HIV infection, the rapid scale-up of combination prevention programmes and HIV care and treatment, in order to improve conditions for sex workers and the general population to contain the HIV epidemic on a global scale, is key.

Please visit the collection at:

Category: Collections, General | 2 Comments

Advocating for Equitable Access to Global Health Internship Opportunities

Kaleem Hawa, Oluwaseyi Owaseye, Tara Kedia, and Ashton Barnett-Vanes comment on unequal access to global health career training opportunities and announce a fundraising campaign to help support internships at WHO Headquarters for young health professionals from low and middle income countries.

Image Credit: tup wanders, Flickr

Image Credit: tup wanders, Flickr

Global health is a field in which thousands of interns work every year. Some may undertake an internship as part of their academic programme, others as a work placement. Irrespective of an intern’s professional background, these placements afford candidates the opportunity to boost their skill sets, prepare or launch their global health careers, and develop academic or experiential global health knowledge that may be invested back into their local health systems.

Curiously, whilst equitable access to health care is a core value of global health and universal health care, equitable access to internships in this field has received far less scrutiny. A report by the UN’s Joint Inspection Unit in 2009 using 2007 data found that United Nations internships (including those offered by the World Health Organization) were inaccessible to many, with almost 60% of candidates from a high-income country. Surveys conducted in 2011 and 2013 at World Health Organization Headquarters (WHO-HQ) in Geneva, Switzerland support this finding, with only a quarter of WHO-HQ interns coming from low- or middle- income countries (LMICs). In many cases, this inaccessibility stems in part from the financial barriers and costs of living associated with an unpaid position in an expensive, global city like Geneva.

Young health professionals from high disease-burden regions have fewer international training opportunities than their peers from lower-burden regions (Figure 1). In the South-East Asia (SEARO) and Africa (AFRO) regions, 81% of countries are defined as low- or lower-middle income. The unpaid status of these internship programs likely restrain such candidates from applying without self-funding or financial support. Perniciously, these countries have the highest health burdens (Figure 1).

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Category: Global Health, WHO | 4 Comments