Preventing Pandemics

As the Chief Wildlife Veterinarian and Project Director of Smithsonian’s Global Health Program, Dr. Murray is responsible for the Smithsonian’s international human and wildlife health research and training. Through this program, she oversees clinical care of wildlife, research in emerging infectious disease, and training for the next generation of health practitioners. She has extensive experience working internationally – particularly in Africa – evaluating health and disease in a full range of species. She serves on several federal panels including the Pandemic Preparedness Forecasting Science and Technology committee and the Foreign Animal Disease Threat subcommittee which helps protect US agriculture from animal diseases. Dr. Murray also serves as the Smithsonian Institution’s Principal Investigator on USAID’s Emerging Pandemic Threats PREDICT grant which combines wildlife surveillance and international training in the quest to predict and prevent the next major emerging pandemic threat to humans.

We have identified and are addressing a critical gap in global health surveillance, comprised of human populations, their livestock and the adjacent wildlife that inhabit drylands across the African continent. Humans and animals in these landscapes are on the frontline and therefore at significant risk of disease spillover, but are under-represented in national health services, and as such, represent a blind spot in pandemic preparedness. Building upon state-of-the-art technology, this project will extend surveillance to these under-served communities through a proof-of-concept system that detects and reports zoonotic animal diseases in wildlife and livestock, while raising awareness of shared human-animal health risks through community engagement.

As well as preventing pandemics that threaten the global population, our approach will improve the livelihoods of pastoralists who rely upon livestock as a source of income, and provide an early warning system for identifying and responding to health emergencies in endangered wildlife.

Over 60% of emerging infectious diseases spillover from animals to people, posing a major threat to global health and the world’s economy, thereby making animal surveillance a crucial component of pandemic preparedness. In sub-Saharan Africa, an estimated 50-200 million pastoralists, their livestock and the wildlife with which they co-exist, are currently unaccounted for in disease surveillance programs. Early warning systems that link remote wildlife and livestock to veterinary services, as proposed in this project, are required to monitor and respond to illnesses in these high-risk animal populations, thus controlling spillover of novel diseases at their source, before they become widespread in the human population.

As well as improving global health, inclusion of wildlife and livestock in health monitoring systems supports UN biodiversity and sustainable development goals in several tangible ways. Livelihoods of pastoralists are intricately linked to the health of their livestock and co-existing wildlife, and alleviating animal disease therefore has a significant impact on pastoralist communities existing within small economic margins. Since many high consequence pathogens shared between wildlife and livestock can also pose devastating consequences for the survival of threatened species, improvements in animal health support conservation efforts and livelihoods of local communities who rely on tourism revenues.

We will establish a proof-of-concept for community-based animal surveillance in Laikipia, Kenya, that can be scaled to drylands across Africa.

We will begin by developing a framework for mapping hotspots of disease transmission between wildlife, livestock and humans, using well-established ecological and epidemiological theory and strategy. Satellite imagery will be used to prioritize geographical areas within Laikipia and will help target animal disease surveillance. Within these areas, we will develop and test a cellphone based syndromic reporting system for wildlife and livestock health, that will be operated by community wildlife rangers and animal health officers. These professionals will collect and submit fecal samples which will be screened for zoonotic diseases. This community-based surveillance system will augment existing national surveillance systems, directly linking remote wildlife populations and pastoral communities with veterinary healthcare.

Development of the community-based surveillance system will be paired with an educational program to engage community members in shared human-animal health issues and sensitize them to the risks posed by emerging zoonotic diseases. Steps will also be taken to deliver education programs regarding interventions that will reduce the risk of exposure to animal-borne diseases.

Finally, we will develop national and regional pathways to scale for the proof of concept.

Ultimately, this model for community-based surveillance aims to improve the health of people worldwide by reducing the risk posed by emerging animal-borne pathogens in under-resourced animal and human populations.

In Laikipia,this community-based surveillance system will directly improve the health-care available to approximately 300,000 people’s livestock, East Africa’s largest population of black rhino, and globally important populations of lion, giraffe and elephant. The reduced risk of zoonotic disease in livestock will improve human health and the marketability of livestock products, thus benefiting all involved in livestock value chains. Reduced mortality of endangered wildlife will benefit local people linked to ecotourism, which generates over $20 million/year and employs 1,300 people.

Community engagement is at the core of this project, and our team has worked closely with communities in Laikipia to understand the health challenges they face, using Smithsonian One Health educational tools. This is a method we have been utilizing for the last five years to create the cross-cutting relationships necessary to ensure that community engagement goals are met. By engaging members of the community in education outreach and to conduct participatory wildlife and livestock diseases surveillance, the project will promote beneficiary-centered and beneficiary-informed local ownership of animal health.

Pandemic preparedness and prevention is one of the most formidable challenges facing the world. Part of our goal in developing this system is to engage high-risk communities – people living with and directly dependent upon animals for survival – in an effort to prevent the next pandemic.

We also seek to address the inadequate integration of pastoralists, their livestock and co-existing wildlife into disease surveillance programs, extending veterinary healthcare to traditionally underserved communities, and improving livelihoods of humans and the health of animals in dryland ecosystems.

I have had the honor of working in Kenya for the past 20 years. During this time our team has led a wide range of conservation and public health efforts focused on building global capacity for surveillance and response to wildlife-borne emerging infections, and championing in-situ wildlife conservation and human health through research, community engagement and education. I have personally seen the true value of cross-cultural collaborative efforts and the importance of community engagement early on to ensure these efforts are effective.

Through partnerships and extensive work with urban and rural communities over the past 5 years, our team has identified consistent gaps in animal health surveillance that cut across much of sub-Saharan Africa. While it is not difficult to identify these gaps, the solution to filling them isn’t always apparent. Drawing on the Smithsonian’s expertise in pathogen discovery, social anthropology, and remote sensing, our team possesses the partnerships, infrastructure, and knowledge of and access to existing technology to fill the surveillance gaps that we have identified. In so doing, we are ideally prepared and positioned to improve human and animal health. For me, this represents a natural and logical progression towards the integration of community and global health.

I have always been passionate about the conservation of endangered species, and from a young age knew that I wanted to work in East Africa on their behalf. As an undergraduate I spent time in Kenya and completed my veterinary school thesis in East Africa with Dr. Jane Goodall as my advisor. I subsequently became board certified by the American College of Zoological Medicine, and as chief Veterinary Medical Officer at the Smithsonian have developed close ties with the Mpala Research Center in Kenya and Kenya Wildlife Services.

Within the last decade, a One Health approach to save both human and animal lives has emerged. While I had achieved my goal of working to save endangered species, I developed and now lead Smithsonian’s Global Health Program to expand upon these goals. One of the places in which we have been most effective is in Kenya, and we are now in a position to link the broad range of scientific expertise within the Smithsonian to our long-standing relationships with Kenyan partners and communities. Efforts like this not only improve the health and livelihoods of at-risk local communities, but can also serve to prevent the next global pandemic.

My background and the skills that I have acquired through training as a wildlife veterinarian and One Health practitioner uniquely position me to appreciate the interface between wildlife and human health. My decades in this field have taught me to value and appreciate partnerships.  I’ve learned that the most successful projects are often formed on the basis of open and trusting partnerships – the same type we have developed in Kenya

Having worked in Central Kenya for more than 20 years, and as an international advocate for One Health, I have a deep understanding of the interconnections between human and animal health and conservation that exist in many rural African communities. Over this period, I have nurtured longstanding relationships with stakeholders – Kenyan and international – who are responsible for informing, developing and implementing policy that improves the health of animals and people in the region.

As a result of these relationships, our team are exceptionally well placed to engage with and connect in-country stakeholders and policymakers – communities, wildlife conservancies, and county officials in Laikipia, Kenya Wildlife Service (KWS) and the Government of Kenya Zoonotic Disease Unit (ZDU) – ensuring that the results of this project are communicated, developed and conducted in partnership with stakeholders.

As a working woman with three young children who had the opportunity to create a new program, I’ve been confronted with adversity on several fronts. I have struggled at times to balance home and professional life, and there were junctures where I failed to be present for my family. Fortunately, these shortcomings have presented clear opportunities, and through iterative feedback these experiences have ultimately produced a stronger family union.

Professionally, I’ve overcome adversity by an unflagging belief and commitment to the mission of our organization and its team. The Smithsonian is one of the world’s most venerable institutions, providing incredible access to expertise and resources, but as a large institution, it doesn’t necessarily provide the ideal setting to incubate a startup program. Creating space for and building a financial base to achieve the goals of our fledgling effort proved much more difficult and challenging than I had anticipated.

Being surrounded by those that care enough to point out failures and celebrate successes builds a team that is prepared to conquer adversity and surmount the challenges before us.

Given the scale and pace at which humanity is transforming the planet’s ecosystems, and catastrophic implications for human and animal health, I believe my leadership potential is best focused on creating the space for multidisciplinary collaborative efforts that bridge knowledge between silos and advance cutting-edge practices in biological, social and technological disciplines.

Smithsonian’s Global Health Program is an example of such an effort. In developing this program, I have built a team and series of projects that represent and bridge differences in profession, gender, age and socioeconomic backgrounds to achieve our goal of improving global health for all humans and animals. Under my leadership, the Global Health Program has brought together physicians, veterinarians, epidemiologists, social anthropologists and conservation biologists to tackle some of the biggest questions about how human and wildlife health outcomes emerge from complex interactions between natural and social systems.

No program can do everything to prevent the next pandemic, but in developing and creating the Smithsonian’s Global Health Program, I have created a programmatic vehicle for people of different backgrounds to combine heretofore separate bodies of knowledge in the effort to surmount challenges that are increasingly intertwined.

The Smithsonian Institution is the world’s largest museum complex, supporting extensive education and research programs. It is a global leader in training programs and cutting-edge investigations in wildlife conservation, wildlife health, world history and has a unique role as a parastatal institution in public engagement sectors. The Smithsonian Conservation Biology Institute (SCBI) is a leader in wildlife conservation, pathology, and ecology, with numerous field research centers globally. As part of SCBI, our team leverages multidisciplinary expertise in wildlife health, molecular diagnostics, geographic information systems (GIS), emerging infectious disease epidemiology and veterinary public health to combat threats facing  public health worldwide.

Technology

·       Rural communities are too frequently not included in human and animal health surveillance efforts in sub-Saharan Africa. Deploying low cost, remote internet access tools (cellphones) we will link remote communities and wildlife populations to central veterinary services, delivering improvements for global health security and more effective healthcare to wildlife and livestock.

·       We will use a state-of-the-art High Resolution Melt analysis (HRM - a form of PCR) to screen fecal samples from sick animals and submitted by community wildlife rangers and animal health officers for pathogens. This is the first time that HRM will have been used as part of a community-based surveillance system.

·       Using epidemiological and ecological models, we will deploy high resolution multispectral imaging to identify and target disease surveillance at high risk communities for the first time.

Social Anthropology

·       Centralized health systems rarely engage communities on animal health issues. By integrating surveillance and education we will promote local ownership of animal health surveillance that mitigates the risk posed by emerging diseases.

·       By engaging the community at risk at every juncture, we hope to build resilience and sustainability

Activity 1: Development of risk mapping framework using high resolution satellite imagery

Output 1: Model that predicts geographic overlap of wildlife, livestock and people – and potential disease sources and at-risk human populations

Short term outcome 1: Selection of high-risk sites for surveillance

Long term outcome 1: New methodology for prioritizing geographic areas for surveillance in dryland settings is available to a global community of scientists and practitioners working to improve disease surveillance

Activity 2: Recruitment and training of at least 15 community wildlife rangers and 15 animal health workers to collect syndromic data on wildlife and livestock health within their communities

Output 2: Routine (daily) submission of records and fecal samples from sick wildlife and livestock in surveillance sites

Short term outcome 2: Enhanced community capacity for detecting zoonotic diseases in high risk areas

Long term outcome 2: Improved detection and diagnosis of zoonotic disease outbreaks

Activity 3: Educational outreach in high risk communities

Output 3: Members of at least 15 communities are educated on the importance of animal health, and steps that they can take to reduce their exposure to zoonotic diseases   

Short term outcome 3: Rural communities have improved understanding of the risks posed by wildlife health, and how they can be mitigated

Long term outcome 3: Reduced incidence of zoonotic diseases in pastoralist communities

Activity 4: Ten veterinary/public health decision-making officials trained in risk mapping framework and interpretation of the data generated by the surveillance system

Output 4: Anticipated ‘end-users’ of data generated by community-based surveillance are able to interpret and formulate a response to data generated through the system

Short term outcome 4: More timely response of central veterinary services to disease outbreaks in remote dryland settings

Long term outcome 4: More effective healthcare is available to animals indryland areas through links to central veterinary services.

Activity 5: Quantitative evaluation of community-based surveillance system

Output 5: Itemized plan and costs for community-based surveillance model presented to stakeholders

Short term outcome 5: Policy makers adopt this approach to other dryland areas in Kenya

Long term outcome 5: Scaling of community-based surveillance across sub-Saharan Africa

·       Currently serving 0 people since the project has yet to begin

·       Aim to serve approximately 300,000 people in Laikipia, within one year

·       Once scaled over 5 years, aim to serve approximately 1.5M people in Northern and Central Kenya

Within a year, our goal is to have implemented a program of community-based animal health surveillance and education within communities identified at high risk of disease spillover in Laikipia, Kenya.

Within two years, our goal is to have performed quantitative evaluation of the community-based surveillance system in Laikipia; developed a costed plan for its implementation; and developed a ten-year pathway to scale for dryland ecosystems in Kenya and the Horn of Africa.

Within five years, and with additional funding, our goal is to have scaled the proof of concept to three counties in Northern Kenya which includes large nomadic pastoralist populations – Turkana, Samburu and Marsabit. This will effectively extend surveillance and veterinary services to approximately 1.5M people and 15,000 square miles of wildlife rangelands in Central and Northern Kenya.

There are a few challenges and barriers that would need to be addressed in order to accomplish our goals. The largest impediment is the financial cost of accomplishing this project. We have the experience, expertise, and the partnerships necessary to make this program work, but not yet the financial support. The MIT Elevate award would be instrumental in making this project a reality.

There are also other potential challenges and issues for us to take into account, but we believe we have the resources to address these. The importance of community engagement and cultural awareness cannot be overstated. As part of our approach on this project as well as other successful projects, we will engage with communities and stakeholders at the beginning and continually throughout the project, as an iterative and interactive process to ensure that all are involved in discussions and decision making.

Also, traditionally, human and animal medicine have worked in parallel and not necessarily as a tight unit. Part of our challenge will be to engage both the veterinary and human medicine communities. We have successfully accomplished this in the past by hiring personnel from both disciplines, and in Kenya we will engage existing partners within the Government’s Zoonotic Disease Unit (ZDU) which has adopted a similar format

We have the experience and the partnerships to address the majority of our barriers, as outlined above. The most pressing barrier that we require assistance for is the financial one. If we were to be awarded the Elevate Prize, we would surely be able to achieve our goal of developing an early warning and rapid response surveillance system in as yet underrepresented, but nevertheless, high risk populations of humans, their livestock and wildlife.

Kenya Wildlife Service: our clinical and research partner for wildlife medicine, with whom we collaborate on training, health and research projects.

National Museums of Kenya (IPR): our laboratory partner for wildlife and human health resaerch and surveillance, and where our coordinator for the USAID PREDICT program has been based.

Government of Kenya Zoonotic Disease Unit: our Kenyan government partner for zoonotic diseases at the interface between wildlife, livestock and human populations. They help to translate our work into policy.

Mpala Research Center: with Princeton University, this is the Smithsonian’s research station in Kenya, and a close partner in One Health training and research in Central Kenya. Our laboratory facilities and veterinary research fellow are located at Mpala Research Center.

University of Nairobi School of Veterinary Medicine: our university partner in Kenya for training in animal health.

International Livestock Research Institute: a close research partner on livestock health and zoonotic disease.

The MIT Elevate funding framework will provide a strong base on which to develop our community-based surveillance model, while establishing long-term partnerships with governmental and non-governmental organizations and demonstrating its impact on human and animal health in Kenya. Our approach beyond Elevate funding will be to ‘operationalize’ the tool, and establish it as open source technology, thus permitting uptake by an even broader array of stakeholders working across Sub-Saharan Africa. Sustained funding to scale the project beyond this proof of concept and establish our open source model will be sought from major donors with whom the Smithsonian has long-standing relationships, and whose remit is to fund work that focuses on One Health, improving people’s livelihoods, and pandemic preparedness. These include USAID (through their Development Innovation Ventures grants), the Bill and Melinda Gates Foundation, the World Bank, and private donors.

The worldwide publicity and mentorship available to me as an MIT Elevate Laureate would provide unparalleled opportunities to engage and seek longer-term funding from major donors to advance the project, and position it for scaling.

Salaries/Stipends:

SI co-investigator (anthropology) (30%): $37,784

SI co-investigator (epidemiology) (30%): $39,767

US Program Support Specialist (US-based) (30%): $20,867

Kenya-based project coordinator/post doc (100%): $55,000

Kenya-based educational lead (50%): $22,000

Supplement for rangers and animal health workers (x30): $15,000

Equipment & Supplies:

Android phones (x30): $9,000

Reagents for High Resolution Melt analysis for zoonotic pathogens (~1,200 samples): $26,400

Stationary/Training materials: $5,700

Outbreak DIY exhibition panels: $1,000

Vehicle supplies: $30,000

Project Launch Workshop:

Venue, local participant travel, and associated costs: $5,900

Travel:

International travel (7 flights for 4 co-investigators and post-doc; associated accommodations and travel-related expenses): $17,190

Total: $285,608

I firmly believe that The Elevate Prize would provide the best platform on which this project can be developed. As a prestigious award, it would increase the impact of my work, enabling me to build collaborations and secure funding to make this project a reality.

Funding is currently the largest barrier to this project being achieved. The Elevate Prize would provide the financial freedom to test whether our approach to surveillance works and build evidence for its use. The value of the prize is ideally suited to this project – most seed grants for the development of applied technology provide limited funding, which would be insufficient to fully develop and test the enhanced surveillance model that we propose.

 The Elevate Prize would also provide a strong platform on which to develop and scale the system. Being a membership of the MIT community, and through publicity and mentorship available as part of the prize, would position the project well for engaging regional stakeholders and seeking funding from major donors on which the scaling of the system and it’s future impact relies.

While the Global Health Program has already achieved several important goals, our ability to build the necessary bridges and harness much of the intellectual input from Smithsonian scholars is a very real opportunity to catapult this program to a higher level.  As someone who worked on the Human Genome Project during its infancy, I've seen first hand how the value of guidance, financial backing, and scientific input can revolutionize our approach to scientific questions and would like to see those same modalities applied to this project

There are several scientific organizations with which we would benefit from working with more closely including but not limited to the Center for Disease Control, National Institutes of Health, and the National Science Foundation to potential funding agencies such as the Bill and Melinda Gates Foundation and USAID, to Universities with a science and technology emphasis such as MIT