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Journalism of Courage
What can provide a true early warning system for a potential pandemic? “Rather than rebuilding and reinforcing the pre-existing silos, a real step forward would be to take lessons learned and bring in novel essential partnerships in a ‘One Health’ approach to preparedness,” said Dr Gagandeep Kang, director of Global Health, Bill and Melinda Gates Foundation.
Joining virtually at a roundtable on One Health, Disease Surveillance and Pandemic Preparedness held at the Indian Institute of Science Education and Research (IISER), Pune, on Monday, Kang said, “We have no time to waste.” Kang made a strong case for developing targeted metagenomic sequencing to assess unusual disease in humans and animals.
“This should be combined with random sampling of environmental samples to capture circulation of pathogens. This can be technically challenging but can provide a true early warning system,” she said.
The event was organised by the Pune Knowledge Cluster – a science and technology cluster set up by the Office of the Principal Scientific Advisor (PSA) to the Government as a G20-Chief Science Advisors Roundtable.
Kang noted that due to inherent limitations, clinical and sero-surveillance programmes provide slow and incomplete data on disease trends.
“Environmental surveillance on a ‘One Health’ platform is a scalable, low-cost alternative that provides timely pathogen-specific disease burden data that can help in public health decision-making,” said Kang. The other experts at the roundtable included Dr Soumya Swaminathan, former chief scientist at World Health Organisation; Dr Parvindar Maini, Scientific Secretary, Office of the Principal Scientific Advisor (PSA) to the Government and Dr Sindura Ganapathi, PSA fellow, office of PSA.
Swaminathan cautioned that while the search is on for disease X, it is also crucial to monitor the endemic ones. “One cannot predict when the next pandemic happens. While equity is at the heart of negotiations of a pandemic treaty (planned by WHO’s member states on pandemic preparedness and response), we know science has provided solutions, but the solidarity part is missing,” she said.
“A pandemic begins and ends in communities and apart from building resilient health systems , providing good health care at the primary level is extremely important. Surveillance systems are not yet where they should be. We need to look at gaps in disease surveillance in humans, in animals and in the environment and see how they can be integrated and collaborated,” said Swaminathan.
The plan ahead is about preparing a research and development blueprint and comprehensive roadmap on responding to unknown pathogens. Dr Sheela Godbole, director of the Indian Council of Medical Research’s National AIDS Research Institute and National Institute of Virology, said there was a change in the patterns of causality of syndromes and called for constant alertness for the new, different and unusual changes in patterns among humans, animals and birds.
“We need simple robust data collection methods and intelligent data sharing,” said Godbole. While a bio-safety level-3 laboratory is being planned at ICMR-NARI, Godbole also said NIV laboratories with start-of-the-art infrastructure are in Bengaluru, Jabalpur and Dibrugarh, with another being planned in Jammu.
“Our preparedness to future epidemic or pandemic outbreaks will be effective only when we develop and deploy early warning systems that are aligned with similar efforts nationally and internationally. Free exchange of information on how to collect and collate data and outcomes of the analysis are key for the utility of these efforts. With this working philosophy, Pune Knowledge Cluster is facilitating the establishment and working of a consortium in Pune region for disease surveillance and pandemic preparedness employing ‘One Health’ approaches,” said Professor L S Shashidhara, director of Tata Institute of Fundamental Research, National Centre for Biological Sciences, Bengaluru and co-founder and director of Pune Knowledge Cluster.
