We all became armchair epidemiologists during the COVID-19 pandemic. We learned about variants, testing, and positivity rates, and the importance of genome sequencing and wastewater surveillance to monitor virus hotspots. Teams of researchers around the world haven’t stopped studying viruses to understand how they shapeshift to survive and where new pathogen strains are emerging.
Multiple mpox outbreaks now have the world’s attention.
In August, the World Health Organization declared mpox a public health emergency of international concern. Cases in the Democratic Republic of the Congo and several neighboring countries increased by 300 percent—with more children infected than in previous outbreaks. While most recover from the painful infection, some become debilitatingly ill, and hundreds of people have died.
Ending an outbreak in any country is enhanced by the ability to utilize pathogen sequencing and surveillance to quickly pinpoint how the virus is changing, who is most at risk, and where the potential for new outbreaks is highest. In several of the countries impacted by mpox, health systems are weakened, and communities may be hard to reach. The challenge of orchestrating a rapid, equitable response is exponentially more complex. Doing so requires coordination from global, national, and local institutions.
In 2020, the Africa CDC and member states of the African Union launched the Africa Pathogen Genomics Initiative (PGI), which is coordinating hub for pathogen sequencing and surveillance across the African continent. The Bill & Melinda Gates Foundation (Gates Foundation) and Gates Philanthropy Partners (GPP) were early funders in this network. Together, we aimed to strengthen pathogen surveillance and early warning systems to provide public health decision-makers with information to take action against infectious diseases. Initially, PGI was intended to have a runway to share knowledge and build capacity in countries across the continent to address gaps in genomic sequencing and pathogen surveillance. The COVID-19 pandemic accelerated every objective of the initiative.
Our funding helped to build a system that can be called upon in emergencies, but also that strengthens day-to-day public health surveillance. With mpox, lab researchers and other experts within the PGI network are leveraging the experience and the expertise gained from COVID-19 to sequence the genomes from collected samples in hopes of understanding how the virus is spreading and adapting in humans. By sequencing the DNA from samples from countries affected by mpox, researchers gain insights into how quickly the virus is changing, how it is transmitted, why particular populations may be more vulnerable to infections, and whether similar symptoms arise. In addition to sequencing, countries are exploring tools to survey large human populations efficiently. Countries are starting to incorporate mpox sampling in wastewater surveillance and leveraging well-established polio environmental sampling.
“We aren’t starting over with every new pathogen,” notes Simon Harris, senior program officer on the Genomic Epidemiology and Modeling team at the Gates Foundation. “Resources are more readily available. Trust is already built between partners. With training and experience, data is more accurate. Decision-makers can point to previous outcomes to reach those most at risk with life-saving tools and information.”
At GPP, we are building on our initial investment that helped lay the foundation of the PGI network, co-funding an mpox response alongside the Gates Foundation. Directed through the Africa CDC and the African Society for Laboratory Medicine, funding from the Gates Foundation will focus on Central African Republic and Republic of Congo. GPP funding will support two additional countries—Burundi and Cameroon—to strengthen their genomic sequencing and surveillance of mpox through investments in equipment and training.
Urgent action is needed to prevent new infections as our interconnected world makes it easier for viruses to travel across borders. The more we understand this virus thanks to genomic sequencing and pathogen surveillance, the more equipped countries will be to stop it.
If you’d like to support our efforts to build resilient health systems that are capable of responding to crises like mpox, contact us at [email protected].
