Over 20 experts from 13 countries met in Uganda at the end of February to firm up plans to improve regional capacity for the early detection of such zoonotic diseases, including Ebola.
“One of the issues during the recent Ebola outbreak in West Africa was lack of preparedness,” said Michel Warnau, who oversees the project at the IAEA. “Through this project, we intend to reinforce existing capacities to diagnose zoonotic diseases early in order to better anticipate risks of outbreaks in human populations and implement appropriate preventive and control measures.”
The IAEA initiative supports the regional strategies of the World Health Organization (WHO) and the Food and Agriculture Organization (FAO) of the United Nations to strengthen the cooperation between human health and animal health experts and to increase preparedness. Experts from WHO and FAO also attended the Uganda meeting.
The technical cooperation project will initially run for two years to train and equip diagnostic teams to better monitor wildlife and livestock for zoonotic diseases that could have major impacts on humans. Priority will be given to viral hemorrhagic diseases such as Ebola, Marburg virus and Crimean-Congo hemorrhagic fever. The Joint FAO/IAEA Division of Nuclear Applications in Food and Agriculture will provide technical support to the project.
Recent Ebola outbreaks have had a major human, social and economic impact in West Africa. Since WHO reported a major outbreak of Ebola in Guinea nearly one year ago, the disease has claimed the lives of nearly 10,000 victims across Liberia, Guinea, Sierra Leone and elsewhere. In order to help limit the spread of diseases such as these, early detection in animals and wildlife is critical, Warnau said.
As human populations grow and spread into previously isolated environments, more and more people come into contact with formerly untouched wildlife and diseases they carry. Experts predict that in the future, outbreaks of current and new zoonotic diseases could be more diverse and even more severe than those the world has faced so far.
The IAEA project makes use of nuclear-derived technologies to quickly diagnose the spread of viruses. Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) and Enzyme-Linked ImmunoSorbent Assay (ELISA) are recognized as fast and efficient diagnostic techniques, and the IAEA has already supported the transfer and application of these technologies in several countries to help fight various diseases including rinderpest and H7N9 avian influenza.
IAEA assistance also includes reinforcement of national and regional networks to share epidemiological information faster and more efficiently, and to ensure national preparedness in the long run.
“Right now international assistance is concentrated in the region so there is a lot of manpower, but the latter will not remain there,” Warnau said.
The project builds on previous support IAEA provided to the region in the use of RT-PCR and other early-diagnostic tools under safe conditions. The agency has also provided specialized diagnostic equipment to help Sierra Leone in its efforts to combat the ongoing Ebola outbreak. The IAEA Board of Governors will soon review an additional project to ensure the sustainability of the early diagnosis effort and to enhance disease control in the region as a whole.
Funds for the current project have come from the United States, Japan and the African Regional Cooperative Agreement for Research, Development and Training related to nuclear science and technology.
Meanwhile, WHO is launching a new policy on safe syringes to help tackle the pervasive issue of unsafe injections and prevent disease spread through contamination and needle stick accidents.
As well as reducing the number of unnecessary vaccinations, WHO recommends use of new “smart syringes” designed to prevent re-use. For example, some models include a weak spot in the plunger that causes it to break if the user attempts to pull back on the plunger after the injection. Others have a metal clip that blocks the plunger so it cannot be moved back, while in others the needle retracts into the syringe barrel at the end of the injection.
Syringes are also being engineered with features to protect health workers from “needle stick” injuries and resulting infections. A sheath or hood slides over the needle after the injection is completed to protect the user from being injured accidentally by the needle and potentially exposed to an infection.
WHO is urging countries to transition by 2020 to exclusive use of the new “smart syringes," except in a few circumstances in which a syringe that blocks after a single use would interfere with the procedure. One example is when a person is on an intravenous pump that uses a syringe.
Syringes without safety features cost $0.03 to $0.04 when procured by a UN agency for a developing country. The new “smart” syringes cost at least twice that much. WHO is calling on donors to support the transition to these devices, anticipating that prices will decline over time as demand increases.