MRC Centre for Genomics and Global Health

A major obstacle to the control of infectious disease is that pathogens and disease vectors are continually evolving. Epidemic disease outbreaks are one manifestation of this process. Another consequence is the progressive shift of endemic diseases towards forms that are more difficult to control. Increasing levels of resistance to drugs, vaccines and insecticides are threatening to destabilise and in some cases to ruin international efforts to reduce the burden of morbidity and mortality caused by malaria, tuberculosis, HIV, pneumococcus and other endemic diseases. A fundamental dilemma in controlling endemic disease is that the whole purpose is to attack an established pathogen or vector population by all means possible, including large-scale public health interventions, but this strategy may backfire by creating a new evolutionary landscape that causes more virulent or resistant forms to emerge. There are many examples of control efforts that have reduced disease burden for a short period of time but have eventually led to the emergence of resistant pathogen strains and the rebound of disease in a less controllable form. Pathogens do not recognise geographical boundaries, so it is essential that collaborating groups around the world can efficiently build, share and analyse large and complex datasets. This presents several challenges. Systems to integrate data across labs and field study sites working on the same disease are often lacking. Moreover, clinical and epidemiological researchers may lack the tools and training needed to make use of large-scale genome variation data, while genetics and genomics experts can lack the tools and data structures needed to make use of large-scale clinical and epidemiological data. There is an urgent need for scientists who appreciate the challenge and have the necessary skill set to tackle this challenge. The starting point for genomic surveillance is for researchers around the world to work together to identify common forms of variation in the global population. Parasites and insect vectors have large complex genomes that require advanced sequencing technologies and analytical methods. The Centre will develop statistical and population genetic methods to solve these analytical problems. Capacity building is needed to enable researchers in resource-poor countries to participate and to develop leadership in this effort. The Centre will help to build data-sharing networks to characterise global patterns of genome variation. Our translational goal is to provide web based tools to help disease control programmes.to plan and monitor the progress of their interventions. This requires changes in pathogen and vector populations to be captured at high spatial resolution and in near real time. The Centre will develop tools to enable groups in the field to do research on genetic micro-epidemiology. To maximise the value of genome variation and population genetic data it needs to be integrated with other sources of information, such as epidemiological and ecological data, in an accessible format. The Centre will develop methods for collecting data from multiple sources to construct integrated maps of the different factors that determine disease transmission and the spread of resistance. The Centre sets out to be an international centre of excellence in the field of genomic surveillance of infectious disease and identification of effective ways to use these new technologies to improve global health.