The emergence of animal-origin (zoonotic) RNA (ribonucleic acid) viruses like SARS-CoV-2 – whether from wildlife, livestock or domestic animals – is an urgent and growing threat to public health.
Understanding how SARS-CoV-2 and other RNA virus outbreaks originate can guide how we can more effectively prevent, mitigate or respond to future emerging infectious diseases (EIDs).
Increasing outbreaks in recent decades have been driven by many factors, including human and livestock population growth, coupled with expanding human-animal- environment interfaces, changing patterns of land use, climate change, globalised travel and trade.
These outbreaks have common characteristics, including zoonotic spillover from an animal reservoir host to humans, with or without involvement of another animal transmission host.
These events highlight the importance of a One Health approach to design relevant, feasible and implementable solutions to prevent, mitigate and respond rapidly to future outbreaks.
The Independent Taskforce on Covid-19 and Other Pandemics, of which I am a member, was formed in November 2021 to assess the available evidence on what drove the origins and early spread of Covid-19 and provide evidence- based recommendations to reduce the impact and improve responses to future outbreaks and pandemics.
It comprises 12 internationally-renowned scientists with diverse expertise in human, animal and public health, virology, epidemiology, wildlife ecology, and EIDs.
This task force is actually an offshoot of The Lancet Covid Commission Task Force on the Origins of SARS-CoV-2, which was formed in November 2020.
The latter was disbanded in September 2021 after 10 months of work due to a dispute over academic freedom, as well as bitter divisions over whether SARS-CoV-2 was triggered from a natural spillover or from a laboratory leak.
The current Independent Task Force is not linked to any one organisation, scientific journal or association, and we are doing this work voluntarily, without funding from any specific agency.
With the addition of two members, we started work immediately after the formation of the Independent Task Force with literature review, interviews with other scientists, analyses of data and weekly video meetings.
This culminated in the report “Pandemic Origins and a One-Health Approach to Preparedness and Prevention: Solutions Based on SARS-CoV-2 and other RNA Viruses”, published in the Proceedings of the National Academy of Sciences (PNAS) journal on Oct 11 (2022).
The report has generated intense interest among scientists, researchers and health administrators, both nationally and internationally, as it highlights the importance of a One Health approach to design relevant, feasible and implementable solutions to prevent, mitigate and respond rapidly to future outbreaks.
Key findings
Among our key findings are that:
- Animal RNA viruses, including coronaviruses, have a long history of crossing species barriers to humans.
The report provides a historic timeline of estimated origin dates for major coronavirus outbreaks affecting people or livestock, and highlights coronaviruses that represent a growing risk to both human and animal health.
- The risk of pandemics occurring increases when people and animals interact closely in new settings driven by land use and climate change, environmental degradation, the wildlife trade, population growth and economic pressure.
Evidence indicates that most new zoonotic outbreaks have wildlife or livestock origins.
The report provides recommendations that target high-risk animal-human interfaces to prevent or mitigate the risk of future spillovers.
- Substantial newly-published scientific evidence reviewed in the PNAS report strongly indicates that Covid-19 originated via a pathway similar to SARS-CoV.
This involves spillover from bats to intermediate animal hosts, then to people within the wildlife trade, leading to the first known cluster of Covid-19 in the Huanan Seafood Market in Wuhan, China, in December 2019.
The Task Force finds no verifiable or credible evidence to support the possibility that SARS-CoV-2 was created in or released from a laboratory.
- Efforts to control and respond to the Covid-19 pandemic were hindered in many countries by politics, misinformation and disinformation, and a growing anti- science/anti-vaccine movement.
- The importance of critically evaluating the potential of a zoonotic link to wildlife is that it leads to implementable One Health-orientated changes in policy and practice that can reduce the likelihood of similar occurrences in the future.
Recommendations
Based on our findings and discussions, the following recommendations were made:
This revolves around targeting surveillance of people, wildlife and domestic animals within emerging disease hotspots, improving methodologies for safe surveillance, and innovating a risk assessment framework to provide early warning of pathogens most likely to emerge.
The benefits of Smart Surveillance conducted by trained personnel using rigorous protocols to maximise safety and security far outweighs the risks and provides critical data for the research and development of vaccines, therapeutics, diagnostics and better early warning systems, as well as informing One Health strategies for prevention and response.
This includes investing in research and development for innovative and broad spectrum diagnostics; coming up with antiviral and vaccine strategies for priority pathogens based on data from Smart Surveillance; streamlining approaches to build capacity for clinical trials, licensure and manufacture of medical countermeasures; and understanding the pathogenesis of potential high-threat pathogens to guide new therapeutic strategies.
This means working with communities and countries on the frontlines of disease emergence to understand epidemiological, value chain and behavioural drivers of EID emergence; implementing risk reduction strategies; developing incentives to minimise human- wildlife contact at interfaces in rural areas and commercial markets; and strengthening awareness of the emerging disease-linked health impacts and costs of land use and climate change to provide incentives for sustainable development.
This involves interdisciplinary research on what drives the emergence, spread and public acceptance of misinformation and disinformation in order to develop robust counter-mechanisms and strategies to counter distrust of science and expert advice.
This includes creating an inclusive, multi-stakeholder One Health-based governance framework at local, regional, national and international levels for pandemic preparedness and response, as well as increasing funding for cross-disciplinary, collaborative One Health research.
Conclusion
Infectious diseases will continue to emerge, especially RNA viruses such as influenza A and coronaviruses, which have the propensity to mutate and/or recombine among strains affecting multiple host species.
History shows that the world has failed to heed the lessons from past EIDs.
Despite Malaysia having fought many outbreaks such as Nipah, avian influenza, SARS, EV71 and Covid-19, it is imperative that we build a better framework based on One Health approach to respond rapidly to the next outbreak and pandemic.
Emeritus Prof Datuk Dr Lam Sai Kit is a virologist, Universiti Malaya research consultant and Academy of Sciences Malaysia senior fellow. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
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