Anna Maria Ekström

Anna Maria Ekström

Professor/Senior Physician

Master of Public Health (MPH) quantitative methods from Harvard School of Public Health (1995), Medical Doctor (MD, 1997, Uppsala University) PhD medical epidemiology (Karolinska Institutet (KI), 2000

Telephone: +46852482824
Visiting address: Widerströmska huset Tomtebodavägen 18 A, plan 3, 17165 Solna
Postal address: K9 Global folkhälsa, K9 GPH Ekström, 171 77 Stockholm
Part of:

About me

  • Master of Public Health (MPH) quantitative methods from Harvard School of Public Health (1995),

    Medical Doctor (MD, 1997, Uppsala University)

    PhD medical epidemiology (Karolinska Institutet (KI), 2000). 
    Full professor (since 2013) in Global Infectious Disease Epidemiology and Senior clinical consultant infectious diseases (överläkare)

    Employed at Karolinska Institutet the Department of Global Public Health (GPH) & Södersjukhuset, Department of Infectious Diseases/Venhälsan, 70% reserach/30% clinical work.

    Research group leader for Global & Sexual Health (GloSH) with about 50 affiliated researchers at GPH, KI.

Research

  • Over 25 years leading international research teams and projects including clinical trials, cohort-studies and qualitative research in Europe, Africa and Asia on sexual and reproductive health and rights (SRHR),  access to HIV prevention and care in adolescents girls and young women (AGYW) and key populations with a special focus on prevention of mother to child transmission of HIV (PMTCT), gender-based violence (GBV/IPV), sexual risk behaviours, maternal and child health, health systems, implementation research, policy implementation, demographic surveillance, norms and values, emerging infections (Mpox, Ebola, Zika, COVID-19), and global vaccine policy and vaccine access

    Published over 285 scientific publications (H-index 42. Top-90-100% in number of publications at KI)

    Funding 
    European Commission (Horizon), Hadea, EDCTP, Bill and Melinda Gates Foundation, Swedish Research Council, Forte, NIH, Sida, WHO, Swedish National Board of Health and Welfare, KI, European CDC, Stockholm County Council, FAS,  EBA, Groschinsky, Swedish Public Health Agency, Solstickan, Gilead, Janssen, South African Medical Research Council, UNICEF.
    As main applicant acquired > 120 million SEK (12 M Euro) in external research grants in competition

    Expert & Leadership assignments

    ·     2026- :Chair, SweDev, Swedish Development Researchers’ Network

    ·     2019-2026: Member KI’s Internationalisation Board

    ·     2025- Expert in EBA: Government appointed Expert Group for Aid Studies eba.se/en/

    ·     2025-: Expert in Sweden’s scientific reference group for access to COVID-19 vaccines (Swedish Government department of Foreign Affairs)

    ·     2022-2026: Sweden's representative in HERA's Advisory Forum- EUs Health Emergency Preparedness & Response Authority

    ·     2023-:  Chair/Member, technical advisory group on Market Access for Vaccines (MVAC), World Health Organization (WHO) https://www.who.int/groups/technical-advisory-group-on-market-access-for-vaccines.

    ·     2023- : Representative in FoUU-committee with hospital and KI management (SÖS)

    ·     2022- :  Board member of Centre for health crisis, Stockholm

    ·     2021-2022: Expert in COVAX Independent Allocation of Vaccines Group (IAVG) for global COVID-19 vaccine allocation, WHO https://www.who.int/groups/iavg

    ·     2021- : Research lead (FoUUi) for at the Department of infectious Diseases, Södersjukhuset (SÖS)

    ·     2020-2024: Chair/Member Sida’s Scientific Council, Swedish International development Agency (Sida)

    ·     2021: Leader KI’s taskforce on COVID-19 and public health and resource group on COVID-19 and global health

    ·     2020-2022: Member Swedish Governments's scientific reference group (Richard Bergström's) for COVID-19 vaccines

    ·     2019-2025: Senior member, Karolinska Institutet’s Ethical Council

    ·     2018-2022: Senior advisor Global Challenges think tank, Vice President for the Health Council

    ·     2014-2018: Board member INDEPTH Scientific Advisory Committee. International network of all health and demographic surveillance sites in the world

    ·     2008-: Leader Global & Sexual health (GloSH) research group https://ki.se/en/gph/global-and-sexual-health-glosh at KI with @50 multidisciplinary international researchers, home of prof. Hans Rosling’s teaching legacy

    Other expert assignments: 
    Sweden’s National Board of Health and Welfare, Advisor Africa CDC.  Institute for Communicable Disease Control, Swedish Migration Dept, Stockholm Needle Exchange, Sweden’s Foreign Dept, Swedish Society of Medicine, Medical Research Council, Noaks Ark’s HIV Foundation, Aids Accountability International, Doctors against AIDS, HIV Outcomes,

    Other merits & Awards:
    Woman of the year 2022- rank 95 among the 100 most influential women in Sweden 2022, Expressen
    Public health/medical expert, Musikhjälpen, helped collect 48 million SEK to health care & 30 M SEK to HIV
    Main supervisor of Ziad El-Khatib awarded Best HIV thesis of the year (Sweden) (2011)
    ERA evaluation: My research group Global & Sexual Health at Karolinska Institutet scored “Excellent” i.e top research groups at KI (2011)
    Harvard School of Public Health’s representative of Students for Human Rights at the Harvard Model UN course in Diplomacy and Negotiations, in Geneva in Switzerland (1995).

Teaching

  • Supervised 31 graduated PhD students (15 as main supervisor) and 50% from LMIC. Ongoing supervision of 10 PhD students.
       
    30 years of teaching university students & course leadership, chair/member of 30 PhD dissertation boards

    Course coordinator undergraduate course "Global health" 4.5 credits
Course coordinator "HIV - an individual focus from a global perspective" 7.5 credits
Course coordinator "Infectious diseases" Master of Global health, 4.5 credits
Responsible for KI's process of internationalisation 2015-2018 to include global health in all study programmes at KI.
Responsible for Massive Open Online Course (MOOC) in Global Health in 2016 with 17, 000 participants across the world. Frequent participant in public lectures, media (TV, radio, newspapers). 


    Scientific coordinator for the Sweden –Tanzania PhD training program sponsored by Sida 2015-2026 and actively involved in the Sweden-Uganda PhD capacity building exchange programmes since year 2000.

Articles

All other publications

Grants

  • Swedish Research Council
    1 January 2026 - 31 December 2028
    In August 2024, multiple viral mpox outbreaks in Africa, uncontrolled spread of new strains, and ongoing global transmission among men who have sex with men (MSM) led WHO to declare a second global mpox emergency (PHEIC). Due to vaccine scarcity, Sweden followed EU recommendations for a dose-sparing intradermal (ID) vaccination regime, using one-fifth (0.1 ml) of the standard (0.5 ml) subcutaneous (SC) dose of the only approved vaccine, MVA-BN. Now, breakthrough infections in primary mpox-vaccinated MSM are rising, also in Sweden. Evidence of waning antibodies and lack of booster studies warrant this randomized clinical trial (RCT).We will conduct a phase 4, low-intervention RCT in 490 MSM who are primary mpox-vaccinated, randomizing them to an ID or SC booster or a control arm. Innovative methods will assess mucosal and serological immune responses (T-cells, binding/neutralizing antibodies) over two years, with noninferiority of ID vs. SC after one month as the primary endpoint. Safety is monitored. The study has regulatory and ethical approval in CTIS. Once funded it is ready to start within Venhälsan’s cohort of &gt
    3800 primary vaccinated MSM at South General Hospital, Stockholm. This study answers pressing public health questions on booster effectiveness, particularly if the ID dose-sparing regime is non-inferior to standard care. Results will guide global recommendations and are urgent, given the need for MVA vaccine stockpiles for bioterror threats amid ongoing scarcity.
  • Swedish Research Council
    1 December 2025 - 30 November 2029
    Violence exposure during childhood and adolescence is strongly linked with poor mental health. In Sweden, nearly half of grade 9 students report exposure to assault, threats, theft or sexual violence, yet few receive appropriate mental health support due to lack of trust, service gaps and other barriers. The purpose of this implementation research project is to assess the potential of a digital task-sharing intervention to address mental health needs among violence-affected youth 15-19 years in socioeconomically challenged areas of Sweden. To do so, we will adapt Inuka, a digital problem-solving therapy intervention delivered by trained lay counselors, which has shown promising results in other settings. Study 1 will use formative qualitative research with youth and professionals to identify barriers and facilitators to implementation. Study 2 will engage youth, service providers, and civil society actors (n~25) in co-design workshops to tailor the intervention to the Swedish context. Study 3 will evaluate the feasibility, acceptability, and preliminary effects in a pilot randomized trial with ~160 youth.  This four-year project is highly feasible, drawing on an interdisciplinary team at Karolinska Institutet, Save the Children, and Inuka Foundation, with expertise in adolescent health, violence prevention, digital interventions, and implementation research. Results will guide future scale-up and evaluation of digital mental health support in Sweden.
  • Swedish Research Council
    1 December 2025 - 30 November 2028
    During the COVID-19 pandemic, Sweden saw a rise in immune-mediated inflammatory diseases (IMIDs) such as inflammatory bowel disease, rheumatoid arthritis, asthma and psoriasis —a trend that has persisted beyond 2022. While viral infections may trigger IMIDs, the role of SARS-CoV-2 infection remains unclear. Emerging factors like mRNA vaccines, reduced social contact, and health care disruptions require investigation but are difficult to assess through clinical trials. The proposed research project leverages Sweden’s unique population registers and biobank data to explore links between SARS-CoV-2 infection, vaccination, social contact, and new-onset IMIDs. We will analyze data from 53 national registers in the SWECOV database (15.7 million individuals, 1990–2024), linked with repeated autoantibody measurements from the COMMUNITY cohort, which includes 2,267 individuals (2020–2024). Five substudies over 3 years will examine: (1) temporal trends in IMIDs (2) effects of SARS-Cov-2 infection by frequency/severity 3) COVID-19 vaccination effects by vaccine type/dose, (4) social isolation via occupation/household factors, and (5) immune markers (autoantibodies) pre- and post-infection or vaccination. This project will clarify mechanisms behind rising autoimmunity and improve our understanding of immunology and peripandemic disease trends, thereby informing clinical practice and public health policy e.g. the need for tailored follow-up care and surveillance.
  • Swedish Research Council
    1 December 2025 - 30 November 2028
    In August 2024, multiple viral mpox outbreaks in Africa, uncontrolled spread of new strains, and ongoing global transmission among men who have sex with men (MSM) led WHO to declare a second global mpox emergency (PHEIC). Due to vaccine scarcity, Sweden followed EU recommendations for a dose-sparing intradermal (ID) vaccination regime, using one-fifth (0.1 ml) of the standard (0.5 ml) subcutaneous (SC) dose of the only approved vaccine, MVA-BN. Now, breakthrough infections in primary mpox-vaccinated MSM are rising, also in Sweden. Evidence of waning antibodies and lack of booster studies warrant this randomized clinical trial (RCT).We will conduct a phase 3, low-intervention RCT in 490 MSM who are primary mpox-vaccinated, randomizing them to an ID or SC booster or a control arm. Innovative methods will assess mucosal and serological immune responses (T-cells, binding/neutralizing antibodies) over two years, with noninferiority of ID vs. SC after one month as the primary endpoint. Safety is monitored. The study has regulatory and ethical approval in CTIS. Once funded it is ready to start within Venhälsan’s cohort of &gt
    3800 primary vaccinated MSM at South General Hospital, Stockholm. This study answers pressing global health questions on booster effectiveness, particularly if the ID dose-sparing regime is non-inferior to standard care. Results will guide global recommendations and are urgent, given the need for MVA vaccine stockpiles for bioterror threats amid ongoing scarcity.
  • Swedish Research Council
    1 December 2024 - 30 November 2028
    Anal cancer incidence is rising globally. The International Anal Neoplasia Society recommends screening high-risk individuals using high-resolution anoscopy (HRA). However, most countries lack anal cancer screening guidelines, and HRA´s limited availability necessitates more efficient risk stratification methods. This project aims to advance anal cancer prevention through comprehensive register-based research and innovative biomarker discovery, with a particular focus on women, an understudied population in anal cancer research. Our objectives are to
    I) quantify Sweden´s anal cancer burden, stratifying by immune status to identify risk groups, II) evaluate the feasibility, cost-effectiveness, and acceptability of implementing international anal cancer screening guidelines for women with HIV, III) investigate DNA methylation markers´ predictive potential for precancerous anal lesion progression, and IV) assess circulating HPV DNA in plasma as a pre-diagnostic biomarker for anal cancer. We will utilize national registers and international collaborations through
    I) a nationwide register-based cohort study of anal cancer burden, II) a prospective register-based study of anal cancer screening in women with HIV, III) analysis of DNA methylation markers in anal samples, and IV) an international register-based nested case-control study of circulating HPV DNA. This project will generate crucial knowledge to inform evidence-based anal cancer prevention policies for high-risk groups.
  • Swedish Research Council for Health Working Life and Welfare
    1 January 2023 - 31 December 2027
    Research problem and specific questionsYoung LGBTQ+ people i.e. Lesbians, Gays, Bisexuals, Transgender and Queer or Questioning persons have high risks for mental health problems but the reasons are unclear. This project will, therefore, focus on mental health of young LGBTQ+ people aged 16-29 years and vulnerable subgroups. Our research questions are:  Have the mental health outcomes of young LGBTQ+ people changed over time (2006-2021)? How has the COVID-19 pandemic impacted on the mental health of young LGBTQ people?How does the mental health of young LGBTQ+ people evolve as they transition into adulthood and what are the risk and protective factors?Why do bisexuals, transgender persons and persons with gender dysphoria have worse mental health than other LGBTQ+ subgroups i.e. gays and lesbians?What do young LGBTQ+ people think are the causes of mental ill-health among their peers and what support do they need? What works and is lacking in existing support to young LGBTQ+ people within first line health services and in society?Data and methodThe project has two parts. Part 1 is quantitative and based on the Stockholm Public Health Cohort (SPHC), a longitudinal (2002-2021) and population-based cohort (N≈140,000) with linked self-reported and registry data. The SPHC includes information on LGBTQ+ status and health, lifestyle and social factors, making it a world-unique dataset to study mental health of young LGBTQ+ people. Part 2 is qualitative and based on focus group discussions and in-depth interviews with young LGBTQ+ people.Plan for project realisationRegion Stockholm´s Centre for epidemiology and community medicine will host the project and has funded the SPHC. We ask for funds to cover costs for salaries for the project staff, data management and research- and conference travel.RelevanceAbout 15% of young people 16-29 years in Sweden (N=211,000) are LGBTQ+ persons, and young LGBTQ+ people have poorer mental health than their non-LGBTQ+ peers. It is, therefore, of great societal interest to address mental health inequities in this population. Our studies will span a very broad spectrum of young LGBTQ+ people, including gays, lesbians, bisexuals, transgender and queer persons and persons with gender dysphoria, making up a substantial share of young people in Sweden. The project will add new knowledge on the mental health of young LGBTQ+ people and help optimize the societal support and reduce inequality.
  • Swedish Research Council
    1 January 2023 - 31 December 2025
  • Swedish Research Council
    1 January 2023 - 31 December 2025
  • Swedish Research Council
    1 December 2022 - 30 November 2026
    In sub-Saharan Africa, adolescent girls and young women (AGYW) aged 15-24 years are more likely than older women to acquire HIV, and once pregnant, to transmit HIV to their infants and drop out of care. This highlights an urgent need to revisit the current one-size-fits-all model of prevention of mother-to-child transmission (PMTCT) programs. The purpose of this project is to optimize PMTCT care for AGYWs, and later their infants, in Tanzania – a setting where HIV remains endemic. To do so, we will use data from a large registry-based cohort (N≈13,800 with 22% 15-24 years) to investigate PMTCT service uptake, retention and health outcomes for AGYWs, as well as subsequent pregnancies and contraceptive use (study 1). We will combine this with a nested prospective cohort to identify social-structural predictors of these outcomes (study 2). We will utilize findings to develop (together with young women, health providers and managers) and prototype a package of micro-interventions that can be implemented in routine care to optimize PMTCT services for AGYWs. Using a cluster-randomized design, we will pilot-test the intervention package for feasibility and preliminary effect, as well as cost-effectiveness.  This five-year project is highly feasible considering the multidisciplinary team with skills and experience in both implementation and experimental research, and will contribute much-needed evidence to advance PMTCT care for AGYWs in line with their unique needs.
  • Sexual and reproductive health and rights for young people: how is the availability, content and quality of care affected by the digitization of healthcare during the covid-19 pandemic?
    Swedish Research Council
    1 December 2021 - 30 November 2024
  • Swedish Research Council
    1 December 2020 - 31 December 2022
  • Swedish Research Council
    1 January 2020 - 31 December 2022
  • Swedish Research Council
    1 January 2020 - 31 December 2021
  • Swedish Research Council
    1 January 2019 - 31 December 2021
  • Swedish Research Council
    1 January 2018 - 31 December 2020
  • Swedish Research Council for Health Working Life and Welfare
    1 January 2018 - 31 December 2022
  • Swedish Research Council
    1 January 2017 - 31 December 2020
  • Swedish Research Council for Health Working Life and Welfare
    1 September 2016 - 31 August 2021
  • Swedish Research Council
    1 January 2016 - 31 December 2018
  • Swedish Research Council
    1 January 2014 - 31 December 2016
  • Show more

Employments

  • Professor/Senior Physician, Global Infectious Disease Epidemiology, Department of Global Public Health, Karolinska Institutet, 2017-
  • Professor/Senior Physician, Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, 2024-2027
  • Professor/Specialist Physician, Department of Global Public Health, Karolinska Institutet, 2013-2016

Degrees and Education

  • Docent, Karolinska Institutet, 2008
  • Doctor Of Philosophy, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 2000

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