A city built on sand, Natal is a tourist destination in northeastern Brazil known for historic buildings, beautiful beaches, and sand dunes standing hundreds of feet high and spilling onto the seashore.
The outskirts of Natal are a different kind of place. The city is ringed with low-cost homes packed closely together on small lots. Organic debris from chickens and other animals provide ideal breeding conditions for the sandflies that carry leishmaniasis.
As Brazil has urbanized, diseases once confined to rural areas have followed people to the cities. In recent years, major cities in northeastern Brazil have experienced epidemics of leishmaniasis, a disease that causes severe malnourishment and can be fatal even with treatment. Having taken root in the northeast, the disease is now moving south.
Selma Jeronimo, a physician-scientist and professor in the department of biochemistry at the Federal University of Rio Grande do Norte (UFRN) in Natal, is looking for ways to control the disease's spread and searching for genes that make people susceptible. As part of an international team studying tropical diseases, she directs a laboratory staffed by 20 Brazilian students and a handful of scientists visiting from abroad.
This article is part of a feature focused on doing science in northeastern Brazil. For more information on this topic, read:
• Science in Northeastern Brazil  (An Introduction)
When Jeronimo began her studies 16 years ago, the climate for science in northeastern Brazil was poor. Laboratories at her institution were ill funded and poorly equipped. A troubled economy beset with runaway inflation left little money to invest into research. The available funds were channeled mostly to a handful of established institutions in the southern part of the country.
For years, Jeronimo maintained her research program thanks to small federal grants from Brazil and funds from the U.S. National Institutes of Health. “We started with very little and had little access to reagents or equipment,” she says.
Over the past decade, the federal government has made research funds available to institutions throughout the country. Now, about 30% of government research funds are directed to institutions in northeast Brazil, Jeronimo says. The funding boost has allowed her to expand her studies and to travel to areas where outbreaks of leishmaniasis occur.
Leishmaniasis comes in several forms, but the one Jeronimo studies, visceral leishmaniasis, is the most fatal. Poverty plays a role because the sandflies that carry the disease thrive in the unsanitary conditions found in many poor, underdeveloped areas. The flies thrive in residential areas just outside the city, where residents keep farm animals next to their house. Jeronimo travels to these places to show people how to clean their environment to decrease the risk of harboring the flies. “Teaching people how to take care of their backyard or how to protect themselves is the most important tool that we have," she says. “Our fear in Brazil is that, with so many asymptomatic people, if those people become immunocompromised, an epidemic of leishmaniasis could occur. So it’s a major challenge,” Jeronimo says.
Jeronimo is used to major challenges. She grew up in a poor area in northeastern Brazil, in the town of Serra Negra do Norte in the state of Rio Grande do Norte. When she was 8 years old, her family moved to Natal, where she worked her way through the public school system.
Inspired by her aunt, a physician, Jeronimo developed an interest in biology and disease. During her last year in high school, she traveled to Chicago as an exchange student. Upon returning to Brazil, she attended UFRN, obtaining a medical degree in 1986.
In 1989, Jeronimo received a Fulbright fellowship and returned to the United States to work in the lab of Richard Pearson at the University of Virginia. There, she collaborated with scientists at the University of Iowa; these and other collaborations with scientists interested in tropical disease have proved fruitful and long lasting.
In 1991, she returned to Brazil, completing her doctorate in molecular biology at the Federal University of São Paulo (UNIFESP) in 1994. She accepted her current position at UFRN the following year.
Jeronimo is part of an international team working to identify genes that influence susceptibility to visceral leishmaniasis. Her data will be compared with data from patients in India and Sudan to determine whether the same genes contribute to susceptibility to the disease in all three places.
In recent years, Jeronimo’s lab has begun to study leprosy, which remains a public health problem in northern and northeastern Brazil. Despite efforts to control the disease, about 35,000 new cases are reported each year in Brazil. Over the past 4 years, Jeronimo’s group has identified areas where leprosy exposure is a serious risk and is working with physicians to identify people in early stages of the disease.
Jeronimo's studies are attracting scientists from outside Brazil. Each year, two to four medical students from the United States come to her lab. A Cornell University physician is currently working there to identify factors that contribute to leprosy susceptibility.
Jeronimo says the climate for scientific research in northeastern Brazil has improved substantially in recent years. The Brazilian government has initiated programs that allow Brazilian students to study abroad, and efforts have been made to hire professors who have received scientific training in foreign labs. Other scientific endeavors in the region, such as the International Institute of Neuroscience of Natal , attract scientists from the United States and Europe.
“We still have some bottlenecks to overcome as far as getting proper reagents and equipment in a timely manner,” Jeronimo says. “Such things take far too long, stretching out for months or even a year.” But, “looking back to the time when I was a student," the change in the scientific climate is "like night and day.”