It's time to move beyond the costly approach to pandemic response. We need a more proactive paradigm that allows for use of knowledge on what diseases might be coming and the development of interventions to prevent or at least control the pathogens at their source.
By David Wolking
On Thursday evening in Morogoro, Tanzania Ruth Maganga climbs a stairway that connects two stacked shipping containers that have been converted in a biosaftey level 2 molecular lab. She starts up her laptop and logs into Skype.
Meanwhile, 300 km west in Iringa, Zikankuba Sijali and Zena Babu gather in the back room of a one-story tin-roofed house that has been turned into field lab, liquid nitrogen generating plant and office building. They begin looking through their online contacts.
It is 8 a.m. in California. My computer is ringing.
“Habari Bwana Davidi, Liz?”
“Safi Bwana, Zika.”
“Poa, David. Hi, Brett.”
It’s raining loudly in Tanzania on tin roofs, the call quality is poor and Zika and Ruth’s Skype icons fade in an out on my MacBook screen.
“Hello, hi, hello Zika? Zika?”
“Yes, yes sir I am here.”
This is the job. This is the reality of global, collaborative research. Every day, sometimes twice a day, our computers or smartphones ring around the world and we connect, sometimes poorly, and we learn and grow together.
There’s a tendency to view foreign aid as a transfer of resources from the haves to the have nots. But that one-way trajectory misses a critical feedback loop in the development of global human capacity. Like pathogens, knowledge can spill over when there is an interface, and it moves in multiple directions. An outbreak of collective intelligence could be the real and lasting success of this project.
THE REAL SPILLOVER
While UC Davis and PREDICT partners work to detect and prevent the spillover of pathogens of pandemic potential that can move between wildlife and people, another spillover, networking and knowledge sharing, is happening all the time, and this spillover could be the real and lasting success of the project.
There is a tendency to view foreign aid and donor-funded programs as a transfer or shift of resources, talent, and expertise from the haves to the have nots. Projects like PREDICT do allocate resources and focus talent in areas like Central Africa where outbreaks frequently emerge and there is little capacity to respond, manage, or control them. But the one-way trajectory of development assistance misses a critical feedback loop in the development of global human capacity.
Through PREDICT, we are improving global capacity to detect and prevent spillover of pathogens at the human:animal interface. Our default setting is to envision a scenario much like in the film Contagion, where a virus or other pathogen is transmitted from an animal to people. But as we’ve demonstrated through One Health Institute research with Gorilla Doctors in Uganda and Rwanda, spillover is not a one-way street; human viruses also infect animals like the human metapneumovirus, detected in critically endangered mountain gorilla populations.
Spillover can be defined quite simply as movement from one vessel to another. Like pathogens, knowledge spills over quite easily when there is an interface. Through projects like PREDICT, USAID has amplified contact at the human:human interface. This promotes knowledge sharing and capacity strengthening. As it does with pathogens, that knowledge transfer moves in multiple directions.
I also work with the One Health Institute’s Health for Animals and Livelihood Improvement (HALI) project in Tanzania. HALI started in 2006 as a collaborative research and capacity partnership between Sokoine University of Agriculture (SUA) and the UC Davis One Health Institute. The project was designed as a systems approach to investigate pathogen transmission between people, animals and the environment in the Ruaha ecosystem.
In short, HALI is a One Health project, a proof-of-concept exercise to demonstrate that a One Health approach can solve problems. HALI was and remains an innovative approach, but it was not new. In Tanzania Professor Kazwala, a SUA veterinarian and HALI co-founder had already been working with Dr. Sayoki Mfinanga, a medical doctor from Tanzania's National Institute for Medical Research (now a HALI Co-Investigator), to study zoonotic diseases in humans and animal populations collaboratively — call it One Health in action.
This experience provided the foundation for HALI’s approach, and Professor Kazwala’s knowledge, along with others at Sokoine like Zika, directly influence the design, strategy, implementation and evaluation of our projects.
A recent critique of the development community by Bill Easterly in his Tyranny of Experts, emphasizes the over reliance on technical solutions to global problems like poverty. In One Health, we have a lot of experts and no shortage of problems.
Through PREDICT we are tackling a major problem in global health: improved capacity to detect and prevent emerging infectious diseases. But we often misdiagnose expertise. Experts are not always designated by degree and title, by their publication record or ability to self promote. Some experts are right in front of you, calling into your laptop from Nepal at 9 p.m.
Success in One Health requires a diversity of expertise and a collaborative environment that encourages that expertise to be shared. While we work to prevent one type of spillover, we are promoting the spread of another.
David Wolking is a Global Operations Officer for the One Health Institute who is working with international programs like HALI and PREDICT to strengthen local capacity for global health research.
PREDICT helped identify and respond to a Yellow Fever outbreak in March of 2012 after five howler monkey carcasses were found near a wildlife sanctuary in eastern Bolivia. Two of the five monkeys were necropsied at the Municipal Zoo in La Paz, and PCR conducted on liver samples revealed that they were infected by a flavivirus.
“The fruit bats have been hanging out in the trees in Lazimpat for as long as I can remember,” said Joshi, who has lived in Kathmandu her entire life. “There are other bat sites around the city, but the challenge is to find one where we can get good samples. On these streets you have people walking directly under the bats exposing them to the droppings.”
For the first time our PREDICT teams could share the fruits of 4+ years of labor sampling bushmeat and capturing bats, rodents, and non-human primates with our partners and the global public.
This video follows an animal sample through the UC Davis One Health Institute lab. UC Davis is the lead organization on the PREDICT project, which is working on the detection and discovery of zoonotic diseases at the wildlife-human interface in hotspots around the world.
The Bagmati River slum in Nepal was selected as a suitable site for the research team’s rodent sampling program. “The people are more vulnerable here because their shelters are so makeshift,” explains Priya Joshi, the project field manager. “There is nothing concrete. They are exposed to the wildlife. Rodents can go directly into their house[s]. There’s no protection for them.”
“These temple sites are a perfect example of how monkeys and humans live together in such high densities,” says Dr. Tierra Smiley Evans, who has come to Nepal to train local field scientists in non-invasive techniques of collecting saliva from the monkeys living in these areas.
We asked some of the One Health Institute faculty and staff to recommend some further reading on the topics of diseases and pandemics. If you make a purchase through one of the Amazon links below, 6 percent of the purchase will benefit the One Health Institute, so please feel to do that.