Varanya joined Professor Olivo Miotto's team at MORU in Bangkok in 2021 as a research scientist for the GenRe-Mekong project. The project aims to provide National Malaria Control Programmes (NMCPs) in the Greater Mekong Subregion (currently operating in Cambodia, Vietnam, Laos, and Thailand) with genomic information about malaria parasites to support public health decision-making in activities related to malaria elimination efforts.
“To be honest, I didn't plan to get into this field,” says Varanya. “I was introduced to bioinformatics during my PhD and wanted to take it further, even though I didn't really have that background.” Despite initially pursuing a bachelor's degree in biotechnology and microbiology and later earning a PhD in plant genomics, both from the University of York in the UK, a career in malaria genomics is one that she stumbled upon by chance.
“As I was coming back to Thailand [after my PhD], I was already giving up on becoming a scientist and was ready to enter the business world.” As things would turn out, Varanya joined the GenRe-Mekong team, and with mentorship and guidance from Professor Olivo Mioto and the team, she worked her way up to the role of Scientific Coordinator of the project. “I just learned on the job! I've picked up a lot of coding and data analysis skills, and built a background in malaria. But the most important factor that has helped me to get to where I am is the amazing mentorship from Olivo and the team – without a good team to support me I would have struggled.”
In her day-to-day role, Varanya’s work encompasses two major areas: scientific data analysis and knowledge exchange. In the scientific realm, she plays a crucial role in supporting surveillance activities and data analysis for malaria in the region. She analyses parasite genetic data processed by the SpotMalaria genotyping platform to generate Genetic Report Cards. Varanya and the team analyse the data and capture key information into maps and reports, which are then shared with NMCPs.
Varanya emphasises the importance of ensuring that the findings are relevant, actionable, and empowering to decision-makers. She is currently involved in the projects’ efforts to characterise different types of malaria outbreaks. To give a recent example, Varanya and her colleagues at GenRe-Mekong partnered with the Laos NMCP to investigate a Plasmodium falciparum malaria outbreak in Southern Laos between 2020 and 2021. The team used genomic epidemiology methods to identify the drivers of the outbreak and were able to offer insights for the NMCP to plan their interventions ahead of the next malaria season. Varanya explained that the Laos outbreak was driven by drug resistance, but the focus now lies in developing more generalised methods for characterising outbreaks. These methods will have the flexibility to be applied to a wider spectrum of outbreak situations.
Building and nurturing relationships with NMCPs in the region is an ongoing endeavour for the project, and for this, they must first understand what information is most relevant to NMCPs in each country. “NMCP staff are usually trained in public health, but are rarely experts in genetics. Therefore, to get the most impact, it is important that we translate genetic data from surveillance into information that is relevant to the decision-making domain. To give an example, NMCPs are more concerned with whether the currently-used therapies are effective in all the regions where they are deployed, rather than the presence of a mutation in a sample, and so in our analysis, we apply this way of thinking. We would make drug-resistance predictions as “resistant” or “sensitive” based on the presence of mutations, so that the information is clearer.”
She also highlights how tailoring communication approaches is pivotal to ensuring better decision-making outcomes. "With the Laos outbreak, we would also try to communicate this in the Thai language as well, because we can understand each other better. And for reports, we try to use more diagrams and intuitive colours.”
The other aspect of Varanya’s varied role focuses on project coordination and facilitating knowledge exchange. From arranging training sessions and workshops for partners in the Greater Mekong Region to organising scientific forums for global stakeholders, her work is helping to build in-country capacity and empower local researchers to conduct independent data analysis. Through these initiatives, Varanya and the team foster relationships with NMCPs and public health partners, ensuring that research findings are translated into practical solutions for malaria control.
Varanya shared her experiences from one such training workshop she organised recently, where public health experts and key scientific partners from various countries (including Cambodia, Thailand, and Vietnam) engaged in a two-day workshop on the use of Genomic Report Card (GRC) data to better understand malaria parasites in the Greater Mekong region. “That was our first ever data analysis training workshop, but the outcome has been amazing,” she remarks. “We are going to be focusing a lot more on the knowledge exchange part because one of the aims of the GenRe-Mekong project is to build in-country capacity, both in terms of the lab resources, but also for the people to be able to evaluate drug resistance data themselves. We want to transfer the skills and build local expertise to enable faster turnaround times and long-term self-sufficiency.”
Looking ahead, Varanya acknowledges the evolving landscape as the region approaches malaria elimination. "I'll be out of a job soon!" she laughed, acknowledging the shift in focus toward tackling other challenges beyond drug resistance. She hopes that the project can resume work in Myanmar soon, where malaria cases have been on the rise. “We had started the project [in Myanmar], but we had to stop right at the beginning because of the political situation that's been going on over the past few years. One proxy that we used to tell that the cases of malaria in Myanmar are getting higher is because the west side of Thailand borders Myanmar, and the number of cases around the border has shot up quite a bit. Starting this year, we will be working with the malaria control program in Thailand to start analysing this data.”
Varanya sees great potential for expanding the efforts of the GenRe project into other key areas of interest. With the progress made towards malaria elimination in the region, the team wants to use genetic epidemiology to help NMCPs and public health partners identify whether a malaria sample is imported or indigenous. “This is quite important for areas that are approaching malaria elimination, because in order to get certified malaria-free, you need to show that there are no indigenous cases. Currently, NMCPs rely on travel surveys from patients to help determine whether it's a local or imported case, but these can be biased and limiting.”
They also want to better understand Plasmodium vivax malaria, caused by a strain of the parasite that is notorious for its ability to lie dormant in the liver. “The other big malaria problem in Southeast Asia is that we have another type of malaria which is more prevalent, caused by Plasmodium vivax,” says Varanya. “Even though we have almost eliminated falciparum from the region, we still have a lot of cases of P. vivax at the moment.” She believes that continuing innovation and collaboration will help address this challenge.
Reflecting on her journey so far, this is Varanya’s advice to those embarking on a career in malaria research or similar fields: “I find that transferable skills are very important. Don't give up trying different ways to solve a problem,” she says, also emphasising the importance of perseverance and seeking guidance when faced with challenges. Above all, she encourages aspiring researchers to find joy in their work and embrace continuous learning.
To know more about the Genre-Mekong Project and its objectives, visit the project page: https://www.malariagen.net/parasite/genre-mekong
Listen to Professor Olivo Miotto’s introduction to the project: https://www.youtube.com/watch?v=XzY4k44Tk2M&t=41s