The Uganda Virus Research Institute (UVRI) is nestled in a series of rolling hills outside of Entebbe, the town on the banks of Lake Victoria that served as the seat of government during Uganda’s time as a British protectorate. At the institute’s main entrance hang maps from old studies and magnified images of some of the viruses that have been isolated or discovered here, including West Nile virus.
But it’s the Zika virus — which has infected tens, if not hundreds, of thousands of people in the Americas in recent months and may be linked to a spate of children born with underdeveloped brains in Brazil — that’s now bringing Ugandan epidemiologists unexpected attention. UVRI scientists first discovered Zika in the blood of a rhesus monkey back in 1947. And while Uganda has never had an outbreak of the virus, the country’s unique approach to monitoring the spread of similar diseases could hold the key to stopping future epidemics in their tracks.
Consider how Uganda dealt with the Ebola virus. Long before Ebola made its recent rampage across West Africa infecting more than 28,000 people, Uganda, had its own Ebola outbreak — two in fact, in 2012. Led by scientists at UVRI, however, the outbreaks were quickly identified and contained. Only 21 people died as a result — in contrast to more than 11,300 in West Africa in the past two years.
“They were prepared for the outbreak,” said Michel Van Herp, an epidemiologist with the emergency medical group Doctors Without Borders. “They had had that kind of training before. They were not naive to those pathogens.”
Uganda’s success in containing outbreaks is no accident. It is the product of a long history of cutting-edge infectious disease research, dating back to the founding of UVRI, then under a different name, by the U.S.-based Rockefeller Foundation in 1936 to stem the spread of yellow fever in East Africa. The institute passed into the hands of the East African Community in 1950 and then over to the Ugandan Ministry of Health in 1977, but it has continued to do groundbreaking work. Scientists here have discovered dozens of diseases and pioneered a viral surveillance system that has played a critical role in curbing potential epidemics.
The Ugandan system contrasts sharply with the short-term thinking of the World Health Organization. On Feb. 1, the WHO declared Zika a “public health emergency of international concern,” triggering a flood of money and attention directed at those South American countries hardest hit by the crisis. But UVRI has shown that crisis management of this sort is a poor replacement for vigilantly monitoring for potential public health crises in the first place and aggressively containing them once they arise.
“Uganda is a biodiversity hotspot,” said Julius Lutwama, UVRI’s senior principal research officer. “We have wide flora, wide fauna, and, of course, the good temperature, the good climate. And what is good for humans, what is good for animals, of course, is also good for viruses.”
Uganda’s record of controlling diseases is far from perfect (a malaria outbreak continues to plague the country’s north). But the presence in the country of so many of the world’s most virulent pathogens has compelled it to become a world leader in virus surveillance. “They’re always monitoring the conditions, so that there’s no outbreak that they’re not aware of,” said Martha Kaddumukasa, an entomologist at Uganda’s Makerere University who did part of her doctoral research at UVRI.
Kaddumukasa calls UVRI’s virus surveillance capacity “one of a kind” for East Africa. In part, this reflects a commitment from the Ugandan government, but also the institute’s unique collaborations with the U.S. Centers for Disease Control and other international institutions.
Uganda’s dealings with Zika showcase both the depth and longevity of the country’s surveillance system. The story of the virus’s discovery is relatively banal: As part of the institute’s yellow fever research, scientists were monitoring a monkey deep in the Zika forest, on the outskirts of Entebbe. One day in 1947, it developed a fever and a blood sample was taken. The scientists isolated a previously unknown virus and, ultimately, gave it the name of the forest where it was discovered.
In the papers heralding their finding, the scientists took care to acknowledge how little they had actually learned about the virus — where it originated, how it was transmitted, or what its impact on humans would be. That didn’t stop one of its discoverers from cautioning: “The absence of the recognition of a disease in humans caused by Zika virus does not necessarily mean that the disease is either rare or unimportant.”
In 2012, UVRI’s overall surveillance and detection capacity got an upgrade when the CDC opened a laboratory to rapidly diagnose viral hemorrhagic fevers, like Ebola. The timing was prescient. Uganda sustained three hemorrhagic fever outbreaks that year — first Ebola, then Marburg, then Ebola again. In each case, doctors with the CDC and UVRI identified the virus within a matter of days and led efforts to contain its spread.
Although UVRI has been able to offer little help in stemming the Zika outbreak, there is a recognition on the Entebbe campus that the institute has an increasingly important role to play, not just in combating future outbreaks, but serving as an example for other disease hotspots to replicate. In addition to modeling country surveillance strategies and promoting regional collaboration, that means continuing to lead the hunt for new viruses and working to better understand the ones that have already been found.
Credit Foreign Policy Magazine. Photo Credit Getty Images