By now, even us laypeople understand the SARS-Co-V-2 virus that causes COVID-19 has a formidable capacity to mutate into new variants, sometimes causing new spikes in infections and illness. In response, the health research community has stepped up surveillance programs to sequence the genomes of virus samples, aiming to identify where and when new such variants emerge. The thing to keep in mind, however, is that not all variants are equally dangerous. Some, like delta and omicron, emerge as “variants of concern.” These VOCs spread quickly through countries or the whole planet, with high potential to cause illness, hospitalization or death.
So among the top concerns for public health decision-makers is the scale of a threat new variants pose. Figuring that out takes an additional layer of surveillance data about the SARS-CoV-2 virus, one that focuses on what epidemiologists call the immunological implications of new variants. In simpler terms: Do these newly emerging variants have epidemic or pandemic potential? Are they breaking through our existing immunity? And how successfully can doctors treat those sickened with the new variants using the tools at hand?
These questions can only be answered in local laboratories and treatment centers, which have varying levels of expertise and resources. Building up that local capacity is the goal of a year-old program by the Bill & Melinda Gates Foundation called the Global Immunology and Immune Sequencing for Epidemic Response (GIISER). The initiative funds laboratories in the Global South that can connect local genomic sequencing of virus variants with their real-world impact. Since it started making grants in 2021, Gates has funded eight GIISER sites. Six are in Africa—in Ghana, Kenya, Nigeria, Senegal, South Africa and Uganda; the other two are in Brazil and India.
Among the important outcomes the GIISER network can enable is faster discovery of new monoclonal antibodies that are critical for understanding the viral variants and developing any new vaccines or therapeutics that may be necessary. And this can best be accomplished by establishing close working relationships between the in-country GIISER sites and the hospitals and other health services that are the only sources of actual clinical data about the health of COVID patients, according to the Gates Foundation.
For now, the foundation will keep the $7 million GIISER program at its current budget. After its initial two-year funding run, the foundation will assess how well it works and what’s been most useful, and may seek funding partners to build more immunological surveillance sites following the GIISER model and goals.
It’s not that this kind of genomic + immunological understanding was never developed before: It just wasn’t done very efficiently or quickly. And when it comes to response to a highly contagious pathogen like SARS-CoV-2, it’s not an exaggeration to say that every day matters. When people are filling up the hospitals, it’s crucial to know why, and to know as fast as possible, says a Gates spokesperson. The omicron variant, for example, was first identified much more quickly than previous variants due to work of Gates-funded South African virologist Alex Sigal, which enabled faster understanding of how omicron-caused illnesses differed from previously identified variants.
One running theme in the Gates Foundation’s health funding in the Global South is the development of scientific capability within those countries. GIISER builds on the capacity supported through the work of such projects as Africa Pathogen Genomics Initiative, which Gates funded to integrate genomic sequencing tools directly into the continent’s public health infrastructure. Having strong immunological surveillance based locally in the Global South also gives health researchers in those countries the ability to better respond to new epidemics of diseases that may not spread beyond their regions—and thus may not draw as much international support from funders in wealthier countries.
The persistence and devastation of the COVID pandemic has, of course, underscored what epidemiologists have been saying for two years: COVID won’t be the last planetary disease threat, and the planet needs laboratory capability everywhere that can identify emerging epidemic diseases and quickly understand their implications for health—locally and globally.