ProMED sees offers of support, but its future remains unclear

With its future in doubt, ProMED, the financially strapped infectious diseases surveillance network, has seen waves of support pour in in recent weeks, with universities and other funders seeking to rescue it, according to the president of the committee that oversees it.

Both the International Society for Infectious Diseases, which has hosted ProMED since 1999, and its moderators, many of whom went on strike earlier this month to protest plans to put the service behind a paywall, have been in discussions with academic and scientific entities and others interested in finding a way to save what the global public health community sees as a vital service.

“We are in serious negotiation with some major universities and a number of major funders. At least one of those initiatives is making significant progress,” Paul Tambyah, president of ISID’s executive committee, told STAT via email.

The striking moderators have suggested ProMED needs a new home — potentially an academic partner that could host the website and govern the operation of the service. Tambyah, a professor of medicine at the National University of Singapore, said the ISID has not ruled out transferring ProMED and its archive to another entity.

“Right now, ISID is considering all options to keep ProMED thriving and financially sustainable. There are talks underway with various options on the table,” he said.

Tambyah also stressed that the society hopes to come to a resolution that would see the moderators return to work. Subject matter experts with long careers in academia and public health, the moderators consider their ProMED work “a labor of love,” as one of the service’s fixtures, Marjorie Pollack, puts it. In exchange for their work, most get paid a mere $7,000 a year. Those stipends are currently in arrears.

When asked specifically if the ISID executive committee would endorse a move by the organization’s administrative staff to fire the striking moderators, Tambyah replied: “I certainly hope not! The aim is to find some way to improve communications and bring everyone back into the fold.”

Lack of communications has been a bone of contention for the striking moderators, who noted in a letter posted to the ProMED website on Aug. 3 that they were not consulted or informed ahead of time of the ISID’s announcement on July 14 that ProMED would move to a subscription model, with non-subscribers only able to see postings over the previous 30 days. (The moderators’ letter was taken down within hours of its posting; it can be read on X, formerly known as Twitter, here.)

“We fervently believe that there is an ongoing need for the kind of rapid, curated disease outbreak reporting that ProMED has provided since its inception almost 30 years ago,” they wrote, noting that for the service to survive it needs proper corporate governance and stable funding. “Unfortunately, such leadership and capacities appear to be beyond the scope and mission of ISID alone and will likely require a co-hosting partnership in a new administrative home with stable funding and a sustainable business model.”

Last weekend the group’s members wrote to ask the executive committee for a meeting. On Wednesday, they were informed that ISID CEO Linda MacKinnon and chief content officer Jarod Hanson would meet with them in a one-hour online forum on Friday at 7 a.m. EDT.

Pollack said some of her fellow moderators were adamant, in protest, that they would not attend; others planned to. “People are wondering if there’s a genuine desire to bring us back,” she said.

MacKinnon declined STAT’s request for an interview, saying she was too tied up with meetings. But she said in an email that ISID is committed to supporting ProMED. “We welcome the global infectious disease community to continue this journey with ISID’s ProMED as trusted submitters and supporters,” she wrote.

Long-time fans of ProMED worry that a service based on a subscription model would put its disease intelligence out of reach for researchers and public health officials in low-income countries. And anything that narrowed the readership of ProMED would likely also reduce the number of tips it receives — tips like the intel that first alerted the world to the 2003 SARS-1 outbreak, the emergence of a new camel coronavirus in the Middle East in 2012 — now known as MERS — and the start of the Covid-19 pandemic.

Larry Madoff, who was ProMED’s editor-in-chief for two decades before being pushed out in 2021 by MacKinnon and then-executive committee president Alison Holmes, said it was always his contention that ProMED should be free for all who want to read it.

He expressed puzzlement about a claim that the society’s leadership has been making — that “super users” have been scooping up ProMED data and selling it. In the July 14 letter, the ISID noted that as a result it had dropped its RSS service and stopped posting updates to X.

While ProMED has alerted the world to a number of critical outbreaks, and some of the information it disseminates is incredibly useful, its signal-to-noise ratio can be daunting at times. It’s the nature of disease surveillance; many disease events, thankfully, are self-limiting or of low consequence. But some become conflagrations.

MacKinnon said the ISID, which has struggled in recent years to raise money to support ProMED, is aware of or has been informed by “multiple entities that they scrape ProMED data, repackage it, and resell it. Or they have built their own mechanisms to pull data from ProMED emails or, previously, Twitter or RSS feeds, into their own internal tools and pass this data on to multiple entities, often getting funds for this data, yet never contributing to ProMED for data production.”

“We’ve seen an uptick in data scraping, while at the same time, we’ve seen a decline in donations and fewer unrestricted grants that were more available in the past,” she said.

Tambyah said that while the ISID executive committee supports the notion of a subscription fee for large commercial entities and government agencies, it is committed to ensuring individual public health professionals and academics — “especially those from low income countries” — will continue to have free access to ProMED.

“The principle is that those who need the key parts of ProMED for free will continue to do so while ‘super users’ pay appropriately to help keep the program sustainable,” he wrote.

Since the moderators’ strike began Hanson, the chief content officer, has been working hard to maintain ProMED’s normal pace of output. At the end of the half-dozen or more reports on human, animal, and plant diseases he has been posting to the network daily, he has been adding — as ProMED moderators often do — comments to contextualize the information in the posts, on topics as varied as pertussis activity in Canada, the discovery of a tularemia-infected hare in Germany, or surveillance of mosquito populations in the United States for West Nile virus.

Seeing one person attempting to moderate posts on so many different subjects isn’t sitting well with the striking moderators, said Madoff, a professor of infectious diseases at the University of Massachusetts. “He’s providing comments on a lot of things that are outside of his area of expertise,” he said. “I mean nothing bad by that. Nobody is an expert in everything. That’s why ProMED has a staff of specialists.”

Madoff, who is in regular contact with a number of the striking moderators, thinks a solution to the standoff can be found, one that will safeguard ProMED’s future.

“They are hoping — I am hoping also — for a soft landing, if you will. That there will be a good outcome for all concerned, including ISID,” he said. “I’m hopeful. And more than hopeful, optimistic, actually. I think that there will be a successful outcome.”

Pollack said she too is optimistic, to a degree. “Yes and no. I share the optimism because of the outpouring of offers of assistance. But I haven’t seen tangible funding coming in yet.” And she’s worried there will be long-term repercussions of the conflict between the ProMED team and the society that hosts the service.

Despite his optimism about a soft landing, Madoff agreed. “I think it has made ISID a less attractive target for funders, because of the internal turmoil,” he said. “Nobody wants to be enmeshed in that.”