IGHS's COVID work expands to include watching for new emerging viruses in high-risk countries

By Cameron Scott

The UCSF Pandemic Initiative for Equity and Action (UPIEA) is embarking on a new project to work with national ministries of health in Latin American and Middle East and North African countries, with backing from the Centers for Disease Control and Prevention (CDC) to develop new viral disease surveillance programs to detect emerging viruses using local hospital data, media reports and other non-conventional data sources.

The project builds on IGHS’s experience in practical public health work, looking for signals that an outbreak of COVID or some future novel virus may be brewing. IGHS built such strategic information expertise beginning in the 1980s to help contain the HIV/AIDS epidemic. The CDC also began investing in pandemic response in low- and middle-income countries around the world in response to HIV/AIDS. Recent national COVID response legislation has provided additional funding for those efforts.

This five-year project will, nevertheless, take IGHS into new territory. The work will take place in Paraguay, Ecuador, Surinam, Brazil, Colombia as well as in Oman and Jordan. The UPIEA team will work with local ministries of health to develop a program and workforce to gather and analyze data in useful ways. Project director Susie Welty, who hails originally from Ecuador, has also led much of UCSF’s HIV/AIDs surveillance work.

“The overarching vision is that the CDC wants to support countries with less robust surveillance systems, especially places where the threats of novel infectious diseases are higher, to stand up surveillance to prevent a future event like COVID from happening,” explained Mike Reid, MD, the principal investigator.

The UPIEA group’s efforts have sprung up in response to the specifics of the COVID pandemic, most notably the need to bolster public health workforces in the United States, where they have been on a long slow decline. As it worked early in the pandemic to create a California contact tracing workforce made up in large part of re-assigned state workers, UPIEA had a front-row seat to see the unequal impacts the pandemic had in marginalized communities. A major part of its mission has become working hand in hand with these communities, to ensure both that public health measures don’t play into inequities and that they work given the cultural and socioeconomic facts on the ground.

The pandemic response has also made a case for the important role academic medical centers play in providing expertise to local and national governments that doesn’t change with the election cycle.

“We’ve learned from COVID that when the local ministry of health or health department is supported by local academic institutions, they can do better,” Reid said. “If you work with a university partner, they are always going to be on the frontlines for the ministry of health – translating research into practice, prioritizing equity and evaluating impact.”

For example, the omicron variant of the SARS-CoV2 virus was identified at an academic medical center in Botswana that has collaborated extensively with Harvard’s medical school. And UCSF has been a key partner for both the City of San Francisco and the State of California in managing the pandemic.

This novel surveillance work also aims to loop in community partners and other UC campuses which may be stronger in some areas. For example, UC Davis is known for its strength in diseases that span human and animal populations, which are a concern in several of the countries the CDC has identified as in need of support. 

The work is intended to look forward at the next potential pandemic, but inevitably it will also work to improve responses to COVID.

“Right now, everybody’s attention is on COVID, and that provides an opportunity to see what’s working well and what’s not,” Reid said. “The reality is that COVID is going to remain a threat, and we can’t afford to take our eye off the ball.”