FEATURE ARTICLE
By Aliya Ahmad Nabil
Every year, the Mahathir Science Award – the most prestigious science award for tropical sciences – is awarded to an individual, group of individuals or institutions for outstanding contributions in tropical medicine, tropical agriculture, tropical engineering and architecture, or tropical natural resources. This year, the Award was presented to Professor Sir Alimuddin Zumla of University College London, in recognition of his exceptional, globally acknowledged research in infectious diseases which is relevant to the development and enhancement of health policy.
We spoke to Professor Sir Alimuddin to know more about his views on infectious diseases, the current COVID-19 outbreak and how best to deal with it.
As we are in the middle of a global pandemic, it is inevitable that I bring up COVID-19 to an infectious disease expert. COVID-19 is obviously impacting the world globally, but the fight against other existing infectious diseases persists. What does the COVID-19 outbreak mean for efforts to eradicate existing infectious diseases like malaria and TB?
COVID-19 has spread globally and presented a huge additional burden to existing health services worldwide, which for developing countries, were already stretched. With the influx of cases, COVID-19 is adding another layer to the already stretched health services at every level, from staffing, diagnostic services to in-patient facilities.
This has had a major negative impact on preventive and curative strategies that were already in place for other killer infectious diseases such as malaria, TB, HIV and others. It is critical that political attention is not diverted from other major killer infectious diseases. Increased resources must be made available and all existing health services should be aligned to incorporate COVID-19 within those services rather than have specific silos developed for COVID-19.
Considering that COVID-19 and other infectious diseases are often so widespread and affect more than one area, what kind of collaboration needs to happen to tackle these diseases?
That’s a million-dollar question, because we’ve had repeated outbreaks for emerging and re-emerging diseases like Ebola, MERS and influenza epidemics.
Many of these pandemics arise from zoonotic diseases, which are diseases that jump the species barrier- moving from animals to humans. Philosophically speaking, all zoonotic diseases are of our own making, due to humans interfering with the animal world in one way or another.
It is vital that human and animal health sectors work together for proactive surveillance, prevention and control of zoonotic infections with full engagement of local communities. This now developing as a specialty through the ‘one-human-environmental-animal-health’ concept which is gaining traction. We have our own large one-health consortium across Africa-Europe (PANDORA-ID-NET) which is now incorporating the Middle East. We hope to expand it to include the One Health networks across all continents and regions, including Southeast Asia.
Furthermore, empowering the younger generation human health and veterinary health professionals to take leadership of the one-health agenda is critical to building and sustaining an upward trajectory of activities and deliverables. That is the future of having control over zoonotic infections.
Collaboration is not just limited to working together, it also includes sharing data and information. Do you know of any platform where this is happening in your field of work?
Absolutely. In all the One Health networks that I am involved in, including PANDORA-ID-NET, we have open data sharing, effective communication and transparency. I think you may have seen this happening with COVID-19 between the WHO, the CDC and Public Health England. An example of this is the Africa CDC getting involved in Africa over COVID-19 in terms of increased global cooperation in an open and transparent way.
Currently, different countries are developing different vaccines for COVID-19. It’s good that we seemingly have many different options, but no one really knows which vaccine will succeed and whether that vaccine can then be effective in a large population. Are there any vaccines currently in development that you see as a frontrunner, or likely to be most effective?
If you look at the history of the development of vaccines for RNA viruses, there has been no effective vaccine developed so far, rolled out for universal human use. That’s quite a pessimistic picture to paint here but this outbreak is different. There have been massive investments in vaccine development. There are over 150 candidate vaccines now, of which about 16 are already in Phase 3 of development. You may have seen these in the media – the Oxford vaccine, the Russian vaccine, the Brazilian vaccine, a Chinese vaccine and an Italian vaccine. I am optimistic that at least one of them will be effective. Hopefully, by the time the vaccine is rolled out, the epidemic will be over.
The main issue here is that one cannot determine how pandemics behave. The SARS virus in 2003 which again originated from China, rapidly spread worldwide, especially to Canada which caused a huge problem. It then disappeared totally, as in eight months, there were no cases recorded. COVID-19 is behaving a bit differently.
The number of deaths worldwide are now decreasing. There have been very few deaths in Africa compared to Europe and the USA. This all suggests that there is a problem with the virus in that it is not happy in the human host. It lives happily within animals and has reached an equilibrium there. Now that it’s entered the human host and the human immune system targets it, it wants to escape. That’s why there’s transmissibility as it tries to find the right host. Hopefully, it will get ‘tired’ and realise that “these [humans] are not the right hosts for me”.
Knowing the erratic and unpredictable behaviour of new virus outbreaks, and the virus not being in its natural animal host, I expect it’s a matter of time before COVID-19 burns out or becomes seasonal with small outbreaks. Whilst the virus is becoming more infectious, it will become less virulent, I hope.
Is there a way to expedite that process and make the virus “die out” faster?
Viruses are very unpredictable. I think at the moment, the best hope for controlling it is the vaccine. But there’s no magical formula. There’s no effective cure, there are no vaccines at the moment, the best shot at bringing the pandemic to an end is to ensure that the standard public health measures and interventions including social distancing, hand washing, use of face masks, testing, contact tracing and isolation, are implemented worldwide. All the communities should be involved too. That is the only way we can keep this pandemic under control.
What must be done now to prevent future pandemics and ensure that nations are ready to face another outbreak?
I think the One Health concept of getting the veterinary health and human health sides together to form large consortia with effective funding and cooperation is the only way forward. I also think that Western dominance of the emerging and re-emerging diseases agenda should now move towards a more equitable partnership with developing countries by making sure that whatever research and development training being done is aligned to capacity development. We need developing countries to take leadership of issues that affect them most.
To read the full interview, please visit http://msa-foundation.org/blog/laureate-chat-alimuddin-zumla/
*Aliya Ahmad Nabil is a contributing writer and programme executive of the Mahathir Science Award Foundation.
**All previous posts about COVID-19 here: https://sciencemediacentremalaysia.com/tag/covid-19/