Democratic Republic

DEMOCRATIC REPUBLIC of the CONGO One Health in action (2009-2020) Improving One Health surveillance capabilities to detect (re)emerging disease threats in the heart of the Congo Basin Photo credit: Jeffrey Marlow, Undark DEMOCRATIC Goma REPUBLIC Kinshasa of the CONGO WESTERN DR CONGO: markets in the capital city, we conducted DRC’s borders with Uganda and Rwanda. Throughout the central African region, syndromic disease surveillance in two large PREDICT worked inside the Mikeno sector demand for wild animal meat (also known hospitals in Kinshasa, which are proximate of PNVi and in the adjacent communities, as ‘bushmeat’) is constant, with as much to key bushmeat markets, and where capturing and sampling primates and bats. as one million metric tons of bushmeat market workers go for affordable medical As well, PREDICT enrolled consenting eaten each year in the Congo Basin. The care when they are ill. febrile patients (including park workers) Democratic Republic of the Congo (DRC) We initiated enhanced, coordinated presenting to health clinics in surveillance is home to endangered wildlife, including surveillance capacity between members activities, collecting biological samples and forest elephants, chimpanzees, bonobos, of the Ministry of Health, the Ministry of administering questionnaires to better and lowland and mountain gorillas who Fisheries and Livestock, and the Ministry understand the extent to which patients inhabit the lush forests. Unfortunately, the of Environment to explore the high-risk were in contact with wildlife. PREDICT biggest threat and leading cause of wildlife disease transmission interfaces. Since 2009, also worked in and around Kahuzi-Biega loss in the Congo Basin is the commercial the PREDICT project in Western DRC National Park in South Kivu Province, bushmeat trade, driven by an ever- was implemented by the Institut National where militia and rebel groups are increasing market. As was heard during Recherche Biomédicale (INRB), DRC’s engaged in illegal activities inside the park interviews with vendors by PREDICT premier reference lab, in close partnership (such as mining and bushmeat hunting), project staff, many wealthy city dwellers with the Kinshasa School of Public Health, where subsistence agriculture occupies indicate a preference for wild meat and private partners, public hospitals, and local the corridor between the park’s highlands will pay a premium for it, even when their communities. and lowlands, and where a national road transecting the park brings heavy traffic protein requirement can be met with EASTERN DR CONGO: cheaper sources (Foerster et al., 2012; of people and livestock into the park in From 2014-2019, the PREDICT project Schenck et al., 2006). Serving bushmeat vehicles and by foot from Tanzania, Uganda, has focused zoonotic virus surveillance in from protected species is a status symbol Burundi and Rwanda. Adjacent to PNKB wildlife and people in the North and South in urban populations and harkens back to is the Centre por Primate Rehabilitation Kivu Provinces because the region presents the nostalgia of hunting traditions in the de Lwiro, which receives and cares for complex challenges at the human-wildlife village. Vigorous trading of wild meat to confiscated and rescued wildlife, mainly interface. Virunga National Park (PNVi) in satisfy urban demand is widespread in all great apes and other primates. North Kivu is a large and highly biodiverse major Central African cities (Hennessey & In North and South Kivu, the PREDICT protected area with abundant wildlife Rogers, 2008; Mbete 2011), including in team collected samples from 141 non- resources, but is a place where militia and the great metropolis of Kinshasa, DRC’s human primates, 289 bats, 12 rodents rebel groups routinely set up camps inside capital city of nearly 12 million people. and 416 febrile human patients. Molecular the park, hunters and harvesters illegally methods (PCR) were used at the Institut For these reasons, our team adopted a enter the park to set snares and make National de Recherche Biomédicale specific focus on the bushmeat trade and charcoal, and community members utilize (INRB) in Kinshasa and at the University of movement of wild animal meat along the bat roosting caves inside and adjacent California Davis One Health Laboratory animal value chain from nearby hunting to the park as water sources. PNVi is to screen samples for evidence of infection and trapping communities in Kongo also visited by international tourists who with or exposure to potentially zoonotic Centrale, which serves as a source of wild come to trek human-habituated mountain pathogens of pandemic potential. animal meat feeding into the bushmeat gorillas. Generally speaking, the area sees markets in Kinshasa. In addition to targeting a tremendous flux of people crossing DEMOCRATIC REPUBLIC of the CONGO>100 DEELOPED the One Health Worforce by training ore than 100 eole in DR Congo. LABORATORY STRENGTHENING5.8 · Institut National de Recherche Biomédicale OPERATIONALIED One Health surveillance and saled over .8K anials and eole, heling iniie the sillover of oonotic disease threats fro anials into huan oulations. 22 29 52,958 PREDICT KNOWN DETECTED 1 unique iruses in both anial and TESTS huan oulations. Global Health Security Agenda >100 DEELOPED the One Health Worforce by training ore than 100 eole in DR Congo. >100 5.8 DEELOPED the One Health Worforce by training OPERATIONALIED One Health surveillance and saled ore than 100 eole in DR Congo. over .8K anials and eole, heling iniie the sillover of oonotic disease threats fro anials into huan oulations. 5.8 22 29 PREDICT KNOWN OPERATIONALIED One Health surveillance and saled over .8K anials and eole, heling iniie the sillover of DETECTED 1 unique iruses in both anial and oonotic disease threats fro anials into huan oulations. huan oulations. 22 29 PREDICT KNOWN DETECTED 1 unique iruses in both anial and huan oulations. WESTERN DR CONGO LOCAL PARTNERS • Centers for Disease Control • Central Veterinary Laboratory of Kinshasa • Food and Agriculture Organization • Institut Congolais pour la Conservation de la Nature (ICCN) • Institut National de Recherche Biomédicale (INRB) • Kinshasa School of Public Health (KSPH) • Lola Ya Bonobo Sanctuary, Kinshasa • Metabiota, Inc. • Ministry of Environment • Ministry of Fisheries and Livestock, Direction de la Production et Santé Animale (DPSA) • Ministry of Health • Mountain Gorilla Veterinary Project (MGVP) • WHO DRC Disease Surveillance team • World Organisation for Animal Health, DRC CHARLES “The PREDICT Project has enabled young scientists like myself to improve our knowledge of microbiology and sample KUMAKAMBA collection through its protocols. With PREDICT, I gained Country Coordinator much experience and grew scientifically.” Metabiota “I have benefited from learning new methods of detection and MARIA characterization of viral pathogens as part of the PREDICT Project. My training as a researcher in the laboratory has MAKUWA been enriched by field work and exchanges with the local Laboratory Advisor & populations—activities hitherto unknown to me. This program Administrative Coordinator also allowed me to share my knowledge with my young colleagues Metabiota and learn from their experience.” ACHIEVEMENTS • Detected bocavirus DNA resembling human bocaviruses with market vendors, managers, and patrons about the in 6 wild non-human primates, which indicates viral possibility of disease transfer between wild animals and sharing; uncovered evidence of more than a dozen humans while distributing information on how to keep different bat coronaviruses, which are of high interest safe from infection. in light of past outbreaks of SARS and MERS; amplified • Helped establish functional communications and 20 different herpes viruses from over 100 primates collaboration between animal and human health and rodents, shedding more light onto the diversity of organizations enabling ministries to better communicate this viral family; and identified 3 novel species of rodent research findings, organization goals, and challenges, thus adenovirus DNA, highlighting how little we know about demonstrating how the One Health framework can the hosts of this virus family. provide value to national health security. • Confirmed the presence of Zaire ebolavirus RNA from • Conducted 179 semi-structured qualitative interviews a human, as part of an outbreak response where the and 12 focus groups with vendors, butchers, and other PREDICT team assisted the government of DRC actors in the animal value chain and identified risky in identifying the causative agent of an unknown behaviors, interfaces, and key areas to inform continued hemorrhagic fever and yielding the first sequence of this and targeted surveillance, as well as risk reduction outbreak’s strain, contributing to the rapid containment recommendations for improved health security. of the epidemic. • Organized an International One Health Day zoonotic disease awareness campaign at the La Liberté and Ndolo markets where bushmeat is sold, and held discussions ONE HEALTH SURVEILLANCE The PREDICT project’s One Health surveillance approach The PREDICT team collected animal samples from nine was designed to strengthen capacity for detection of emerging viral bushmeat markets around Kinshasa. Through hospital based threats and to improve our understanding of risk of zoonotic syndromic surveillance, the PREDICT/Western DRC team WESTERN DR CONGO diseases in communities with close and frequent animal contact. enrolled 418

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