When Peter Piot entered medical school and told his professor he wanted to study viruses, the professor warned: “There’s no future in infectious diseases. They’ve all been solved.” Fortunately for the world, Piot didn’t listen and went on to become pivotal in the identification and containment of some of the world’s most ruthless viruses. By MANDY DE WAAL
The year was 1976 and Peter Piot was a researcher training in virology in Antwerp when vials of blood came in from Kinshasa. They were housed in a plastic thermos, and one vial had already been broken.
“We would regularly receive samples from Africa, for historic colonial reasons, as you could imagine. Someone had just given us a thermos with a few vials of blood, and the diagnosis read ‘Yellow Fever or not?’” says Piot, speaking to Daily Maverick from the London School of Hygiene & Tropical Medicine.
Piot handled the blood with latex gloves and Financial Times reports that another vial was dropped on a supervisor’s shoe. “We did a routine laboratory test and it turned out that it was something completely different, and that something different turned out to be a completely new virus.”
“Today it is much easier. With DNA probes you look at the genetics directly and what cells they grow in, but what was very important back then was what the virus looked like. You would look at a virus under an electro-microscope. Which is what we did, and what we saw was quite stunning. It looked like a worm, and a very big worm by the standards of a virus,” explains Piot.
The worm-like virus Piot was peering at under that microscope was the Ebola virus, but it would take a while before he knew what he was dealing with. “This was way before the internet. Today you can Google immediately and compare what you’re looking at, but back then we had to go to the library and look through atlases of viruses.”
The mystery virus looked a lot like the Marburg virus, which had been discovered a few years earlier in Germany. “Right before we got the blood, there had been a few cases of Marburg in South Africa. But how do you prove it is Marburg and not something else? And that is where we got stuck. We couldn’t identify it any further, and that is why that was done in Atlanta, at the Centres for Disease Control.”
After tracking the Ebola outbreak to its source and discovering its transmission mechanisms, Piot would live and work amongst dying villagers and terrified missionaries to collect the hundreds of blood samples he needed to start to decode the epidemic. By living with those with the disease, he believed he could understand enough about the disease to contain it.
Says Piot: “When we started with the laboratory investigations we thought the diagnosis was Yellow Fever, which was a known quantity. But while we were working on it we got this news that there was a big epidemic in the then-called Zaire, and several Flemish nuns had died. That’s when it became a matter of enormous urgency. You know when an epidemic starts, but you never know where it will end. That’s the frightening thing, because it is such an unknown.” Fortunately in the case of the Ebola virus, the epidemic died down fairly soon.
Later Piot would cross the quarantine zone again when he travelled through Africa to lead Aids initiatives on the continent. During the 80s and 90s, when millions suffered and died from Aids, Piot and his team would battle corruption and denialism to set up the fledgling UNAIDS agency.
The story of how Piot helped identify a deadly new disease called Ebola and was dispatched to the quarantine zone in the then Zaire (now called the Democratic Republic of the Congo) is contained in the scientist’s memoir called No Time to Lose: A Life in Pursuit of Deadly Viruses. The book also describes how Piot faces off against another mystery epidemic: Aids.
Currently director of the London School of Hygiene & Tropical Medicine, Piot was also founder and Executive Director of UNAIDS, and it was here that he would meet Thabo Mbeki - a man who would disappoint him. “To be honest, I am still puzzled why an intelligent man like him had the view he did on Aids. It is still a big question mark for me,” says Piot.
“Peter, don't you know what the real problem is?” Mbeki once asked Piot. “Western pharmaceutical companies are trying to poison us Africans.” He was convinced that it was a virus created to make countries like those in Africa dependent on Western drug giants and give the pharma companies a ready market.
“What is more important to me now is that that time has gone,” Piot says. “South Africa has lots of challenges with regards to Aids, but the country is taking on the epidemic in a big way. However, so much time was lost, and that is the real tragedy,” he says.
But, says Piot, as a scientist he should not be amazed. “One of the things I learned at UNAIDS - and one of the reasons I wanted to write a book - is to illustrate that the world is very complex. Why people do what they do and why politicians make the decisions they take is because it is not all a rational process. Where we have made progress on Aids, for example, it is where science and politics met each other,” he adds.
Piot says when that happens and it is complimented by on-the-ground action, humanity stands a good chance against viruses like Aids. “You need politics and science to work together. Politics without science can be very dangerous. This we have seen with Thabo Mbeki. However, science without the politics is powerless.”
South Africa’s Treatment Action Campaign gets singled out for high praise from Piot. “The mother of all activist groups in the world is really the Treatment Action Campaign, not only in terms of what they have achieved, but also in terms of strategy,” he says.
“What I found so smart - when compared to other activists - is that they had street demonstrations and civil disobedience, but on the other hand they went to court and they made alliances with churches, Cosatu, and the chamber of mines. That was very clever and made a huge difference. I am convinced that without them we wouldn’t have the achievements we have had in Aids today,” Piot says.
Daily Maverick asks Piot what the odds are of a massive epidemic wiping out a section of humanity. “When I look at my short life, I have seen so many new viruses coming up,” says Piot who starts going through the list - Aids, Ebola, Sars, mad cow disease, toxic shock syndrome and all manner of contagion from contaminated food.
“We will continue to see this with globalisation, with people travelling so much more and faster, and with our food chain, which has seen food supply become so globalised and integrated,” he says, reminiscing about the old days when, if you had a diseased chicken in the back yard, the contagion would be limited to the other chickens, your family and possibly your neighbours.
“Today they cultivate chickens and there can be one million chickens on one farm. These are exported to the other side of the world. So the problem of food-borne viruses will intensify. Viruses can be genuinely new or some sort of mutation. As is often the case they originate from animals, like the flu virus that originates in ticks and then infects ducks. Traditionally this comes from East Asia and China, but last time it popped up in Mexico. It showed that we can be prepared to a certain degree, but the world is never prepared enough for new epidemics,” he says.
“There are things that you can’t predict or can’t control, which means that rapid detection, good systems and good communication are really key.” DM
- Aids tragedy 30 years on – tragedy and hope on Discovery
- Virus hunting in Africa at The Wall Street Journal
- Watch Peter Piot talk on the challenge of global health on Vimeo
Main: Peter Piot (Imperial College London/Tom Whipps)
Second: Ebola virus (Wikimedia Commons)