A Week of Immunology, a Shared Hotel and a 'Transformative' Claim With No Alumni Count

I’ll admit that the line I keep rereading in the International Union of Immunological Societies’ course-planning guidelines has nothing to do with T cells. It’s about breakfast. Organizers are told to put students and faculty in the same hotel, because “meeting people at breakfast or dinner greatly enhances the interactions!” I love that exclamation point. I also want to know what all those breakfasts have added up to, a few dozen courses later.

On October 13, nine members of the union’s Education Committee (IUIS-EDU) offered their answer in a Comment in Nature Immunology, describing a teaching model that “has proven transformative for faculty and students.” By embedding training in local contexts, they write, the framework “builds confidence, skills and leadership” among early-career scientists, and those elements “foster scientific autonomy and enable sustainable global engagement.” The authors include Yanet Valdez Tejeira, an independent consultant in Vancouver who is also affiliated with Universidad Peruana Cayetano Heredia in Lima, plus the three who wrote the program’s 2019 account of itself: Clive Gray of Stellenbosch University, Dieter Kabelitz of the University of Kiel and Michelle Letarte of Toronto’s Hospital for Sick Children. The Comment lays out a framework, a circular diagram with three pillars and a long thank-you list of volunteers. I went looking for a count of who came out the other side and where they went, and I didn’t find one.

The machinery itself is wonderfully physical. According to the committee’s 2022 organizing guidelines, an IUIS course is a one-week regional course in a low-to-middle-income country, and it takes 12 months to prepare. Its 15 to 20 faculty, a mix of local and international experts, are told to stay through the whole course “and not just fly in and out again,” and organizers get a blunt warning: “an IUIS course is NOT a congress!” Days are crammed with poster sessions, meet-the-expert round tables, grant-writing exercises and lessons on how to write a scientific CV. Applicants are chosen on a CV, a motivation letter, a supervisor’s support letter and an abstract.

The homework starts before anyone boards a plane. About 6 weeks out, trainees get modules on Immunopaedia, a platform Gray started in 2005 to teach South African pediatricians the basics of HIV immunology. In a 2019 account of the program in Frontiers in Immunology, Kabelitz, Letarte and Gray wrote that trainees had to score above 75 percent on the quizzes at the end of each module, and that in 2018 all 145 registered participants across the courses completed them. African courses usually take 40 to 50 PhD students, postdocs, young scientists and physicians, with gender balance weighed in the selection. Immunopaedia’s course archive now lists at least 32 IUIS courses, from early runs in Colombia, Tunisia and The Gambia to Zambia in 2022, Peru and Cambodia in 2025 and Cameroon in 2026.

What a worm does to an allergy test

I started out skeptical of the program’s central premise. An antibody is an antibody, so why should it matter where you learn about one? The guidelines insist that it does. The topic, country and location of each course are chosen with the regional IUIS federations and “should be based on the immunological topics most relevant to the particular area,” which is why the 2020 Ethiopia course spent time on leishmaniasis and helminths and the Benin course took on immunity in pregnancy, malaria and worms.

A 2019 doctoral thesis from the London School of Hygiene & Tropical Medicine changed my mind. Gyaviira Nkurunungi compared rural Ugandan communities, where the blood fluke Schistosoma mansoni is endemic, with urban ones. The rural participants made weaker antibody responses to the standard protein components of common allergens and stronger responses to cross-reactive carbohydrate determinants, sugar decorations that turn out to be abundant on the allergen extracts used in testing. Their elevated IgE against those sugars “did not translate into clinical allergy.” Reactivity to one particular sugar motif, core α-1,3-fucose-substituted N-glycans, was even inversely associated with asthma.

So how does someone end up with a positive allergy test and no allergy? The answer was simpler than I expected. The test picks up IgE sticking to an extract, and in these communities a lot of that IgE is gripping sugars instead of the allergen proteins behind the sneezing and wheezing. Nkurunungi concluded that this likely produces false diagnoses of allergic sensitisation in tropical helminth-endemic settings. A clinician who was never taught about that sugar cross-reactivity risks taking the positive result at face value. One trained where the worms live has a better chance of knowing to question it.

The need for that kind of training is easy to document. In a June opinion article in Frontiers in Medicine, University of Cape Town immunologists Mohlopheni Marakalala and Sabelo Hadebe write that immunology “often remains underrepresented in undergraduate curriculum” in the regions carrying the heaviest infectious disease burden, and that its vocabulary can feel “alienating to a second or third language speaker.” South Africa has 10 universities with medical schools and, by their count, not one MD-PhD program.

So did the week work? The program’s own leaders were candid about the limits of what they knew. In the 2019 paper, Kabelitz, Letarte and Gray listed what they had measured: whether participants enjoyed the course, whether they used Immunopaedia, how easy it was to learn from, and multiple-choice tests before and after the course to capture short-term knowledge gain. They wrote that whether trainees gained the ability to apply and synthesize what they learned had yet to be assessed, and that assessing it would mean working with education specialists. The goal they set was much bigger than a quiz: “in-country immunology leaders who can attract funding and a critical mass of followers.”

That goal can be counted. Where did the 145 trainees from 2018 end up? How many stayed in their home countries, won grants, opened labs or trained students of their own? Neither the 2019 paper nor this week’s Comment puts that count in front of readers. A 100 percent quiz-completion rate tells you people did the homework, and it can’t tell you whether a lab exists in Addis Ababa or Banjul because of a week in a hotel. “Transformative” is a claim about outcomes, which takes a cohort, a follow-up and a number to back it, and the Comment delivers the verdict without any of them.

Autonomy with a patron

Then there’s the money, which sits awkwardly against all the talk of autonomy. The 2022 guidelines say the EDU budget “allows to partially support 3 courses per year,” and they don’t sugarcoat the rest: “The EDU support will not suffice to fully cover the expenses of the course.” Local organizers are told to raise the difference from “industry, your Regional Federation, private foundations,” and faculty may be asked to pay their own airfare if the money never arrives.

The patrons have names. The 2019 paper credits the Bill & Melinda Gates Foundation with the Ethiopia and Brazil courses, the Volkswagen Foundation with The Gambia, Benin and Ethiopia, and NIAID at the US National Institutes of Health with South Africa. The new Comment thanks the Volkswagen Foundation, the Pasteur Institute and the Gates Foundation as sponsors of IUIS-EDU activities, and its authors declare no competing interests and no relevant funding for the Comment itself.

On paper, the regional federations, not the donors, pick the country and topic. But a course the committee can only partly pay for happens only when someone else’s money shows up, and “scientific autonomy” that rests on grants from Seattle, Hanover and Paris is autonomy with a patron. Marakalala and Hadebe propose a structural fix: a dedicated Bachelor of Science in infectious disease immunology and a Master in Medicine specialising in immunology, recognised by the Health Professions Council of South Africa. A degree program survives the end of a funding cycle in a way a visiting week can’t.

The case for teaching immunology where people live holds up, and the Ugandan allergy data makes it all by itself. The case that this particular model transforms careers is still waiting for its numbers. If I were writing this committee a check tomorrow, I’d earmark the first dollars for tracking down those 145 trainees from 2018 to find out where they work and what they’ve published, and only after that would I pay for another round of hotel breakfasts.

Sources

1. Nature Immunology: Valdez Tejeira et al., A unique and equity-driven approach to immunology education in low- and middle-income countries (2026)
2. Frontiers in Immunology: Kabelitz, Letarte and Gray, Immunology Education Without Borders (2019)
3. IUIS Education Committee: How to organize an IUIS Immunology Course (2022)
4. LSHTM: Nkurunungi, Helminth-allergy associations in rural and urban Uganda (doctoral thesis, 2019)
5. Frontiers in Medicine: Marakalala and Hadebe, Bridging the immunology gap in sub-Saharan Africa (2026)
6. Immunopaedia: IUIS EDU Committee course archive