By Lauren Azmon
At STOP Spillover we know that outbreaks can start or stop at the country level, and that country-level and country-led interventions are key to preventing and reducing the impact of outbreaks. That’s why I’m so pleased to introduce you today to Doreen Birungi, who leads STOP Spillover’s work in Uganda.
Doreen comes to the project with more than 10 years of experience working on zoonotic infectious diseases in Uganda and holds a Master of Science in International Infectious Diseases Management, from Makerere University. Doreen is excited to work on STOP Spillover, because she sees the project's One Health approach as unique and believes we can create real and lasting impacts for the people of Uganda.
I sat down (virtually!) with Doreen to hear about her vision for STOP Spillover’s work in Uganda.
Lauren: STOP Spillover recently launched in Uganda. What are your goals and aspirations for its future?
Doreen: We are excited to enter into the implementation stage of the project. The next immediate steps are to engage key stakeholders. With this engagement, we plan to come up with a detailed spillover ecosystem in the country and this will help us prioritize high risk interfaces, priority pathogens, and really define the roles of different stakeholders. Once we have this ecosystem map, we plan to start on risk characterization and on the design and evaluation of interventions to reduce the risk of spillovers in the country. We have lots of work ahead, but I’m very excited to get started.
Lauren: What do you think is unique about the STOP Spillover Project?
Doreen: The uniqueness of STOP Spillover really comes about in our commitment to using a One Health approach to look at the human, animal, and environment interface all together. Also, the project is distinctive, because it truly integrates epidemiology and social sciences to detect and mitigate the risk of spillover of infectious agents between wildlife, livestock, and people. We know that risk of spillover has lots of factors and they’re not just environmental - they can be social like gender for example - and they need to be equally understood and addressed. I believe by working together with various stakeholders, we can achieve our goals and improve the health and lives of people here in Uganda.
Lauren: What do you think are the biggest challenges to preventing spillover?
Doreen: There are a few things I’d mention.
First, stakeholders working in silos is one big challenge. Each stakeholders’ priorities are different. We need to have a unified vision and work together to prevent and respond to emerging threats. That means people from all sectors and all government departments working together – and we need policies in place that encourage this type of collaboration.
Second, related to that, there is a lack of data sharing. Different sectors may have different data which could benefit the others, but due to lack of data sharing platforms, this data can’t be accessed or used efficiently and effectively to reduce spillover risks.
Third, health care is not prioritized in our country budget. Each time an epidemic or pandemic hits we panic to reallocate funds to meet that emergency - but that’s not sustainable. We need to prioritize health at all times and truly invest in health care infrastructure to be able to prevent and better manage future emergencies.
Fourth, I would also say that miscommunication and misinformation between different communities is another challenge. Project implementers need to understand the intricacies of how information spreads in a particular community and share correct information through the most appropriate and trusted sources in a community. This may be different in every community we work with.
Fifth, we need to truly engage communities in the solutions and explain the why clearly to get buy-in. Too often the solutions come from the top down and people just don’t understand why they need to do something new.
Finally, we can’t expect people to give up their livelihoods that depend on wildlife interactions that can put them, their communities, and the world at risk without offering any alternatives. They have to be provided other options.
Lauren: What impact do you think the COVID-19 pandemic has had on the trajectory of addressing future spillovers?
Doreen: STOP Spillover is working on many of the world’s most dangerous viral zoonotic diseases - not just COVID-19. However it’s impossible to understate the effect the current pandemic has had on our work and our communities.
Health workers are overwhelmed with the COVID-19 response, and engaging them in other surveillance activities may be a challenge right now. Also we, like everyone else, have been working mostly virtually which has its challenges.
But the reality is we can’t wait on this. If we want to prevent the next outbreak, epidemic, or pandemic, we need to do the work now to reduce risks of future spillovers.
The current pandemic has also amplified the conversation around zoonotic viruses and spillover, and we plan to be part of this conversation - providing evidence, data, and solutions to reduce risks of spillover and help prevent the next pandemic.
Lauren: Do you have a favorite book? What is it and why?
Doreen: “Do You Value What Really Matters?” This book was authored by my friend, Karungi Viola, a lecturer at Makerere University and it’s a guide for young people to attain clarity of their personal values about people, ideas, and material things.
Lauren: What’s something not a lot of people know about you?
Doreen: Hmmm!!! I have a sweet tooth. I like chocolate and cake.
Lauren: What advice would you give to leaders around the world who want to prevent the next pandemic before it starts?
Doreen: Viruses do not care about country borders, so it’s up to all of us to work together to prevent the next pandemic. Embracing the One Health approach is the way to go. We can’t address dynamic health issues like spillover by working alone or only looking at one sector or one aspect of what drives spillover risk. Everything needs to be on the table.
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(This conversation has been edited for length and clarity.)
