Reimagining infectious disease treatment for greater health equity: Kwasi Adu-Berchie

Facing a malaria infection almost annually during his childhood in Ghana, while knowing the disease is nearly eradicated in other countries, inspired Wyss Scientist Kwasi Adu-Berchie to work towards more equitable health outcomes across the world

By Jessica Leff

 

Kwasi Adu-Berchie, traditionally named for the day of the week he was born, came into the world on a Sunday in Koforidua, Ghana. Before he started elementary school, he moved to Kumasi in the Ashanti Region, regarded by many as the cultural capital of Ghana.

His father was an agricultural scientist, and his mother was a social worker who eventually became the Regional Director of Social Welfare. Though his parents had the resources to dress him in suits for school, Kwasi loved the traditional, colorful outfits made from hand-woven Kente cloth.

Unfortunately, growing up in a middle-income family did not prevent him from contracting infectious diseases like malaria.

The challenges of treating malaria

Malaria is a life-threatening disease caused by parasites transmitted to humans through mosquito bites. It has a complex life cycle: it starts in the blood, goes to the liver, and then returns to the blood. The disease is particularly dangerous for pregnant people and babies.

Kwasi remembers, “When I was growing up, I got malaria almost every year. Those were the times that, even in the very hot environment, it felt like the middle of winter. Because of the fever, I was shaking. My parents would put their winter jackets on me to keep me warm.”

There were two courses of treatment: injections and chloroquine. Kwasi recalls, “Before I was old enough to swallow pills, I had to take the liquid version of chloroquine. It was so bitter that you would have to drink soda immediately to counteract the taste and prevent you from throwing up.”

Treatments haven’t evolved much since Kwasi’s childhood, though the medication is less bitter, and the course of treatment is a bit shorter. While prophylactic medicines are available, many people in Ghana cannot afford them. When people do get malaria, it can be challenging to reach a hospital if they live in a rural village. Plus, because of the complexity of the disease, there’s always a risk that treatment won’t work.

While mosquito nets can provide some protection, Kwasi notes they are a double-edged sword. “When they work, they work really well. But, if there’s a small tear and one mosquito gets in, then they have a feast. Plus, the nets lose their effectiveness over time, and you need another one. Growing up, there were times I had to wash my nets, which made them less effective, because new ones were expensive. I remember sleeping under a net while I was shaking in my bed because I had malaria.”

Because of these challenges to effective treatment and prevention, people in Ghana and other low-income countries accept malaria as an inevitable part of their lives. Kwasi explains, “People say, ‘You should be fine,’ but they are not necessarily fine. I think that is a big problem. We shouldn’t be normalizing malaria.”

While some people, like Kwasi, fully recover after their illness, others can suffer central nervous system complications or even liver failure. He reports, “Thankfully, it has not been fatal for my close friends, but it has come close to being very scary. You can certainly die from malaria.”

Sparks of inspiration for a future scientist

Despite annual malaria infections, Kwasi performed well on his national exams and was invited to apply to the African Leadership Academy in South Africa. He’d never left the country or been on an airplane, but his parents encouraged him to apply. Once accepted, he spent the last two years of high school in South Africa with students from all over the continent.

Each student took core classes in leadership, entrepreneurship, and African studies. “We asked questions like, how can we gradually wean ourselves off of aid from the West? What sort of leadership are we seeing in Africa? Then you also take regular classes like chemistry, physics, and biology.”

In his early years, Kwasi wasn’t interested in biology, but all of that changed in South Africa, where he had an excellent biology teacher and formative experiences both in and out of the classroom. He remembers, “I took cells out of my cheek and saw my own DNA. I didn’t even know that was possible.”

His class also took a field trip to Durban, a region in South Africa with high rates of tuberculosis and HIV. “We talked to scientists to learn what they were doing to make a difference. From there, we went to an HIV clinic. I got to interact with actual patients. It was really eye-opening to know that science is cool, but when it works, it also makes a real impact.”

Then, Francis Collins, M.D., Ph.D., a leader in the International Human Genome Project and former Director of the National Institutes of Health (NIH), visited Kwasi’s high school. “I got to have dinner with him. It was a great conversation about his scientific experience – then he played his guitar. It excited me that you can have fun doing science and know your output can be beneficial.”

From South Africa to Michigan to Boston

In 2011, Kwasi took an even longer plane ride to begin his undergraduate studies at Michigan State University. His first week was challenging. “I really missed my family, but I didn’t have a phone to call them. I didn’t have a computer to use the internet. I didn’t have much money. Luckily, once I found my friends, people showed me the ropes.”

Kwasi was eager to get started on research as soon as possible but faced resistance since he was just a freshman. He went to see his Honors College advisor, who told him about a funding opportunity through the Howard Hughes Medical Institute, which would make him more appealing to professors. There was one problem: the deadline was that evening. “I stayed up until close to midnight,” Kwasi remembers. “It was probably something like ten essays. Somehow, I got the application in and received the funding. That opened doors for me.”

Not only did Kwasi do research during all four years at Michigan State, he also had the opportunity to do multiple internships. One was back in South Africa, at the same institute he visited in high school. His work there focused on using biomaterials in tuberculosis research. “It was really nice to go back and not only watch people doing science, but actually do the science myself.”

After graduating, Kwasi worked as a Research Assistant at the Massachusetts Institute of Technology for a year while applying for Ph.D. programs. In his research, he came across a YouTube video of Wyss Core Faculty member David Mooney, Ph.D., speaking at Georgia Tech. Kwasi says, “That’s when I fell in love with the science and how he presented it. I was so impressed with the idea of making a biomaterial to regulate your immune system. He also seemed like the sort of PI that allows students to drive their projects and was happy to acknowledge their work.”

Since Kwasi already had his eye on using his research to improve patients’ lives, the Wyss was also a natural fit. “I’ve been thinking about how to get technologies from the bench to the bedside for a long time. The fact that I get the opportunity to participate in translational research at the Wyss is amazing.”

Reimagining equitable treatment for infectious disease

From the beginning, Kwasi made his goals clear: “I remember one of the first conversations I had with Dave. I told him that I wanted to use technology to make healthcare more equitable globally, especially for those in Africa. That led to my thesis proposal, which asked how we can make materials to better modulate our immune system in a way that will increase the effectiveness of existing medications while making them cheaper and more accessible.”

Kwasi has completed his Ph.D. and is currently a scientist at the Wyss Institute. While his role may be different, Kwasi is still committed to that vision. “If I could Reimagine the World, people would not die from infections that are very treatable in other parts of the world.”

Reaching this goal is incredibly complex. Kwasi explains, “Medications are generally made for Western countries and applied in the African context. In the case of malaria, you often have people from Western institutions coming to African countries for blood or tissue samples, returning home to do the analysis, and then publishing their work. If the process works, great. But it doesn’t always translate, and in doing research this way, you are not building the competencies that we need on the African Continent to ask questions that directly benefit us or provide the resources to address those questions.”

Kwasi continues, “Collaboration between African countries and Western institutions is critical for the health of the Continent in general, but how can we make it sustainable so we can reach a point where African countries are not dependent on Western technological advancements for access to basic healthcare?” 

Using the immune system to realize his vision

Within the last year, a new vaccine called Matrix M was approved for malaria. This promising vaccine has over 75% efficacy against the disease. Unfortunately, in countries like Ghana, where there are significant barriers to accessing healthcare, it will be challenging for patients to receive the four required doses. As part of a project funded by the Bill and Melinda Gates Foundation, Kwasi aims to decrease the dose to one or two shots. He and his colleagues will do this using a biomaterial with a slow-release mechanism, which they hope will improve the immune response and make it more durable.

This project hits close to home for Kwasi, literally and figuratively. “I bring a level of passion that people who’ve never had malaria would not necessarily have. At the same time, I deeply appreciate that others are on board with this project. The Gates Foundation has been immensely helpful with this, and seeing the concern from people who haven’t been directly affected is great.”

Recently, it was reported that Egypt is now malaria-free. Kwasi hopes that can be the case for all tropical regions one day. On the way, he envisions a future where malaria is truly not a big deal, because there are readily available treatments and vaccines. Kwasi explains, “Growing up, I wasn’t afraid of getting polio, because I knew I was generally protected with a vaccine. In the same way, I want children around the world to be free to run around without fearing malaria.”

In addition, Kwasi is leading two Validation Projects that also aim to use biomaterials to fine-tune different aspects of the immune system. One technology, Tolerance-Inducing Biomaterials, can be used to deliver T regulatory cell therapies to specific tissues and create a niche to maintain their function over extended periods of time in cases of chronic inflammation. The second one, ProTx, involves generating T cell precursors called “progenitor T cells” that are known to travel directly to the thymus and equipping them with beneficial cytokines that promote thymic regeneration, minimizing harmful side effects.  

Keeping his family and homeland at the heart of his work

Though Kwasi doesn’t have to worry about malaria in Boston, his family and friends in Ghana are not so lucky. Kwasi’s father was thrilled to hear about his son’s malaria research, as other health complications make the disease particularly dangerous for him. “If my dad hears a mosquito in the house, he will not sleep until it’s dead,” Kwasi explains. “If he has a fever, he starts taking malaria medications even before the test comes back. When he got malaria recently, it was horrible.”

So, Kwasi continues his work towards more accessible infectious disease treatments with his family, country, and continent at the top of his mind. One simple way he does this is through his clothing. Kwasi can often be seen proudly wearing traditional outfits, and even wore one while presenting at the 2023 Wyss Retreat. “It is good to represent my culture and tell people that it’s okay to wear an African outfit to a formal event.”

He explains, “For me, it is important to do two things in my career. The first is to ask the right questions, where the answers will directly benefit the African Continent. The second is that, as we find answers, hopefully I can play a role in setting up the systems that would enable follow-up questions to be answered directly on the Continent. As I do my work in the United States, I have my eye back in Africa, so that one day people won’t have to leave their home to do science that benefits them.”