The global disruption caused by the COVID-19 pandemic served as a wake-up call to the world’s lack of resilience and infrastructure to guard communities from viral pathogens. This, in turn, has driven a global focus on viral pathogenesis, fostering collaboration and innovation. It also triggered a landmark coordination effort in vaccine development: mRNA vaccines were produced in under a year after SARS-CoV-2—the virus that causes COVID-19—was identified, whereas under normal circumstances, vaccine development can take 10 to 15 years.
Now, almost six years since the initial outbreak, leaders in global health and immunology are advancing in three key domains of viral disease: Diagnostics, therapeutics and prevention, and epidemiology and health outcomes. The Infectious Diseases and Immunity in Global Health Program (IDIGH) at the Research Institute of the McGill University Health Centre (RI-MUHC) is integrating research in infectious diseases, immunity, and global health through cross-disciplinary working groups with a translational focus.
In their event co-hosted with the McGill Research Centre on Complex Traits (MRCCT) and the Wainberg Centre for Viral Diseases, IDIGH brought together experts to examine advances and challenges in viral diseases and emerging therapies.
Leo Liu, assistant professor in McGill’s Department of Microbiology & Immunology, presented work that advances understanding of SARS-CoV-2 replication. He described a ‘Swiss-Army-knife’ molecular pore formed by viral non-structural proteins. Coronaviruses build this pore inside double-membrane vesicles—small sacs pinched from cellular membranes that shield viral activity from bodily immune sensors—where they copy their ribonucleic acid (RNA), the strand of genetic instructions the virus uses to make proteins and new genomes.
Because the pore spans the vesicle and serves as a conduit for both copying and exporting RNA, it is an attractive drug target. By disrupting the pore, therapies can block RNA synthesis and export simultaneously, effectively halting the production of infectious particles.
Liu’s broader lab focus—virus-host sensing and coronavirus biology—furthers this exploration by investigating how pore function intersects with innate immune detection and viral evasion, as well as the mechanisms by which viruses evade host immune responses. He argues that engineering therapies that target antiviral innate immunity—our bodies’ non-specific defence system—and RNA virus biology concurrently can maximize attenuation.
“Rather than seeing them as stand-alone mechanisms, this model of combinational viral attenuation leverages both host factors together,” Liu concluded.
Another speaker, David Kelvin from the Department of Microbiology & Immunology at Dalhousie University, discussed his lab’s ongoing work on a novel outbreak of Mpox— previously known as monkeypox—Clade 1b. Mpox outbreaks are occurring with increasing frequency in its endemic regions of West and Central Africa, and current data indicate shifting transmission patterns, with more sustained human-to-human spread having a disproportionate burden on children compared to prior waves.
Through contact tracing, his team’s facility in Kamituga, Democratic Republic of the Congo (DRC), identified a likely index case in the mountainous town of Liwro, and followed the rapid transmission through the DRC into Rwanda and Burundi. His work examines two viral mutations believed to be involved in sustained human-to-human transmission of this variant, an OPG32 gene deletion and an OPG164 partial gene deletion.
“Ongoing mutational analysis of animal viruses compared with sporadic human infections with limited human-to-human transmission compared with sustained human-to-human transmission will help in identifying potential hotspots for detailed investigation on transmission and pathogenicity,” Kelvin explained.
An audience member asked questions about the state of vaccine development and distribution, citing Moderna’s efforts to develop an mRNA-based mpox vaccine. Kelvin noted that the international response from the World Health Organization (WHO) and other international organizations lagged behind the growth of cases after the initial outbreak in 2023.
“I think the initial supply was about 200,000 doses, and we need millions. And then who should get them?” he asked.
This raises difficult questions of priority, in addition to the preexisting challenges of low attrition for multi-dose vaccines, coupled with a lack of infrastructure. Kelvin also noted that the outbreak coincided with extreme political instability and conflict in an already isolated region, making distribution near impossible.
Such concerns highlight complicated challenges beyond virology: Leaders in global health and infectious disease must confront equity and access, structural barriers to care, and the political, social, and economic conditions that shape who gets protected—and when.
