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Alison Elliott

Theme Leader for Endemic, Neglected
Emerging & Reemerging Infectious Diseases Uganda Virus Research Institute

Prof. Alison Elliot was , in the 1980s, among the first to demonstrate the association between tuberculosis and HIV infection in Zambia, and effects of HIV on tuberculosis presentation and infectiousness. They demonstrated that the widely-recommended thiacetazone-based combination therapy for tuberculosis caused severe skin reactions in HIV co-infected people, contributing towards discontinuation of its use. It was hypothesised that tuberculosis-induced immune activation accelerates HIV progression and that adjuvant, immunosuppressive prednisolone therapy would be beneficial during co-infection. In Uganda, studying HIVassociated pleural tuberculosis, Eliot group showed that prednisolone should not be used, because of increased cancer risk, a finding recently confirmed by others for HIV-associated pericardial tuberculosis. Work with tuberculosis control programmes in endemic countries highlighted the tremendous logistical challenge of achieving control through treatment, the huge potential benefit to be achieved with an effective vaccine, and frustratingly poor efficacy of BCG in tropical settings. Alison and group therefore turned attention to factors affecting vaccine responses in tropical settings, and the hypothesis that treating maternal helminth infections might improve infant BCG responses (and other birth outcomes). They found that this was not so. Conversely, treating maternal helminths increased the incidence of infantile eczema– the first demonstration that intervention during pregnancy could influence allergy-related disease risk in the offspring (albeit adversely). This led to expansion of their work to address helminth-induced immunomodulation more broadly, and its implications for human health. Their projects have contributed a platform for African research capacity development: the only long-term, sustainable solution to Africa’s health challenges. Work in Zambia was forerunner to the now-flourishing Zambart tuberculosis and HIV research programme. In Uganda, the established Infection and Immunity training programme was re-launched in January 2016 under DELTAS Africa as the Makerere University–UVRI Centre of Excellence (MUII-plus). Infrastructure has been established, and leaders are emerging who will build African research for decades to come.

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