Medicine on the move

The 14th Asia-Pacific Travel Health Conference is set to take place in Kathmandu from 18-21 September, bringing together 200 delegates from 27 countries to explore advances in travel medicine which have relevance for Nepal’s own tourism industry.

The biannual conference is the first in four years after its 13th iteration in New Zealand in 2020 was cancelled due to the Covid-19 pandemic. Previous conferences have been held in Bangkok and in Kathmandu in 2016.

Lessons for the travel industry from the Covid-19 pandemic will be prominent in the agenda of the conference in which experts from the International Society of Travel Medicine will also be taking part. Nearly 60 of the 200 participants are from Nepal.

"The careful practice of travel medicine can be an important sentinel for diseases,” says Buddha Basnyat, MD, Chair of the Oxford University Clinical Research Unit-Nepal, who is part of the Nepali delegation.

The 3-day event will kick off with a day-long Pre-Conference Seminar on Adventure and Wilderness Travel, as well as separate sessions on mental health strategies and military medicine before the main events next week.

“Travel medicine is very relevant to Nepal because it has always been a desirable tourism destination,” says Pratibha Pandey, MD, of CIWEC Hospital and Travel Medicine Center, which is a partner to the Asia-Pacific Travel Health Society.

She adds: “Outbreaks of diseases like dengue, issues of road and aviation safety, and economic hardships have had an impact on the number of travellers coming to Nepal, which will be reflected at the conference.”

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Each day of the conference will include three plenary panels, followed by parallel symposia, communication sessions, and interactive workshops. The conference will highlight special groups, including the elderly, pregnant, and otherwise immuno-compromised travellers.

An ‘ABC’ workshop which will provide participants with the basics of setting up a clinic and explain pre-travel consultations. Other sessions include discussion about vaccines, including a plenary on the changing immunisation landscape, newer vaccine technologies, as well as a seminar on the Japanese Qdenga vaccine against dengue that has not yet been licensed for use in Nepal.

Travel medicine is not just important for tourists coming to Nepal, but also for Nepalis since non-endemic infections like Mpox and other diseases can be brought here by visiting carriers.

“We were diagnosing dengue and typhus fever in travellers to Kathmandu who came via Rajasthan or Bangkok in the 1990s, long before these diseases became well-established in the local population,” explains Buddha Basnet, who is delivering a lecture on the Typhoid Conjugate vaccine and its roll-out in Nepal in one of the symposia.

The conference will also discuss airlift and emergency evacuation and a workshop on the role of the military in disaster and outbreak relief operations — both especially relevant to trekking and mountaineering in Nepal. Climate breakdown has increased the need for better preparedness and rescue.

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Other sessions include a plenary on sustainable travel in the age of no-jet set and climate guilt, as 4% of greenhouse emissions are from air travel. Workshops will also look into other infectious diseases and the use of AI and Large Language Models like ChatGPT on travel medicine.

Because travel medicine specialises in diseases and health conditions that are acquired during international travel, it involves pre-travel, during travel, and post-travel consultations. Apart from the relevance of travel medicine to provide medical care to visitors to Nepal, there is also the opportunity to advance pre-travel and post-travel medicine for Nepalis.

Says CIWEC’s Prativa Pandey: “Heartbreaking as it is, migrant workers and students are leaving in droves, and many migrants are coming back with kidney failure, about which there is very little data or research, so there is an urgent need to address those areas as well in Nepal.”

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Some of the participants include the ‘father of travel medicine’ Robert Steffan from Switzerland, Tomas Jelinek of the Berlin Centre for Travel and Tropical Medicine, editor of the Journal of Travel Medicine Annelies Wilder Smith, David Shlim who was Medical Director of CIWEC in Kathmandu 1983-1998, and Sir David Warrell a world expert on snake bite, rabies and infectious disease.