School of Public Health Executive Director Steven Jones spent years working to control Ebola outbreaks. (Photo: Dave Stobbe)

Collaborative public health key to fighting epidemics

Steven Jones says it takes more than an Ebola vaccine to prevent disease outbreaks and unnecessary deaths. Interdisciplinary collaboration and communication are critical.

“So, tell me about inventing the Ebola vaccine.”

It’s a question that Professor Steven Jones has been asked countless times since he and two former colleagues at the National Microbiology Laboratory in Winnipeg developed what is now known as VSV-EBOV to successfully combat Ebola—an incredibly virulent infectious disease with a mortality rate of up to 90 per cent.

“It’s interesting to talk about the vaccine,” said Jones, who received his PhD in immunology and microbiology. “But I’m more interested in discussing the broader context of why Ebola is a problem—particularly in the African health-care setting—and what we can learn from investigating how infectious diseases emerge and spread.”

Prior to joining the University of Saskatchewan as executive director of the School of Public Health, Jones spent nearly two decades studying and controlling diseases such as Ebola and its equally lethal sister virus, Marburg.

During that time, Jones gained insight into a number of issues surrounding the contraction and transmission of these and other diseases—particularly in countries where limited resources and a combination of environmental and social factors can contribute to large-scale outbreaks.

“People usually get infected with Ebola by accident through exposure to bats,” said Jones, “or quite often through the human consumption of bush meat from Great Apes—gorillas and chimpanzees that have been exposed to infected bats.”

Human encroachment into relatively untouched ecosystems increases the risk of human exposure to Ebola-infected animals according to Jones. So too does the impact of climate change on the expanding geographical areas occupied by these virus hosts.

Once the Ebola virus has been transmitted from an animal host to a human host, human-to-human transmission can spread fast, leading to outbreaks such as the 2014 West African epidemic responsible for more than 11,000 deaths. Most recently, the World Health Organization confirmed more than 100 people have died in a new Ebola outbreak that began in August this year and continues to spread in the Democratic Republic of Congo.

In these outbreaks, communicating transmission risks and developing stronger government reporting processes is critical when dealing with epidemics in the context of developing countries.

“The African health-care setting is so resource deprived that, by the time the local government realizes there is a problem, it’s already a very big problem,” said Jones. “We need to control the disease before it ever gets to that point. But, in order to do that, there are several factors that need to be addressed by public health professionals.”

“Building capacity in communities, working with community health workers and village leaders to develop government reporting and response mechanisms—that’s what’s required. And that’s what students in our university public health programs are learning,” said Jones.

Understanding the social determinants of health—such as food insecurity and education—and collaborating with specialists in those areas is also fundamental, according to Jones.

“Ebola outbreaks are caused by poverty. Poor people. Poor education. Poor health systems,” he said.

Jones also believes that interdisciplinary collaboration in the fight against Ebola should be leveraged in order to view health issues through a planetary health lens.

“Leaders in the fight against infectious disease need to work with social scientists, specialists in climate change, local economy, government relations and more,” he said. “Vaccines such as VSV-EBOV are a fundamentally important public health intervention, but preventing infectious disease in the developing world takes more than focusing on one approach.”

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