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Science diplomacy and pandemics

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Science diplomacy is the collaborative efforts by local and global entities to solve global issues using science and technology as a base. In science diplomacy, collaboration takes place to advance science but science can also be used to facilitate diplomatic relations. This allows even conflicting nations to come together through science to find solutions to global issues. Global organizations, researchers, public health officials, countries, government officials, and clinicians have previously worked together to create effective measures of infection control and subsequent treatment. They continue to do so through sharing of resources, research data, ideas, and by putting into effect laws and regulations that can further advance scientific research. Without the collaborative efforts of such entities, the world would not have the vaccines and treatments we now possess for diseases that were once considered deadly such as tuberculosis, tetanus, polio, influenza, etc. Historically, science diplomacy has proved successful in diseases such as SARS, Ebola, Zika and continues to be relevant during the COVID-19 pandemic today.

Severe acute respiratory syndrome (SARS)

The 2003 severe acute respiratory syndrome (SARS) pandemic is often labeled the first pandemic of the 21st century. It initially appeared in China at the end of 2002 and quickly spread to more than two dozen countries in North America, South America, Europe, and Asia. The virus that causes SARS is known as SARS-associated Coronavirus (SARS-CoV) and is highly contagious, producing sometimes fatal respiratory illnesses. It can easily spread through close person-to-person contact.[1] In 2003, the World Health Organization (WHO) reported a total of 8098 infections and 774 deaths. Only 8 tested positive for SARS-CoV in the United States at the time.[2] The collaborative efforts by organizations, countries, researchers and public health officials all over the world led to containment of the virus within about 5–6 months.[3] WHO first announced a global alert for a severe pneumonia-like disease on March 12. Measures taken by WHO ensured that consistent reports regarding countries most affected by the outbreak were received. WHO’s collaboration with other organizations such as media outlets, UN agencies, and Global Outbreak Alert and Response Network (GOARN) allowed for identification of locations with new SARS cases. WHO also utilized the Global Public Health Intelligence Network (GPHIN), developed for WHO by Health Canada, to improve the speed of outbreak detection and advance the response time.[4]

Immediate action was taken to implement proper containment measures when outbreak locations were identified. WHO also partnered with GOARN to dispatch teams of experts into areas heavily impacted by SARS such as China, Hong Kong, Singapore, and Vietnam. These experts represented around 20 different organizations and 15 different nationalities and worked in several sectors to contain the virus. Epidemiologists of varied backgrounds also worked together to review the measures to control the spread of the virus as well as analyze the behavior of the virus in transmission. Such epidemiologists hailed from the Health Protection Agency (United Kingdom), the National Institute of Infectious Diseases (Japan), the Robert Koch-Institut (Germany) and more[5]. Clinicians representing over 11 countries also played integral roles in measures to fight the virus by working together to create effective treatment plans and improve infection control procedures in hospitals worldwide. Some of them were from Hõpital Universitaire de Genéve (Geneva, Switzerland), National Institute of Health (Slovenia), and Adelaide Meath and National Children’s Hospital (Dublin, Ireland).[5]

In addition, researchers from laboratories around the world shared their findings with each other in hopes of gaining better understanding of the disease to test possible vaccines for SARS.[5] Along with these organizations, the Center for Disease Control and Prevention (CDC) has also closely worked with WHO throughout the course of the SARS outbreak. The CDC had promptly activated its Emergency Operations Center (EOC) just days after WHO’s global alert and informed the public of this novel disease while providing precautionary protocols to avoid infection. They also established and dispatched teams of specialists of multiple backgrounds to conduct on-site investigations of SARS and carried out extensive research to test SARS specimen in order to identify its cause and transmission behavior.[2] In July, WHO officially announced that the SARS epidemic had been contained.[3]

However, even after intense efforts, no successful vaccine was created to combat SARS. In 2003, it took a considerable amount of time before the genome sequence of the virus was available and it wasn't until 2004 that possible vaccine trials were conducted in humans.[6] Researchers in a 2005 journal proposed possible methods of vaccine development noting the possibility of an inactivated SARS-CoV based vaccine. They also proposed spike (S) protein, a glycoprotein component of SARS-CoV membrane, based vaccines as well as a recombinant RBD (a fragment in S protein) based vaccines. They concluded that of these methods, RBD vaccines may be the safest means of combating SARS, though no such effective vaccine currently exists.[7] Nonetheless, collaborative efforts around SARS lead to major advancements in global public health. After SARS, the U.S. Department of Human and Health Services "amended the regulations to streamline the process of adding future emerging infectious diseases." Quarantine regulations of CDC were also revised to streamline the responsiveness to global health emergencies and "increase legal preparedness."[8]

Collaboration between the U.S and China also improved after SARS as Tommy Thompson, U.S. Secretary of Health and Human Services visited China in October of 2003 and "signed a multiyear partnership with the Chinese Ministry of Health to develop a more robust public health infrastructure in China. Thompson also established an HHS health attaché at the U.S. embassy in Beijing."[9] China's overall responsiveness and preparedness to infectious disease has also significantly improved since SARS as evident by their cooperative efforts in curbing the current SARS-CoV2 pandemic. Collaborative efforts were crucial to the containment of SARS. The importance of open collaboration was acknowledged formally in May 2003 when a resolution was adopted on SARS by delegates at the World Health Assembly; it called for the full support of all countries in combating SARS along with full transparency and steadfast reporting of requested information.[10] A second resolution to improve International Health Regulations gave WHO the authority to take a much stronger role in case of infectious diseases that pose a threat to public health. This allowed WHO to act and respond to outbreaks using its own resources rather than waiting for official government notifications of outbreaks.[4]

Ebola

The Western African Ebola virus epidemic took more than 11,000 lives. Science diplomats traveled the world and worked with scientists from other countries in the hope of finding a vaccine to conquer the Ebola outbreak.[11] The Ebola virus causes severe bleeding causing organ failure, lack of oxygen to the body, and it can lead to death. Scientists first discovered the Ebola virus in 1976 in Democratic Republic of Congo. Since then it has spread to other countries. It affected mostly West African countries. The largest outbreak of the Ebola virus from 2014–2016.[12] There were over 28,000 cases. The virus had spread to Guinea, Liberia, Guinea, Ivory Coast, Gabon, Sierra Leone, Mali, Nigeria, Italy, the United States, and more.[13]. The virus spread to more than 17 countries. UNESCO played a huge role in preventing the spread of Ebola to neighboring cities and countries of West Africa. They funded $20,000 to a radio station in Sierra Leone to keep the people informed about the virus and the precautions that they could take in order to avoid it. Ebola did not spread to Koinadugu, Sierra Leone even though it borders the Republic of Guinea.[14] which had 3814 cases and 2844 deaths[15]

Moreover, the United Nations and International Non-Governmental Organizations have supported the public health response to bring an end to the Ebola epidemic in the Democratic Republic of Congo (DRC). They have made huge efforts to track the Ebola virus, to find out where it moves next in order to prevent transmission of the virus.[16] The first Ebola outbreak was discovered in the DRC in a village near the Ebola River, which gave the virus its name.[17] The 1976 Ebola outbreak was much more contained than the 2014–2016 outbreak. The 1976 Ebola outbreak lasted about 11 weeks. There were 318 cases and 280 deaths. The death rate was around 88 percent. In contrast, the Western African Ebola virus epidemic lasted more than two years, had nearly 29,000 cases and 11,310 deaths. The death rate of the Western African Ebola virus epidemic was around 50 percent.[18]

During the Western African Ebola virus epidemic, science diplomats and other medical professionals traveled around the world to help track the outbreak. They tried to reduce the number of cases and deaths of the Ebola virus by studying the disease and testing possible vaccines or treatments to contain it. Even though it looked like they were not progressing, Scientists made huge efforts to minimize the Ebola virus. They tested many vaccines and treatments. Canadian scientists had been working on the Ebola vaccine research decades before the 2014–2016 outbreak. But, they were not making huge progress because they did not have enough funding. In 2010, Lead scientists left to do other research. But, one dedicated manager kept the research going. It wasn’t until the 2014–2016 outbreak that they received more funding. In August 2014, Canada donated 3.6 million dollars to the WHO and MSF. Scientists received more than 120 million dollars from the Canadian government, the US government, and the WHO to support clinical trials during the epidemic. Canada developed the first vaccine approved by the world. Millions of dollars were spent to create the vaccine and it was developed by Merck. But it would not have happened without scientists from three different continents in multiple countries.[19] The vaccine ERVEBO is used to protect against the Ebola virus. It was approved by the Food and Drug Administration in December 2019.[20] Although there are no antiviral drugs approved by the FDA to treat people who currently have Ebola,[21] there are alternative treatments such as: IV fluids, oxygen support, blood transfusions, and the vaccine ERVEBO, among others.

Zika

Zika is a flavivirus (a genus of viruses in the family of Flaviviridae) is a mosquito-borne infection that was first identified in monkeys in the Zika forest of Uganda in 1947.[22] It mainly spreads to people through the bite of an infected Aedes aegypti or Aedes albopictus mosquito. In 1952, the first human illness caused by the Zika virus was reported in Nigeria. The first outbreak of Zika virus outside of Africa or Asia took place in 2007, within the state of Yap in Micronesia. In 2013, a large-scale Zika infection in French Polynesia and other countries and territories in the Pacific was recorded. In March 2015, Zika virus was first discovered in the Americas, when Brazil reported a large outbreak of rash illness, soon identified as Zika virus infection. By March 2016, the virus had affected at least 33 countries and territories in America.[23] According to the World Health Organization (WHO), more than 87 countries have reported evidence of mosquito-borne Zika virus.[24] The increase in the number of cases led to the World Health Organization (WHO) confirming Zika virus as an international public health emergency.[25]

In July 2015, Zika virus was discovered to be the cause of fetal microcephaly, as well as other neurological abnormalities in unborn babies[26] The humanitarian organization for children called Save the Children, aimed to educate children and families of underserved communities in the U.S and other countries about Zika. The group has been working with collaborators in 200 schools in 20 states and has launched services to help them learn about Zika.[27] Direct Relief, another humanitarian organization active in all 50 states and more than 80 countries, established a Zika fund and worked closely with health officials and hospitals in 14 impacted countries to provide the necessary supplies to vulnerable community.[28]WHO and other international health organizations carried out research development activities focused on diagnostic tests, vaccines, treatments and innovative methods to control mosquitoes. According to WHO, 18 companies were working on the vaccines, as of March 2016. The World Health Organization’s priority was to develop a vaccine that was safe for use by pregnant women. With that in mind, the research institutions aimed to create inactivated vaccines, which were produced by treating infectious viruses with chemicals that destroy infectivity but maintain the capacity of the virus to induce a protective immune response. [29]

In 2016, The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, conducted a human clinical trial of the vaccine called the NIAID Zika virus investigational DNA vaccine. [30] In 2017, the phase 2/2b clinical trials were conducted, with the target of obtaining more safety and immune response against the diseases caused by Zika virus. [31] There is no effective vaccine available for Zika virus infection yet, therefore, different countries have taken precautionary steps to limit its spread. Since Zika was a global threat, it was important for scientists, healthcare professionals, and legal counsels to understand the role of law and policy in preparing to slow down the virus and to respond accordingly. Various organizations have helped raise funds to fight the virus. March of dimes helped fight the Zika virus with the assistance of thousands of volunteers and supporters who signed the petition asking for congressional intervention on Zika prevention.  The Senate and the House of Representatives approved bills offering $1.1 billion in funding to combat Zika, which President Obama eventually signed.[32] Secretary of Health and Human Services (HHS) Sylvia Burwell, at the behest of Governor Alejandro Garcia Padilla, announced a public health emergency for Puerto Rico, suggesting that the ongoing outbreak of Zika virus presents a serious threat to public safety. [33]

WHO issued guidelines outlined in the Zika Strategic Response Framework to effectively interfere and help families, communities and countries to control Zika virus disease. [34] The 4 main goals of The Response Plan, detection, prevention, care & support and research, have supported national governments and communities to prevent and manage the complications of Zika virus. [35] Innovative ways of coping with mosquito control were directed in countries. The World Health Organization (WHO) has also helped improve the capacity of Laboratories to test for Zika virus infection worldwide. The US Centers for Disease and Prevention (CDC) provided an action plan to prevent the spread of the Zika virus. CDC provided surveillance instructions for taking precautions before and during the mosquito season. MAC-ELISA testing kits were developed and distributed to the states. CDC has also developed Trioplex rRT-PCR that helped to detect Zika and other related viruses, including dengue and chikungunya virus RNA. [36]

COVID-19

On December 31, 2019, authorities in Wuhan, China reported the first cases of an unknown pneumonia to the World Health Organization (WHO). Shortly after that, on January 4, 2020, the WHO reported on social media that there had been a group of pneumonia cases in Wuhan, China but that no deaths had been reported.[37] The unknown pneumonia was a novel coronavirus, which they later named COVID-19. WHO quickly realized that it was a serious problem and issues between science and diplomacy on the topic of COVID-19 became evident. The Chinese government did not alert the WHO about the full extent of the seriousness of the outbreak.[38]

By the time the WHO realized that the problem was serious, the false information of a low mortality rate and its low risk to non-senior citizens had already spread very rapidly. The United States and the WHO tried to send scientists to help China fight COVID-19; however, China refused the help[citation needed]. China did eventually share the genome sequence of COVID-19 with the global community and later accepted another offer from the WHO to send a team of scientists to help[citation needed]. The lack of communication and the slow transmission of information between science and government caused failures to slow the spread of the virus in its early stages. To further complicate this stage, when scientists did give information or guidance, governments did not take it into proper consideration[39]. As a result, by not acting fast enough, many people were infected and local economies suffered due to the slow decision to act in unison. The overall impact on society would have been less detrimental if governments had acted in collaboration with each other and scientists.[40]

Some progress has been made among the scientific community itself in creating transparency, so local scientists in each region have access to the information they need to fight COVID-19. For example, the global scientific community began making efforts to communicate and share relevant information to help combat COVID-19 without delay. The WHO reported that a global research roadmap has been created in March of 2020 to fight COVID-19.[41] Scientists are publishing research findings before they are peer-reviewed and sharing other discoveries without delay. Scientists and clinicians are working to fight the epidemic by sharing data through information sharing technologies using bioRxiv, medRxiv, ChemRxiv, and arXiv, which allows them to share information in real time. [41] These tools are helping biopharma research and development, academic labs, government regulators, and the clinical community to speed up the process of testing new pathways to treating COVID-19 patients more efficiently.[41] As one researcher explains, “We are experiencing a shift towards Open Science at a speed that was previously unthinkable. It began with the publication of the genetic sequence of COVID-19 by Chinese scientists in early January 2020 via GenBank – an open-access DNA database operated by the US National Center for Biotechnology Information” [40]

Additionally, The World Economic Forum has partnered with the WHO to mobilize and help supply the needed resources required to fight COVID-19 itself and the economic impact it is having.[42] With the sharing of this information around the world by scientific communities, each individual country is better equipped with the knowledge they need to combat the pandemic and investigate possible treatments, testing, and vaccines. In the most current WHO published table of COVID-19 vaccines, there are 124 candidates that are in different stages of vaccine development [[43]].

See also

References

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  22. ^ Nabel, Gary J.; Zerhouni, Elias A. (2016-03-16). "Once and future epidemics: Zika virus emerging". Science Translational Medicine. 8 (330): 330ed2. doi:10.1126/scitranslmed.aaf4548. ISSN 1946-6234. PMID 27089202.
  23. ^ "WHO | The history of Zika virus". WHO. Retrieved 2020-05-13.
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  38. ^ "Open Science Diplomacy to tackle the COVID-19 pandemic". EU Science Diplomacy. 2020-04-17. Retrieved 2020-05-13.
  39. ^ "Experts Highlight How Science Diplomacy Combats Pandemics". American Association for the Advancement of Science. Retrieved 2020-05-13.
  40. ^ a b "Response to the COVID-19 Pandemic: Catastrophic Failures of the Science-Policy Interface". Science & Diplomacy. Retrieved 2020-05-13.
  41. ^ a b c Pisupati, Balakrishna (April 2020). "Science Diplomacy: COVID-19 and Beyond" (PDF). RIS Diary 3rd Special Issue on COVID-19: 5.
  42. ^ "Here's how 'science diplomacy' can help us contain COVID-19". World Economic Forum. Retrieved 2020-05-13.
  43. ^ CohenMay. 26, Jon; 2020; Pm, 3:20 (2020-05-26). "Merck, one of Big Pharma's biggest players, reveals its COVID-19 vaccine and therapy plans". Science | AAAS. Retrieved 2020-05-27. {{cite web}}: |last2= has numeric name (help)CS1 maint: numeric names: authors list (link)
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