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Neglected Tropical Diseases

A Case for Promoting Innovation and Transdisciplinary Perspectives in Liberal Arts Education

Journal of College Science Teaching—May/June 2020 (Volume 49, Issue 5)

By Kevin M. Bonney

The goal of liberal arts education is to prepare engaged global citizens with a wide range of knowledge and transferable skills. Science is an integral pillar of a solid liberal arts education with a crucial role in achieving this goal. However, scientific concepts are often taught in isolation from other disciplines, which may obscure the importance of science in liberal arts. The separation of specialized knowledge, or disciplinarity, is a barrier to the core ethos of liberal arts, which emphasizes diversity and connectedness of knowledge and skill. A more effective practice is that of transdisciplinarity. In the context of education, transdisciplinarity is an approach that strives to thoroughly integrate the study of different subjects to produce a synergistic effect on learning. Transdisciplinarity transcends boundaries that separate disciplines by contextualizing learning in terms of real-world problems, incorporating evolving methodology and innovative technologies, and relying on sustained collaboration (Bagnol et al., 2016; Derry & Fischer, 2007; Hyun, 2011; Russell et al., 2008). Ultimately, transdisciplinarity and liberal arts share one common goal: to prepare students to effectively and purposefully engage in civic life (Derry & Fischer, 2007; Hyun, 2011; Russell et al., 2008). Pursuit of this goal promotes, if not necessitates, pedagogical innovation and reinvention of traditional disciplinary approaches to teaching.

The aim of this essay is to illustrate the critical role of science in achieving the goals of transdisciplinarity and liberal arts education. These include promoting acquisition of the knowledge necessary to evaluate and interpret information, promoting development of skills needed to synthesize and communicate cogent arguments, and facilitating experiential learning that fosters development of an empathetic worldview. To clarify, the term “science” is a moniker for a number of distinct disciplines: the formal sciences, which include mathematics; the life sciences such as biology; the physical sciences (e.g., physics); and the social sciences (e.g., psychology). A number of scientific topics could inspire transdisciplinary pedagogy that is relevant and engaging for liberal arts students, including climate change, food security, genetic modification of organisms, sustainability, and vaccinations. This paper focuses on Neglected Tropical Diseases (NTDs), an important topic from the field of biology, as a platform for building transdisciplinarity within liberal arts. Rationale for increasing the integration of science with other subjects, and a plan for incorporating NTD-themed lessons into a range of courses are provided here. The role of innovation in enacting this plan, including creative use of technology and inventive learning activities is discussed along with specific examples of NTD-themed lessons.

Challenge: Unmet need for neglected tropical disease education

NTDs are some of the most common diseases that many people have never heard about. A total of 1.4 billion people, or 20% of the world’s population, is currently affected by soil-transmitted helminthiases, trachoma, schistosomiasis, Chagas disease, or one of the other 13 NTDs identified by the World Health Organization (WHO, 2013). Soil-transmitted helminthiases alone affect over one billion people (CDC, 2011). Many of those infected simultaneously suffer from other diseases, such as trachoma, the world’s leading cause of infectious and preventable blindness, or schistosomiasis, which has been described as the second most devastating parasitic disease after malaria (CDC, 2011). Shockingly, Chagas disease has been called “The New HIV/AIDS of America” because the infection that causes it is now more than five times as common as HIV throughout the Americas (CDC, 2011; Hotez et al., 2012). Each NTD is caused by a different bacteria, virus, single-celled protozoan parasite, or parasitic worm. What unites this group of highly diverse diseases is that they all involve chronic, long-term infections that are potentially debilitating and deadly, and mostly affect low-income people in tropical areas. One other important characteristic of NTDs is that the medicines used for treatment often cannot be administered to everyone in need due to harsh side effects or because the drugs are too costly or difficult to administer.

Because NTDs mostly affect people living in developing countries, the seriousness of this public health problem and the need for assistance may be underestimated or overlooked by the global community. This is one reason why better treatments for NTDs have not yet been developed. However, the socioeconomic impact that NTDs exert on the world exceeds that of all other infectious disease except AIDS (Norris et al., 2012). This includes billions of dollars in treatment and prevention costs, tens of millions of hours of lost health and productivity, and 200,000 annual deaths spread out over 149 countries (CDC, 2011; WHO, 2013). The impact of NTDs reaches from deep within the histories of endemic regions, out into the future political, economic, and health policies of nations around the world. Globalization, immigration, and travel have increasingly directed the threat of NTDs, and the responsibility of addressing that threat, at nonendemic nations such as Australia, Japan, the European Union, and the United States (Bonney, 2013). Successfully addressing the problem of NTDs will require a concerted effort among those most affected and the leadership of nations that possess the economic and scientific resources and logistical framework to make substantial progress. But before people can take actions to address the problems posed by NTDs, they must know about them.

It is concerning, though not surprising, that the average American or European knows little about NTDs. Even in university courses dedicated to teaching future healthcare professionals and other students majoring in science, NTDs are rarely discussed. For example, despite their outsized impact, NTDs are mentioned on less than 3% of pages in the best-selling textbook titled Microbiology: Principles and Explorations, which is commonly used to teach microbiology courses in the United States (Bonney, 2013a). Anecdotally, this is commonplace among mainstream textbooks. Creating awareness of a serious potential threat to global health and economic security is itself a strong justification for including more detailed lessons about NTDs in the curriculum. It can also be argued that resource-rich nations have a moral obligation to aid global health efforts, whether or not their own citizens are directly impacted. Of greatest relevance to the argument made here is the tremendous potential for NTD-themed lessons to promote transdisciplinarity in liberal arts.

Recommendations: Transdisciplinarity and innovation in science education

The far-reaching impact of NTDs provides myriad opportunities for students and scholars of all disciplines to develop an understanding of the biologic, economic, historic, and political factors that influence human interactions. Many suggestions can be provided for how to weave scientific concepts into nonscience courses using NTDs as a unifying theme. For example, data and questions related to a problem involving NTDs can serve as prompts in economics courses to promote application of economic theories and the statistical tools of economics. Such a lesson could start by introducing a real-life example of the deleterious impact that NTDs have on the fragile economies of developing nations, such as that of Chagas disease in Mexico. To understand this example, it is important to know that the parasite that causes Chagas disease often establishes a lifelong infection if not treated, which eventually leads to a fatal heart disease in many individuals. There is no vaccine for this parasite. Although 60% of those infected can be cleared of the infection by treatment with existing medications, those drugs can be prohibitively expensive, costing up to $14,500 per year while the gross domestic product of Mexico per capita is less than $10,000 (Vallejo et al., 2002). Successful treatment also requires regular administration of the drug over a period of 60 to 90 days (Rassi et al., 2010). This is not sustainable for individuals who must work long hours at sites far from treatment centers to support their families. An alternative approach to the Chagas disease crisis is prevention. To maximize effectiveness, Chagas disease prevention campaigns must be multifaceted, involving public health education, screening campaigns, and widespread efforts to eradicate the insects that transmit the parasite. This requires the efforts of both governmental and nongovernmental agencies, along with the cooperation of local residents. Organization of such campaigns is not without a complicated cost structure and logistical needs, hence the need to apply economic principles and statistical tools.

The second part of this lesson involves developing a plan to address this problem, starting by first evaluating the financial feasibility of existing plans proposed by public health organizations. A cost/benefit analysis of treatment compared to prevention strategies could initiate a class debate on the issue. To extend this exercise, students could be tasked with proposing a development plan for a theoretical nongovernmental organization preparing to slow the spread of Chagas disease in Mexico, and addressing the potential threat of infection spreading to nonendemic nations, such as the United States. These discussions are of particular relevance in the current political climate of United States–Mexico relations, especially given the role of politically charged issues such as global warming, healthcare economics, and immigration in shaping the future of this pandemic.

Similar exercises could be used to incorporate NTDs into courses in other disciplines, including African and Latin American studies, ethics, history, mathematics, political science, and writing. Teaching about NTDs also provides opportunities to incorporate themes from other liberal arts disciplines into science courses. Investigation of the history and socioeconomic factors that influence risks and responses related to disease outbreaks could all be paired with discussion of the biological aspects of those diseases. Even within science exists a multitude of opportunities to use NTDs to form connections between disciplines. For example, students can discuss the pharmacology of relevant medications in a biology course, or analyze the movements of NTD-causing pathogens in a physics course. Collaborating to develop solutions to real-world problems emphasizes the meaningful integration of disciplinary themes characteristic of transdisciplinarity. In contrast, transdisciplinarity is not achieved by learning exercises that are purely theoretical, are not directly related to a real-world problem, do not rely on collaboration, or do not extend beyond disciplinary boundaries. To maximize the benefits of transdisciplinarity, learning should reach beyond the classroom into local and global communities (Bagnol et al., 2016; Birkholtz et al., 2012; Christie et al., 2007). One way to extend learning is through use of innovative pedagogy, such as the case study teaching method. Case studies deliver content as a narrative complemented by learning activities that promote critical analysis, communication, and application of knowledge and skills. Frequent formative assessments are often included to help guide the learning process. First proven effective in business and medical education, the case study teaching method has more recently been adapted for use in undergraduate science courses (Herreid et al., 2011). A number of existing resources provide case studies at little to no cost for use in a variety of educational settings. One example of these is the Global Health Case Studies Project (), which provides several case studies related to NTDs, including “Chagas Disease Vector Control in Honduras” (Hashimoto & Ratigan, 2017) and “The Global Trachoma Mapping Project” (Brooks et al., 2016).

The National Center for Case Study Teaching in Science also include several case studies about several NTDs, including African trypanosomiasis (“African Illness: A Case of Parasites?”) (Bonney, 2012), Chagas disease (“Sick on a South American Sugarcane Plantation”) (Bonney, 2013b), and (“The Case of a Tropical Disease and its Treatment”) (Santanello & Rehg, 2007), and Dengue fever (“The Unfortunate Nurse”) (Aguirre, 2007) and (“Dengue in the Landscape”) (Rusch & Perry, 2011). Some of the case studies provided by these sources include instructional videos and animations, laboratory simulations, interactive computerized presentations, and other innovative technologies. Use of other open educational resources could enhance the applicability and effectiveness of case studies. Examples of these include game-based learning, videos with interactive features, and web-based simulations of realistic field and laboratory research activities. Students can potentially even be involved in real infectious disease surveillance through crowd-sourced data analysis. This concept, which has already been shown feasible in helping combat malaria, could provide students an opportunity to make a real difference in the fight against NTDs from their home or classroom (Luengo-Oroz et al., 2012). Regardless of the interface, what makes case study teaching particularly effective for promoting transdisciplinarity is the focus on real-world problems and collaboration.

An even more active approach to teaching and learning involves partnering with study abroad and service learning programs to extend teaching and learning beyond the classroom to reach communities directly. This can be achieved through laboratory research, fieldwork, and civic engagement. In addition to programs organized by individual instructors and institutions, a number of programs accept applicants from outside institutions to join projects with transdisciplinary and disease-related themes. One example is the Ohio University Tropical Disease Research Program, which promotes public health in Ecuador by educating local communities about NTDs and completing research and home-based health promotion projects. Participants engage in two to six weeks of hands-on fieldwork and educational interaction with local residents. Seattle-based Global Brigades Association also oversees public health projects with a similar mission in several developing countries.

A suggestion for educators seeking middle ground between classroom-based learning and field or laboratory research projects is the approach promoted by the National Center for Science and Civic Engagement (NCSCE). The NCSCE is an international initiative dedicated to strengthening science education by emphasizing interdisciplinary connections while focusing on real-world issues. Their website provides valuable open educational resources in the form of model course modules. These modules include syllabi, learning activities, assessment tools, and other helpful resources. To complement these materials, the NCSCE advocates civic engagement through its Science Education for New Civic Engagements and Responsibilities program. This program extends the impact of education beyond the classroom by facilitating citizenship projects that address important issues.

Reflecting on the examples provided here, it should be both easy and logical to conceptualize myriad ways that NTDs can facilitate transdisciplinarity and innovation. Redesigning individual courses to implement these suggestions has potential to substantially increase teaching effectiveness. However, a more significant reconstruction of the curriculum is required to maximize the benefits of transdisciplinarity. Educators should reinvent the modular format of liberal arts education by replacing disconnected courses with sets of interconnected classes that are linked by a common theme or problem of public concern. The first step is for faculty to coordinate teaching plans and materials in order to emphasize connections with the chosen theme and with the other linked courses. Next, an extracurricular project involving research or civic engagement is established to extend learning beyond the classroom. Cohorts of students are then recruited to enroll in the linked courses. Finally, during the implementation phase, students and faculty are encouraged to develop strong connections while they work in small cohorts to fulfill coordinated learning objectives. This approach, which has been referred to as a “learning community,” has been shown to be highly successful (Smith & Bath, 2006; Tinto, 2000). Consider the previous example of a life science course and an economics course that examine the problem of Chagas disease in Mexico. To form a learning community, these courses could be linked to a humanities course, a social science course, and a writing course. The faculty who teach all four courses would work together to develop course materials and an extracurricular project related to Chagas disease in Mexico. Groups of students would then enroll in all four courses, either simultaneously or consecutively, while also participating in the project. This is just one example of a path for reinventing liberal arts education to include greater emphasis and integration of science throughout the curriculum.


Transdisciplinarity and innovation are keys to overcoming barriers that often separate the knowledge and approaches of different disciplines, and can form the foundation for reinventing liberal arts education. Educators are encouraged to reinvent their curriculum to form learning communities that use a spectrum of approaches, knowledge, and technology to address real-world problems. NTDs are one of many scientific topics that exemplify the pressing need for expanding integration of science and liberal arts. Because these exceedingly common and potentially deadly diseases are significantly underrepresented in the education system, yet have wide-ranging and ever-increasing influence on global economies, histories, and societies, the argument for including discussion of NTDs in a variety courses to promote is strong. If the suggestions presented here are adopted accordingly, increased knowledge and interest of NTDs could lead to a reduction in morbidity, mortality, and financial burden. Importantly, as a means to this end, an NTD-based reinvention of liberal arts promises to fulfill the ultimate goal of producing knowledgeable, skilled citizens collaborating to promote a common good.

Kevin M. Bonney ( is a clinical associate professor in Liberal Studies at New York University in New York, New York.


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