Pennies to Prevent Pandemics -- Virodiversity as a Grand Challenge for Global Health Security

For the cost of a packet of sweetener for your coffee just once each year, we could understand what is lurking around us, reduce outbreaks, speed diagnosis and control of new emerging diseases, discover new cures, and protect us from continual and massive economic losses.
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What would you say if you were asked to pay three cents a year to possibly prevent hundreds or thousands of deaths, reduce terrifying disease outbreaks and save billions of dollars in economic losses due to infectious diseases? Being asked this exact question just became a distinct possibility. According to a findings from a large international team (myself included) published this week in the scientific journal mBio, the universe of viruses lurking in the wild that could someday infect humans is far smaller and much more approachable than previously thought.

More precisely, 320,000 viruses rather than the millions we and many others expected. Of course, like any scientific finding, it's based on a few assumptions that ultimately could make the total higher or lower. For example, rather than including all manner of animals, we limited the calculation just to mammals (4,486 different species) because they share the most viruses with humans. But birds also carry a few others that need to be accounted.

The work was not just theoretical and it was a massive multi-year undertaking, requiring the safe capture, sampling and release of thousands of very wild animals in very wild places, combined with sophisticated laboratory diagnostics and high-end bioinformatics as just the beginning. Much of that work was being undertaken as part of a USAID global health program called PREDICT, so we knew what was feasible and what the efforts cost. Then, Dr. Peter Daszak, CEO of EcoHealth Alliance recognized a grand opportunity: Rather than just waiting for the next outbreak or pandemic, could we take our experience, match it to what is known about biodiversity and determine the possibility and practicality of identifying every virus that could threaten human and animal health?

Without being so explicit, the work lays the groundwork for an achievable but grand challenge for both national and global health, worthy of investments from governments, foundations or private enterprise. Like the human genome project that has found the roots of thousands of genetic disorders and also the new human brain initiative that will unlock both imaginable and unimaginable mysteries, a global virodiversity initiative would be big, bold, and immensely beneficial to humankind.

Every species carries dozens and dozens of different viruses, and in many ways they represent vast libraries of genetic material -- the codes of all life. Not having read all the books in the Library of Congress is understandable, but what if we had not yet even catalogued them? Biodiversity loss is the living world's equivalent of burning down the Library of Congress and its database.

The good news is that with advances in computational technology and the dramatic reduction in costs being seen in gene sequencing, we could actually reverse that trend and protect ourselves in the process.

So how much will all this cost? If we try to find every virus of every mammal, the estimate is $6.3 billion spread over 10 years. Of course, a cheaper approach might be possible. That's because doing a perfect job takes longer and costs more than just doing a great job which when starting from near zero would nonetheless be hugely important.

If we forget about the rarest of the rare for now and focus on the low-hanging fruit, it might be possible to capture 85 percent of viral diversity in mammals for $1.4 billion spread over 10 years, or $140 million a year. That works out to just about two cents per person on the planet per year. I added another penny in my opening question just in case someone wants to include birds or snakes, or delve into the sea to truly catalog all the possible viruses. To put this in perspective, the wildlife virus that became SARS in humans caught everyone off guard and resulted in $16 billion in economic losses around the world in less than a year -- $2.25 per person on the planet -- or roughly 100 times the annual cost of this grand challenge.

For the cost of a packet of sweetener for your coffee just once each year, we could understand what is lurking around us, reduce outbreaks, speed diagnosis and control of new emerging diseases, discover new cures, and protect us from continual and massive economic losses. A modern Mary Poppins might sing that a spoonful of sweetener makes the medicine go down, or in this case, would contribute to making the world a much healthier and productive place.

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