Ebola Bundibugyo: Africa's Wake-Up Call for Science and Preparedness | ACRN Podcast EP06

Ebola, Diagnostics, and Africa’s Scientific Future: Dr. Tariro Makadzange on the Bundibugyo Outbreak

A new Ebola outbreak in Central Africa is raising urgent questions about disease preparedness, diagnostic capacity, vaccine development, and Africa’s ability to respond to emerging health threats.

In this episode of the ACRN Health Podcast, Dr. Wilfred Gurupira sits down with Dr. Tariro Makadzange, CEO of the Africa Clinical Research Network, infectious disease physician, and vaccine immunologist, to unpack the science behind the current Bundibugyo Ebola virus outbreak and why it presents unique challenges for public health systems. 

Together, they explore:

•  Why this Ebola outbreak is different from previous outbreaks 
•  The Bundibugyo strain and why existing Ebola vaccines and therapeutics may not be effective against it 
•  How diagnostic gaps delayed outbreak detection 
•  The critical role of genomic surveillance and laboratory capacity 
•  Why Africa must invest in its own scientific and diagnostic infrastructure 
•  The challenges of developing vaccines and treatments for diseases with limited commercial incentives 
•  What this outbreak reveals about clinical research, public health preparedness, and healthcare systems across the continent 
•  How ACRN is working toward an "always-ready" clinical research ecosystem for future outbreaks 
•  Why stronger science, stronger health systems, and stronger collaboration are essential for Africa’s future 

Dr. Makadzange also shares a powerful vision for Africa’s life sciences future—one where African scientists, institutions, and innovators lead the development of diagnostics, therapeutics, vaccines, and clinical research that address the continent’s most pressing health challenges. 

This is a timely conversation about infectious disease preparedness, scientific sovereignty, and the investments needed today to protect future generations.

Listen now and join the conversation on the future of clinical research and public health in Africa.

#Ebola #PublicHealth #ClinicalResearch #AfricaCDC #InfectiousDiseases #Vaccines #Diagnostics #GlobalHealth #LifeSciences #ACRN #HealthInnovation #DiseasePreparedness #Genomics #AfricaHealth #MedicalResearch

Transcript

SPEAKER_00 0:00

This month, May 2026, health workers in the Eastern Democratic Republic of Congo started dying. Four deaths in four days. Once the virus was real and the threat was escalating, tests kept coming back negative. Today we find out why what that means for Africa and what the continent research networks are doing about it.

SPEAKER_01 0:24

The WHO has declared a public health emergency of international concern. So as of uh today, uh there have been over a thousand suspected cases, and there's a bit of a disconnect between the Welcome to another episode of the ACRN Health Podcast.

SPEAKER_00 0:59

My name is Wilfred Gurupira, and I'm joined by someone who needs no introduction, uh Dr. Tariroma Kazange, the CEO of ACRED. Although today we have her in her capacity as a practicing infectious disease physician and a vaccine immunologist. Welcome, Dr. Tarirong.

SPEAKER_01 1:18

Thank you, Wilfred.

SPEAKER_00 1:19

So getting straight into it, um uh Dr. Tarirong, there is an active Ebola outbreak there right now, and um the assumption most people will have is they know and understand what an Ebola what Ebola means, and myself included, I mean we've we've had outbreaks before. But it seems like this outbreak is different in a very specific way. So can you just start by explaining what exactly is happening and what what are we dealing with?

SPEAKER_01 1:48

Yeah, thanks, thanks Wilfred, and I think it's a good good question to start off with. When most people hear about Ebola, we think about the 2014 to 2016 West Africa epidemic, uh, or uh a little bit more recent um DRC outbreak in 2018 uh to 2020, and there was uh more recently one in Uganda as well. But the West Africa and the DRC outbreaks, those are caused by the Zaire Ebola virus. Um there are um many different members of the Ebola virus family, about six, six of them, uh four of them that are known to cause um significant human disease. And so the Ebola Zaire is the one that we know uh quite a lot about. Um, and the one that we've built uh therapeutics and vaccines against. But this one that is currently circulating right now in the DRC and Uganda is a different species entirely. Uh, it's the Bundi Bugio virus. Uh, I'm gonna call it Bundi for short, if that's okay. Yes, uh the Bundi Ebola virus. Um, and uh that's that distinction is a real uh distinction. Um, and we will talk a bit about it more, uh, but it is a different uh virus um uh than the Zaiv virus that uh we have since uh built some monoclonal antibodies licensed uh vaccines. Um but at the moment uh none none of those therapeutic options exist for the Bundi uh virus.

SPEAKER_00 3:29

Okay, but surely, uh Dr. Tarilo, this is not it it could be a different uh strain, the Bundy virus, but we have it covered, surely?

SPEAKER_01 3:42

We have it covered, not quite, and this is why you know science is is so important. Um uh not quite. We're really at the beginning in terms of countermeasures. There's no licensed vaccine, there's no approved uh therapeutic um beyond supportive care, which is very important, and we learned a lot about supportive care in the West Africa epidemic. Um but this is a species that before around 2006, there were only uh two recognized outbreaks of this particular strain, one in Uganda in 2007 and one in the DRC in 2012. So it's relatively rare, it's relatively understudied, um, and we've kind of been caught without the necessary tools that we need for for counter countermeasures.

SPEAKER_00 4:36

Hmm. That's that's yeah, that's that's quite something when you when you say it like that. Um so give us a sense of the scale. Um where are we as as of today?

SPEAKER_01 4:50

So as of uh today, uh there have been over a thousand suspected cases, and there's a bit of a disconnect between suspected and confirmed cases, but over a thousand suspected cases and 121 confirmed uh cases. Uh, Uganda has seven confirmed uh cases, all of those linked to importation uh from the DRC. Uh the WHO has uh declared a public health emergency of international uh concern. Um, and we're really here looking at uh some confirmed uh spread, particularly in the Turi region, the North Kivu, South Kivu regions of DRC, um, and then a linked case as far as uh Kampala, uh, and then one uh patient that was transferred uh to Germany. Um so it it is um quite a significant um event, uh, particularly with the large number of suspected uh cases. Um uh the confirmed cases are lagging uh behind for a number of reasons, uh, but the suspected uh cases should really make us all pay significant attention, as the WHO has done.

SPEAKER_00 6:08

Okay. From your description, it it sounds like uh we don't have any deaths recorded um from your statistics. What is the current death toll, if any?

SPEAKER_01 6:21

So there have been uh deaths recorded. So this is data from a couple of days ago, um, about 17 confirmed deaths and over 200, close to 250 suspected uh deaths. Um the gap between suspected and confirmed, similar to the uh diagnostic testing uh piece, uh, is something that we should talk about, um, particularly relating to the importance of of diagnostics in this outbreak and in any any outbreak.

SPEAKER_00 6:56

Yeah, I I was actually going to uh it's funny you say that. I was going to kind of quiz you about that, this gap that you keep referring to. It's it's it's an alarming detail. Um, and it's something I spoke about when I started this podcast. That gap and um detection, or rather, how this outbreak wasn't detected initially. Can you just walk us what happened with these gaps and how how did they happen?

SPEAKER_01 7:25

Yeah, so when you start to look at the reporting uh timelines, um there's a sense that the actual outbreak started in late August, so probably around the 24th or sorry, not August, April, uh probably around the 24th of April is when we think we know the earliest known uh case. Um uh but the um the World Authorities WHO was alerted around the 5th of May uh when four healthcare workers uh died um in uh Mongvalu uh in Ituri province. Um and that's uh something really important to note, right? Our healthcare workers are really at the front lines. Um many of us and many people listening to this podcast are healthcare workers. We do this because we love our work, we love our patients, we love uh what we do. Um and um uh uh healthcare workers doing what they do best, taking care of patients, may not have realized uh what they were uh dealing with. So it was when uh these uh healthcare workers died um uh that there was concern um uh that something was going on, some high mortality illness. It wasn't necessarily clear that it was Ebola uh at that time, in large part because the assay that was used uh to test uh for this, um, in this case, the gene expert Ebola assay is good at detecting uh Ebola Zyea, but kept coming back negative uh for for this uh particular uh strain. So they didn't think they were dealing with Ebola. Sorry.

SPEAKER_00 9:14

Right. No, I just I just wanna that's uh it's a point I want you to kind of elaborate on. How does a test uh come back negative? How is that possible?

SPEAKER_01 9:28

Yeah, it's it's a great question. Um so so tests are designed for specific purposes, right? So a gene expert test is a PCR-based uh test, uh, and as a PCR-based test, it's designed to pick up the specific pathogen. Uh so um scientists have studied the sequence, uh, found the areas of uh the pathogen that are best suited for a diagnostic uh test, and have created uh the tools, uh things like primers that are specific uh to that pathogen. Um, and so this uh test, an assay, is very good at doing what it's supposed to do, uh detect um Ebola Zaire. But as we mentioned right at the beginning, the strains are quite different from each other. There's something like 40% sequence divergence between the Bundibuncio virus or the Bundy uh Ebola virus, as I'll call it, and the Zaire uh Ebola virus. And this sequence diversity um is what uh drives some of the challenges around vaccines, uh monoclonal therapeutics, and diagnostic uh probes that have limited the diagnostic uh detection of this uh particular strain. Um so it was not, it was only when broader pan-phylovirus, um, belongs to a broader family known as the phylovirus uh family. It was only when those broader PCR assays uh were done at the INRB uh laboratories in DRC that it was then confirmed as the Bundibuggio uh uh virus uh in mid-mid-May.

SPEAKER_00 11:18

Okay. So if we look at uh the timelines that you've just spoken about, April uh is when we suspect uh the first cases, but clear identification, like you've said, on the 15th of May, that's a month between the first case and confirmation. If we look at it in terms of uh timelines, you if if we work by the information that you've just said, uh you suspected case in April, but confirmation in May, um that's what? That's nearly a month between that case and confirmation.

SPEAKER_01 11:59

That's that's correct. Um that's that's correct. Um, so so this uh gap um is really important to note because it likely allowed some wider uh community healthcare associated transmission before anybody knew what we were dealing with. Um so so this is a systems failure with genomic uh roots to it. Um so we've built our diagnostic infrastructure around one specific Ebola virus uh species, and this outbreak has exposed um the risks of that kind of assumption.

SPEAKER_00 12:38

So kind of taking it broader, um what does this mean for the ACRN and what does it mean for the labs that uh within the ACRN network?

SPEAKER_01 12:55

It's a great question. I I think less specifically for ACRN and the labs within the ACRN network, but maybe I'll take it out a little bit more and more think about it for Africa in in general, right? So uh, you know, the ability to um build our own diagnostic tests is currently relatively limited on the continent, regardless of of this particular outbreak. So that is a problem that I think we as a continent need to deal with and to address. For example, if you are a young student at the University of Zimbabwe and you want to explore studying a new virus, um let's say not at all related to Ebola virus, and you download the sequence from a public registry, uh, just as uh the team in the Congo and Uganda have done, they immediately publish the sequence data into a public registry. Um let's say you wanted to study a virus, uh pull the sequence from a public registry, and you want to design primers so you can uh study that virus or even detect or test that virus, it's actually quite difficult for you to do that. Um there are very few uh labs opportunities uh for you to purchase primers locally. Uh, you might need to purchase primers from Europe, from Asia. Uh, there is a group in South Africa where you can purchase uh primers, but it also takes you a long time, etc. So you're at a significant disadvantage to scientists elsewhere in the world. So aside from the Ebola question, I think there's a very real question on our capabilities on the continent to be able to do science. We're quite hamstrung uh in that regard. And then more specifically to the uh Ebola uh um uh concern and issue, um, you know, it made sense to focus on the Zaire strain that was the cause of some of our major um uh uh outbreaks. But it's also important to realize that you know viruses exist with us as humans. Um uh they are environmental, ecological, social things that happen that can really surface uh epidemics and being prepared. And so it's great that they had this panphylovirus um uh uh assay that enable them to detect Ebola. Um and maybe now the challenge for us is to um uh develop a gene expert like it doesn't necessarily have to be gene expert uh assay that can be taken to the grassroots um in regions that are most affected, for them to be able to much more rapidly include that, rapidly and cost-efficiently include that as part of the diagnostic testing panel.

SPEAKER_00 16:00

Okay, very interesting, very interesting points that you raised there. Um so uh I want you to talk a little bit about some of the information that has come out um with this new strain. I'm sure there's a fascinating story there.

SPEAKER_01 16:18

Yeah, so so the the labs in in the Congo, so the INRB and the Central Public Health Labs in Uganda really moved fast and and and should be applauded, um uh moved fast to generate and then publicly share those uh genomes uh uh via a number of public uh genome sequencing uh databases. And that's a plus, right? The more that we share data globally, the more likely it is that you know somebody in Lagos or somebody somewhere else can rapidly develop uh the diagnostic tests and start to think about the science uh of this uh pathogen. Um uh and so these uh showed uh that um uh this was uh the Bundibugio um uh strain and that these uh 2026 uh uh virus clusters uh cluster tightly together and are distinct from the 2007 and the 2012 uh outbreaks. Um so this suggests um uh that uh it probably is a new spillover from an animal reservoir, uh, most likely, rather than a continuation, a low-level continuation of a previous uh strain. Um we don't know what the host uh is, um, but the sequencing data can start to really help folks start to think about the epidemiology um and the transmission uh dynamics as well.

SPEAKER_00 17:56

So so so Dr. Tara, if I if I'm getting you right, um, and I'm I'm gonna go very slowly here because of the weight of what you're just saying. Are you saying that with this Bundy virus, Ebola virus, this is a new introduction from an unknown source?

SPEAKER_01 18:17

That's most likely that's correct. So it's it's possible that the virus kind of came in somewhere between late March um and late April and has been uh circulating un undetectable uh before it really announced itself um uh uh through this cluster of healthcare, healthcare care workers.

SPEAKER_00 18:48

Okay. Yeah, uh I I'm still uh uh trying to get wrap my mind around around that. But uh maybe let's move to something a bit more upbeat. Okay, so treatment. Um Ebola. Uh we've had outbreaks before, there's been treatments, uh surely there's a treatment for this?

SPEAKER_01 19:11

So so treatments um uh uh Wilfred um are really driven by science, right? And and that's really part of the premise of um what we're constantly talking about as ACRN. Um so as ACRN, we're talking about clinical research, clinical trials, etc. But that is only a small part of the full ecosystem of life sciences and life sciences uh development. A really critical part is being able to generate therapeutics. Uh, so the upstream part, the science, the discovery science, and then the pharmaceutical component of developing uh therapeutics. So, because of the outbreaks uh caused by Ebola Zaire, uh, they have been uh treatments developed uh for ebona xyre, and we've made some pretty remarkable progress, and there were some really pivotal uh clinical trials that uh that really highlighted um uh the efficacy of the therapeutic uh agents. Uh so there have been two um monoclonal antibodies, uh one marketed as Ibanga and the other known as in Mazib from uh Regeneron as well. Um and those uh showed that they work, they save lives. There was the PON trial uh which uh showed the impact of these monoclonal uh antibodies um uh in reducing uh mortality. Um uh so we do know for Zaire that they are uh therapeutics uh available. Uh and then uh similarly uh vaccines were developed, um, but we can talk to that a little bit later. Um but yes, therapeutics exist for Xaire, um, but therapeutics uh do not currently exist or no known therapeutics currently exist uh for the uh Bundibuchiode uh string.

SPEAKER_00 21:16

Yeah, Dr. Tara, you have to give me some wins here. Unknown uh source, no known therapeutics. I I need I need some sort of win here. And it it kind of feels a bit like going back back in time where you know we didn't have anything uh for for treatment. Give me a win, please.

SPEAKER_01 21:36

Yes, Wolfrid. So they they you know the one of the key things. So earlier we talked about the sequence divergence, right? Um, and and these antibodies target certain proteins, like glycoproteins uh on the virus particle. And so these were specifically targeting the xyea glycoprotein, um, but you know, the Sequence genomic diversity is pretty broad, so you can't really assume that there's cross-neutralization and that the ZIEA specific products will work. It's obviously important to test that and to see where the science uh takes you. Um, but right now the mainstay for patients with the Bundibuggio virus uh outbreak is supportive uh care. Uh so that really means um you know managing uh the uh physiological impacts of this viral infection, and that's becomes very difficult in relatively low resourced uh places, uh low-resourced uh settings. But thinking about fluid resuscitation, electrolyte management, hemodynamic support, treating coinfections, all of that is very important. And we learned a lot in the um West Africa epidemic. Um, and so so there's a lot of lessons from there that can be uh can be very, very useful uh in supporting the management and care. Um, but you know, again, this is happening in a setting with very challenged healthcare systems, which again really brings the point that, you know, we as Africans, you know, we're only going to thrive economically, socially if we have good healthcare systems. Um they don't have to be fancy healthcare systems, but they have to be functional healthcare systems uh that can enable us uh to manage crises such as these.

SPEAKER_00 23:39

Yes, well uh yeah, very good points, very good points. Maybe what I want to ask you, Dr. Taler, um what we currently have, the support of care, is it enough?

SPEAKER_01 23:51

So it's always important to try and develop um investigational uh uh agents. Um, and um uh the WHO has put out countermeasures, uh road map. Um, so looking again at antibody uh therapeutics, um, you know, are they antibody uh therapeutics that do have activity? Uh there's some uh uh data and animal um uh on animal models uh that suggest uh that there may be antibodies. Um so all of these have awful long numbered names before they uh get an awful un easy to say commercial name. Um but there's uh one called MBP134 uh AF that has some activity and in animal uh models, um, has done some phase one uh studies. So that is part of the the roadmap. You know, certainly monoclonal antibodies would be would be great, but at the moment we we don't have uh yet human uh efficacy uh data. Uh and then there's also an oral agent. So you know, monoclonal antibodies are great, but we've just talked about how fragile healthcare systems are on the continent. Um so imagine you're dealing with a crisis, um, then you're trying to get an IV in place, you know, even in the best of times in Harare, you know, getting an IV, normal saline, etc. etc. Now imagine you're out in the middle of nowhere in an area where uh there's um what we call in Zimkosa, you know, there's war, there's conflict, um, uh there's uh artisanal minors, I think is the the English. Yes, that's uh so you know the an area of quite relative instability, um IV therapeutics become quite a challenge. Uh so there is an effort on aurals, um oral therapeutics would be ideal. You know, unfortunately, um uh um uh small molecules have not performed as well as the monoclonials in in the Xyir um epidemic, uh, but maybe a small uh molecule could have activity here. So there's uh work on a pro-drug um uh called a bald desivir, uh which is a pro-drug of remdesivir, uh, which has uh some activity against uh phyloviruses. Um so that has shown some uh data, non-human uh primates um and and some post-exposure trials are um in the works for other strains, so like the Ebola, the Sudan uh variant. So it's unclear how this would work with the Bundy uh Buggio uh strain. Um so I don't know where that that is um at at this stage, but therapeutics are desperately needed.

SPEAKER_00 26:57

Yes. Uh and vaccines is is is anything happening in that space?

SPEAKER_01 27:02

Yeah, so so vaccines, um so so again, you know, for the Xaire vaccine, uh there was a recombinant VSV uh Ebola virus uh that was uh developed, um, and that was uh targeted specifically for the Xaire uh Ebola virus. Um and then there was an AD26, so an adenovirus, uh together with an MVA uh Ebola virus uh vaccine that was uh developed. Um but unfortunately um uh that um uh the EU marketing authorization was withdrawn by the sponsor uh in May of this year for commercial reasons, um uh commercial reasons, not safety uh reasons. Um uh but again, none of those are licensed for Bundibuggio, um, and there's no real reason to believe that they would necessarily work for this uh strain. Um so they are intense efforts uh underway uh from a variety of groups, um uh the the groups at Oxford, etc., uh, to develop uh vaccines for Bundibuggio. Um if I may put in a plug for the continent as well here, um, this is another reason why you know our leadership really needs to invest in science. Um, you know, these sorts of countermeasures uh should be um developing in our labs, in our institutions, in our universities, uh, with our young people driving uh the science. So I'm hoping that you know we learn some lessons from COVID. I think nature is always giving us a wake-up call, viruses, bacteria don't care about your politics, they have care. You know, you have 55 countries, you you have disordered um you know, uh financing priorities, but if we prioritize us as uh humans and human health, um we really need to be investing in driving that science that develops the monoclonials, the the small molecules, the vaccines uh locally. It's not there today, but can we today start to commit to this so that 10, 20 years from now, this kind of outbreak, you know, there's young folks in Accra or in Harare that are developing the therapeutics to solve this?

SPEAKER_00 29:38

Well, okay. I was going to ask, I mean, if we have spoken about uh the drugs, the oral drugs, the pro drugs, uh some of the vaccine work. Someone listening may have this question: why don't we have a vaccine for uh the Bundy uh virus? I mean, it's not a new virus, and you know, you've explained that it's uh there's that generic uh genetic variation, but surely by now we should have developed a vaccine, maybe in anticipation?

SPEAKER_01 30:15

It's a great question. So, you know, uh as you probably remember from COVID, you know, humans we have a very short memory, right? We were all locked down and miserable, and then immediately after things opened up, uh, you know, we totally forgot that we had gone through a pandemic. We we even started to have people who were vaccine skeptics after the vaccines enabled us to get back to life, etc. And so one of our challenges as humans is we have short memories, we're very quick to move on to the next thing. And you could argue with the Bundi Strain, Bundi Bugio, that um, you know, there had only been two relatively smaller outbreaks before. And so the commercial imperative to develop a therapeutic was relatively minimal. Um, and and so, you know, perhaps that's why it was identified and then forgotten, you know, nobody funded uh extra extra research uh on this. Um and for too long for us as a continent, our research funding has been from external partners, uh, whereas you know, if things were operating where they should be, um, as Africans, as AU, as that, you know, the Central East Africa region, um, you know, could have pulled resources together to support investigators in Congo, Uganda, etc., to better study the strain, study the immunology, uh uh study, you know, what are the correlates of um uh uh protection, if there are any uh uh what what do we need to be targeting for an effective uh vaccine? Um so you know the challenge for these Africa-specific diseases is there is no market, right? There's no commercialization pathway. And so where you don't have a commercialization pathway, you need a national, a public system that says this is important, we're gonna support the research in this because this is important. And that's why you have in China the government funding research and the US the NIH funding research, etc. There's no commercial drive for this, but there's a massive public health uh drive for this. Um so putting in those public resources is going to be important. And then you you do have global entities uh such as SEPI, etc., uh, that are also there to think about the viruses that other folks who may not have a commercial imperative to develop, um uh but um you know the need to develop is there uh because you do lose lives as we're seeing uh now. Um and even though some countries are closing borders, you know, seeing uh in the US some screening, etc., uh wanting to put a hospital in in Kenya so that you know any um Americans get seen there, et cetera, et cetera. You can do that, but you know, the thing with infectious diseases, it doesn't respect our borders. And so we we all need to work together as humans to target um uh known as well as unknown pathogens that are likely to cause significant morbidity and mortality.

SPEAKER_00 33:43

Wonderful. I like how you're phrasing it, and it leads me very nicely into what so what can we do? Um talking uh specifically about the ACRN and and our mission as an ACRN. This outbreak is happening on the continent, it's happening in in two countries uh where we operate. What's our role in a situation like this?

SPEAKER_01 34:09

Yeah, so that's a great, great question. Um, and for us as ACRN, we're still young. We're we're only about a year and a half, two years old, so we're really building the systems. But my goal and hope is that in two, three years uh time we really have all the systems to support and enable the clinical trials piece uh to support this kind of effort. And and that's part of our mission, having an always-on, always ready system that can be rapidly deployed to enable clinical trials. There are a few things that are already taking place and a few things that regulators uh can do. Uh so one, when you look at clinical trials and studies, part of the biggest challenge is that startup period. That startup period takes too long from you know, an outbreak has happened, first patient, first visit for a trial. So, what we really should all be doing collectively, and I think Africa has a unique opportunity to do this, is to think in peacetime, and these peacetime windows are relatively short, right? A couple of months ago we were talking about, or less than a couple of months, we're talking about hunter virus, Ebola virus. There's always something going on. But are we planning for that? Are we making sure our regulators are smooth, effective, efficient? Um, are we using technology appropriately to enable us to get from that ideation to a protocol, to uh a data collection uh system efficiently and more uh streamlined? Do we have contracts in place so that getting a study up and going is not months of lawyers going back and forth debating uh terms, but things are already kind of well uh set up, and we can plan the budgeting, the logistics, the operations to be able to execute and move studies through. And so what some places are doing is having protocols, uh defined emergency protocols uh in place uh that regulators have uh looked at um uh already, that ethics uh committees uh have uh looked at um uh already. Uh, and Uganda did this very nicely in the 2025 uh Sudan uh virus uh outbreak that enabled them to launch a uh ring vaccination trial within weeks of the outbreak uh beginning. So doing those kinds of things at peacetime and peacetime and quotation uh is really important. So that that startup is very, very quick. And then another critical piece to this is the community engagement and trust uh building. You know, I cannot overemphasize that. And we talk about that as one of our pillars because it's so important. No, now imagine if you are in um uh the province where this outbreak is taking place, you've taken your your baby to the the clinic, they're not feeling well, you didn't get a diagnosis that it was Ebola, you went back home, um, uh the baby got sicker, your husband, your child got sicker, everybody's not doing well. How is that going to affect your perception of the healthcare system, your perception of trusting uh the healthcare um uh system? And despite all of the good intentions of the healthcare workers, um, you may lose communities as you try to do things like ring vaccination, etc. So I think really thinking about community engagement all the time is super important. You know, do we really understand the pathogens that affect all of us? You know, as scientists, we assume everybody thinks as a molecular biologist, but the vast majority of people, you know, don't know what genomics is, uh, don't know uh uh what a bacteria is, what a virus uh is, etc. So what are we doing to communicate that uh all the time? Similarly with trials, you know, the social media is super strong at giving the perception, oh, you're a guinea pig, or oh, vaccines are bad, etc. They message us super loud. Um, but our message is not as loud. And how can we do that intentionally all the time, putting out a message to help people understand? Because in the research that we've done, you know, understanding is a key component, knowledge is a key component. And it's not just an Africa thing, it's a US thing, it's a Europe thing, it's a global thing, knowledge about diseases and pathogens, then understanding safety, side effects. That's what most people are concerned about. How does this affect my family, my kids? Is it safe, etc.? Understanding the purpose of trials. We would not have the vaccines, the therapeutics for Zaire if those trials were not uh done, and if we didn't have systematic evidence. So building that trust is super important and really makes or breaks any not just trial but any subsequent uh intervention.

SPEAKER_00 39:38

Right. And as as a network, the ACRN is building towards that uh amongst other things, right?

SPEAKER_01 39:45

Yeah, absolutely.

SPEAKER_00 39:51

So I I just want to get into um some of the um plugins that you're mentioning about Africa, and we now know there's um it's it's important that we have our own data, like you said. Um we understand sequencing and and and genomics. How does our infrastructure fit into um into all this?

SPEAKER_01 40:21

Our infrastructure is ACRN or the infrastructure we need to build as a continent.

SPEAKER_00 40:28

As a continent.

SPEAKER_01 40:29

Yeah. So I think the the investments that have been made over the last few decades, um, particularly around infectious diseases, have really helped. Um, and and that's how you have uh stronger public health laboratories, etc. Uh, as overseas assistance for those systems diminishes, I think we have to be very intentional as Africa, and this is where the AU, the Africa CDC, the continental bodies become super important. We have to be intentional as Africa about how we pick this up and how we continue uh this uh this thread. Uh, because this this is um so pivotal, right? We we um have built-up scientists uh who can uh do the diagnostic tests, uh support the epidemiology, etc. How do we keep that resourced uh at all times, at peacetimes, as well as uh at outbreaks? Um, how do we ensure that uh those capabilities are sustained is super important. And that's down at the institution level. So are those institutions resourced and able to do the work that they do, but also goes up at the policy level. Uh are we creating policies that promote science? Um creating policies that promote our own drug discovery, development, therapeutics uh discovery, clinical trials. That's the niche that we're uh currently focused on as ACRN. But the whole ecosystem needs to exist. Um none of this is going to work if we don't have the full ecosystem from the policy side to the research side, to the drug development side, to the clinical trial sites, uh, to the registration, uh, the regulatory aspect. Um and it's great that many of these components starting to come together on the continent. AMA is great. Uh the the work uh that networks uh such as ourselves are doing, uh, universities, uh, research institutions, the public sector. Uh none of this is going to work if we're gonna expect it all to come from government. It's it's not gonna come from uh government. What government needs to do though is create an enabling environment uh to support science and then pick up the areas where there won't be a commercial value and a commercial interest?

SPEAKER_00 43:09

Wow. So I'm Dr. Tango, I'm just reflecting on everything that we've been discussing today and some of our previous conversations, particularly about how you know Africa is such a large disease burden, but not enough of the clinical trials are done in Africa. And so I have to ask you, does this current Ebola outbreak reflect that problem?

SPEAKER_01 43:35

Totally. Totally. Please explain. Well, if I had an alternate universe and and we don't have an alternate universe, but it you know, if you look at China, and I've said this many times, you know, twenty, thirty years ago, the China FDA was no different from MCAZ, right? And Zim is a tiny country on the continent, so it's the same across the continent. But what was different? And you know, they scholars who know this even better than I do, but as uh just reflecting on it, a couple of things strike me. So one is a recognition that life sciences industry is at the core of any economic development, right? Science in general is at the core, whether you're talking about physical sciences, computational, engineering, etc., there's no country on the planet that develops without substantive uh investments in science. But life sciences is super important. It's a major source of GDP if you look at Europe and North America, and China recognized uh that. But it's also critical for keeping your population healthy. If you want to thrive, you need to have good life sciences, good therapeutics for society uh to thrive. And then, secondly, making it a national priority. So just as we prioritize mining and you know, a whole bunch of other things, let's prioritize life sciences so that the story in 20 years, and and I say 20 years because I know this is not a flip off a switch, but it's a lot of intentionality that builds towards it. So that the story in 20 years is very different from the story today. We are globally collaborative, and science by its nature is, but you really have the roots on the continent that you can address this, um, not only from the epidemiological side where we're very strong, but all the way from the discovery, the drug development, the trials, the registration, that full independence and capability and leadership. Um, you know, I'd love to see in 20 years, you know, more innovative drugs coming out of Africa than anywhere else. Um it seems crazy to say it, but I think if we're intentional, uh we can do it. There's no reason why we couldn't do it. So that's a long aversion to the question you asked, but absolutely this is not necessary to happen in the future. And also, I mean, part of this happening is where is it happening? It's in a conflict zone with artisanal, you know, the whole environment creates this kind of outbreak uh to happen. Um, and so that really brings much broader social-political questions and and issues uh to bear. So you obviously have to fix those things as well, um, but also having a strong life sciences uh industry is is very important.

SPEAKER_00 47:00

Okay. So as we come to the end of this podcast, I I want to ask you in the in the coming weeks, what are you most closely watching for with this particular outbreak that our our viewers and our listeners can also tag along?

SPEAKER_01 47:20

I think there are there are a few things for us to to closely uh watch and and um you know hopefully uh these things will happen and advocate for. I think here the leadership of the um African CDC, the AU, the local country health systems, governments, um, and you're seeing some of that come together quite nicely, the WHO, uh all of these bodies are very important uh bodies for um uh supporting and and controlling uh these kinds of uh outbreaks. Um so really be watching uh for that. Um also be watching for innovations, what sort of therapeutics are being uh developed, what sort of trials are taking place, um, how quickly, efficiently, effectively are those trials uh taking place, and how are we learning the lessons from this to mitigate and prevent uh the next um uh uh outbreak? Um and then I think collectively, as humans, remembering that we're all in this together, you know, these sorts of things you can't really shut your borders uh to um uh because the world doesn't exist that way anymore. Uh so a crisis in one part of the world is a crisis for all of us. Um, and infectious diseases and pathogens um uh can uh overcome us if we don't work collectively uh as humans to to address the risks uh that that face us uh and improve the health and and the lives of everyone everywhere. Uh this will not stop uh unless we have stronger healthcare systems, stronger science, stronger inclusive research uh and science to tackle all the global issues.

SPEAKER_00 49:16

Very, very, very important points. Um and and and thank you for giving us pointers on what to look for. So any any any final thoughts? Um any thing to you know for our viewers and listeners to to take away?

SPEAKER_01 49:35

Yeah, so I think my final thoughts are really, you know, thoughts to the communities that are being affected uh by this outbreak, to the healthcare workers who are really at the front line of addressing uh this um uh outbreak and the public health officials uh that are leading this. Um, you know, they there's some unsung heroes in this world, and I think our public health uh personnel and officials are really among among those and the frontline uh health workers. Um so really concludes off with thoughts to them. Uh and then also to say, you know, we we have an ambition and a vision and a dream for Africa that may uh seem you know out of proportion to the reality on the ground. But just to say that as a continent, if we don't dream, if none of us push the envelope, uh then the status quo remains. But if we dream and we push the envelope, uh we could have a very different future. The probability of having a different future is there, versus if we do nothing uh for certain, nothing will change, uh, nothing uh new uh will uh emerge.

SPEAKER_00 50:53

You know, Dr. Taira, I I want to thank you um um for this very important topic, which is also quite sobering. But I also want to thank you for ending on a win and on a high because you know when we started, I was counting all my all the losses and wondering surely there's there should be some wins. So thank you for ending uh on on a high. And uh definitely I want you back, but maybe not on on the Bundy Bundy Bundy virus. I I need more wins uh to take to take away with.

SPEAKER_01 51:32

Yes, definitely we'll we'll be back. And and thanks uh for having me on on this episode.

SPEAKER_00 51:44

This has been another episode of the Acer and Health Podcast. I wish the topic was uh much lighter, but it's it's been very sobering. Please like us and share this information with others so that people know and don't forget to follow us until the next time.