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Chapter 1: What is the main topic discussed in this episode?
Hey, it's Flora and you're listening to Science Friday. The current Ebola outbreak in the Democratic Republic of the Congo and neighboring Uganda is caused by the Bundibuja virus. There's no specific treatment or vaccine for this strain, unlike the more common Zaire strain, which caused the 2014 outbreak. Here to give us an update and put the news in context is Dr. Christian Happy.
He's a molecular biologist who has dedicated his career to improving genomic sequencing capabilities and virus monitoring across the continent of Africa.
Chapter 2: What is the Bundibujo virus and how does it differ from the Zaire strain?
Dr. Happy is a distinguished professor at Redeemers University and runs the Institute of Genomics and Global Health in Nigeria. Welcome to Science Friday. Thank you for being here.
Thank you.
So I want to start with the Bundibujo virus. What's different about it compared to this Zaire strain?
The Bundibujo virus or strain of Ebola is different from the Zaire strain simply because it has diverged. It has evolved. It has followed a different evolutionary path. And for that reason, the virus is quite divergent.
Chapter 3: Why is there no specific treatment or vaccine for the Bundibujo virus?
from those that you strain. And that divergence actually creates its own challenge because diagnostics, vaccines, and drugs are often very strain-specific because they are targeting some very specific epitopes in any virus. And because the bunjibujo virus has not been studied extensively.
That is a reason why now we want to use this outbreak in order to not only sequence the virus, but actually leverage the data that will be coming from the outbreak to develop the necessary countermeasures. And these countermeasures are drugs, vaccines, and diagnostics.
Had it not been sequenced before?
Not really. I think, you know, when we had our last outbreak, when the Bujumbuja outbreak, I mean, occurred, I think that was probably 2007. There were, I mean, at that time, genomic sequencing was not really at the state where it is now. It was a technology that was in infancy. And at that time, we didn't have the capability to actually to generate the data through genome sequencing.
And between 2007 and now, a lot has changed. And they will really want to take advantage of it now to study this virus in a way that wasn't done before in order to develop the countermeasures as I mentioned before.
Why hasn't there been as much research into this strain?
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Chapter 4: What challenges does Dr. Christian Happi face in disease surveillance?
Simply because there is, you know, the global health community in general and then the governments in Africa in particular have not really invested in If we had intentionally invested in doing, you know, to do viral disease surveillance or to do pathogen genomic surveillance, we could have probably come across, you know, the viral sequence state.
And then eventually today, we wouldn't have been in the situation where we are. So clearly, it's simply because there have really not been intentional investment on disease surveillance using a genomic approach.
I mean, that is exactly your thing, right? Genomic surveillance. I want to talk a little bit about the Sentinel project. You co-created this early warning pathogen detection network called Sentinel, along with Dr. Pardis Sabeti of the Broad Institute of MIT. Talk to me about Sentinel and talk to me about your role in this outbreak.
The Sentinel system is an early warning system for pandemic preemption and response. It is that system that we invented and started implementing in 2014 to change the way we respond to disease outbreak. And in 2014, we tested and pressure tested and validated the Sentinel system.
And 2014, there was another Ebola outbreak.
That was when we had the largest Ebola outbreak ever. And that was in West Africa.
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Chapter 5: How does the Sentinel project enhance pathogen detection?
Yes. And the Sentinel system is built on three major pillars. The first pillar is detect, which is basically detection in near real time of known and unknown pathogens, and eventually developing tools to detect pathogens very quickly and share this information with national public health authorities. The second pillar is connect.
That is basically making sure the information is available in real time to policymakers and people across the decision-making chain so that they can use those information to make targeted and very coordinated intervention to respond to outbreak. Because we've realized that, you know, you need two major things to contain an outbreak. One is speed. Second is accuracy.
And then the third pillar is empower. Pretty much that is empowering all the actors that are involved in disease surveillance and in outbreak response in a way that everybody across the value chain is empowered. And then they can actually use and we can coordinate the response in a way that from grassroots to the top, you know, everybody is involved and everybody feel concerned.
The Sentinel system actually demonstrated its ability and its capability in 2014. For the first time, we're sequencing the genome of Ebola in West Africa and in Africa. We had an outbreak that started in Lagos, in a city with 23 million people, in a country of 230 million people.
We deployed Sentinel, we worked with public health authorities in Nigeria, and we showed that we could control that outbreak in a very spectacular way.
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Chapter 6: What role does genomic sequencing play in outbreak response?
Nigeria actually was able to contain the Ebola outbreak in 93 days with only 20 cases and a death. That was a first demonstration of the power and the firepower behind the Sentinel program. And then we went further in subsequent years to contain local outbreaks.
I can give you the instance of a situation whereby in the southern part of Nigeria, for instance, within two weeks, 179 children died of a mysterious disease in court. A lot of the tests that they did locally proved negative. The Nigeria Center for Disease Control sent 20 samples in our lab, and in 72 hours, we established that it was yellow fever.
But then this yellow fever that was killing children of school age was different from the ones that have been circulating in Nigeria for the past 94 years. And within 10 days, that outbreak was contained, saving thousands of lives. The Sentinel system proved that it worked.
It proved that it was efficient and it proved that it can contain this outbreak in a very spectacular way at each time when we deployed it.
So with this outbreak, was early detection a challenge? I mean, I've read, and I'd like your take on this, that the virus was possibly circulating for months before it was detected. Is that your assessment? And what happened?
Yes.
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Chapter 7: Why has the Bundibujo strain received less research attention?
I mean, the early detection was a challenge. Also, remember that this outbreak started in a place called Ituri. Ituri was a place where there's almost virtually no government. The place is governed by armed groups, you know, militias that are all controlling mineral resources. So I think when an outbreak starts in a social place where there's virtually no government presence, who reports what?
And then who actually takes the necessary measures to actually put that under control? That's what happened. But then it's been circulating, but eventually when it got to places where, you know, in Bunia, for instance, where there could be government presence, then you could see the governments of the country responding.
I mean, the unfortunate part for this outbreak, it started in a place where there's really no governance, and then where the challenge for organizing, you know, a response to it was obvious.
You know, you've said I've heard you say that stories of Africa are often spoken out of Africa by people that don't know Africa and don't understand what Africa is all about. What do you think the West is getting wrong about this current outbreak?
Well, I don't think it is about the West getting something wrong about the current outbreak. I think we are all getting it wrong, both the West and Africa actually getting it wrong about the current outbreak. What we got wrong about the current outbreak is the fact that after SARS-CoV-2, after COVID-19, we went back to sleep on our laurels. We went back to do business as usual.
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Chapter 8: What lessons should we learn from COVID-19 for future outbreaks?
We did not learn from COVID-19 or whether we learned, but we refused to apply the lessons learned from COVID-19, which was basically understanding that we need to continue to intentionally do disease surveillance. We need to cooperate and work together. We need to ensure that we share information. We need to understand that we have to be very intentional in investing in research and development.
and accelerate processes related to research and development, and accelerate process related to vaccine, drugs, and diagnostic development. We fail to understand that we need to put in place or strengthen the health system in places that are hard to reach, like the DRC and in other places in Africa.
We fail to understand that an outbreak anywhere in the world should be considered as an outbreak all over the world. Because an outbreak that starts anywhere can reach the marketplaces within 48 hours. These are the failures that we all, you know, should assume. So it is not the responsibility of the West.
It is not the responsibility of, I mean, solo responsibility of the countries where this does happen. As a global and health community and as a people, You know, we have failed to learn from COVID-19 and we might end up paying the heavy price for it.
I mean, speaking of resting on our laurels, are there other pathogens like Bundibujo that public health officials should be paying attention to right now, even though they're not an emergency right now?
There are definitely probably many other pathogens that we don't even know about that may be even more dangerous than Bujumbujo. And by yet, if we're out there doing surveillance, we should be able to discover them before they get to us. The reality is that we keep, as humans, encroaching into nature as well. And because these are existing in nature, they have co-evolved with us over centuries.
They are out there, but we don't really know much about them. But then we should have a system. We should establish a system where we are sharing information, where we are working together, where when you share information, you are not discriminated against, you are not stigmatized against. So we need to actually just keep working together and continue to do the surveillance because...
Nature on its own is a big laboratory, and we have to be very intentional about studying nature and understanding what is circulating in nature and try to see how we can learn from those experiments to actually prepare better for potential disease outbreaks in the future.
There are several studies and several simulations that have said that in the next 10 years, the world will experience another major pandemic. with an increased number of that. But then the question is, are we preparing for it?
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