lørdag den 26. januar 2013
Who emerged first: humans or viruses?
Should we understand emerging
viruses before we bring them to Europe?
In November
2012 the French Institut Pasteur inaugurated
a new center:Francois Jacob research center for
the study of emerging diseases. The center is named after the Institut Pasteur scientist and 1965
Nobel medicine laureate. The background of the center, it says in the press
release is: “In recent decades, we have
witnessed growing concern in the scientific community about the emergence of
new viruses and bacteria that can lead to widespread epidemics in record time.
The Institut Pasteur has decided to step up its capabilities to deal with this
new threat by building one of Europe’s largest research centers on its
historical site in Paris”.
The cost of
the building is 61 million EUROS and as it says in the press material, the
François Jacob Center “is fitted with a
wide array of state-of-the-art technological equipment and was designed to
encourage open, collaborative research. It will eventually house more than 400
leading scientists who will work together in multidisciplinary teams, exploring
new approaches to help combat and contain emerging and re-emerging diseases”.
The Pasteur
Institute argues that new epidemics cause by viruses like SARS, Chikungunya, H1N1
influenza and dengue emerge every year and very 5 years a new virus threatens to
disrupt economy, travel and global health and that some of the viruses have demonstrated
an ability to spread faster than news.
While there
is no doubt about the severity of these viruses and that they have been a
wake-up call to broaden our concept of health there is something wrong with the
basic rationale and arguments behind building a 61 million EURO laboratory in a
part of the world where the risk of actual human exposure to these potentially
dangerous zoonotic viruses is nil. And the consequences that the Institut
Pasteur draws based on their perception of a world threatened by emerging
viruses is even more of a wild shot. Starting with a lab in Europe to fight a
transmission of wildlife/animal viruses to humans occurring in and near rain
forests on the other side of the globe is bound to fail. This is the way we
have tried for centuries to deal with global health threats since the earliest
colonial days and we have never succeeded this way. We have succeded when we
applied a broader perspective on health matters in both understanding and
intervening against disease and mortality.
As Nathan Wolfe has demonstrated we need to set up
surveillance laboratories, not in Paris, London or Copenhagen, but in the
countries where transmission occurs because only then can we identify emerging
or re-emerging infections and only then can we intervene timely in the sociological
and geographical environment where the transmission threatens to become human
and serious (see Origins
of major human infectious diseases and Bushmeat Hunting,
Deforestation, and Prediction of Zoonotic Disease Emergence).
What
Institut Pasteur, and other international research and funding agencies, like
to sell is that what we are facing is viruses that emerge are “new” viruses and
that they can be detected and controlled by flying blood samples to Paris and
possibly controlled later by a vaccine. The fact is that none of these viruses
are new or emerging. The only look that way because it is a convenient way for
tropical researchers and global health bodies to justify their research and
funding. The viruses, parasites and bacteria were here long before we were. We,
humans, are the ones to have emerged and we have disrupted a biological
environment in certain parts of the world by using former rain forest areas for
farming, thereby increasing wild life density and increasing human exposure to
wild life viruses that are new to us as humans but not to the globe as such.
We have
emerged and created a new equilibrium and new transmission ways for viruses and
parasites and to monitor, determine and control this we need to start setting
up laboratories in (very-) low income countries as well as in some emerging (!)
economies where the majority of human-zoonotic exposure and transmission occurs
(see Global
trends in emerging infectious diseases).
Virus do
not follow the money hence viruses do not live and thrive in Paris where the
funding is and the low income countries will never be able to raise funding for
the types and quality of the laboratories that are necessary to identify and monitor
potential human threats.The priorities of low income countries lie very far
from helping high income countries protect themselves against theoretical threats
from relatively rare viruses they have never heard of, when they themselves are
facing children still dying of pneumonia or measles because of lack of penicillin
and vaccines.
So maybe
the 61 million EUROS would have been wiser and better spent in Brazil, Burma or
Congo so that we could monitor not only virus DNA in blood samples from wild
life hunters but also human interaction with wildlife and the socio-economic circumstances
that lead to this changing interaction. Something is emerging in the
borderland between forest and agricultural land and in the constantly changing
borderland of mega cities in tropical and subtropical areas but it is human
beings that emerge and not viruses or parasites. If we continue to solve global
health problems in laboratories far away from reality, viruses, bacteria and
parasites will very soon regain their global position and reestablish the ecology
they enjoyed before humans interrupted them for a brief period of time. Global
health is about investing where the problems live are not where funding and
researchers like to live.
Morten
Sodemann