The Middle East might not be the most obvious place to go to escape sexism and political instability, but that’s exactly what Associate Professor Susu Zughaier did in 2017. She left the United States – where she had a research position at Emory University searching for new ways to stop bacterial infections – because she says the country’s politics had become so febrile.
“The gender gap had always been there, it’s there in every country around the world, but I think it had been multiplied by 10 with the Trump factor,” says Zughaier, now an associate professor of microbiology at Qatar University.
“Words like ‘Muslim’ and ‘refugee’ were also being used with so much anger,” she told The Brilliant. “I’m all those things and so it became clear that it was time to leave the USA because the atmosphere had become so unpleasant for a Middle Eastern woman.”
Zughaier was born in Jerusalem where, she says, life came with many restrictions as a Muslim, and so she moved to Jordan in the early 1980s like many Palestinian refugees before her. Encouraged by her father, she then went to study at University College London and Cardiff University in the United Kingdom before crossing the Atlantic to work at Harvard University and then later Emory University.
While Zughaier had many good experiences in the U.S. and continues to collaborate with former colleagues, she found the process of applying for funding to be a flawed one. “It’s so competitive and there’s also an implicate bias. If my name was on the application, there would always be many questions and extra hoops to jump through,” she says. “But if I had someone else’s name attached then it would be funded much quicker.” There are plenty of independent studies to back up her experience. They show a significant racial disparity when it comes to the awarding of coveted NIH grants. The pattern holds true for gender too, meaning a woman of colour has an uphill battle to secure enough money to properly do research.
Something in me made me realise I didn’t want to spend the rest of my career battling these issues,” she says. “I wanted to get on with my research and I had been to conferences in Qatar where I had seen the money, the infrastructure and the environment they were developing for science. It was a calculated decision to come here.”
A fresh start
Qatar University gave her the opportunity to set up a lab and she took it. Her research is focused on combatting antibiotic resistance, a looming public health crisis. Drug-resistant strains of bacteria and fungi are already killing approximately 700,000 people per year globally and the United Nations has warned that figure could reach as many as 10 million by 2050 if things don’t change. That would make antibiotic resistance a bigger killer than cancer.
Zughaier is trying to stop this from happening by preventing infections from taking hold in the first place. She’s working on a vaccine for gonorrhoea, the second most common sexually transmitted bacterial infection after chlamydia. The World Health Organization estimates that 82 million people were infected with gonorrhoea in 2020. Most of those cases are thought to have occurred in Africa and the Western Pacific regions, but infection rates in Australia also increased by 63% between 2012 and 2016, according to the Department of Health. Many infections are asymptomatic so the actual caseload could be much higher. “Previously a patient would be treated with one dose of penicillin and that would be the end of it,” says Zughaier. “But now, far too many strains are resistant and many worry it won’t be treatable in the future.”
Zughaier and her collaborators started their vaccine project back in 2013. The first few years were taken up with creating a proof of concept, which they did by infecting mice with gonorrhoea having pre-treated them with the vaccine to see if could prevent infection. “It takes years just to get the formulation right with the ratio of ingredients,” she says. “We’ve done that with a mouse study to show it works, which we’ve then repeated a good number of times to be sure we’ve got the formulation right.”
What Zughaier is proposing isn’t a traditional vaccine, delivered by an injection. Instead, she’s developing what’s known as a “nano vaccine.” It’s a patch – not unlike a band aid or plaster – which is applied to the skin for a period of time. This delivery model comes with three key advantages. “It’s a dry formulation so it cuts the need for a refrigerated supply chain, which saves a lot of waste and also allows the vaccine to reach remote areas,” says Zughaier. “The second bonus is more scientific. It’s a slower release of the active ingredients, which provokes a better antibody response. Finally, it’s needle-free so you cut out the fear.”
It’s one thing to prove something in a rodent experiment, but quite another to bring it to market. Making such a transition is where many erstwhile promising projects fizzle out. Securing the funds and ethical clearances to test the vaccine on a sufficiently large cohort of humans is no small feat. “That’s why we call this stage the Valley of Death,” jokes Zughaier. “We can’t really do it alone; we’ll need a pharmaceutical partner. It’ll never become a real product without passing those clinical trials.”
From working to prevent a future crisis to addressing a current one
All this work was put on hold when the pandemic hit. Zughaier was asked to shut her lab and refocus efforts towards the pandemic. “I’m sure a lot of scientists can relate to the disruption,” she says. “I started a COVID-19 taskforce to pull all the university’s scientists together to orchestrate their projects and make sure they weren’t duplicating work.”
It became clear quite quickly, however, reagents and other chemicals needed for COVID-19 research were getting caught up in supply chain backlogs. Countries around the world began stockpiling their own supplies, making it hard to get hold of the basics. “I therefore decided to develop a blood test to measure the antibody response of someone who had been infected,” she says. “I needed the test to be made locally, in-house with ingredients readily accessible in Qatar so that we wouldn’t have to worry about supply chains.”
She succeeded and the test is still being used today by researchers at Qatar University. After the first wave of COVID-19 eased, she returned to her previous research. Restarting the lab wasn’t a straightforward process, however, it took her time to regrow strains of bacteria that had to be killed when the lab was shut down, for example. For now, though, she’s returned her focus back to what she suspects could be the next major public health crisis. “If we don’t tackle antibiotic resistance while we can, we’ll regret it,” she says.
Article by Benjamin Plackett