By Jonna Mazet
During the past decade, attempts to control deadly viruses like SARS and H5N1 have been, out of necessity, almost entirely reactionary. It is time to move beyond that costly approach, which measures impact in death tolls and money spent on diagnosis, treatment, and containment. 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.
The World Bank estimates that from 1997 to 2009, at least $80 billion was spent responding to just six outbreaks of deadly zoonotic diseases, caused by viruses shared between people and animals. We believe that total could be drastically reduced if the health community can get upstream and predict the risk from these diseases before they emerge rather than waiting to respond after they’ve already begun spreading.
That means going to the most likely source: high-risk transmission interfaces where animals and people come together.
We can choose to focus on all of the doomsday scenarios, but I prefer to think of our time as one in which we have the opportunity to really benefit from the advances of technology.
At the UC Davis One Health Institute, we’re especially trying to detect and limit the spillover of pathogens of pandemic potential that can move between wildlife and people. Funded by the U.S. Agency for International Development (USAID), our PREDICT global surveillance strengthening program is collaborating with governments and a wide network of partners in over 20 countries around the world to identify new and known viruses related to those that have caused epidemics and pandemics in the past. We focus our work in places where environments and market systems are changing in ways that are conducive to the spillover of viruses from animals to people. We work on the ground with our local teams, which include health professionals, scientists, educators, and ministry officials. Our local teams are key to understanding the biology and the potential transmission interfaces of each distinct area, as well as how best to get surveillance done in their countries.
The collaborative PREDICT consortium we have built is also strengthening 35 laboratories to allow for advanced diagnostics on four continents in those areas that have been determined to be hotspots for the emergence of new diseases. Much of our work is based in lower income countries, because our science has shown us that those areas are the most at-risk for the next disease emergence.
It’s important to focus on animals because they harbor many viruses that humans may not have seen in the evolutionary history of our health systems, so when one of those viruses spills over to us, we may be very susceptible to severe disease and not have any tests to diagnose it. If that virus is also transmissible from human-to-human, it could travel around the world very quickly if left unchecked.
Instead of spending billions of dollars reacting to outbreaks, we’re hoping to contribute to a system to identify disease potential and prevent pandemics before they start.
AN INTERCONNECTED WORLD
Web-based communications have also helped stop the spread of disease by making it much easier to distribute real-time information throughout the world, among government agencies as well as on social media.
When the SARS outbreak happened in China just over 10 years ago, the disease had already crossed international borders when a global alert was issued in March 2003. More than 750 people died in the outbreak.
In April 2013, China was hit by an outbreak of H7N9 flu, but this time they were quick to report it. The Chinese government controlled live poultry markets and brought scientists in to do intensive lab testing, hindering the spread very quickly.
All the while, the public was sharing information on a Chinese social media site called Weibo. This gave the public a real-time voice that they didn’t have 10 years earlier, which supplemented China’s quick response to the outbreak.
But the information hasn’t circulated so easily everywhere.
Last spring, Middle East Respiratory Syndrome (MERS), which first appeared in Saudi Arabia, claimed the lives of almost 70 people in 12 countries, including western European countries like France and the United Kingdom. Air travel enabled those victims to carry the disease to other countries, and lack of diagnostics for mystery diseases slowed the recognition and response.
Through PREDICT, we're working to bridge these gaps – improving surveillance, diagnostics, and global health communications.
Jonna Mazet, DVM, MPVM, PhD, is the Executive Director of the One Health Institute in the UC Davis School of Veterinary Medicine. Learn more about the PREDICT project and our partners here.