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Uganda Virus Research Institute

REPUBLIC OF UGANDA

Why is there Need for Long-Term Investment in the Uganda Virus Research Institute, The Home of Zika?

Why is there Need for Long-Term Investment in the Uganda Virus Research Institute, The Home of Zika?

By Julia Ross Cummiskey and Louis Mukwaya

For Luganda click here.

In early 2016, people across the United States became aware of a new threat—Zika virus. A New York Times article that April featured a description of the discovery of Zika virus in “a remote Ugandan lab” in the 1940s.[1] But while that story acknowledged the contributions of scientists in Uganda, it mistook the laboratory in question, the Ugandan Virus Research Institute (UVRI), for a “remote” place when in fact it was, and is, a major center for virus research. Indeed, while the processes that led to the isolation of Zika virus have been detailed many times (first in the scientific publications that announced its discovery and preliminary epidemiological and clinical findings in the 1940s and 1950s, and more recently in retrospective accounts following the outbreaks in Latin America), these accounts have largely omitted the institutional context in which Zika was first discovered.

Such accounts have obscured the legacies of institutional investment, personal dedication, and professional commitment that led to the Zika virus and many other discoveries, the importance of which may not yet be fully appreciated. Moreover, while retrospective accounts have celebrated the European and North American scientists credited with Zika’s discovery, they have largely ignored the Ugandan scientists who continued the tradition of virological and entomological investigations in Entebbe, ensuring the survival of the institute and its records, knowledge, and resources.

In this post, we offer a different account of Zika virus, one in which its discovery is an entry point into a broader history of the UVRI and the people who worked there. In doing so, we combine autobiographical and historical narrative, drawing on our experience as an entomologist who has worked at the UVRI since 1965 (Mukwaya) and as a historian who has studied the history of virus research in Uganda (Cummiskey).

Over the years, the institution where Zika was discovered has been known by several names, including the Yellow Fever Research Institute, the East Africa Virus Research Institute (EAVRI), and finally, the UVRI. We discuss the work that allowed the UVRI to survive the transition to Ugandan independence, the violence of successive authoritarian regimes, the devastation of a Civil War, and the imposition of economic austerity measures. The evolution of the UVRI from an imperial and colonial institution to a regional cooperative venture to a national institute with partnerships across the world has been the result of strategic positioning and a record of excellence in research. The historical context of the institution that discovered Zika virus shows that when global institutions invest in long-term, stably funded institutions around the world, they produce unanticipated dividends, such as the discovery of Zika virus. As North American and European governments limit or cut funding to overseas scientific research and training, it is important to reflect on what that funding has achieved in the past. The UVRI’s commitment to creating and curating important data about viruses that, like Zika, travel from “remote” Ugandan forests to the metropolises of Southeast Asia, the Americas, and Europe, illustrates what the global community stands to lose when governments divest from such institutions.

The 2016 New York Times article described researchers in the 1940s “stumbling” onto the Zika forest and its “petri dish” of viruses. In one sense, this was the case. No one had been looking for Zika virus. But the research that the field workers were conducting in Uganda was systematic, deliberate, and very well-funded. In 1936, the Rockefeller Institution’s International Health Division reached an agreement with the colonial government of Uganda to establish a laboratory on the banks of Lake Victoria to study yellow fever. Yellow fever was one of the most feared epidemic diseases in colonial Africa, and the recent discovery of its presence in East Africa raised fears that it might cross the Indian Ocean, infecting the heretofore unaffected Indian subcontinent and wreaking havoc on imperial trade. The Yellow Fever Research Institute was created to establish the limits of yellow fever endemicity, the animals involved in its transmission, and the environmental factors that dictated its spread. Among other things, this involved collecting hundreds of thousands of mosquitos.

The career of the first Ugandan scientist to work at the UVRI offers a case study in the ways that international support for institutions like the UVRI built capacity to tackle both known and unanticipated problems related to virus research. Louis Mukwaya’s career illustrates the value of work done by Ugandan scientists and the continencies that shape what we know and don’t know about Zika and related viruses.

In 1965 Alexander J. Haddow, director of the EAVRI and one of the scientists credited with discovery of the Zika virus, retired and moved back to his native Scotland. In August of that same year, Mukwaya joined the staff of the institute as its first Ugandan scientist. Mukwaya was born in 1939 in the Luweero District of central Uganda in a village called Kangavve. He developed an interest in studying medicine and pharmacy when, as a young boy, an herb applied by his auntie cured a serious swelling of his eyes that Western medicine had been unable to fix. In 1960, Mukwaya began a course in zoology at Makerere University College. Lectures by Peter Miller and Hugh Rowell, Cambridge University zoologists and in particular, Miller’s account of the tower in the Zika forest where scientists were studying the feeding behaviors of different species of mosquitoes—sparked Mukwaya’s interest in mosquito research and inspired him to take up a career in entomology.

Rowell assigned Mukwaya a special project: to develop a way to breed nsenene, the local grasshopper, in the laboratory—a feat that had thus far eluded scientists. Mukwaya’s success meant that entomologists could now study the mechanisms for color variation and other characteristics. This research ultimately led to an offer to join the EAVRI as a trainee entomologist in 1965. After Uganda gained independence from Great Britain in 1962, and expatriate employees of the colonial government were leaving the country, the EAVRI and similar institutions were in the process of “Africanizing” their scientific staff. By the standards of the time, the highly skilled Ugandans who had worked at the Institute for decades were not considered scientists, so Mukwaya became the first Ugandan scientist on the EAVRI staff.

Both local experience and international support was vital to the EAVRI’s survival during the political upheavals of the 1960s and 1970s in Uganda. In his first several years at the EAVRI, Mukwaya learned the techniques for collecting and identifying wild mosquitos from experienced technicians, including Yovani Ssenkubuge. Ssenkubuge was a veteran of entomological field work who had spent several decades at the Institute. He taught Mukwaya about managing his field staff and how to operate in the field. For his PhD, Mukwaya researched the genetic basis of Aedes simpsoni mosquitoes’ feeding preferences (this work was supervised by Rowell); this led to a 1973 postdoctoral fellowship at Princeton, funded by the WHO.

 

Image 1: Pinned mosquitoes and other specimens from Mukwaya’s collection

By the end of the fellowship, the political situation in Uganda, where Idi Amin had seized power from Milton Obote in a coup in 1971, had deteriorated to the point where Mukwaya’s supervisor at Princeton attempted to persuade him to stay in the United States. But Mukwaya was committed to his research on Aedes simpsoni, and needed to be in a place where the mosquitos could be collected.  He returned to Uganda at the end of 1974 and kept a low profile. In 1976 the state of affairs in the country worsened, with Amin’s regime violently repressing real and imagined dissent across the country and with increasing commodity scarcities. In the span of two years, both the director and deputy director of the EAVRI fled the country. In 1977 Amin withdrew Uganda from the East African Community, the international body representing the governments of Uganda, Tanzania, and Kenya which oversaw the EAVRI. Only a skeleton staff of mainly technicians and junior staff remained at the nationalized and re-named Uganda Virus Research Institute. Under the circumstances, Mukwaya found himself appointed acting Director of the Institute.

Mukwaya’s management skills, learned from senior technicians at the EAVRI like Ssenkubuge and from his experience in international laboratories, were vital to the persistence of the Institute. If the UVRI had collapsed, its collection of perishable specimens, its institutional memory, and its potential for future renewal would have been irretrievably lost. Amin had directed that if the UVRI staff were to abandon the site, the institution would be turned into a military hospital or barracks. In order to prevent this eventuality, Mukwaya recruited scientists and technicians who had lost their jobs at other now-defunct East African Community institutions, with whom he kept the UVRI operating.

When war with Tanzania broke out in 1978, Mukwaya and his colleagues were unable to maintain a robust research program, but they kept the generators running with fuel supplied by sympathetic soldiers based at the airport in Entebbe. This preserved a collection of sera, virus isolates, and reagents that represented a rare, if not unique collection of raw material for arbovirus studies with unknown potential for future use in identifying and studying human disease. They also permitted a baseline level of research to continue. Because many people in the area feared being infected by viruses, the Institute escaped wartime looting.  

International funding remained critical to Mukwaya’s work, and to the work of the UVRI more broadly, in the years following Amin’s regime. In 1979, after Amin had been deposed, the WHO funded another fellowship for Mukwaya to study at the University of Florida in Gainesville. In Gainesville, Mukwaya learned techniques in biological control and insect pathology with a view to setting up a laboratory for biological control of mosquitoes in Uganda. Mukwaya was also invited by the Body of Science and Technology for International Development (BOSTID) in Washington D.C. to attend a meeting on mosquito research and draw guidelines for determining strategies for developing countries. When he returned to Uganda, Mukwaya won a number of grants from BOSTID, which he used to equip his laboratory in Entebbe. That funding secured the UVRI’s first computer. Mukwaya’s international contacts allowed him to contribute resources to the institution whose survival he had helped to ensure in the previous decade. In 1984, the U.S. Academy of Sciences offered a grant to Mukwaya to spend six months at the University of Notre Dame to learn new techniques for Aedes simpsoni species differentiation. This knowledge enabled several subsequent BOSTID-supported projects in Uganda.

Investment in Mukwaya’s career by people in Uganda and abroad also served the interests of the broader community of people responsible for studying and controlling arboviruses. After returning to Uganda in 1981, Mukwaya started collaborating with colleagues in the United States to study microbes pathogenic to mosquito larvae—research which continues today. When a yellow fever outbreak occurred in Nigeria in 1987, Mukwaya was recruited as a WHO consultant to investigate the epidemic. While there, he collected Aedes mosquitoes from different parts of Nigeria which he shipped to the Entebbe laboratory for future studies. His career has included work at the Smithsonian Institution in Washington, D.C. and collaborations with the scientists at the Vero Beach laboratories in Florida, the British Museum, and the Liverpool School of Medicine—ventures that resulted in publications and further avenues of investigation for him and his collaborators. In 2009, Mukwaya was honored by mosquito taxonomists who named a subgenus, Stegomyia (Mukwaya), for him in recognition of his contributions to medical entomology, especially knowledge of Aedes simpsoni.

Image 2: Photograph of Dr. Louis Mukwaya in the insect pathology laboratory at Gainsville, Florida in 1979

Mukwaya understands his work as a continuation of a legacy in entomology and arbovirology started by the scientists who ran the Institute when Zika was discovered. When most of the research at the Institute was disrupted after the breakup of the East African Community in 1979 and during the War of Liberation that followed Amin’s overthrow, Mukwaya saw himself as a custodian of the Institute’s legacy. And when international attention to HIV/AIDS in Uganda led to vast international investments in AIDS-related projects at the UVRI in the late 1980s and 1990s, Mukwaya advocated for continued support for basic research in medical entomology and arbovirology, building on the foundations established in the 1930s and 1940s.

Mukwaya’s story, and those of the scientists who came before him at the UVRI and worked alongside him, illustrate how situating the production of medical knowledge outside the so-called west provides a new window on the history of international health. By profiling Mukwaya and other UVRI scientists of different generations, Cummiskey is working to understand how he and other scientists in Uganda understood, navigated, and shaped their relationships with international partners over several decades. This historical work aims to show that Ugandan scientists have been crucial to the production of knowledge about viruses and will be crucial to the continued growth of that knowledge. The histórias of these scientists suggest new ways of thinking about relationships between countries with resources to invest in global health programs and the countries in which those programs are implemented, such as Uganda. As Mukwaya’s story demonstrates, these relationships are complicated, and can have long-term benefits for all involved, though the Ugandan partners have historically struggled to receive proportionate recognition for their work. But as countries like the United States threaten to cut funding for institutions where these collaborations take place, both present and future expertise is jeopardized.

Mukwaya’s investment in training junior scholars has ensured a continuity of knowledge production in Entebbe. One of Mukwaya’s earliest trainees, Julius Lutwama, is now the assistant director of the institute. Another former trainee, John Paul Mutebi, works for the United States Centers for Disease Control. Mukwaya also worked to protect Zika Forest, with its 120-foot steel tower, from threats to cut it down for timber and redevelopment, work that was recognized by the NIH. Today, at the tower in the forest where Zika virus was first discovered, new work on the mosquitos responsible for disease transmission continues.[2]

Image 3: View from atop the 120-foot-tall steel tower in Zika forest, Uganda

Sustained investment in virus srveillance, research, and management is crucial to combatting diseases like Zika virus. As one journalist put it in 2016, “Uganda Discovered Zika Virus. And the Solution for It.”[3] Support for the institutions and careers of scientists based in Africa is a critical component of that solution. The World Health Organization, individual researchers affiliated with laboratories in the United States and the United Kingdom, and the government of Uganda have all supported Mukwaya’s career and made it possible for him to continue to create scientific knowledge and train junior researchers.

Zika virus is just one of many viruses whose discovery and rediscovery was made possible by people like Mukwaya, and failure to invest in these international research sites and the scientists that work there threatens to undermine the infrastructures that protect the global community from those viruses.

In a 1951 comment that seems remarkably prescient more than half a century later, a colonial official opining about the future significance of the institute noted, “The virus known as Mengo Myeloencephalitis [sic] was discovered during yellow fever surveys and was first regarded as a discovery of purely local interest. But further work in the United States of America and Entebbe and the correlation of the respective results now indicate a probable worldwide distribution of the virus although its epidemiological significance is still quite unknown.”[4] Like Mengo encephalitis virus, Zika virus started out as a local curiosity. But while Mengo has remained relatively obscure, Zika has certainly eclipsed its local origin. The story of the UVRI and the people that have worked there is a reminder that the world relies on such institutions to study those curiosities before they become global threats.

Notes

[1] Joshua Kron, “In a Remote Ugandan Lab, Encounters with Zika and Mosquitoes Decades Ago,” New York Times April 5, 2016.

[2] See, inter alia, M. Lukenge, J. Birungi, Jonathan Kayondo, Charles Masembe, and Louis G Mukwaya , “Isolation and Molecular Characterization of Gram Positive Entomopathogenic Bacteria Against the Major Malaria Vector Anopheles gambiae in Uganda,” International Journal of Mosquito Research 4,1 (2017): 50-57.

[3] Andrew Green, “Uganda Discovered the Zika Virus. And the Solution for it.” Foreign Policy 2016, http://foreignpolicy.com/2016/02/10/uganda-discovered-the-zika-virus-and...

[4] Memorandum from Eric Horgan to the Administrator of the East African High Commission, n.d. [1951], UK National Archives CO 927/180/8.”