Towards a coordinated strategy for intercepting human disease emergence in Africa


Emerging zoonotic viruses are one of the greatest threats to human health and security, as evidenced by the increasing frequency of disease outbreaks.

To date, the main pre-emptive response to these outbreaks has been extensive, cost-heavy efforts to document virus diversity in wildlife (eg, PREDICT and the Global Virome Projects).

Although these efforts have resulted in the identification of thousands of novel viruses, fewer than 1% are described to date, substantial challenges remain around access and benefit sharing from viral discovery programmes, and—perhaps most problematic for public health application—the spillover hazard of these viruses can only be coarsely inferred at present.

Our ability to control and restrict the spread of infectious diseases is critically dependent on early detection. This vigilance should include viruses that might not pose immediate or widespread public health threats, but where repeated spillover or persistent, unchecked transmission chains in humans provides latitude for the evolution of increased pathogenicity, host immune evasion mechanisms, and efficient human-to-human transmission.

Building on existing research, here we emphasise the importance of a coordinated and targeted strategy for early detection of virus spillover and emergence in humans. This model is based on inter-related study or evidence types and is a collaborative framework geared towards African and other low-income and middle-income countries where risk of disease emergence is often great, infectious disease-related morbidity and mortality are over-represented compared with in high-income regions, undescribed virus diversity is high, and resources are constrained.

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