Analysis: the withdrawal of normal healthcare services due to conflicts creates a perfect breeding ground for new pathogen outbreaks
The conflict and chaos spreading through Afghanistan parallel the human body trying to grapple with a new invading virus. Whatever path ensues for the people in that region of the world, we can be certain that normal healthcare will stop. This means many life-saving vaccinations, medical interventions and routine treatments will just not happen. New and existing infections will worsen, and spread on to family, friends and the vulnerable.
When we go to the doctor, clinic or hospital to get seen or for a check-up, we can get rid of whatever bug is infecting us faster and the infection case can be recorded. Our medical and scientific approaches pivot on knowing the current problems that people face. War, disruption and poverty result in the absence of appropriate health treatments and also ignorance of what is happening. The consequence of these elevated unregulated infection rates will inevitably mean new outbreaks, new variants and new nasty superbug surprises.
Infections cause disease. The more infections there are, the more genetic mutations they will collectively get. While most new mutations will have no real functional effects, a small number will. This means a high rate of patient cases supplies more opportunities for adaptive mutations and more fuel for the evolutionary fire. Moreover, more infections also mean more mixing of different genetic lineages that fuse, reshuffle and combine their DNA to yield new Frankenstein-esque assemblages to infect us all.
From BBC, 2017 documentary on understanding viruses
Pathogens are the "bugs" that cause us disease. They love to exchange genes: getting new DNA upgrades like we all download new mobile phone apps. Although limited by pathogens' need to understand one another's DNA, this genetic jiggy-jiggy lies at the origins of all our pandemics, endemic diseases and future threats. These new genetic apps mean new ways of infecting us, harming us and spreading to the most vulnerable.
Many low and middle-income counties have acute healthcare issues, including Leishmania parasites that infect our cells and slowly chew away at them. After malaria, leishmaniasis is one of the most severe long-standing parasite diseases about which we also know more now from the recent war in Syria. Our research and the work of other researchers have shown that new hybrid parasites emerged during that time in Syria and Afghanistan. They showed unexpected genetic changes, like whole new chromosomes, amplified multi-drug resistance genes and worse disease in patients.
What happened there will happen in Afghanistan too. Our initial work identified molecular quirks differentiating these Leishmania parasites from across the Middle East and Central Asia. Novel hybrids are created just like new Sars-Cov-2 variants will inevitably emerge from high infection rates, just like we can predict the morning sunrise. Combined genetic, microbiological and medical approaches can help tackle this.
We can mitigate the evolution of new pathogens if we re-focus vaccine delivery, genetic testing, medical treatments and disease surveillance
Pathogens evolve by remixing and tweaking their DNA like a musician searching for the best tune, and so genetic analysis tell us a lot about what we are hearing. We all appreciate now how routine genome-sequencing has been instrumental in forewarning us all about emerging Sars-Cov-2 threats, and we wish it was faster. This DNA monitoring can help us understand emerging and unexpected threats across all pathogens, but only if we choose to investigate hard-to-reach areas where people are in acute need.
Large-scale broad DNA sequencing of our wider environment will unlock discoveries we could not imagine at present. Such efforts can track the new species, novel hybrids and potential pathogens living beside us right now. Genetic analysis helps us decipher the patterns of transmissions and infections to reveal hidden histories that might otherwise be missed. This can even be applied to pathogens from over a century ago, which will aid our understanding of zoonotic (animal) disease origins.
Our current (mis)treatment of the environment and animals shunts us into a continuing series of pathogens with pandemic potential, from Arbovirus to Zika virus. For the current pandemic, we are failing because the Global North has hogged the Sars-Cov-2 vaccines. The 50 poorest countries have one in five of the world's people, but only 1/50th of the available vaccines. This neocolonialist 'vaccine apartheid' based on the free market approach to global vaccination is harming us all.
We have a choice to look beyond the immediate and consider the long-term interests of humanity and our descendants worldwide. More genome-sequencing and DNA testing of infected livestock and people in rural and urban areas could have helped us react faster to the current pandemic. We can mitigate the evolution of new pathogens if we re-focus vaccine delivery, genetic testing, medical treatments and disease surveillance on the frontiers of human societies.
The views expressed here are those of the author and do not represent or reflect the views of RTÉ
