With people still missing and mud covering the villages affected by the October 29th floods in Valencia, we pause to reflect on what happened in the sky that fateful day, what lies ahead of us in this part of the Mediterranean and beyond due to global warming, and how science is advancing to provide us with the best tool for action: knowledge. We interviewed Xavier Rodó (Terrassa, 1965), ICREA Research Professor and Head of the Climate and Health Research Group at ISGlobal.

-As a climatologist, were you surprised by what happened in Valencia?

-It is difficult not to be surprised by such an event. You are surprised by the magnitude of its consequences, although relatively speaking, and it is hard to say, it is very small compared to, for example, tropical cyclone Nargis, which killed more than 100,000 people and destroyed entire communities in Myanmar in 2008, or the drought in the Horn of Africa in 2011, which claimed more than 250,000 lives, according to estimates by the World Weather Attribution (WWA) group. However, in what we might call the “first world”, it is an extreme and catastrophic event in terms of its consequences. In terms of the specific meteorological situation, although such events don’t occur often, they are not uncommon in this part of the western Mediterranean and has been well known for many years. What was initially unexpected was the energetic load associated with this particular event, which caused very heavy rainfall. However, the forecasts pointed in the right direction.

-So we will have more extreme events?

-Unfortunately, they will become more frequent. It is no longer science fiction, we must begin to understand that the predictions are coming true. From a social point of view it is a disaster, but from a scientific point of view it is a success. What is happening in the Mediterranean is going to get worse, because we have a very active cyclogenesis zone in the western part, which is going to get stronger as the sea continues to warm.

-Is the western Mediterranean considered a planetary hotspot?

-Yes. On the one hand, we see a progressive and steady increase in surface air temperatures and the warming of the Mediterranean Sea, accompanied by less rainfall during the two main rainy seasons, as a long-term trend. On the other hand, we are witnessing an intensification of extremes: the Spanish Levant region has a very active cyclogenesis zone, where autumn conditions lead to collisions between cold air masses and warm, moisture-laden air masses. These interactions fill the air column and, when released, trigger energetic discharges in the form of torrential rains. These heavy rains are expected to become more frequent. We could go from drought conditions to situations where it rains heavily but the reservoirs remain half empty. This reflects a dichotomy between decreasing water resources and increasing extreme weather events. We must begin to adapt to these increasingly variable and diminishing resources.

-What other factors are at play?

-Global warming, which raises air and water temperatures, also changes general atmospheric circulation patterns. For example, as in the case of an isolated high-altitude cold air mass, it can cause "bubbles," or masses of very cold air at high altitudes, to break away from the usual mid-latitude flow over Europe and move toward the Mediterranean. In addition, certain planetary-scale phenomena can amplify this process in certain years - for example, the strong El Niño that began last year and continued well into 2024. This phenomenon transfers a significant amount of energy through climate teleconnections to latitudes outside the tropics. It's like heating up a pressure cooker: the heat has to escape somehow. The excess energy finds regional outlets, many of which are well known, including the Mediterranean Sea, especially its western part. As a result, when a large amount of energy accumulates, it can lead to extreme rainfall events, such as the one in Valencia, where almost a year's worth of rain fell in just eight hours.

3 degrees of warming is a different world

-We already know that 2024 will be the hottest year on record and the first to exceed 1.5 degrees of warming above pre-industrial levels, the limit set by the Paris Agreement. How does this data make you feel?

-It's hard to say. As a scientist, there is a sense of satisfaction in seeing the work of so many years validated. But as a citizen, the disappointment is immense. Nevertheless, I believe that knowledge gives us tools for action, and that the generation of new scientific knowledge can somehow mobilize action in various fields. What worries me most is that at the current rate of emissions, we are heading for 2.7 to 3 degrees of warming by the end of the century. That would be a very different world.

-What will be the consequences if we reach 3 degrees of warming?

-The models may not be perfect - they are always approximate - but they clearly show that at 3 degrees of warming, the Atlantic thermohaline circulation would collapse. This is the system of ocean currents that circulates water in the Atlantic, moving warm water north and cold water south, and is crucial to maintaining Europe's temperate climate. Its collapse would trigger numerous cascading effects across the planet. Let's be clear: while we often talk about limiting warming to 1.5 degrees, the reality ahead is much more alarming. This naturally fuels pessimism, but I also want to change the narrative and focus on solutions.

-How can the message be turned around?

-From a scientific perspective, we are gaining an increasingly detailed understanding of how the planet and climate systems behave. While there have been surprises, particularly regarding the planet's high climate sensitivity as seen recently, this knowledge should strengthen our conviction as a society to pressure governments to change the system. We need to redefine our relationship with the environment. It's essential to move away from the historical mindset of humans as limitless resource extractors and understand that infinite growth is not possible. We've already reached planetary limits, and this requires a reorganization of the distribution of wealth. This doesn't mean going back to the way we lived 50 years ago - although in many ways life was better then - but rather managing our development based on the finite resources available rather than on unchecked demand. This change must occur at the local, regional, state, and national levels. It's time to change the way we organize ourselves as a society and ensure that intelligence and foresight are reflected in decision-making at the highest levels.

Summits to avoid decisions

-How do scientists in this field feel about the fact that climate change denial is gaining momentum?

-It is not a scientific problem; it is a sociological problem - a problem of human behavior. It goes beyond what we as scientists can directly address. A broad societal debate is needed to address this issue, and we are not the only ones who should decide how to proceed. Climate denial exists and will continue to exist, and it is gaining strength under the current global political conditions. It has become a widely used tool to justify inaction.

-Can COP29 do anything?

-Climate summits have become increasingly bureaucratic, making transformative decisions more difficult than ever. In fact, such decisions are simply not being made. It often feels like summits are designed to avoid making them. We've become too used to the ritual: late-night negotiations on the last day, as if the previous two or three weeks had been wasted on procedural formalities. ISGlobal is an accredited observer at COP29, and I see the same pattern emerging: endless debates over the wording of minor clauses in sub-paragraphs, while the most critical issues are completely sidelined. Enough is enough - we have already had 29 climate summits! This is a major problem. It's the same dynamic with biodiversity summits; we've had 16 of them now and little has changed. This is dangerous. We need to change the way we work - not only within the scientific community, but also with the general public. Most importantly, we need to put pressure on governments to act decisively.

-What are the issues that need to be addressed urgently?

-The COP has been dealing with the same issues for many years. One is the mechanism and the size of the Loss and Damage Fund—how to compensate the countries and regions that have been suffering the effects of climate change for years, and who is responsible for paying for it. On the other hand, there is no subsequent verification mechanism or agency to ensure that states comply with their commitments and pay this debt (which, in fact, we must consider as a debt already incurred by developed countries and both historical and current emitters). In the end, everything will be purely voluntary, and we will get nowhere.

-What can we do about this lack of action by the summits?

-We need to create a new mechanism that forces countries to compensate for the effects of their historical actions, which are already well-documented. What we need is both the political will and a new framework, because it is clear that the theory of the "common good" does not work for this type of global issue. But this seems difficult, as we can see that UN decisions are very weak in other areas, such as armed conflicts, where resolutions often go unenforced. So, how can we expect the resolutions of a subordinate organization, which depends on the UN, to be respected? In any case, despite the risk of sounding pessimistic, I always end up believing that the power of the people, which is starting to shift in many countries due to climate disasters, will eventually change the way many governments act.

We are not Tuvalu, but we are halfway there.

-Is there anything we can do at the individual level, or should we focus on demanding action from governments?

-You can help reduce your environmental impact, for example, by following the "three Rs" (reduce, reuse, and recycle). However, it must also be said that the aware citizen has been overly blamed, while large corporations and multinational companies have been insufficiently held accountable. The major oil lobbies and business groups coined the term "carbon footprint" to put the spotlight on individuals, and this term has been used ad nauseam, even by left-wing politicians. As citizens, we should follow the guidance of experts on what to do, but the solution to a problem of this magnitude goes far beyond individual actions, and in some cases, beyond what the state can address alone. The Spanish state, in particular, is starting to suffer more than other countries because we are warming much faster than the rest of Europe, and because mitigation and adaptation policies and plans have been entirely inadequate so far. We're not Tuvalu, but we're halfway there, and the solution needs to come not only from our state, but also from international agreements. On a global scale, however, one might argue that it’s not entirely bad that the effects of climate change are now reaching wealthy countries, because this could spur action.

-Do politicians and administrations consult you on these issues?

-In Catalonia and Spain, we still operate in an outdated manner, and I'm sorry to say it, but we need to speak out. Here, if a politician knows someone or has been told that a person is an expert, they pick up the phone and get an expert opinion right away. We should aim to work much more objectively, as is done in countries with a long tradition of climate research, which are much more advanced than we are—by using the best available information at any given time. We have excellent researchers and research groups that are underutilized by our political class. Politicians, and especially the public, deserve to have the best possible information, even if they have to seek it from outside the country, because, unfortunately, not enough has been invested in this field of knowledge here.

Intensity and forgetfulness

-Will anything change after what happened in Valencia? Can it be a turning point?

-I would like to say yes, but if I had to bet, I would definitely say no. All we have to do is look at the example of the COVID-19 pandemic, where, in theory, we were all supposed to learn a lot, but the truth is that very little has changed since then. For starters, we still do not have a national epidemiological agency or a pandemic forecasting system that fully utilizes the available tools, because the political class neither understands nor believes in them. If we were to face that situation again, we would encounter the same problems and shortcomings. An event like the floods in Valencia, like all extreme phenomena, has an intense psychological impact in the first few weeks or months, but then it is forgotten. In this sense, I would say that there will be no changes. On a broader level, beyond politicians, there is no perception of the magnitude or seriousness of these events, and unfortunately, we are learning this the hard way, through the experiences and suffering of many people.

Drawing the line

-Are we at a point of no return or can we still slow down climate change?
-From a scientific point of view, we have a better understanding of how the planet behaves. However, this also leads us to see that, throughout many crucial moments in Earth's history, climate has played a fundamental role. In a positive sense, because we know that 600,000 years ago, climate was the trigger for the emergence of multicellular life, thanks to the end of the Snowball Earth period, when the planet was no longer frozen, and also because of the climatic role during a major episode of global oxygenation. But also in a negative sense, less than 250,000 years ago, during the Permian-Triassic transition, we know that the magnitude and frequency of El Niño events in the tropical Pacific were so extreme that they led to a major extinction of species and a massive loss of terrestrial and marine biodiversity. And this occurred under conditions of CO₂ emissions ranging from 410 ppm to 860 ppm. Warning! These values are already included in the climate change scenarios projected for the coming decades! This should give us pause for thought.

-How can science help us?

-We are now able to design "safe" climate scenarios, where certain planetary variables must not be exceeded. These are called safe pathways. In other words, we are anticipating what politicians might ask us to do in the coming years, and there is a significant international research effort in this direction. What are the planetary emissions limits? If we stop emitting, will the planet return to previous conditions, or will there be hysteresis (the transition of the climate to a new state of equilibrium, driven by a forcing that causes an irreversible chang), leading to a different world, depending on where we are? What are the deforestation limits in certain parts of the world to prevent the collapse of biodiversity or the transition from forests to savannas? Is the sequestration of greenhouse gases possible as a planetary solution? What should we avoid doing or going beyond? We are generating immense knowledge that we didn't have before. Ten or twenty years ago, it would have been impossible to argue that this could be done - and now we are doing it. We can simulate a parallel planet and manipulate it to better understand how it behaves. So even if we as a society are in a boat approaching a waterfall, we now know exactly how much time we have to get out of the boat or what we need to do to steer it to safety. All we have to do is decide to take action.

Interview by Yvette Moya-Angeler.

Date

04/09/2024 - 20/11/2024

Hour

Wednesdays, 16:30 -17:30 CET

Place

Virtual

Speakers

Anna Young, Arthur Tenenhaus, Augusto Anguita, Congrong Wang, Chris Gennings, Inès Amine, Jesse A. Goodrich, Lea Maitre, Nikolaos Stratakis, Ville Pimenoff, Vishal Midya

This program consisted of 9 sessions spanning over three months, covering different topics related to multi-omics data integration in Human Exposome Studies. The detailed workshop program with further information about each session content can be consulted HERE.

To maximize the impact of this course, all sessions were recorded and are available on YouTube for asynchronous consultation.

Additionally, the materials generated during the course—slides and code—have been compiled HERE, creating a valuable resource for the research community. These resources not only offer lasting value but also allow us to track the long-term impact of the workshop.

Organisers

This workshop series has been organised by Léa Maitre and Augusto Anguita. Please contact Rodney Ortiz (rodney.ortiz@isglobal.org) for any queries or further information.

About the workshop series

The field of exposomics delves into the complex interplay of environmental, social, lifestyle, genetic, and other biological factors and warrants promise to advance precision environmental health. Beyond genetics, the integration of exposomics and multi-omics in epidemiology research can enable a more precise understanding of disease and promote health, especially for the most vulnerable population subgroups.

In this series of virtual workshops, we will introduce novel designs and analytical approaches for multi-omics integration that were recently developed and applied in the exposomics field to address critical data analysis challenges (dimensionality reduction approaches, mediation, predictive modelling, feature selection, networks, etc). The focus is on the practical application of these methods.

Do you want to revisit the course?

Recording for all the sessions have been already uploaded to YouTube, so you can revisit it whenever you want. For accessing slides and codes, please, click HERE or inspect the workshop proceedings HERE.

Introduction, overview, and multi-modal data integration - Session 1, Part 1

https://youtu.be/ecgh8FRZ1BM

Introductory session:

• Introduction to multi-omics data integration challenges in exposome studies - Dr. Léa Maitre
• Overview of approaches - Dr. Augusto Anguita
• Multi-modal data integration through dimensionality reduction: Motivation, concepts and theory - Dr. Arthur Tenenhaus

Introduction, overview, and multi-modal data integration - Session 1, Part 2

https://youtu.be/pCDsn0iTfDM

Continuation of the following introductory presentation (see video part 1 first)

• Multi-modal data integration through dimensionality reduction: Motivation, concepts and theory - Dr. Arthur Tenenhaus

Dimensionality reduction - Session 2 

https://youtu.be/xeCNueFLQYw

• Practical aspects of multi-modal data integration through dimensionality reduction (MOFA, PLS, RGCCA, etc). By Inès Amine, Inserm.
• Case studies of multi-omics and exposome data integration through dimensionality reduction in HELIX cohorts. By Congron Wang, UHasselt.

Strategies for Multivariate Mediation Frameworks – Session 3

https://youtu.be/RVaYY6zucDk

By Vishal Midya, Icahn School of Medicine at Mount Sinai, New York

Multi-Omic Analysis Framework for Precision Health: Omic mediation analysis in exposome research – Session 4

https://youtu.be/pNh770YYrn0

By Jesse Goodrich, from University of Southern California Keck School of Medicine

Networks visualisation for multi-omics integration – Session 5

By Léa Maitre, ISGlobal

https://youtu.be/fw99Rtz2VHk

Development of exposome mixture methods for high-dimensional omics data to investigate environmental risk factors of disease – Session 6

By Dr. Chris Gennings from Icahn School of Medicine at Mount Sinai, and Dr. Anna Young from Emory Rollins School of Public Health

https://youtu.be/PSDHhw75zP4

Comprehensive biotic exposome estimation from wearable device metagenomes – Session 7

By Dr. Ville Pimenoff, Adjunct Professor in Evolutionary Medicine at the University of Oulu, Finland

https://youtu.be/ldzPVn4g1X4

Multi-omics and eXplainable Artificial Intelligence (XAI) for predictive purposes: a focus on interpretability and explainability – Session 8

By Dr. Augusto Anguita, a biological data scientist specialised in the analysis of complex epidemiological datasets such as those composed of clinical, omics, biochemical, and environmental data at ISGlobal

https://youtu.be/HVsuGh3D0so

Patient similarity networks for the identification of molecular endotypes of obesity – Session 9

By Dr. Nikolaos Stratakis, an Environmental Epidemiologist and Postdoctoral Fellow at the Environmental and Health over the Lifecourse programme at ISGlobal.

https://youtu.be/AD_Yclu99YE

Target audience

This workshop is aimed at Master/PhD students, researchers, clinicians, and other professionals working in the fields of exposomics, epidemiology, or toxicology with an interest in understanding how omics data, including the exposome, can be integrated in epidemiological research.

With over 800 people registered, this program achieved an average attendance of ~90 participants per session and more than 2,000 views in our Youtube channel.

With the support of the grant CEX2023-001290-S funded by MCIN/AEI/ 10.13039/501100011033.

The Barcelona Institute for Global Health (ISGlobal) consolidates its position as one of the key entities in Spain's participation in Horizon Europe, the largest research and innovation programme in Europe. During the programme's first three years (2021-2023), ISGlobal has positioned itself among the 20 Spanish entities with the most funding received and ranks third among the category of research centres.

In this same period, Spain has become the third most funded country in Horizon Europe, behind only Germany and France, achieving a record economic return that underlines its growing prominence in the European field of research and innovation.

Leading role in health research funding

Horizon Europe is Europe's largest research and innovation programme, with a budget of close to 100 billion euros. This programme has been instrumental in boosting strategic sectors such as life sciences and health research.

During 2021-2023, ISGlobal has stood out at the European level, leading fundraising in the EDCTP3 programme (European Developing Countries Clinical Trials Partnership), which focuses on the fight against infectious diseases in global contexts. In addition, it has led fundraising in Spain within Cluster 1 - Health, Demographic Change and Well-being, which includes the Innovative Health Initiative (IHI) and Mission Cancer.

Horizon Europe boosts research and innovation in Spain and Catalonia

In global terms, Spain has achieved a return of 3,416.9 million euros in the calls awarded during the first three years of the programme, with a rate of return of 11.7%. This success reflects the growing prominence of Spanish entities, which coordinate 16% of the funded projects and participate in one of every three successful proposals.

For its part, Catalonia has consolidated its position as a national benchmark in fundraising, attracting 1,076.4 million euros, which represents 31% of the national total. In the health sector, Catalonia accounts for 52% of these funds, as well as 50.4% of the funds from the European Research Council (ERC) and 46.7% of those from the European Innovation Council (EIC).

ISGlobal's achievements strengthen Spain's position in research and innovation and highlight the institute's ability to lead projects with international impact in global health.

Date

25/09/2024

Hour

9.30 - 16.40 h

Place

PRBB
(Dr. Aiguader, 88) Barcelona

 For the first time, institutions across the Barcelona area gathered for the Barcelona Exposome Symposium, an event designed to promote collaboration within the growing exposome research community. The exposome is the integrated compilation of all the physical, chemical, biological and psychosocial factors, and their interactions, which have an impact on biology and health.

The program featured 3 invited talks, 18 abstract-selected presentations, and 15 posters that provided a panoramic view of local exposome research. Key topics included technological advances in measuring environmental exposures in biological samples, novel biomarkers for pollutants and dietary intake, and the role of environmental exposures in chronic diseases and early-life development. They were also discussions on how to integrate the exposome in clinical studies with deep phenotyping such as the Barcelona Brain Health Initiative (BBHI) - A Cohort Study to Define and Promote Determinants of Brain Health, led by the Institut Guttmann. 

This event, which brought together around 90 participants, was made possible through the joint efforts of ISGlobal’s Exposome Hub, CSIC, the University of Barcelona, and EMBL - Human Ecosystems Transversal Theme, reflecting the forefront of exposome research in Barcelona. Through the open abstract call, further institutions were represented such as the Universitat Rovira i Virgili and Eurocat. It also highlighted key community needs such as increased networking opportunities, knowledge exchange, interdisciplinary collaboration, and additional funding. 

The symposium marks a step forward in the larger initiative to build an International Human Exposome Network and advance the integration of exposome research into public health and policy. There will be further editions.

This event aimed to facilitate the sharing of knowledge, ideas, and resources within the exposome research community in the Barcelona area. With a series of invited presentations, abstract-selected presentations and posters, it provided a panorama of exposome research across different institutions in the Barcelona area.

The exposome represents the comprehensive set of environmental exposures that an individual encounters throughout their life. The exposomics field aims to evaluate how the exposome impacts on biology and health through discovery-based analytical approaches. This local-level symposium was part of a larger initiative to build an International Human Exposome Network.

The symposium covered the following topics:

1. Technological Innovations and Methodologies in Exposomics

• Advanced Analytical Techniques: Innovations in non-targeted chemical exposome characterization, including anthropogenic pollutants and diet related compounds.
• Computational Methods and Data Science: Application of big data, artificial intelligence, and machine learning in exposome studies
• Novel Biomarkers and Detection Methods: Development of new biomarkers and tools for measuring environmental exposures, e.g. microplastics, accurately and comprehensively
• Sensors and Geospatial Modeling Applications: to collect and analyze spatial data on environmental exposures. This includes wearable sensors, remote sensing, and GIS for mapping and analyzing the spatial distribution of exposures and their health impacts.

2. Exposome and Human Health

• Social and physical environment in Low and Middle Income Countries' contexts.
• Early-life Exposures and Child Health: Research on multiple early-life exposures and their effects on child health and development.
• Chronic Diseases and Aging: The role of cumulative environmental exposures in the development of chronic diseases such as cancer, respiratory diseases, and neurodegenerative disorders.
• Precision Medicine: Utilising exposome data to advance precision medicine and improve health outcomes in clinical settings.

3. Biological Impacts and Experimental Modeling in Exposomics

• Molecular and Cellular Responses: Investigating how environmental exposures influence molecular and cellular processes, including gene expression, epigenetic modifications, and metabolic pathways.
• Animal and In Vitro Models: Use of animal models and in vitro systems to study the biological effects of environmental exposures and to identify potential mechanisms of toxicity.
• Integrative Omics Approaches: Combining genomics, proteomics, metabolomics, and other omics data to understand the comprehensive biological impact of the exposome.

4. Translational Research: Bridging experimental findings with clinical and epidemiological studies to better understand the health implications of exposome-related findings​.

Scientific Core Committee

• ISGlobal - Exposome Hub (Léa Maitre, Martine Vrijheid, Mariona Bustamente)
• CSIC - Institute of Environmental Assessment and Water Research (Pablo Gago-Ferrero)
• University of Barcelona - Biomarkers & Nutritional and Food Metabolomics Group (Cristina Andres-Lacueva)
• University of Barcelona - Artificial Intelligence in Medicine Lab (Karim Lekadir)
• EMBL, Barcelona - Organoid models of neuroendocrine development and cancer (Talya L. Dayton)

Agenda Outline

• 09.30 - 10.00 h — Welcome Coffee - Networking
• 10.00 - 10.30 h — Introduction local and global exposome research landscape (ISGlobal)
• 10.30 - 11.30 h — Part 1: Invited scientific presentations
• 11.30 - 12.30 h — Coffee Break - Poster session for early career researchers (selected based on abstract selection before the event)
• 12.30 - 13.30 h — Part 2: Invited and abstract-selected scientific presentations

Find here the detailed programme of the symposium. 

DETAILED AGENDA

ABSTRACT BOOK

Abstract Submission and Review Process

Abstracts submitted to the Barcelona Exposome Symposium underwent a streamlined review process, starting with an initial screening and coordination by the core team, followed by a detailed evaluation by committee members. The scientific committee then selected the final abstracts. Authors of accepted abstracts were notified by July 27th. The selection criteria focused on relevance to the symposium's topics, scientific rigour, clarity of presentation, interdisciplinary merit, and potential public health impact. This thorough and fair evaluation ensured that the symposium featured high-quality discussions that were both impactful and informative.

Oral presentations (12 min) and Posters were invited for broadly defined exposomics and environmental health related topics. Posters covered a wide range of subjects within these fields.

Coordinated by:

Support provided by:

The Catalan Institution for Research and Advanced Studies (ICREA) has granted the prestigious position of research professor to Mònica Guxens and Davide Rasella, research staff at ISGlobal, and Anna Roca, who will join the team in February 2025. They thus join the four ISGlobal researchers who already have positions: Quique Bassat, Hernando del Portillo, Alfred Cortés and Xavier Rodó.

Attracting outstanding research talent

This institution, promoted by the Government of Catalonia, aims to attract and retain research talent of excellence in various areas of knowledge. ICREA positions are among the most prestigious recognitions in the international academic field, as they offer stability and resources to leaders of high-impact research. This call offered 20 senior research positions aimed at researchers from all over the world. Applicants had to have international experience, a track record of excellent research, and leadership skills to drive innovative projects.

Mònica Guxens, Research Professor at ISGlobal, is a Medical Doctor specialised in Preventive Medicine and Public Health. Her work focuses on analysing how various environmental factors, such as air pollution, affect children's growth and development, with particular attention to brain development and sleep. Additionally, she has extensive experience in birth cohort studies. In 2016, she won the prestigious Walter A. Rosenblith New Investigator Award from the Health Effects Institute in the United States, in recognition of her exceptional career and promising professional path.

Davide Rasella, Associate Research Professor and head of the Health Impact Assessment Group (HIAE) at ISGlobal, is a social epidemiologist. With over two decades dedicated to public health, his work focuses on evaluating interventions to mitigate poverty-related diseases and reduce inequalities in low- and middle-income countries. His expertise spans both health impact assessments and studies on prevalent diseases in disadvantaged settings, such as HIV/AIDS and tuberculosis.

Finally, Anna Roca is Professor in Infectious Disease Epidemiology at the MRC Unit The Gambia in the London School of Hygiene & Tropical Medicine, with more than 15 years of experience in Africa. Her work combines surveillance, diagnosis, clinical trials and evaluation of public health interventions, with a special emphasis on bacterial and viral pathogens. She has led studies on infection determinants and transmission routes, using various epidemiological methodologies.

This recognition by ICREA highlights the impact of their scientific contributions internationally, as the institution's key values are collaboration, international openness and excellence. Furthermore, it underscores the commitment of ISGlobal professionals to address crucial public health challenges and strengthens the institute's mission as a centre of reference in research and global health.

Perinatal mortality—deaths occurring some weeks before or after birth—remains unacceptably high in low- and middle-income countries (LMICs). Understanding the causes of these deaths is critical to designing effective prevention and care strategies. A new study led by the Barcelona Institute for Global Health (ISGlobal), a centre supported by “la Caixa” Foundation, shows that a simple ultrasound method could improve the accuracy of gestational age estimates in foetal and perinatal deaths, paving the way for better diagnoses.

The challenge: missing gestational age data

Determining gestational age is vital to distinguish between two leading causes of perinatal death: prematurity and intrauterine growth restriction. While both conditions are common, they require very different approaches to prevention and management. However, in many low-resource settings, data on gestational age is often incomplete.

“This is because recall of the last menstrual period is frequently imprecise, and first-trimester ultrasounds are rarely performed,” explains Natalia Rakislova, co-senior author of the study together with Jaume Ordi, both researchers at ISGlobal. To address this challenge, they explored whether post-mortem ultrasound measurements of the cerebellum—a part of the brain—could provide an accurate estimate of gestational age in foetal and perinatal deaths.

The test: validating the ultrasound method

Between August 2020 and November 2022, Rakislova and colleagues conducted a study at Barcelona’s Hospital Clinic, performing post-mortem ultrasound assessments on the cerebellums of 137 foetal and perinatal deaths. These assessments included measurements taken both within the uterus and after the foetus had been removed.

The results were promising. Among the various types of cerebellum measurements tested, the extrauterine transcerebellar diameter emerged as the most reliable predictor of gestational age. Importantly, its accuracy was not affected by factors like the trimester of gestation, restriction growth, or central nervous system abnormalities.

“Our results demonstrate that this method is valid for estimating gestational age,” says Núria Peñuelas, first author of the study.

What This Means for LMICs

This relatively simple and non-invasive method holds particular promise for low- and middle-income countries (LMICs) where MITS – a technique pioneered by ISGlobal – is being used to determine causes of death with almost the same precision than complete autopsies. By integrating ultrasound-based gestational age estimates into MITS, researchers and healthcare providers could significantly improve diagnostic accuracy.

Certainly, access to ultrasound equipment may pose challenges in LMICs. But low-cost, portable ultrasound devices have been successfully used in these settings, even when operated by personnel without highly specialised training.

“Future studies should validate our findings in larger and more diverse populations, especially in low-resource settings,” emphasises Rakislova. “Importantly, the technique can be done by trained laboratory technicians, without the need of a doctor,” she adds. Ultimately, this ultrasound method could improve the understanding of the causes of perinatal deaths, and help to design targeted interventions to prevent them.

Reference

Peñuelas N, Saco A, Marimón L et al. Gestational age assessment by ultrasound cerebellar measurements in fetal and perinatal deaths. AJOG. 2024. https://doi.org/10.1016/j.ajog.2024.11.016

Judging by the comments of the more than 250 attendees, ISGlobal’s Annual Scientific Meeting, which took place on Tuesday 3 December at the CosmoCaixa, was a clear success. Key to that success was the “action-packed agenda” prepared by the organisers Carmen Fernandez and Payam Dadvand including the keynote lecture on frugal science delivered by Manu Prakash of Stanford University. In her opening remarks, ISGlobal’s scientific director Denise Naniche already set the tone: “we need to ensure our research goes beyond publications and reaches society”.

Frugal science: scaling impact with low-cost solutions

“Don’t create a pen that does not eradicate ignorance and shame”. With this Arabic saying, Manu Prakash introduced his uplifting talk on frugal science – or how to invent cost-effective solutions that can be scaled up. He presented examples of how he and his team have designed inexpensive tools that can reach everyone, everywhere, and help to address some of the planetary-scale challenges we are facing. To list just a few: the foldscope – a folding paper microscope costing just one dollar - 1000 times less than an optical microscope- which has reached over 2 million people across the world, forming the largest online microscope community. Or the 20 cents paperfuge, inspired by an ancient toy, capable of spinning biological samples at incredibly high speeds in places where there is no electricity. Or Abuzz, an AI-powered app that identifies mosquito species by their buzz, empowering citizens to help researchers track disease-transmitting mosquitoes. Or Octopi, a low-cost, modular AI-driven microscope that allows to detect malaria parasites, as well as bacteria in bodily fluids.

Beyond producing these tools, Prakash emphasised the importance of making their designs open-access and sharing them early on with the people who will use them. “Never forget to ask yourself who is that science for” he urged. Many of his ideas have come from talking with community health workers, who often have to perform diagnostics “under a tree” and whom he described as “the world’s largest citizen science program”.

The day before, Prakash engaged with students from the Master of Global Health, sharing his ideas and demonstrating some of the tools developed by his lab.

Synergies across research programmes

ISGlobal’s five research programmes presented highlights of their work, with clear examples of synergies between programmes and potential for societal impact. Examples included: DENMAL, a simple diagnostic test to simultaneously detect dengue and malaria infections in travellers; a new antimalarial compound that seems to be also effective, in vitro, against Leishmania and T. cruzi; an ongoing project in Sierra Leone to evaluate whether adding azithromycin to preventive malaria chemotherapy can reduce under-five mortality; and early warning systems that can forecast, and help to mitigate, the health impacts of extreme heat and cold (Forecaster.health) or air pollution (Forecast-AIR).

The session also celebrated the recently renewed Severo Ochoa programme, followed by a round table on how to further unlock synergies between programmes.

Equity, Innovation and Early Career Development

The afternoon sessions delved into gender equity in ISGlobal and reflections on decolonization. The innovation team showcased concrete examples of how it is helping early stage or advanced research projects to protect intellectual property, and find funding and partnerships to develop and transfer their outputs as part of their pathway to impact.

Additionally, predoctoral and postdoctoral researchers had the opportunity of presenting some of their work and have an open discussion on the challenges and opportunities of being an early career researcher at ISGlobal.

Looking ahead

In his concluding remarks, ISGlobal general director Quique Bassat, with a touch of humour, praised the quality of the presentations and expressed his belief that ISGlobal is now operating as “a single, united institution.” He emphasised the importance of “concentrating on our work” amidst the current global political landscape, highlighting the need to strengthen partnerships particularly in LMICs. “We must firmly believe in the impact we can generate,” he concluded.

Carmen and Payam are very grateful would like to express their sincere thenks to all those who helped with the organisation of the event, especially Yolanda Salleras and Gemma Punyet.

Exposure to air pollutants (PM_2.5 and PM₁₀) is associated with an increased risk of persistent long-COVID symptoms, partly due to its impact on the severity of the acute infection. This is the main conclusion of a study led by the Barcelona Institute for Global Health (ISGlobal), a centre supported by “la Caixa” Foundation, in collaboration with the Germans Trias i Pujol Research Institute (IGTP), and published in Environmental Health Perspectives. 

Long-COVID is a heterogeneous condition in which symptoms like fatigue, breathlessness, and cognitive issues persist for months after a COVID-19 infection and cannot be explained by other diagnoses. The real burden of long-COVID remains unclear, but millions of people are estimated to be affected worldwide. Its risk factors are also not well understood, since even people with mild or no symptoms during acute infection can develop long-COVID.

“We previously found that air pollution exposure is linked to a higher risk of severe COVID-19 and a lower vaccine response, but there are very few studies on long-COVID and the environment,” explains Manolis Kogevinas, ISGlobal researcher and senior author of the study. In this study, he and his colleagues investigated whether air pollution and other environmental exposures such as noise, artificial light at night, and green spaces, were associated with the risk- or persistence- of Long-COVID.

The study followed over 2,800 adults of the COVICAT cohort, aged 40- 65 years living in Catalonia who during the pandemic completed three online questionnaires (2020, 2021, 2023). These surveys collected information on COVID-19 infections, vaccination status, health status, and sociodemographic data. Researchers estimated residential exposure to noise, particulate matter, ozone, nitrogen dioxide, green spaces, and light at night for each participant.

Long-COVID risk factors

The analysis showed that one in four people who contracted COVID-19 experienced lingering symptoms for three months or more, with 5% experiencing persistent symptoms for two years or more. Women, individuals with lower education levels, those with prior chronic conditions, and those who had severe COVID-19 were at highest risk of long-COVID. Vaccination, on the other hand, made a positive difference: only 15% of vaccinated participants developed long-COVID compared to 46% of unvaccinated ones.

Air pollution and persistence of symptoms

Exposure to particulate matter (PM_2.5 and PM₁₀) in the air was associated with a slight increase in the risk of persistent long-COVID (i.e. people who reported long-Covid in 2021 and whose symptoms were still present the last week before the 2023 interview). The risk of persistent long-COVID increased linearly with greater exposure to particulate matter in the air. In contrast, factors such as nearby green spaces or traffic noise showed little impact on long-COVID.

The researchers note that while air pollution may not directly cause long-COVID, it could increase the severity of the initial infection, which, in turn, raises the risk of long COVID. “This hypothesis is supported by the association between particulate matter and the most severe and persistent cases of long-COVID, but not with all cases of long-COVID,” says Apolline Saucy, first author of the study.

Further research is needed to break down the different types of long-term symptoms and get a more detailed picture of how environmental factors might play a role. “This type of studies is particularly relevant as more people continue to recover from COVID-19 and deal with its potential long-term effects,” says Kogevinas.

About COVICAT

The COVICAT cohort is a COVID-19-population-based cohort designed to characterize the health impact of the COVID-19 pandemic on the population in Catalonia, Spain. Baseline data originates from the GCAT (Genomes for Life) project of the Germans Trias i Pujol Research Institute (IGTP).

Reference

Saucy A, Espinosa A, Iraola-Guzman S, Castaño-Vinyals G, Harding BN, Karachaliou M, Ranzani I, De Cid R, Garcia-Aymerich J, Kogevinas M. Environmental exposures and Long-COVID in a Prospective Population-Based Study in Catalonia (COVICAT study). Environmental Health Perspectives. 2024. https://doi.org/10.1289/EHP15377

“On the basis of information about the upcoming Horizon Europe 2025 call for proposals, the European Commission has proposed a budget of around €970 million for health research—yet, alarmingly, no funds are allocated to research on the effects of climate change on health. This needs to change.”

Thus, with the above paragraph, begins a statement with which the SPHERA consortium denounces what it understands to be a “disappointing omission” in the European Commission's draft Horizon 2025 research grant program. SPHERA brings together Europe's leading environmental, climate and health research institutions, including ISGlobal.

“Let's not wait for the next crisis to act,” SPHERA demands, while recalling that the data show that the Mediterranean region is suffering a more accelerated warming than the world average. “The European Union, along with the World Health Assembly and global authorities, has recognized the grave risks climate change poses to human health”, they argue. For this reason, they believe that by omitting specific approaches to climate change and health from research agendas, a contradiction is being made.

Extreme weather events, warming and other health threats

The scientific staff signing the document recalls that climate change already poses a serious threat to health in Europe, giving as an example the extreme weather events, such as the recent floods in Valencia or those that have occurred in Italy, Germany, Poland or Central Europe.

Another of the key issues to be addressed is the risk posed by rising temperatures, after a year, 2024, which will again beat heat records and when studies are available that quantify in about 70,000 and 47,000, respectively, deaths attributable to heat in the summers of 2022 and 2023.

“Furthermore recent results from the large  EXHAUSTION project pointed out at synergistic health effects of air pollution and heat on cardiorespiratory health across Europe”, they note.

Other climate-related health issues of concern to the scientific community are “longer pollen season and introduction of new pollen species” or “sharp increases in forest fires and related air pollution episodes.”

Common front

SPHERA's statement closes with an offer to work together to find solutions: “Our institutions stand ready to support the EU in developing and delivering the evidence-based solutions needed to protect public health and build a resilient Europe in the face of climate change.”

SPHERA statement

The full SPHERA statement is available here. 

Quique Bassat, an epidemiologist and Director General of the Barcelona Institute for Global Health (ISGlobal), has been appointed to the Management Board of the European Centre for Disease Prevention and Control (ECDC) as a representative of the European Parliament. This appointment underlines his track record in infectious disease epidemiology and public health and strengthens the representation of Spanish experts in high-level European bodies. 

Coordinating the response to health threats

The ECDC, based in Stockholm, Sweden, is a European Union agency coordinating and strengthening the EU’s public health response to communicable disease threats. Its tasks include collecting and analysing public health data, supporting surveillance systems and issuing recommendations for preparedness and response to health emergencies. It works closely with other EU bodies and international agencies to ensure a coherent and effective health response. Its work has been particularly prominent during recent health crises, such as the COVID-19 pandemic and other infectious disease outbreaks, including Mpox.

Scientific leadership to strengthen the European response

Quique Bassat, a paediatrician and ICREA Research Professor, has combined clinical work with biomedical research on infectious diseases affecting the poorest and most vulnerable populations, with his two main areas of interest being childhood malaria and respiratory infections (bacterial or viral). With his appointment, ISGlobal's Director General will join a select group of experts charged with advising on the agency's strategies and policies, ensuring that its activities are relevant and aligned with the needs of member states. 

“It is a privilege to be part of such an important institution for the health of European citizens. In an increasingly interconnected world, the ability to respond to health threats in a coordinated and effective way is vital. I look forward to contributing my expertise in infectious diseases to the ECDC's mission of strengthening prevention and control capacities across Europe,” he said after his appointment was confirmed. 

The user name on this social network is @isglobalorg.bsky.social

ISGlobal now has an active account on the Bluesky social network: @isglobal.org This profile will be used to report on the institution's research activity and results, as well as to publicise issues related to ISGlobal's scientific agenda. The account will combine publications in English, Spanish and Catalan.

👋🏼Hello Bluesky, here we come! 👋🏿Hola, Bluesky, ¡allá vamos! 👋Hola, Bluesky, ¡som-hi!

[image or embed]

— ISGlobal (@isglobalorg.bsky.social) 19 de noviembre de 2024, 15:13

Bluesky is a microblogging social network that is reminiscent of the beginnings of Twitter and, in fact, emerged from the Twitter team before it became known as X. Despite their similar appearance, there are substantial differences between the two platforms: Bluesky aims to be a decentralised network and, at least for now, it has no advertising and the content displayed is not determined by algorithms, so each user sees by default the messages of the accounts they follow in chronological order.

ISGlobal's leap to Bluesky comes at a time when many people and institutions in the scientific community are betting on this new channel in which, at least initially, the users themselves are the ones who decide what they want to see and, consequently, all profiles are on an equal footing.

The new Bluesky account will coexist with those that ISGlobal maintains on other social networks, such as LinkedIn, Instagram, Facebook, X and Tiktok.

ISGlobal's Bluesky profile

https://bsky.app/profile/isglobal.org

Severo Ochoa and María de Maeztu Centres of Excellence on Bluesky

https://bsky.app/starter-pack-short/Qp5DLAh

https://bsky.app/profile/isglobalorg.bsky.social/lists/3lbh2liwrhi2f

Meningitis contributes to higher child mortality rates than estimated by the WHO, according to a new study by the CHAMPS network and led by the Barcelona Institute for Global Health (ISGlobal), an institution supported by “la Caixa” Foundation. The study, published in Journal of Infection, reveals a high prevalence of drug-resistant bacteria in hospital cases, highlighting the need for earlier suspicion and faster diagnosis and appropriate treatment to reduce mortality.

Meningitis remains a serious condition, especially for young children, with high death rates and lasting neurological effects in survivors. Vaccines can protect against the most common types of meningitis-causing bacteria, such as Haemophilus influenzae type B (Hib), Streptococcus pneumoniae, and Neisseria meningitidis. Yet, reaching the World Health Organization’s (WHO) goal to eliminate meningitis by 2030 requires a clearer understanding of the global impact of this disease and the specific pathogens involved.

“Meningitis poses a diagnostic challenge due to its non-specific symptoms, which often resemble those of other serious illnesses,” explains senior author Quique Bassat, ICREA researcher and General Director at ISGlobal. “Identifying the specific pathogens behind meningitis cases would allow us to make a better use of resources and guide the development of new highly-awaited vaccines,” he adds.

The study draws on data from the CHAMPS network, which is conducting an in-depth investigation into causes of childhood deaths in seven countries: Bangladesh, Ethiopia, Kenya, Mali, Mozambique, Sierra Leone, and South Africa. Using a technique called MITS (minimally invasive tissue sampling), researchers perform biopsies to obtain samples of key organs or fluids, including cerebrospinal fluid, followed by histopathological examination, molecular testing for 126 pathogens, and microbiological cultures.

A significant contributor to death

The study found that meningitis was a contributing factor in 7% of the 3,857 deaths analysed. The highest proportions of child deaths due to meningitis were observed in South Africa (16.6%) and Ethiopia (15.6%), followed by Mali and Sierra Leone. Most of these deaths (66%) occurred in newborns, with the remaining cases diagnosed in older infants and young children. “The higher incidence among newborns may be due to the vertical transmission of pathogens infecting their mothers, and the lack of specific strategies to protect them during delivery. Additionally, their underdeveloped immune systems also confer a higher vulnerability,” says Sara Ajanovic, ISGlobal researcher and co-author of the study.

A shift towards antibiotic-resistant bacteria

The prevalence of pathogens associated with meningitis deaths in the hospital and in the community varied between regions. However, the most common pathogens were Acinetobacter baumannii and Klebsiella pneumoniae, particularly in deaths occurring in healthcare settings. These multi-drug resistant bacteria are often acquired in the hospital, which means that improving infection prevention practices in hospitals is essential for reducing meningitis cases. Worryingly, it also means that without the appropriate antibiotics, the risk of dying from meningitis remains high. 

Almost half of meningitis deaths occurred at the community, likely due to limited access to healthcare. While vaccines have significantly reduced cases of Streptococcus pneumoniae, this bacterium still caused many of the community-acquired cases of meningitis.

These findings indicate a shift in the landscape of pathogens associated with meningitis, with an increase of pathogens like K. pneumoniae and A. baumannii, alongside a decline in S. pneumoniae and Hib due to vaccination efforts. This shift, the authors point out, “challenges the foundations of current empirical antibiotic guidelines.”

Implications for public health

CHAMPS' findings suggest that meningitis contributes to higher child mortality rates (7%) than the WHO’s estimate of 5.1%. Critically, many of these cases had not been recognized as meningitis before death, highlighting the need for faster diagnosis and treatment to prevent fatalities. “Less than a quarter of all confirmed meningitis cases had undergone a lumbar puncture -the gold standard technique for diagnosing meningitis - prior to death, highlighting the urgent need to deploy more actively this diagnostic approach to avoid missing cases of this life-threatening infection,” says Bassat.

"The changing landscape of the pathogens causing lethal meningitis in children in these settings underscores the positive effect of vaccine campaigns conducted in the last decades, which must be continued,” adds Ajanovic. However, the findings highlight an urgent need for developing new vaccines against emerging pathogens such as K. pneumoniae, and for updating clinical guidelines. This includes testing for these pathogens and their resistance patterns, as well as adjusting antibiotic regimens to ensure an effective treatment.

CHAMPS work recognised in Catalonia

On 26 October, the Catalan Society of Clinical Microbiology and Infectious Diseases awarded the Josep Barrio Infectious Diseases Prize to Quique Bassat for the best scientific paper published in 2023 by a member of the society. The paper was a study by the CHAMPS network showing that infectious diseases continue to cause most deaths in infants and children, often in conjunction with malnutrition.

Reference

Mahtab S, Madewell ZJ, Baillie V et al. Etiologies and Comorbidities of Meningitis Deaths in Chilren Under 5 Years in High-Mortality Settings: Insights from the CHAMPS Network in the Post-Pneumococcal Vaccine Era. J Infection. 10.1016/j.jinf.2024.106341

ISGlobal researcher Elisabet Tintó-Font has received the Ramon Margalef Prize at the twentieth edition of the University of Barcelona’s Board of Trustees Awards. The prize honours the best research article in the field of experimental and health sciences published as part of a doctoral thesis.

Tintó-Font's work, published in the journal Nature Microbiology, describes how the malaria parasite Plasmodium falciparum adapts to adverse conditions in the host, such as high temperatures during fever, solving a key question in the parasite’s biology.

Research that addresses key questions

The prize-winning study focuses on how malaria parasites that lack the HSF1 transcription factor, which is typical of other eukaryotic organisms, manage to survive the high temperatures associated with fever. Tintó-Font and his thesis supervisor, Alfred Cortés, showed that the PfAP2-HS gene is responsible for regulating this response to ‘heat shock’. The findings have significant implications: parasites lacking PfAP2-HS are not only more vulnerable to feverish temperatures but also more sensitive to the antimalarial drug artemisinin.

Elisabet Tintó-Font has a degree in biomedicine and a master's degree in advanced microbiology. In 2019, she obtained her PhD in Biomedicine in the laboratory of Alfred Cortés at ISGlobal, where she continues to work as a Research Assistant. Her research interests include the epigenetic regulation of the malaria parasite’s sexual conversion and its heat shock response mechanisms.

The award ceremony took place on 3 December in the Aula Magna of the UB's historic building. Other prizes were also awarded, such as the José Manuel Blecua Prize, for a publication on the perception of safety in urban parks, and the Antoni Caparrós Prize, which recognised advances in the teaching of history and the treatment of histamine intolerance.

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The effects of air pollution on human health are causing concern among health professionals. For this reason, several institutions have launched a campaign to collect support for a document warning of these effects and calling for political measures to improve air quality. The initiative is promoted by the Barcelona Medical Association, the Catalan Society of Paediatrics, ISGlobal's Climate, Air Pollution, Nature and Urban Health programme and the groups Revolta Escolar and Eixample Respira.

The document was unveiled at a press conference held in Barcelona on 28 November 2024 with the participation of ISGlobal researcher Mónica Ubalde. Institutions and individuals who wish to sign up to this manifesto can do so by filling in the following form.

The manifesto recalls that the estimated premature deaths related to air pollution exceed 8 million worldwide, being the second cause of death after hypertension. More than 700,000 of these deaths would occur in children under 5 years of age.

‘In the same way that a few years ago, in the light of scientific evidence, decisive action was taken against tobacco consumption, restricting places where smoking was allowed and promoting healthy lifestyles, it is now crucial to implement strict and ambitious policies, with a public health vision, to reduce the levels of atmospheric pollutants produced mainly by the use of fossil fuels,’ the document states.

Briefly, the document outlines the main health consequences of exposure to air pollution, including cardiovascular diseases, respiratory diseases, various types of cancer, problems in child development and mental health, as well as dementia.

‘Air pollution is not only a public health issue, but also a social justice issue,’ they say, noting that it is ’the most vulnerable and poorest communities that often suffer the most from the negative impacts of pollution.

Co-benefits

‘An improvement in air quality linked to changes in urban and transport planning’, the document continues, “would also imply an improvement in other factors that aggravate health risks, such as exposure to excessive levels of noise or heat or the lack of green, naturalised and pacified spaces that favour social interaction, street play and physical activity”.

Call for political action

For all these reasons, the people and groups signing the text urge ‘all sectors of society and, in particular, those responsible for designing and implementing public policies’ to ‘improve air quality with effective and immediate measures’.

More information

Letter/statement

Sign up form