Unseen Enemy: urgent call to action on pandemics

School partners on major documentary exploring growing risk of global outbreaks.

The growing threat of global pandemics due to population growth, mass urbanisation, climate change and increased travel, is the subject of a major new documentary film featuring the London School of Hygiene & Tropical Medicine.

Written and directed by Emmy award-winning film maker Janet Tobias, Unseen Enemy follows doctors and disease experts including the School's Professor Peter Piot, Dr Heidi Larson, and alumnus Dr Soka Moses.

The film examines the reasons why 21st-century populations are experiencing a rash of diseases that were once only outbreaks, but have now become full-blown epidemics.

The increased risk that we face, and the ways society and individuals can work together to reduce that risk, are explored through the case studies of three epidemics: Ebola, influenza and Zika.

​School Director, Prof Piot, reflects on his experiences investigating the first known outbreak of the Ebola virus in what was then Zaire (now DRC) in 1976, the reasons why Ebola took hold on such an unprecedented scale in West Africa in 2014, and what the future risks might be: "We live in an ever more globalised world where we are all connected, so there's a much greater risk that familiar diseases will spread quickly and mutate, and others will emerge, often jumping from animals to humans."

The role of rumours and mistrust in perpetuating outbreaks through increased hesitancy in vaccines is highlighted by anthropologist Dr Larson, Associate Professor in the School's Department of Infectious Disease Epidemiology. Her work on the Vaccine Confidence Project maps these issues around the world: "The internet and social media mean misinformation spreads quicker than ever before, and it's much harder to control public health messages." During the Ebola outbreak Dr Larson led the EBODAC project to promote the acceptance and uptake of a new Ebola vaccine, working to tackle stigma surrounding Ebola and suspicion of vaccines in general.

The film also follows Liberian doctor Soka Moses, who ran Monrovia's largest Ebola Treatment Centre during the 2014/15 Ebola epidemic. Just two years out of finishing his medical internship, Dr Moses was caring for patients while supervising 125 staff, only 40 of whom were professional health workers. He describes the overwhelming numbers of patients, with people queuing outside the treatment centre each day: "When there were so many deaths. That caused a lot of confusion, and panic. Infected patients and contacts started to run to different communities and with them they took the infection and infected more people."

While working in the treatment centre, Dr Moses discovered the School's free online course on Ebola, and he was able to get advice and share his experiences with other health professionals worldwide. When the worst of the crisis was over, he decided to come to the School to study for an MSc in Control of Infectious Diseases. He graduated in March 2017 and is now back in Liberia conducting vital research on the lasting effects of Ebola on survivors, and still continues to work as a general practitioner. He says: "I've changed my resolve. To spend the rest of my life offering selfless service to the community, and to people."

Prof Piot said: "Soka's story embodies what the London School of Hygiene & Tropical Medicine is all about. One of our most important missions is to train the next generation of health leaders to help strengthen health systems in vulnerable countries, and prevent future disease epidemics which can devastate societies."

The School is at the forefront of preventing and responding to disease outbreaks. During the Ebola crisis, School staff advised governments and international agencies, analysed data to assist in response planning, conducted clinical trials of vaccines and treatments and volunteered on the frontline in Ebola treatment centres. The School was named 'University of the Year' in the prestigious Times Higher Education Awards in recognition of its response to the crisis.

The School also jointly runs the UK Public Health Rapid Support Team with Public Health England. Funded by the UK Government, the team is ready to respond to disease outbreaks around the world before they develop into health emergencies, and conducts rigorous research to improve our response to future epidemics.

The Unseen Enemy film makes the case that we are all on the frontline in global health, and that preventing and containing epidemics can be achieved through coordinated efforts of medical professionals, researchers, governments, communicators and the public. As Prof Piot puts it, it really is "act now or pay later."

Unseen Enemy will be broadcast in a number of countries in early April, including the US and Canada (CNN), France (Arte) and China (RTHK). Full details on the schedule are listed on the campaign website. It will air in the UK later in the year.