Go for global genetic warning system

During Raisi’s presidency, for instance, Iraq hosted five rounds of negotiations between Iran and Saudi Arabia, culminating in the historic normalisation of relations between the two in early 2023. As a former advisor of strategic communication to the then-Iraqi prime minister, it became evident to me that Iran was earnest about forging a strategic, long-term, robust relationship with its neighbours. The outcome of these negotiations marked the end of a lengthy civil war in Yemen, facilitated the normalisation of Arab countries’ relations with Syria, and contributed to enhanced stability in Iraq

During the Covid-19 pandemic, genomic surveillance tracked the spread and evolution of the virus in real-time, enabling the rapid development of public health strategies, vaccines, and treatments. As avian influenza threatens to jump to humans, scientists recommend implementing genomic surveillance globally to protect against future infectious diseases and antimicrobial resistance. These efforts should use the latest sequencing technologies, span human, animal, and environmental health in a ‘One Health’ approach, and include all regions equitably.

The Covid-19 pandemic turned the world upside down. In fighting it, one of our most important weapons was genomic surveillance, based on whole genome sequencing, which collects all the genetic data of a given microorganism. This powerful technology tracked the spread and evolution of the virus, helping to guide public health responses and the development of vaccines and treatments. But genomic surveillance could do much more to reduce the toll of disease and death worldwide than just protect us from Covid-19. Writing in Frontiers in Science, an international collective of clinical and public health microbiologists from the European Society for Clinical Microbiology and Infectious Diseases (ESCMID) calls for investment in technology, capacity, expertise, and collaboration to put genomic surveillance of pathogens at the forefront of future pandemic preparedness.

“Epidemic-prone infectious diseases cross borders as fast as people and trade goods travel around the world,” said lead author Prof Marc Struelens of the Université libre de Bruxelles, Belgium, and formerly Chief Microbiologist at the European Centre for Disease Prevention and Control (ECDC). “A local outbreak today may become the world’s next pandemic crisis tomorrow.”

A vital head start

Most illnesses not seen before in humans are zoonoses—diseases found in animals that infect humans. Many diseases in animals are also treated with antibiotics and other antimicrobials that are used for humans. However, the widespread use of antimicrobials in humans and animals has led to resistance, as microbes evolve to survive. So we face two major, overlapping public health threats: one from new infectious diseases that are zoonoses, and one from rising antimicrobial resistance. Tackling these threats requires a collaborative One Health approach—championed by the World Health Organization (WHO)—which recognizes that human health is dependent on the health of our ecosystem.

The answer, the scientists say, is to repurpose the increased genomic surveillance technology and capacity brought by Covid-19 to act as sentinels. Genomic surveillance that brings together public health agencies, veterinarians, and doctors need to be used to monitor human and animal diseases and antimicrobial resistance. By integrating epidemiological and clinical data from all these fields, we can get a comprehensive picture of pathogens and the risks they pose. “Pathogen genomic surveillance is a tool that looks at the interplay between antimicrobial selective pressure on populations of microbes and the adaptive evolution of those microbes towards drug resistance,” said Struelens. “It lets us detect the emergence and disentangle the transmission dynamics of super-fit, multidrug-resistant epidemic clones—’superbugs’. Genomic surveillance can help track both zoonotic and inter-human transmission of viral variants, strains of bacteria, and signs of drug resistance.”

Real-time genomic surveillance of pathogens can allow us to quickly detect new strains of resistant bacteria and new diseases making the jump between humans and animals, and to monitor their spread and evolution. This information can inform vaccination campaigns, help design targeted treatments, and guide public health responses—all of which could help prevent epidemics from flaring up. Monitoring whole genomes would also allow us to study new diseases and the evolution of known diseases in more depth, to gauge how dangerous they are and identify countermeasures. In a globalized world, where pathogens travel quickly, genomic surveillance would make it possible to diagnose and treat infections equally quickly.

A connected world

To make genomic surveillance effective, the scientists say, we need worldwide, accessible, real-time data. To achieve this, we need massive investment in capacity and expertise that takes into account different levels of infrastructure and training available around the world. During the Covid-19 pandemic, countries that already had access to genomic surveillance expertise and equipment had a major advantage in monitoring the pandemic and tailoring their response. The authors provide a framework for the equitable implementation of globally interconnected surveillance systems that include lower- and middle-income countries.

“To ensure universal participation in collaborative systems of genomic surveillance around the world, our critical challenges are sufficient laboratory and sequencing

capacity, the training of an expert workforce, and access to validated genomic data analysis and sharing tools within a comprehensive, secure digital health information infrastructure,” said Struelens.

“Integrating epidemic pathogen genomic information with epidemiological information must happen at scale, from the local to global level.”

(Courtesy: https://www.frontiersin.org)