Implications of US Ebola funding cuts
IN a move that worries many public health experts, the US federal government is quietly shutting down a surveillance programme for dangerous animal viruses that someday may infect humans.
The United Nations Environment Programme (UNEP) estimates that a new animal disease that can also infect humans is discovered every four months.
Ending the programme, experts fear, will leave the world more vulnerable to lethal pathogens like Ebola and MERS that emerge from unexpected places, such as bat-filled trees, gorilla carcasses and camel barns.
The programme, known as Predict and Run by the United States Agency for International Development (USAID), was inspired by the 2005 H5N1 bird flu scare. Launched 10 years ago, the project has cost about US$207 million.
The initiative has collected over 140 000 biological samples from animals and found over 1 000 new viruses, including a new strain of Ebola. Predict also trained about 5 000 people in 30 African and Asian countries, and has built or strengthened 60 medical research laboratories, mostly in poor countries.
Dennis Carroll, the former director of USAID’s emerging threats division who helped design Predict, oversaw it for a decade and retired when it was shut down. The surveillance project is closing because of “the ascension of risk-averse bureaucrats”, he said.
Because USAID’s chief mission is economic aid, he added, some federal officials felt uncomfortable funding cutting-edge science like tracking exotic pathogens.
Congress, along with the administrations of George W. Bush and Barack Obama, were “enormously supportive”, said Dr Carroll, who is now a fellow at Texas A&M’s Bush School of Government and Public Service.
“But things got complicated in the last two years, and by January, Predict was essentially collapsed into hibernation.”
The end of the programme “is definitely a loss”, said Peter Daszak, president of the EcoHealth Alliance, a non-profit global health organisation that received funding from the programme. “Predict was an approach to heading off pandemics, instead of sitting there waiting for them to emerge and then mobilising. That’s expensive.”
The goal of Predict was to speed up and organise the previously haphazard hunt for zoonotic diseases — those that may jump from animals to humans. In recent years, scientists have discovered many lethal viruses lurking in wild and domestic animals.
Ebola circulates in bats and apes, while SARS was found in captive civet cats in China.
In South Asia, Nipah virus reaches humans through pigs or date palm sap infected by bats carrying the virus. In Saudi Arabia, MERS also is carried by bats; they infect camels, which then infect humans. The virus can jump from human to human, especially in hospitals.
Novel influenza viruses originate in migratory ducks and geese. The viruses spread first to domestic poultry flocks, then to pigs and humans. Mutations picked up along that viral highway can render the viruses far more dangerous.
These discoveries led to new ways of preventing spillovers of infections into human populations: closing markets where wildlife is butchered for food; putting bamboo skirts on sap-collection jars to keep bats out; or penning pigs and camels in places where they cannot eat fruit that bats have gnawed.
Predict teams have investigated mysterious disease outbreaks in many countries, including a die-off of 3 000 wild birds in a Mongolian lake. One team proved that endangered otters in a Cambodian zoo were killed by their feed — raw chickens infected with bird flu.
A Predict laboratory helped identify batborne viruses that a boys’ soccer team might have been exposed to while trapped for weeks in a cave in Thailand.
Allowing Predict to end “is really unfortunate, and the opposite of what we’d like to see happening”, said Dr Gro Harlem Brundtland, the former prime minister of Norway and former World Health Organisation director-general.
She was co-chair of a panel that in September issued a report detailing the world’s failure to prepare for pandemics. “Americans need to understand how much their health security depends on that of other countries, often countries that have no capacity to do this themselves,” Dr Brundtland said.
Even though USAID is “incredibly proud and happy over the work Predict has done”, the programme is closing because it reached the end of a 10-year funding cycle, said Irene Koek, acting assistant administrator of the agency’s global health bureau.
“We typically do programmes in five-year cycles, and it had two,” she said. Some similar research will be part of future budget requests, “but it’s still in the design-and-procurement cycle, so exactly what will continue is a bit of a black box”.
In mid-October, the agency said it would spend US$85 million over the next five years helping universities in Africa and Asia teach the “one-health” approach that Predict used. (“One health” describes the nexus between animal, human and environmental medicine).
But it will not involve the daring fieldwork that Predict specialized in. The Washington Post
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