Professor Scott O’Neill
Founder & Head of the Eliminate Dengue Program
In the drier and temperate regions of Australia, many people may not regard mosquito-borne diseases as a serious issue, but they are a silent and prevalent killer for those who are closer to the equator.
The World Health Organisation (WHO) has ranked dengue fever as the most critical mosquito-borne viral disease in the world and the most rapidly spreading – with a 30-fold increase in global incidence over the past 50 years. Each year an estimated 390 million dengue infections occur around the world. Of these, 500,000 develop into dengue haemorrhagic fever, a more severe form of the disease, and dengue results in up to 25,000 deaths annually worldwide.
The statistics are alarming with over 2.5 billion people (more than 30% of the world’s population in over 100 countries at risk of infection). The most significant recent epidemics have occurred in South-east Asia, the Americas and the Western Pacific.
Deadly Dengue And More
For years, countries and governments have attempted to mitigate against the disease as well as more recent mosquito-borne disease threats such as Chikungunya and Zika. These measures have been largely ineffective. The Eliminate Dengue Program (EDP), a not-for-profit international collaboration led from Monash University in Australia – part of the Institute of Vector-Borne Disease – has an innovative solution to the transmission of such diseases.
The programme is headed by scientist, Professor Scott O’Neill and brings together scientific collaborators from around the world with a range of skills and experience including Wolbachia mosquito biology and ecology, dengue epidemiology and control, and public health education and promotion.
“In each country we work in, we partner with local people – local research institutes, governments, regulatory authorities, private enterprise and community members,” explains O’Neill, a biologist, who started this research more than 20 years ago.
What propelled O’Neill’s interest in the field study was to create a project and movement for a social purpose, instead of solely for scientific experimentation. After working in this field in Australia and the USA for several years, O’Neill’s team had a breakthrough with the Wolbachia innovation. The scientific team managed to transfer Wolbachia (commonly found in many insects such as the fruit fly) into the Aedes Agypti mosquito after more than 10 years.
Wolbachia is safe for humans, animals and the environment. It is found in many insects associated with human food and is widely consumed by humans; and it does not infect humans or other vertebrates. What the Eliminate Dengue Program innovation has done, is enable the Aedes agypti mosquito to block the transmission of disease. The EDP method uses Wolbachia, a naturally occurring bacteria, to reduce mosquito’s ability to transmit harmful human viruses such as Dengue, Chikungunya, and Zika. (Wolbachia has also been known to block the transmission of Yellow Fever and West Nile viruses.)
Expansion to Eliminate
Now, the EDP project has shown that its method of dengue control is feasible, thanks to initial field trials which have shown that the Wolbachia continues to block disease transmission. So far, the disease has been blocked for up to five years in communities where Wolbachia mosquitoes have been released. The team expects this to continue on an ongoing basis. Mathematical modelling by independent experts shows that the disease will continue to be blocked for 30 years.
“We are now further developing the method for low-cost, large-scale application across urban areas in countries affected by dengue.”
The programme is currently deploying its method in Australia, Vietnam, Indonesia, Brazil and Colombia with plans to expand into other top 20 countries affected by mosquito-borne diseases.
Within the next six years, the project aims to reduce the burden of the disease by 90%. As well as continuing to carry out large scale field releases in several countries, the team is planning large randomised trials in at least one city, Yogyakarta (Indonesia) until 2018-2019.
“We work with local universities, researchers, government agencies and communities in the countries we’re present in.” O’Neill and his team include close to 400 people working on the Eliminate Dengue project, with some 60 people based in the Monash University headquarter in Melbourne.
Unlike commercialised drugs administered to patients after an infection, EDP focuses on providing sustainable protection from disease. Application (release of mosquitoes with Wolbachia) is only done once over a short period (2-3 months) with no need for repetition.
“Our method is quite novel. People think you have to kill mosquitoes, but we have a different focus.”
A core part of the EDP method and innovation is the way the team involves communities. Key for O’Neill is “authentic engagement before, during and after mosquito releases”. The teams and partners engage with local communities and share details of what is involved, and share results as releases progress. They involve the media. Their focus is on accessible and transparent communication and a respectful and inclusive approach.
“Our field trials in five countries in over 30 sites have shown no reported adverse events; and good disease blocking,” says O’Neill. “In Indonesia we are conducting a large scale release and an impact study across Yogyakarta through to 2019.”
This type of new approach requires forward and bold thinking,” explains O’Neill.
While still recognised as a new method, funding for all science based interventions continues to be a challenge. Eliminate Dengue is a non-profit organisation that is looking to increase its philanthropic and government support base globally.
“We believe governments would prefer our method because it is safe, and takes financial pressure off their health systems, especially in countries where they are low on resources,” explains O’Neill.
The work is possible because of the vision of great philanthropists such as Bill and Melinda Gates, The Tahija family, the Gillespie family, the Wellcome Trust and governments including the Australian, UK and Brazilian governments and USAID. In order to expand the life changing work, the scientific team are looking for more partners and supporters.
而沃尔巴克氏菌体对人体，动物和环境是安全的，通常在与人类食物相关的昆虫中发现，并且被人类广泛使用，对于人类或其他脊椎动物不会造成感染。至于消除登革热计划能消解伊蚊并阻止疾病的传播，那是因为EDP利用天然沃尔巴克氏菌体，降低蚊子传播有害病毒例如登革热，基孔肯亚和寨卡的能力。(沃尔巴克氏菌体也证实阻断黄热病(Yellow Fever)和西尼罗病毒(West Nile viruses)的传播。)
许多慈善捐献证实这项工作的可行性，包括闻名的慈善资金会：比尔及梅林达·盖茨基金会(Bill & Melinda Gates)，Tahija家族，Gillespie家族，维康信托(Wellcome Trust)，还有澳大利亚、英国和巴西政府，包括美国国际开发署(USAID)都一致愿景。而为了扩大这项改变生活的意义工作，科学团队正在寻找更多的合作伙伴和支持者。
AN ITCHY FACT:
There are over 3000 species of mosquitoes in the world and only two (Aedes aegypti and Aedes albopictus) are responsible for transmitting dengue, chikungunya and Zika.) The O’Neill team’s innovation is focussed on the Aedes aegypti mosquito.