Dr Clare Smith has a simple philosophy for her career – chase adventure, expand horizons and ask questions. After growing up on a farm on the island of Tasmania, she is ticking all boxes. Today, Smith is a scientist working at the University of Massachusetts Medical School in the US where she plays a major role in the global battle against tuberculosis (TB).
After researching pioneering ways to fight malaria while studying for a Bachelor of Biotechnology at the University of Tasmania and a PhD at the Menzies Institute for Medical Research, Smith has widened her expertise to include tuberculosis, working with leading researcher Chris Sassetti at his UMass lab outside Boston since 2013.
Tuberculosis is a bacterial infection that kills about one million people across the world each year.
“One in three people in the world are still infected with the bacterium Mycobacterium tuberculosis and that is crazy,” says Smith. “Most of us don’t even know we have TB unless we get sick and it reactivates. That is when transmission occurs.”
An alternative approach to prevention
Smith’s research on malaria is among the first that studies potential treatments where the host – a human – is the focus rather than the pathogen. This research led to her current work on TB at UMASS Medical School where she is looking at the contribution of both host and pathogen genetics.
“We are some of the first to come up with a ‘dual genome’ model where host and bacteria genes can be investigated at the same time, at a broad scale.”
One of the factors Smith is considering is the BCG vaccine – a vaccine widely used against TB and usually given to babies and children. BCG is on the World Health Organization’s List of Essential Medicines but has reported variable levels of efficiency. Smith’s research considers how the host and bacterial genetics interact with the environment.
“The BCG vaccine can work up to 70 per cent of the time in people but sometimes it doesn’t,” she says.
“The answer may be in a person’s genetic makeup."
“If I am being super nerdy, I will say I am a geneticist,” Smith says. “I want to know what is it about you and your genes that makes you get sick. Why can you resist certain diseases? Why are you susceptible to certain drug treatments? We all have a genetic blueprint so what is it about that blueprint that leads us to get certain diseases?
“Other questions are, how good are the diagnostic tests and the treatment? An antibiotic drug course can last eight or nine months which is really nasty. The drugs are now failing because of resistance. For TB treatment, superbug resistance is really scary.”
Smith’s research is combining her expertise as a host geneticist and her mentor Chris Sassetti’s knowedge of bacterial factors in TB.
“This is the first model of its kind looking at host and bacterial variation,” Smith explains. “I’ve used that model to look at BCG and see why it doesn’t work in all people.”
For her work to decipher the genetic determinant of tuberculosis susceptibility, Smith received the prestigious Verne Chapman Young Scientist Award from the International Mammalian Genome Society and served on the organisation’s secretariat for two years.
Clare Smith. Credit: Peter Mathew
Pioneering malaria research
Smith’s TB work is rooted in her earlier, pioneering research into malaria. Malaria affects millions of people around the world each year, many of them children under the age of five.
Smith’s PhD research, under the mentorship of Professor Simon Foote, looked at host genetics and took her around the world searching for people who were immune to the disease, including the Pasteur Institute in Paris where her lab work formed an important conclusion for her PhD thesis. Her time in Paris was funded by the Bede Morris Fellowship from the Australian Academy of Science and the Australian-European Malaria Fellowship.
At just 27, she discovered a new antimalarial compound while she was a PhD student at the Menzies Institute for Medical Research. It was this work that opened the door to her next-level opportunity in the US.
In recognition of her malaria research, Smith was a 2014 national finalist in the prestigious Young Australian of the Year Awards, a program which recognises exceptional Australians who inspire discussion and change on issues of national importance.
“The malaria research community in Australia is wonderful,” Smith said. “It is a hub of great research. Malaria is not something that particularly affects Australia but it affects our neighbours a lot.
“It feels like being a detective,” she says.
“The big reason to take on this research is because people are dying from these diseases. I’m excited that I have contributed to the body of knowledge on the disease.”
Clare Smith in Boston. Credit: Christopher Padgett
Engaging the public is the future challenge
Smith would like to see more women in science but says the challenge is not in encouraging young women and girls into the field but retaining them at a senior level in academia.
“In the US and Australia, the gender balance is about 50/50 in undergraduate students,” she says. “The numbers are similar in postgraduate study but in postdoctoral research we notice women are falling out of the field. There are barely any women in the next level. Where are all the female professors? The female lab heads? The next generation of female scientific leaders? We need to encourage women to get into science and we also need to retain them at the senior academic level.”
In line with her approach to her own field of research, Smith sees other challenges for the research community in a different way to many others. She believes the future of medical research is not necessarily about new cures, techniques or medical technology but in how scientists engage the public with their work.
“I know trying to cure TB is important and I know that understanding about host genetics is important but why should anyone else care?” she says. “Is anyone vocally demanding a cure for TB? No. If people are engaged with the work done by medical researchers then there will be interest from funding bodies. That is where medical research needs to go – engaging and communicating how important this work is.”
Smith says scientists have got what it takes to make discoveries but need to learn to be better at communicating their ideas and explaining what they are doing.
“We have all the tools for taking on and understanding different diseases but what is the point of that if we can’t engage with the public?’ she says. “We need to share our enthusiasm and findings with our communities. There is nothing better than giving a talk to a bunch of 16-year-olds who become so enthusiastic they then go and tell their parents about genomes.”