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| Expect Zika virus to reach India and Africa, medical research charity warns Expect Zika virus to reach India and Africa, medical research charity warns | |
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| The Zika virus, which causes brain damage in babies, is likely to spread to India and the continent of Africa, according to the director of the Wellcome Trust, a medical charity deeply involved in research to try to limit the damage. | The Zika virus, which causes brain damage in babies, is likely to spread to India and the continent of Africa, according to the director of the Wellcome Trust, a medical charity deeply involved in research to try to limit the damage. |
| “I think we can anticipate global spread,” said Jeremy Farrar, speaking to the Guardian alongside Sue Desmond-Hellmann, the chief executive officer of the Bill and Melinda Gates Foundation. “Given the [Aedes aegypti] mosquito’s availability across the world, I think the spread will next be across Asia and I think we really have to be prepared for it spreading in Africa. I don’t see any reason why it wouldn’t.” | “I think we can anticipate global spread,” said Jeremy Farrar, speaking to the Guardian alongside Sue Desmond-Hellmann, the chief executive officer of the Bill and Melinda Gates Foundation. “Given the [Aedes aegypti] mosquito’s availability across the world, I think the spread will next be across Asia and I think we really have to be prepared for it spreading in Africa. I don’t see any reason why it wouldn’t.” |
| Last month, 16 pregnant women in Singapore were confirmed to have zika virus. “You can anticipate reports from Vietnam, from Indonesia, from India. I don’t think we’re even at the start of the Zika knowledge base yet,” said Farrar. | Last month, 16 pregnant women in Singapore were confirmed to have zika virus. “You can anticipate reports from Vietnam, from Indonesia, from India. I don’t think we’re even at the start of the Zika knowledge base yet,” said Farrar. |
| If Zika goes off the radar, it is because of the seasonal nature of the infections, when the mosquitoes are breeding, added Desmond-Hellmann, not because the epidemic is anywhere near its end. “The seasonality of this epidemic shouldn’t make us complacent,” she said. “I think that’s really important. The other thing we shouldn’t underestimate is a generation of families who are now going to see this impact with their children. It feels like a tip of an iceberg that we’ve seen in terms of the devastation on those children and their families.” | If Zika goes off the radar, it is because of the seasonal nature of the infections, when the mosquitoes are breeding, added Desmond-Hellmann, not because the epidemic is anywhere near its end. “The seasonality of this epidemic shouldn’t make us complacent,” she said. “I think that’s really important. The other thing we shouldn’t underestimate is a generation of families who are now going to see this impact with their children. It feels like a tip of an iceberg that we’ve seen in terms of the devastation on those children and their families.” |
| The two philanthropic organisations, together with the Brazilian, US and UK governments, have announced $18m (£14.7m) funding for an ambitious project to release mosquitoes infected with Wolbachia bacteria in two urban areas of Brazil and Colombia. The bacteria renders the mosquitoes unable to transmit viruses. They breed with local mosquitoes, producing offspring with Wolbachia, a bacteria carried by 60% of insects that is harmless to humans. | The two philanthropic organisations, together with the Brazilian, US and UK governments, have announced $18m (£14.7m) funding for an ambitious project to release mosquitoes infected with Wolbachia bacteria in two urban areas of Brazil and Colombia. The bacteria renders the mosquitoes unable to transmit viruses. They breed with local mosquitoes, producing offspring with Wolbachia, a bacteria carried by 60% of insects that is harmless to humans. |
| If it works, it will help limit not just Zika but also other flaviviruses, including dengue and yellow fever. | If it works, it will help limit not just Zika but also other flaviviruses, including dengue and yellow fever. |
| There is a lot that is still not understood, including the human response to infection and what may happen in Africa, where Zika has been detected in the past, which means there may be a background level of immunity, explained Farrar. In the long run, he said, to end the threat will require not just Wolbachia – if it really does work at scale, about which he said he is “in equipoise” – but a vaccine as well. | There is a lot that is still not understood, including the human response to infection and what may happen in Africa, where Zika has been detected in the past, which means there may be a background level of immunity, explained Farrar. In the long run, he said, to end the threat will require not just Wolbachia – if it really does work at scale, about which he said he is “in equipoise” – but a vaccine as well. |
| Zika, and before it Ebola, have driven home to the scientific community that technology is not the whole answer to pandemics. The Gates Foundation, in London hosting its Grand Challenges meeting, where scientists are invited to bid for funding for innovative solutions to global problems, has moved from what was once perceived as a very hi-tech and scientific focus to a much broader outlook. | Zika, and before it Ebola, have driven home to the scientific community that technology is not the whole answer to pandemics. The Gates Foundation, in London hosting its Grand Challenges meeting, where scientists are invited to bid for funding for innovative solutions to global problems, has moved from what was once perceived as a very hi-tech and scientific focus to a much broader outlook. |
| “We definitely like to get our geek on, as people talk about it,” said Desmond-Hellmann. “We love data, we love science, we love technology. But increasingly one of the exciting things in science and technology is what people call implementation science and social science. It is at anyone’s peril if they think they’re going to make a difference in the world and not deeply understand that aspect of the work.” | “We definitely like to get our geek on, as people talk about it,” said Desmond-Hellmann. “We love data, we love science, we love technology. But increasingly one of the exciting things in science and technology is what people call implementation science and social science. It is at anyone’s peril if they think they’re going to make a difference in the world and not deeply understand that aspect of the work.” |
| With Ebola, it was vital to understand the cultural traditions surrounding death and burial. With Zika, the Gates Foundation is very concerned about access to family planning, an issue it has made a global priority. | With Ebola, it was vital to understand the cultural traditions surrounding death and burial. With Zika, the Gates Foundation is very concerned about access to family planning, an issue it has made a global priority. |
| Both Gates and Wellcome believe the world is moving in the right direction on pandemic preparedness. They point to good collaboration and the sharing of ideas between many organisations. The much criticised World Health Organisation (WHO) has, they say, an invaluable role in standard-setting, while philanthropic organisations, government, NGOs and industry are all talking and influencing each other. | Both Gates and Wellcome believe the world is moving in the right direction on pandemic preparedness. They point to good collaboration and the sharing of ideas between many organisations. The much criticised World Health Organisation (WHO) has, they say, an invaluable role in standard-setting, while philanthropic organisations, government, NGOs and industry are all talking and influencing each other. |
| “I believe we are going in the right direction. There is almost universal consensus,” said Farrar. | “I believe we are going in the right direction. There is almost universal consensus,” said Farrar. |
| Increasing urbanisation, trade and travel will mean pandemics continue to happen. There needs to be sustained investment in public health – “the first line of defence for the world”, said Farrar – and there needs to be commitment to research and development, both in technologies and the social sciences. Desmond-Hellmann added surveillance to that list – an area in which her foundation is investing heavily, so that “the world has what it needs for an early read-out” when disease outbreaks occur. All agree that strengthening health systems is vital. | Increasing urbanisation, trade and travel will mean pandemics continue to happen. There needs to be sustained investment in public health – “the first line of defence for the world”, said Farrar – and there needs to be commitment to research and development, both in technologies and the social sciences. Desmond-Hellmann added surveillance to that list – an area in which her foundation is investing heavily, so that “the world has what it needs for an early read-out” when disease outbreaks occur. All agree that strengthening health systems is vital. |
| At the London meeting, Priti Patel, the UK’s international development secretary, announced her department would continue to invest 3% of its budget on research, amounting to £390m a year for the next four years. That includes £357m for infectious diseases through the Ross Fund, which aims to develop medicines, diagnostics and insecticides against diseases. | At the London meeting, Priti Patel, the UK’s international development secretary, announced her department would continue to invest 3% of its budget on research, amounting to £390m a year for the next four years. That includes £357m for infectious diseases through the Ross Fund, which aims to develop medicines, diagnostics and insecticides against diseases. |
| The WHO is democratically accountable, unlike the foundations, but Desmond-Hellmann said the Gates Foundation too is accountable, in a different way. “We are accountable – to the governments we interact with, the communities we interact with, the scientists, researchers, academics we interact with, and so I don’t see it as accountable or not. I see it as a very different way of coming at the world’s most important problems,” she said. | The WHO is democratically accountable, unlike the foundations, but Desmond-Hellmann said the Gates Foundation too is accountable, in a different way. “We are accountable – to the governments we interact with, the communities we interact with, the scientists, researchers, academics we interact with, and so I don’t see it as accountable or not. I see it as a very different way of coming at the world’s most important problems,” she said. |
| Asked about the major outstanding global health issues, Farrar named mental health. “It is such a huge, complex area with a huge burden of disease around the world, is neglected and is desperately in need of progress and comes with stigma and a huge burden on young people and so for me that’s something outside of what we are doing at the moment,” he said. | Asked about the major outstanding global health issues, Farrar named mental health. “It is such a huge, complex area with a huge burden of disease around the world, is neglected and is desperately in need of progress and comes with stigma and a huge burden on young people and so for me that’s something outside of what we are doing at the moment,” he said. |
| For Desmond-Hellmann, there is nutrition. “The economic cost of stunting and wasting globally is a huge problem and if we’re all about getting people to reach their full potential, we need to more deeply understand what’s behind healthy birth, growth and development and how to be most efficient for governments and communities to make sure everybody has an equal chance both from a general nutrition but – really importantly – for cognition and for human potential. That’s a big deal globally.” | For Desmond-Hellmann, there is nutrition. “The economic cost of stunting and wasting globally is a huge problem and if we’re all about getting people to reach their full potential, we need to more deeply understand what’s behind healthy birth, growth and development and how to be most efficient for governments and communities to make sure everybody has an equal chance both from a general nutrition but – really importantly – for cognition and for human potential. That’s a big deal globally.” |
| • This article was amended on 27 October 2016 to correct the spelling of Sue Desmond-Hellmann’s name. | • This article was amended on 27 October 2016 to correct the spelling of Sue Desmond-Hellmann’s name. |