US-UK Collab: Biological and Human Dimensions of Primate Retroviral Transmission

One of the great enduring mysteries in human health concerns the origin of AIDS. HIV-1, the retrovirus that causes pandemic AIDS, entered the human population from wild primates many decades ago, probably near the turn of the 20th century. How did this happen? Specifically, what social factors created the conditions that allowed a primate-borne virus to be transmitted to people, ultimately spreading around the world to become one of the deadliest infections in human history?

We will attempt to provide answers to these questions by studying present-day interactions between people and wild primates in a "hot spot" of human-primate conflict and contact in western Uganda. We will focus on communities of people who live in close proximity to red colobus monkeys, an ideal study species for this research. Decades of research on these primates has revealed that they interact regularly with local people in a variety of contexts, including antagonistic interactions leading to the killing of primates and/or human injury, and that such interactions increase rates of disease transmission between the species. Our study will build on this exceptional base of information to understand how human social factors underpin "risky" human-primate interactions. Our study will begin with a series of surveys to understand how people perceive and experience the risks of disease transmission from primates. Because risky human-wildlife contact is tied to social resources (e.g. power, access, social situation, economic status), we will reconstruct social networks in order to identify individuals who hold critical knowledge about human-primate contact and the risk it might entail. We will then target these individuals in order to probe their attitudes and knowledge with respect to human-primate contact. We will complement this interview-based approach with "activity-space mapping," which will reveal the physical locations of human-primate contact. To gain insights into perceptions and cultural norms, we will use "participatory video," in which people are instructed in the use of video cameras and asked to record events from their own lives, to share stories, and to voice opinions on topics related to primates or disease transmission.

At the same time that we study the human dimensions of disease transmission from primates, our colleagues based in the United States will study the primates themselves, in an effort to understand how retroviruses are maintained within primate populations with complex structure and demography. Our overall collaborative effort will yield a holistic picture of the root biological and social factors that drive the transmission of primate retroviruses. This effort will substantially improve our understanding of the biological and social conditions under which new and similar diseases might emerge, which will benefit public health on a global scale.

Integral to our efforts will be the training of international scholars. We will train a unique team of British, Ugandan, and North American scholars in core methods from the social and natural sciences, and we will send our British scholars to Uganda and North America to participate in fieldwork and laboratory work, respectively. The international, cross-cultural exchange represented by our training efforts will enhance the quality of life, health, and creative output of British citizens now and into the future.

Most broadly, this research will benefit the public at large, since the research is focused on understanding, predicting, and preventing new zoonotic diseases from entering the human population. Pandemic diseases such as AIDS are phenomenally costly to treat after they emerge; preventing such diseases therefore carries enormous economic and societal benefits.

International health policy makers will benefit directly from our research. In Uganda, we will partner with Conservation Through Public Health (CTPH; www.ctph.org), a Ugandan non-governmental organisation focused on preventing zoonotic disease through public health education, to relay our findings to local communities in Uganda (see attached letter of support from Dr. Kalema-Zikosuka). Members of our team hold appointments in a variety of institutions across a breadth of disciplines, from university posts in anthropology and veterinary medicine to positions in the Centers for Disease Control and Prevention in the USA, who are major players in the global public health community. We will make full use of the unique positions of our team members to relay our findings to key decision makers in academia and government. Our analyses of social drivers of disease transmission will help direct the application of novel preventive medical technologies towards the most vulnerable parties.

In the past, members of our team have given public lectures, been featured in nature films (e.g. by BBC, Scorer Films, Omni Films, and National Geographic), and participated in other similar venues to educate the public about ecology, health, and social science. The research will enhance the information that we can present in these formats and will allow us to expand these activities within the UK and internationally, thus benefiting public sector and third sector stakeholders.

The final product of our effort will be a new and holistic picture of the biological and social forces that cause wildlife diseases to enter the human population and to spread. This information will be critical for predicting and preventing new infections and targeting education and intervention programmes in the future. For this reason, the research has great potential to impact on health and well-being of society. Currently, over 1.1 million Ugandan Citizens have been diagnosed with AIDS, and over 60,000 have died (Ugandan Ministry of Health, 2009). The average cost of treatment for an infected individual is $18,000 per year. Preventing future epidemics of this sort would therefore reap enormous benefits for both individuals and Ugandan society and , as well as for other nations around the world.

The benefits of our research will realistically be realized on a timescale of decades. This is because implementing international public health policy is a slow process. We note, however, that AIDS emerged over three decades ago, and still no effective vaccine is available. Long-term preventive medicine through global public health policy appears, therefore, to hold as much promise as more technological solutions.

A major goal of our research will be to train scholars in research and professional skills related to social science and its applications to the health-related disciplines. The British, North American, and African scholars whom we train will be uniquely poised to apply their new skills to employment sectors ranging from academia to commercial industry to public service.