Dynamic Drivers of Disease in Africa: Ecosystems, livestock/wildlife, health and wellbeing

Lead Research Organisation: University College London
Department Name: Genetics Evolution and Environment

Abstract

Health is a critical aspect of human wellbeing, interacting with material and social relations to contribute to people's freedoms and choices. Especially in Africa, clusters of health and disease problems disproportionately affect poor people. Healthy ecosystems and healthy people go together, yet the precise relationships between these remain poorly understood. The Dynamic Drivers of Disease in Africa Consortium will provide a new theoretical conceptualisation, integrated systems analysis and evidence base around ecosystem-health-wellbeing interactions, linked to predictive models and scenarios, tools and methods, pathways to impact and capacity-building activities geared to operationalising a 'One Health' agenda in African settings.

Ecosystems may improve human wellbeing through provisioning and disease regulating services; yet they can also generate ecosystem 'disservices' such as acting as a reservoir for new 'emerging' infectious disease from wildlife. Indeed 60% of emerging infectious diseases affecting humans originate from animals, both domestic and wild. These zoonoses have a huge potential impact on human societies across the world, affecting both current and future generations. Understanding the ecological, social and economic conditions for disease emergence and transmission represents one of the major challenges for humankind today.

We hypothesise that disease regulation as an ecosystem service is affected by changes in biodiversity, climate and land use, with differential impacts on people's health and wellbeing. The Consortium will investigate this hypothesis in relation to four diseases, each affected in different ways by ecosystem change, different dependencies on wildlife and livestock hosts, with diverse impacts on people, their health and their livelihoods. The cases are Lassa fever in Sierra Leone, henipaviruses in Ghana, Rift Valley Fever in Kenya and trypanosomiasis in Zambia and Zimbabwe. Through the cases we will examine comparatively the processes of disease regulation through ecosystem services in diverse settings across Africa.

The cases are located in a range of different Africa ecosystem types, from humid forest in Ghana through forest-savanna transition in Sierra Leone to wooded miombo savanna in Zambia and Zimbabwe and semi-arid savanna in Kenya. These cases enable a comparative exploration of a range of environmental change processes, due to contrasting ecosystem structure, function and dynamics, representative of some of the major ecosystem types in Africa. They also allow for a comparative investigation of key political-economic and social drivers of ecosystem change from agricultural expansion and commercialisation, wildlife conservation and use, settlement and urbanisation, mining and conflict, among others.

Understanding the interactions between ecosystem change, disease regulation and human wellbeing is necessarily an interdisciplinary challenge. The Consortium brings together leading natural and social scientific experts in the study of environmental change and ecosystem services; socio-economic, poverty and wellbeing issues, and health and disease. It will work through new partnerships between research and policy/implementing agencies, to build new kinds of capacity and ensure sustained pathways to impact.

In all five African countries, the teams involve environmental, social and health scientists, forged as a partnership between university-based researchers and government implementing/policy agencies. Supporting a series of cross-cutting themes, linked to integrated case study work, the Consortium also brings together the University of Edinburgh, the Cambridge Infectious Diseases Consortium and Institute of Zoology (supporting work on disease dynamics and drivers of change); ILRI (ecosystem, health and wellbeing contexts); the STEPS Centre, University of Sussex (politics and values), and the Stockholm Resilience Centre (institutions, policy and future scenarios).

Planned Impact

Many major policy studies - from UK Foresight to the UN - have identified the global dangers of disease emergence, especially from areas where understandings of disease dynamics, detection and response is poor. A recent report in PNAS (Chan et al., 2010) looking at all disease outbreaks globally showed how detection of infectious diseases and warning of emerging epidemics was extremely poor in Africa, yet the continent is the origin of half the world's outbreaks.

A 'One Health' approach, integrating human, animal and ecological health in a holistic framework, has been suggested as a response. But what should a One Health approach look like, and how would it work in African settings? The DDDAC will gear its outputs towards producing the answers to these questions, ones being posed by policymakers across the globe. Through its detailed case study work, focused on four important, but often neglected, diseases in five locations across Africa, combined with broader modelling and scenarios work, looking at disease drivers and future impacts, the Consortium will build a 'One Health' toolbox for use by practitioners and policymakers in Africa. It will provide cost-effective methodological tools for developing an effective 'One Health' approach for the African setting.

Through its novel approach to interdisciplinary analysis of ecosystems, health, poverty and well-being, and particularly its focus on integration across scales, disciplines and sectors, DDDAC will contribute to the growth of the new cross-disciplinary fields of eco-health and socio-ecological systems, providing new concepts, frameworks and methodologies for a growing research and practitioner community.

Engaging potential users of DDDAC research will happen from the very beginning. Key users will cut across sectors - from environmental management to wildlife conservation to veterinary and health systems, as well as broader rural development actors. Research users will involve diverse government departments, non-government agencies, the private sector and local communities, and will stretch from the local to national to international levels. All country project teams involve a partnership between government officials in key departments (usually the DDDAC host) and university researchers. This allows the Consortium an important opportunity to link research directly with national policy, gaining access to high-level national policy discussions from the outset.

In order to establish a Consortium-wide approach to research communications and policy engagement, we will use an adapted Participatory Impact Pathways Assessment (PIPA) approach which has been used successfully within the STEPS Centre. This articulates well with the ESPA impact framework, and provides a practical methodology for implementing it. Early stakeholder dialogues in all project sites will allow DDDAC to engage with users in refining research design, map potential impact pathways and define an impact and engagement plan.

This plan will operate across scales from particular field sites, involving community actors, local officials and development projects, to national level debates cutting across environment, health and agriculture/rural development sectors to the international level, where UN agencies such as the WHO and FAO, as well as major environmental and development NGOs, are eager to engage with the Consortium to define a practical 'One Health' approach, grounded in solid, field-based evidence.

Publications

10 25 50
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Bardosh KL (2017) Engaging research with policy and action: what are the challenges of responding to zoonotic disease in Africa? in Philosophical transactions of the Royal Society of London. Series B, Biological sciences

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Cunningham AA (2017) One Health, emerging infectious diseases and wildlife: two decades of progress? in Philosophical transactions of the Royal Society of London. Series B, Biological sciences

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Cunningham AA (2017) One Health for a changing world: new perspectives from Africa. in Philosophical transactions of the Royal Society of London. Series B, Biological sciences

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Franklinos L (2019) The effect of global change on mosquito-borne disease in The Lancet Infectious Diseases

Related Projects

Project Reference Relationship Related To Start End Award Value
NE/J000507/1 01/02/2012 29/04/2012 £941,807
NE/J000507/2 Transfer NE/J000507/1 30/04/2012 29/04/2016 £904,800
 
Description As exemplified by the current COVID-19 global pandemic, the health and economic consequences of spillovers of wildlife diseases into human populations can be devastating. This research has improved the understanding of how ecological, epidemiological and socioeconomic factors interact to drive spillovers of these 'zoonotic' diseases into humans.
Exploitation Route The research has informed global zoonotic disease research funding priorities, for example in guiding wildlife disease surveillance efforts, informed international policy priorities (UN, IPBES, WWF) and public health responses to disease outbreaks (FCOD), as well as improving the public understanding of links between the extinction and climate crises on zoonotic disease spillover risk.
Sectors Agriculture, Food and Drink,Environment,Financial Services, and Management Consultancy,Healthcare,Government, Democracy and Justice,Security and Diplomacy

URL https://steps-centre.org/project/drivers_of_disease/
 
Description The impact of research falls into three main areas: 1 - informing zoonotic disease research funding, 2 - influencing international policy priorities and public health responses to disease outbreaks, and 3 - improving public understanding of links between environmental change and zoonotic disease spillover risk. 1. Research funding priorities The research has informed funding priorities both internationally and nationally. Some key examples include: (1) Evidence contributed to the 2020 IPBES report on Biodiversity & Pandemics has influenced the establishment of the EU's PREZODE initiative to develop fundamental and operational research to prevent and manage future zoonotic disease outbreaks; and (2) Key evidence on zoonotic spillover informed the 2020 Trinity Challenge representing millions of pounds of investment. 2. Policy and public health responses The research is among key evidence linking emerging zoonotic diseases and land use and climate change and has informed international and national policy priorities and public health responses to disease outbreaks. Some key policy impact examples include: (1) Evidence provided for the rapid assessment 2020 report by United Nations Environment Programme 'Preventing the next Pandemic' led to UNEP joining the tripartite Alliance of OIE, FAO and WHO in recognition of the need to strengthen the environmental dimension of One Health global efforts; (2) Underpinning evidence provided to the WWF 'Beyond Boundaries' 2020 report contributed directly to WWF's ongoing work to influence policy and practice in a range of areas on linkages between environmental degradation, emerging infectious disease risk and human health, for example their work around mitigating the risk posed by wildlife trade, particularly in East and South East Asia; (3) Evidence on the impact of ecosystem degradation on zoonotic risk provided in 2020 for The Dasgupta Review commissioned by UK's HM Treasury setting out how nature should be accounted for in economics and decision making, will inform policy discussions at CBD COP 15, UNFCCC COP 26, and the G7 meeting in 2021 [S8]; (4) In 2019, as evidenced by communication with the Chief Scientific Officer at FCDO Prof Charlotte Watts "The Ebola risk map from Redding et al. provided important contextual information to inform discussions with ministers in our short and medium term thinking on our response to Ebola"; and (5) Evidence on zoonotic disease emergence is informing current discussions within UK government and the G7 to develop a more strategic approach to understanding emerging zoonotic and biodiversity threats. 3. Public understanding The research in understanding zoonotic disease spillover processes has been extensively communicated through the international broadcast news and print media over the assessment period, thereby improving public understanding of zoonotic disease risks. Clear scientific communication is particularly relevant during the current global COVID-19 pandemic and the research team have appeared in over 150 national, specialist, and international media outlets in 2020 sharing the research with an estimated audience of over 300 million people (https://issuu.com/zoologicalsocietyoflondon/docs/zsl_annual_report_2019-20?fr=sMDU1OTIwNDgxMTg). Highlights have included contributions to BBC Radio 4's flagship news show the Today Programme, Inside Science, BBC World Service. Additionally, Prof Jones gave a cross departmental talk within the UK government on predicting pandemics and co-wrote with Dr Redding a special briefing to UK Government's Cabinet Office informing several of the UK prime minister's recent speeches for example, to the UN Summit on Biodiversity and to the UN General Assembly in 2020. The research also helped to provide evidence on the environmental links to the emergence of zoonotic diseases for the UK Environmental Audit Committee report 'Growing back better: putting nature and net zero at the heart of our economic recovery' (https://committees.parliament.uk/oralevidence/421/pdf) in 2020, and Prof Jones acted as a scientific consultant on BBC's Horizon programme and the 'Extinction the Facts' documentary presented by David Attenborough covering the links between deforestation and pandemic risk.
First Year Of Impact 2020
Sector Environment,Healthcare,Government, Democracy and Justice,Security and Diplomacy
Impact Types Cultural,Societal,Economic,Policy & public services

 
Description Evidence to UK Parliament, and other international organisations
Geographic Reach Multiple continents/international 
Policy Influence Type Participation in a advisory committee
Impact The impact of research from this grant falls into three main areas: informing zoonotic disease research funding; influencing international policy priorities and public health responses to disease outbreaks; and improving public understanding of links between environmental change and zoonotic disease spill-over risk. As evidenced by communication from the Wellcome's Director: "This research has had a global impact over many years, events of the last twelve months have underlined just how critical it is to all our health here in the UK, in so many countries around the world and to global health security". Informing research funding priorities for zoonotic diseases: Evidence from this research has contributed to the 2020 Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES) report on Biodiversity & Pandemics, has influenced the establishment of the EU's PREZODE initiative to develop fundamental and operational research to prevent and manage future zoonotic disease outbreaks. Key evidence on zoonotic spill-over has informed the 2020 Trinity Challenge (a coalition aiming to improve the world's protection against health emergencies, using data-driven research and analytics) representing millions of pounds of investment. Trinity Challenge Board Chair and former UK Chief Medical Officer Dame Professor said: "Your work on identifying global hotspots and EID risk has informed a lot of our early thinking in our "Identify" category of The Trinity Challenge". Policy and public health responses: Evidence from the research was used for the rapid assessment report (2020) by United Nations Environment Programme 'Preventing the next Pandemic' led to UNEP joining an alliance with OIE, FAO and WHO, recognising that there was a need to strengthen the environmental dimension of One Health global efforts. Underpinning evidence provided to the World Wildlife Fund (WWF) 'Beyond Boundaries' 2020 report contributed directly to WWF's ongoing work to influence policy and practice in a range of areas on linkages between environmental degradation, emerging infectious disease risk and human health. One example is the organisation's work around mitigating the risk posed by the wildlife trade, particularly in East and South East Asia. Evidence on the impact of ecosystem degradation on zoonotic risk in 2020 for The Dasgupta Review commissioned by the UK's HM Treasury setting out how nature should be accounted for in economics and decision making. This will inform policy discussions at CBD COP 15, UNFCCC COP 26, and the G7 meeting in 2021. In 2019, as evidenced by communication with the Chief Scientific Officer at FCDO: "The Ebola risk map from Redding et al. provided important contextual information to inform discussions with ministers in our short and medium term thinking on our response to Ebola". Finally, evidence on zoonotic disease emergence is informing current discussions within UK government and the G7 to develop a more strategic approach to understanding emerging zoonotic and biodiversity threats. Increasing public understanding of zoonotic disease risk The research in understanding zoonotic disease spill-over processes has been communicated extensively through the international broadcast news and print media over the assessment period, thereby improving public understanding of zoonotic disease risks. Clear scientific communication has been particularly relevant during the global COVID-19 pandemic and the research team have appeared in over 150 national, specialist, and international media outlets in 2020, sharing the research with an estimated audience of over 300 million people. Highlights have included contributions to BBC Radio 4's flagship news show the 'Today Programme' and its 'Inside Science' programme, as well as the BBC World Service. Additionally, Professor Jones gave a cross-departmental talk within the UK Government on predicting pandemics and co-wrote, with Dr Redding, a special briefing to UK Government's Cabinet Office. This informed several of the UK prime minister's speeches for example, to the UN Summit on Biodiversity and to the UN General Assembly in 2020. The research also helped to provide evidence on the environmental links to the emergence of zoonotic diseases for the UK Environmental Audit Committee in 2020. Jones acted as a scientific consultant on the BBC's Horizon programme and its 'Extinction: the Facts' documentary presented by David Attenborough, which covered the links between deforestation and pandemic risk.
 
Description Medical Research Council Rutherford Skills Development Fellowship
Amount £290,603 (GBP)
Funding ID MR/R02491X/1 
Organisation Medical Research Council (MRC) 
Sector Public
Country United Kingdom
Start 11/2017 
End 04/2020
 
Description Wellcome
Amount £603,494 (GBP)
Funding ID Sir Henry Dale Wellcome/Royal Society Fellowship 
Organisation Wellcome Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 04/2020 
End 06/2025
 
Description University of Sussex, Institute of Development Studies 
Organisation Institute of Development Studies
Country United Kingdom 
Sector Academic/University 
PI Contribution This grant was one part of a multi-institution grant led by the Institute of Development Studies, University of Sussex. My grant developed the statistical and mathematical modelling of infectious disease component of the project, as well as some data from in situ experimental studies in Ghana.
Collaborator Contribution Institute of Development Studies (IDS) led the grant and brought together social scientists, with ecologists and epidemiologists to understand the socioeconomic and ecological drivers of zoonotic infectious diseases in Africa. IDS also provided a lot of the socioeconomic framing for the project.
Impact Cross-disciplinary approaches to understanding socioeconomic, epidemiological and ecological drivers of infectious diseases. Full details of the outcomes are reported in the relevant sections of the form.
Start Year 2012
 
Description Providing Evidence for IPBES report on Biodiversity & Pandemics 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact The research contributed evidence to the 2020 IPBES report on Biodiversity & Pandemics. This report has influenced the establishment of the EU's PREZODE initiative to develop fundamental and operational research to prevent and manage future zoonotic disease outbreaks.
Year(s) Of Engagement Activity 2020
URL https://ipbes.net/pandemics
 
Description Providing Evidence for the BBC Documentary - 'Extinction the Facts' 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Providing evidence to BBC's 'Extinction the Facts' documentary presented by David Attenborough covering the links between deforestation and pandemic risk.
Year(s) Of Engagement Activity 2020
URL https://www.bbc.co.uk/programmes/m000mn4n
 
Description Providing Evidence for the BBC Documentary - 'The Jump' 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Providing an interview for BBC's Radio 4 Programme 'The Jump' documentary covering the links between ecosystem degradation and pandemic risk.
Year(s) Of Engagement Activity 2020
URL https://www.bbc.co.uk/sounds/series/m000symq
 
Description Providing Evidence for the Dasgupta Review 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact The research provided evidence on the impact of ecosystem degradation on zoonotic risk for The Dasgupta Review commissioned by UK's HM Treasury setting out how nature should be accounted for in economics and decision making. This review will inform policy discussions at CBD COP 15, UNFCCC COP 26, and the G7 meeting in 2021.
Year(s) Of Engagement Activity 2020
URL https://www.gov.uk/government/publications/final-report-the-economics-of-biodiversity-the-dasgupta-r...
 
Description Providing Evidence for the UK Government Environmental Audit Committee 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact The research helped to provide evidence on the environmental links to the emergence of zoonotic diseases for the UK Environmental Audit Committee report 'Growing back better: putting nature and net zero at the heart of our economic recovery' (https://committees.parliament.uk/oralevidence/421/pdf) in 2020
Year(s) Of Engagement Activity 2020
URL https://committees.parliament.uk/oralevidence/421/pdf
 
Description Providing Evidence for the United Nations Environment Programme 'Preventing the next Pandemic' Report 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact The research provided evidence for the rapid assessment 2020 report by United Nations Environment Programme 'Preventing the next Pandemic'. This report has led to UNEP joining the tripartite Alliance of OIE, FAO and WHO in recognition of the need to strengthen the environmental dimension of One Health global efforts.
Year(s) Of Engagement Activity 2020
URL https://www.unep.org/resources/report/preventing-future-zoonotic-disease-outbreaks-protecting-enviro...