PREDICT

The PREDICT project in Malaysia is an exemplary One Health success between Conservation Medicine, EcoHealth Alliance and the Malaysian Government (human, wildlife and veterinary authorities) working together to find new viruses and strengthen human and laboratory capacity, an important step towards sustainable disease surveillance.

Conservation Medicine and EcoHealth Alliance, the Ministry of Health, the Department of Wildlife and National Parks Peninsular Malaysia, and the Department of Veterinary Services have been working together on zoonotic disease surveillance in Malaysia since 2005. Expanding to Sabah in 2012, Conservation Medicine, EcoHealth Alliance, Sabah Wildlife Department, and Sabah State Health Department began collaborating on zoonotic disease surveillance.

This united and committed group of individuals and institutions have made significant advances in Malaysian research and surveillance infrastructure and have strengthened technical capacity through the PREDICT project, including the creation of two internationally certified labs dedicated to wildlife disease screening. In Malaysia, the project to date has identified 76 novel viruses and 29 known viruses, providing the Malaysian government with actionable data to inform risk mitigation policies at the national and state level.

To improve our understanding of pathogen circulation and exposure risks, we conducted concurrent animal-human sampling in 9 Orang Asli communities. Behavioural surveys were conducted to identify perceptions and practices around wildlife, domestic animals, hunting, and livelihood. Working with our partners from the Ministry of Health District Health Teams, the Department of Wildlife and National Parks and the Department of Veterinary Services we sampled 1,390 people, 736 wild animals and 696 domestic animals and pets – a huge sampling effort that has strengthened the multisectoral platform for partnership around One Health and zoonotic disease surveillance.

To date, this work with the Orang Asli has found two novel coronaviruses in 3 bats, 4 known coronaviruses in 15 people, one known influenza in one person, one known coronavirus in two chickens, and one known coronavirus in a rat. Serological screening of people and wildlife in Orang Asli communities is ongoing.

Initial results suggest that there has been exposure to Nipah-related & Ebola-related viruses in bats, non-human primates, and indigenous communities. This ongoing work will build from PREDICT and continue to improve our understanding of zoonotic viral spillover risk in communities living in close association with wildlife.

Gaining the trust of these communities generated an entry point for continued engagement. Each sampling trip started with a community meeting and meal to share information about zoonoses and also provided a chance for these communities to get to know the team. Participants were given a health assessment, and provided with treatment by the District Health Teams, providing a pathway for improved access to health care. Returning to each community to share results with participants and a summary of project findings strengthened this relationship and provided another opportunity to share health information such as the PREDICT guide “Living Safely with Bats”. This work demonstrates how One Health novel pathogen surveillance and outreach can be combined with wider public health service delivery for known disease threats to tackle overall health needs.

In Sabah we conducted syndromic surveillance with our partners at Sabah State Health Department, Queen Elizabeth Hospital and the Kota Kinabalu Public Health Laboratory to identify individuals with zoonotic viruses not being detected by normative diagnostics and found one known paramyxovirus. While the Deep Forest Project, sampling wildlife across land-use disturbance gradients in Kinabatangan and Telupid, allowed us to better understand the impact of land-use change on species diversity, the viruses that they carry and the distribution of host species. We sampled at 18 Deep Forest sites, each site was sampled twice in the wet season and twice in the dry season and we identified 62 novel pathogens. In addition, with our partners BCI we conducted 856 Human-Animal Contact Surveys with people living near our Deep Forest sites, to better understand how different communities interact with wildlife. This information has been shared with our partners and can be used to help design targeted healthcare interventions for different communities.

Over the last 10 years in Malaysia, Conservation Medicine and EcoHealth Alliance have trained 662 current and future One Health workforce individuals, with most attending multiple events and receiving regular refresher trainings on biosafety, surveillance and diagnostic techniques including sharing SOPs and protocols, outbreak response and risk assessments. These trainings helped build capacity and help ensure the competency and safety of lab and field teams in Malaysia.

The creation of the Wildlife Health Unit in Sabah and the Department of Wildlife and National Parks Wildlife Disease Surveillance Program highlights the Malaysian government’s commitments to these efforts and guarantees that the wildlife authorities continue to be able to play an important role in zoonotic disease surveillance by identifying novel viruses before they spill over into human and livestock populations. The significant capacity building across all our partners’ laboratories, disease screening, and biosafety and field training activities in Malaysia complements all our government partners’ efforts to improve One Health surveillance and capacity building among their staff.

The establishment of the Molecular Zoonotic Laboratory at the Department of Wildlife and National Parks Peninsular Malaysia National Wildlife Forensic Laboratory and the Wildlife Health, Genetic and Forensic Laboratory for Sabah Wildlife Department has significantly strengthened viral surveillance capacity in wildlife and resulted in the identification of 76 novel viruses. Noteworthy mentions include the discovery of 12 novel coronaviruses in bats and rodents, some of which are genetically related to SARS-CoV-1 CoV and SARS-CoV-1 CoV2 (the strain of coronavirus that causes COVID-19), 15 novel paramyxoviruses found in bats and a moonrat, and 1 novel flavivirus detected in a bat. Many of these novel viruses warrant further investigations to determine their pandemic potential.

This ongoing effort is a critical step in understanding the risk that wildlife viruses pose to humans and will provide actionable data for our government partners to help keep the Malaysian public safe from emerging zoonotic diseases. Any efforts that build capacity and strengthen zoonotic disease surveillance in tropical countries around the globe that are most at risk of emerging zoonotic diseases, help protect people and economies everywhere.

The PREDICT project has helped Malaysia fully embrace the concept of One Health and recognise the importance of ongoing zoonotic disease surveillance. The ongoing collaboration between Conservation Medicine, EcoHealth Alliance, and our Malaysian government partners allows for the continuation of efforts to find new viruses and strengthen human and laboratory capacity in-country.

We have helped build laboratory capacity at the following institutions: