A: My impression from the presentations made was that QNRF has made a very important contribution to the development of research capacity and the fostering of a rigorous scientific environment in Qatar. The biggest challenge for a place like Qatar is its size; it has a very small population, with an even smaller population of investigators. Qatar has to figure out a way to appropriately use its funding to stimulate additional good science in the surrounding countries and the region. This would make the impact of Qatar Foundation (QF) greater than it could be if it was only able to fund science in Qatar, where there will always be some limits because of the population size.
 

After holding conferences in Tunisia, Greece, and Turkey, we decided we would like to do one in the Middle East, and recalled the conversations we had had with QF. We had also been contacted by Weill Cornell Medical College in Qatar, with an expression of interest that they would like to try to work with us as well. We contacted Weill Cornell and QF and told them about our interest in holding a meeting on 'Emerging Viral Infections' somewhere in the Middle East and asked them if they would be interested in co-sponsoring it, as well as being the local host. To our great gratification both Weill Cornell and QF said yes and both were very actively supportive.
 

Q: Did Mers have anything to do with your interest in the Middle East?

A: The timing turned out to be perfect, because we had this emerging viral disease, and we were already hoping to do something in the Middle East. We had wanted to concentrate on HIV and hepatitis, because the Middle East is the only region in the world where HIV is increasing, and from a research point of view its been neglected in the region. However, the emergence of Mers contributed to the other topics we chose. It is the reason we included coronaviruses on the agenda, and of course we’ve always had an interest in Alkhurma – which is a disease you can’t really study anywhere else. And then there was also interest in QF to include influenza, so it all came together quite naturally.

Q: You are working with QNRF on a joint funding programme - what will that look like

A: NIAID collaborate with an organisation called Civilian Research and Development Foundation Global (CRDF Global), which utilises US government money to support scientific cooperation around the world. We use it as our mechanism to offer small collaborative grants to people who participated in meetings, or from institutions of those who participated. We invite small grant applications from those individuals.

Our ultimate goal is to offer a small grant, which then cultivates a relationship, generates some preliminary data and will allow that same partnership to apply for much more money through our other larger funding mechanisms. NIAID has found this to be successful. We’ve had 2 or 3 grantees who have actually made it into the higher level of funding. We explained this to QF, and they decided the ideal way for them to begin collaboration with us would be by also contributing to the small grant pool. Therefore, CRDF will make awards that have been jointly supported by QF, QNRF and us. Those small grants are being solicited, and we hope we will get a lot of very strong applications because we’ve set aside several hundred thousand dollars to be able to do this through CRDF.
 

This round of grants will focus on viral diseases; the ones that were at the meeting: hepatitis, HIV, coronavirus, flaviviruses, influenza, etc. The reason we limited it to those who participated, or people from participating institutions, is because we do not have that much money, and we want to limit the pool. There are two levels of the competition. Firstly, to participate in the meeting you had to submit an abstract, and that was reviewed by the scientific committee and then chosen for participation, and secondly, those who submit applications for these small grants will be reviewed by a review committee that will be formed and managed by CRDF. In addition, both QF and NIH have been asked to submit possible names of reviewers, and it will be run very much like an NIH review with identification of any conflicts of interest and a high level of rigour.

 

Q:Given the facts that HIV infection rates are increasing here, and there are new emerging viral diseases such as Mers, is there any kind of increased risk for this kind of disease in MENA?

A: I wouldn’t say so; I think the risk is everywhere. I don’t know if there is much that sets the Middle East aside as particularly vulnerable to emerging diseases. In fact, there may be some things that are a little bit protective. One is that there is not a lot of crowding (although the crowding now in cities is starting), but it is a relatively under-populated region, and crowding has an impact on transmission. On the other hand, you have big gatherings of people, like for Hajj, where you have to pay special attention. But viruses emerge all over the world, and I think what is really important is not whether or not there is greater risk in the MENA, but that there are surveillance systems that are very reliable, in-place, and well-maintained, so that when viruses emerge (which is just a reality of existence), they are identified early, and dealt with appropriately.

 

And then there are situations where there are dangerous viruses already circulating, like HIV. You want to be sure that you understand those epidemics, and that all of the barriers to getting people into early diagnosis, early treatment, and management of the epidemic are out of the way. You also need to make sure that the research is being done so that you understand the problem and can take appropriate actions to limit it. So, its not that the MENA is more susceptible to the development of new viruses, but that it is still catching up on addressing some of these through enhanced surveillance, enhanced research, and establishment of public policies that allow the best possible medical and public health interventions.

 

Q: Given that all viruses, some day, develop drug resistant strains, and eventually fight back, what sort of outcome would you consider a success in the fight against viral diseases?

A: The development of successful vaccines and highly effective therapeutic agents. If you have a very high quality vaccine, and you deliver it in an efficient way, then drug resistance is not the issue that it is if you’re relying only on treatment. And I wouldn’t say that we have evidence that there is always drug resistance. It just depends on how well we are able to manage our identification and treatment of a disease.

 

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Mr. Handley, we thank you for your time and insights into the new grant programme and look forward to further cooperation in the field of emerging infectious diseases.