WHAT WILL WE LEARN FROM ESEI RESEARCH?

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1 WHAT WILL WE LEARN FROM ESEI RESEARCH? Mark Woolhouse University of Edinburgh

2 WHAT WILL WE LEARN FROM ESEI RESEARCH? Dealing with diverse disease ecologies Diversity and generalisation Endemic diseases vs epidemics Reactive research Combatting infectious disease Diagnostics Surveillance Interventions Vaccine priorities AMR Cross-disciplinary working Interdisciplinarity Economics Social sciences Technologies What next? Special calls Skills Beyond ESEI

3 THE INFECTIOUS DISEASE PROBLEM A quarter of all deaths; a quarter of all morbidity Big Three = malaria, AIDS, TB Major cause of child mortality Epidemic shocks HIV/AIDS (1980s-present): 39M deaths, 35M infected SARS (2003): ~1000 deaths, huge economic cost Ebola ( ): >10,000 deaths, US$Bs >>1000 species of human pathogens 3 to 4 new pathogen species discovered per year HOW TO ALLOCATE RESEARCH EFFORT?

4 REACTIVE RESEARCH

5 SEEING THE FULL PICTURE

6 INTERDISCIPLINARY RESEARCH infection biology public health epidemiology ecology genomics bioinformatics computer science systems biology mathematics statistics economics climate change geography demography immunology urban planning agriculture wildlife conservation clinical medicine drug development social sciences anthropology

7 ECONOMICS

8 SOCIAL SCIENCES

9 TECHNOLOGIES

10 DIAGNOSTICS

11 SURVEILLANCE Guanarito, Junin, Lassa, Lujo, Machupo, Sabia, Andes, Bwamba, Crimean-Congo haemorrhagic fever, Oropouche, Rift Valley, Severe fever with thrombocytopenia syndrome, Zika, Middle East respiratory syndrome, Barmah Forest, O Nyongnyong, Ross River, Semliki Forest, Venezuelan equine encephalitis, Bundibugyo ebola, Lake Victoria Marburg, Sudan ebola, Nipah, BasCongo, Nelson Bay, Titi monkey, Macacine herpesvirus 1, Simian virus 40, Monkeypox, Orf, Vaccinia

12 INTERVENTIONS PREVENTION TREATMENT SPECIFIC Vaccination ART GENERIC Hygiene Antibiotics

13 VACCINATION PRIORITIES The MRC commits 5m towards a new UK R&D Vaccines Network WHO publishes list of top emerging diseases likely to cause major epidemics The initial list of disease priorities needing urgent R&D attention comprises: Crimean Congo haemorrhagic fever, Ebola virus disease and Marburg, Lassa fever, MERS and SARS coronavirus diseases, Nipah and Rift Valley fever. The list will be reviewed annually or when new diseases emerge.

14 ANTIMICROBIAL RESISTANCE

15 THE FUTURE: SPECIAL CALLS Environment & Social Ecology of Human Infectious Diseases Zoonoses and Emerging Livestock Systems

16 THE FUTURE: SKILLS

17 BEYOND ESEI Ecology of infectious disease includes the health system Awareness and access to therapy Prevention: EPI, bednets Other (infectious) diseases and the health response to them Health budget and infrastructure Mutapi et al. (under review) Lancet Inf. Dis..

18 BEYOND ESEI Ecology of infectious disease includes the health system Awareness and access to therapy Prevention: EPI, bednets Other (infectious) diseases and the health response to them Health budget and infrastructure Need right balance of research on: Target species versus animal models, in vitro studies Real world studies versus experimental systems Comparative studies of health system performance Reasons why interventions or clinical trials succeed or fail ECOLOGY OF INFECTIOUS DISEASES = HEALTH SYSTEMS RESEARCH FOR THE 21 st CENTURY

19 THANK YOU!