WHO on Thursday launched a new global initiative that aims to tackle a group of fast-growing and poorly understood viral diseases that are carried by insects – and which have future pandemic potential.  

The Global Arbovirus Initiative aims to tackle diseases such as Dengue, Yellow fever, Chikungunya and Zika – which have few effective treatments, with the exception of yellow fever vaccines. 

Their span and impact is also rapidly expanding – borne by air and ocean transport to far-flung lands, leap-frogging from forests to cities, and moving into Europe and North America as global warming creates more favorable climate conditions in which mosquitoes can thrive.   

The name ‘arbovirus’ is little known. But it is an acronym for “arthropod-borne” virusës, referring to viruses transmitted by mosquitoes and ticks. Although malaria is a mosquito-borne virus, it is in fact a parasitic disease, not a virus.

And unlike malaria, or many other parasitic diseases, there is also a dearth of ready treatments.  Notably, dengue fever, which infects 390 million people in 130 million countries where it is endemic, and Zika virus, which came to center stage during a 2016 epidemic in Latin America, have no readily available treatments. Zika causes birth defects, such as microencephaly, while dengue fever infections and subsequent attacks can recur, in worsening forms that cause dengue hemorrhagic fever and death.  Since the 2016 epidemic, outbreaks have occurred regularly in countries as far-flung as India. 

“These diseases are the diseases of our time,” said Jeremy Farrar, head of the Wellcome Trust, who appeared with a long line-up of WHO officials and virology experts from virtually all corners of the world in a launch event on Thursday. 

“These are things of the 21st century because the drivers of these diseases are drivers that are going to be with us in the 21st century,” he added. “And those drivers we all know are about: climate change. land use change, ecology change, urbanization… increasing trade and travel, for instance, between Asia and Africa, wholly welcomed but [this] will lead to changes in the dynamics of infections,” he added, noting that “the links between Central and South America, Southern United States, Southern Europe and all other parts of the world means that the mosquitoes, which are some of the most remarkable things on Earth, are adapting to different communities, in the context of 21st century, which is why this is just so important.”

Particularly in light of heightened awareness about pandemic risks from new or re-emerging viruses, post-COVID, this initiative that tackles a family of single strand RNA viruses is important, said Farrar. 

”In the context of the last two years, the world has changed, and we need to change with it, and provide the leadership that change requires,” Farrar concluded.  

Integrated approaches 

The new six-point WHO initiative aims to better link the various research, surveillance and vector control efforts happening around the world in a more formal network of collaboration – building around six pillars, including: 

• improved real-time monitoring of outbreak risks in countries; 
• early detection, investigation and response;  
• strengthened vector control initiatives, particularly in cities where viruses like dengue are now flourishing in waste and water containers; 

Along with that stronger global collaboration and surveillance; research innovation and partnerships are key to the new strategy, said WHO’s Sylvie Briand, Director of  Pandemic and Epidemic Diseases and WHO Assistant Director General, Minghui Ren. 

“As urban populations continue to expand, the threat of these diseases grows more alarming, as close living arrangements amplify the spread of these viruses,” said Ren.  “We must address these challenges now to prevent catastrophic impacts on health systems in the future.”  

“We have been through two years of COVID-19 pandemic and we have learned the hard way what it costs not to be prepared enough for high impact events,” Briand added. 

“The next pandemic could very likely be due to a new arbovirus. And we already have some signals that the risk is increasing. Since 2016, more than 89 countries have faced epidemics due to the Zika virus,” she said, citing just one example among many. 

“In addition, many other viruses circulate in the wildlife,” Briand added. “As the interface between humans and animals expands, the opportunity for new zoonosis increases. 

“And given human mobility and urbanization, the risk of amplification of localized arbovirus  outbreaks is real. So what can we do to better manage this? What did we learn from the COVID-19 experience and from years of combating arboviral diseases to help us to get better prepared for the next high impact event? 

“I would like three cite three key aspects:  collaboration, trust and community engagement as essential.”

Building on a series of regional consultations 

The new initiative represents the culmination of a series of global and  regional consultations that was undertaken by WHO to ensure a “more integrated approach” to this family of viruses,  which have often been ignored, said WHO Health Emergencies Executive Director Mike Ryan, also appearing at the session. 

The buy-in gained from the consultations was evident in the launch session, which was attended by dozens of researchers from far flung countries in Latin America, Africa and Asia, as well as Europe and North America.  

The initiative “brings together a network of partners which has enabled an efficient and successful collaboration across a range of pathogens and disciplines,” said Ryan, referring to the consultations leading up to the launch. “The COVID 19 pandemic and the public health emergencies that preceded it continue to humble us. As a society we remain susceptible to many recognized and some unrecognized infectious disease threats. However, these events have also highlighted the possibilities for effective collaboration.”

Despite their relative neglect, recent “virus-specific” advances in the field of arboviruses can be leveraged by such a coalition, Ryan said. 

‘Integration’ key to progress

Indeed, a more integrated approach to the prevention, detection and treatment, is key to success, stressed Farrar.  

“In fact, the progress in some of the areas around arboviruses in the last 10 to 15 years has also been staggering – and may have been forgotten a little bit in the last few years as everybody’s focused on COVID,” Farrar said. 

“But because there is no single bullet that is going to give an answer to every arbovirus, it is all about integration.” 

Along with that, he stressed that biomedical research needs to be linked up better with social science in terms of ensuring that communities and policymakers take up solutions and really use them. 

“It is about social sciences. It’s about anthropology. It’s about behavioral science. And if we don’t embrace that after the last few years, what have we learned?”

Image Credits: Sanofi Pasteur/Flickr.