Mpox: How Africa's scientists are protecting the world from contagion

By Janice Kew

They study the planet’s deadliest diseases in remote, conflict-prone areas in countries with the lowest health spending and fewest resources, yet the world relies on them to stop the next pandemic.

Meet eight Africa-based scientists and doctors using cutting-edge genomic tools, data-sharing platforms and shoe-leather epidemiology to identify, track, and counter the spread of emerging pathogens on a continent that’s spawned some of humanity’s most devastating diseases — yellow fever, HIV, Ebola, and Lassa among them.

A new strain of the mpox-causing monkeypox virus spreading in central Africa is the latest scourge to set off a global health emergency, but climate change, urbanization, deforestation, and intensive livestock production are accelerating the emergence of contagious threats. This is only heightening the need for early detection and response by a growing cadre of local experts.

These include:

 

Ibrahima Socé Fall, an infectious diseases epidemiologist from Senegal who heads the World Health Organization’s neglected tropical diseases global program. He’s spent more than three decades training local medical teams to not only control malaria, but prepare for and respond to dangerous new outbreaks.

“The best epidemiologists are in Africa right now because we have so many outbreaks and are building capacity to respond to that,” Fall says. “In 2016-2017, we were sending samples to Europe and the US to confirm Ebola and Lassa fever. Now, we can do it in Africa.”

In the Democratic Republic of the Congo, for example, public health laboratories in Kinshasa and Goma can diagnose Ebola cases and analyze genomic sequence data to trace chains of transmission, he says.   

Marietjie Venter, a virologist at the University of the Witwatersrand in Johannesburg, who’s helped establish infectious disease surveillance networks in Africa that have contributed to local and global knowledge of reemerging respiratory and mosquito transmitted viruses. This has prioritized the development of diagnostics and vaccines on the continent.

Using genomic-based techniques, scientists can screen for 30 or more pathogens from a single specimen, accelerating disease detection. 

“At the moment, mpox is interesting for the world, but there are many diseases that occur here that don’t get the attention they need,” she says. “It’s important that we identify them locally, but then also find solutions locally.” 

Africa is at the coalface of the 21st century’s most pressing health threats, Venter says. “We see the effect of global warming with the increase in vector borne diseases,” which include Zika, dengue, West Nile, Sindbis, Shuni and Rift Valley fever viruses. “We are right in the middle of it. Although we may have limited resources, we basically use the opportunities that we have here.”

Shabir Madhi, a pediatrician and vaccinologist at the University of the Witwatersrand, who’s working on immunizations to prevent deaths from antibiotic-resistant bacterial infections. 

Madhi says an element of cultural imperialism — the idea that research can be better done in high-income countries — is giving way to an appreciation of the unique skill set that exists in Africa, especially as donors and philanthropic organizations focus more on supporting the continent’s scientists and encouraging them to lead research projects, not just implement them.

Raymond Hamoonga, a veterinarian and epidemiologist at the Zambia National Public Health Institute, studying the intersection of human, animal, plant, and environmental conditions that gives rise to new microbial threats.

Hamoonga says Covid highlighted the disparities that exist across the globe and the ingenuity of under-resourced African medical teams who created novel ways to deliver care at home when faced with a lack of facilities to isolate coronavirus patients. “Our health systems aren’t as strong, but we learned beautiful lessons,” he says. “I dare say, we were even innovative.” 

Hamoonga, who completed post-graduate training in New Zealand before returning to his native Zambia 10 years ago, says it may not be as lucrative working back here in Africa, but “I think we’ve got an environment that is right for research.”

Helen Rees, a medical doctor, scientist, executive director of Wits RHI at the University of the Witwatersrand and chair of the WHO’s African immunization technical advisory group. She’s pushing for greater access to critical vaccines, including local manufacturing in Africa, to make the region less vulnerable to over-looked microbial threats, while vaccines are stockpiled in rich countries.

“After Covid, the initiative to have vaccine manufacturing was warmly embraced,” Rees says, “but because of what’s happening with mpox, people are saying, ‘This is real. This is going to continue to happen unless we can access our own [vaccines].’”

There needs to be a commitment to build sustainable research capacity across Africa. “We can’t load more and more expectations onto low-resource, low-income countries unless we’re serious about increasing those resources,” she says.

Jacqueline Weyer, who heads up the emerging zoonotic and parasitic unit at South Africa’s National Institute of Communicable Diseases, where she studies viruses, like Crimean-Congo hemorrhagic fever, that circulate in animals and cause disease when they spillover and infect humans.

The spread of SARS-CoV-2 highlighted the importance of global collaboration, she says. It also renewed interest in virology and funding research into pathogens with pandemic potential.

“Some of these really formidable diseases come from Africa,” Weyer says. “People are realizing that we need to support African scientists and African research institutes because we can’t continue the way we’ve been going, where outside groups come in, do what they need to do, and go home with no capacity left behind.”  

Khadija Khan and Alex Sigal, scientists at the Africa Health Research Institute, who are conducting immunologic studies to better understand the burden of under-studied diseases.

“We did some amazing work with SARS-CoV-2 looking at vaccine-induced hybrid immunity,” Khan says. “What that highlighted was the importance of being able to respond to these emerging infections, especially ones with pandemic potential.”

The research also established connections with collaborators in countries like Brazil, where the same mosquito vectors are present, posing similar risks for diseases like chikungunya, which are impacted by climate change.

“There are definitely barriers. People don’t take heavy African science, like hardcore, applied immunology, seriously,” Sigal says. “With Covid, we proved that we can also do it and at the highest level.”