How Botswana discovered the omicron variantBMJ 2023; 382 doi: https://doi.org/10.1136/bmj.p1653 (Published 26 September 2023) Cite this as: BMJ 2023;382:p1653
It was a day like any other—albeit at the height of a global pandemic. Monkgomotsi Maseng and her colleagues were processing covid-19 samples from various patients and observing the results.
“All positive samples were sent for sequencing,” she remembers of that day in November 2021. “By the end of the day, about four sequences with a strange pattern were observed.”
Maseng was part of a team led by the Botswanan scientist Sikhulile Moyo that helped establish SARS-CoV-2 testing in the southern African country. Moyo and the team had worked over the weekend to run quality checks, cross referencing the results against the other known variants. After coming up with the same patterns they were convinced that this was a new variant: omicron.
Little did they suspect that in little over a year this variant would be the dominant form of SARS-CoV-2 in most parts of the world, and their discovery would be one of the milestones in the accelerated history of covid-19. It was a career highlight for Maseng, who like everyone else had been overwhelmed by how covid-19 had struck suddenly and claimed so many lives. This planted a seed in her—the conviction to dedicate more of her time to researching infectious diseases and helping people to develop immune resistance.
Maseng is a medical scientist at the Faculty of Health Sciences in the University of Botswana, based in Gaborone. She is also a research fellow at the Botswana-Harvard AIDS Institute Partnership. In countries such as Botswana, medical laboratory scientists working in hospitals and other health settings play an important role: data produced in their labs, in terms of patients’ results, influence most of the clinical decisions taken by medical doctors. But although this work was fulfilling, says Maseng, what she wanted was to do more research.
“Making laboratory diagnosis is fun, but I got tired of it mainly because it’s routine work,” she says. “I needed something challenging to keep me on my feet, finding answers to difficult questions that sometimes routine diagnostic work cannot answer. Research can inform testing protocols for diagnosis and better treatment.”
Maseng trained in Australia but returned to her home country after graduating in 2009. She explains, “I had a family to come back to. I was also on a government scholarship that dictated that I come back and work for my country, which is a good thing.” Like many countries, Botswana suffers from a shortage of doctors, nurses, and other medical workers, and the workers it does have endure low wages and insufficient resources. “This leads to overcrowding in clinics and hospitals, as health professionals resign to look for greener pastures outside the country,” says Maseng.
The healthcare system in Botswana is showing signs of improvement, she adds, pointing to a universal healthcare system that provides treatment at almost no cost, including free antiviral drugs for HIV/AIDS and testing services for sexually transmitted infections. It’s seen a reduction in maternal mortality rates, as well as a decrease in measles cases and tuberculosis.
But the country is experiencing a rise in non-communicable diseases including cancer, diabetes, kidney diseases, and hypertension. Moreover, there’s a considerable gap between public and private medical care. Maseng says that the public sector mainly serves citizens on low incomes, while the private sector is available only to people who can afford medical insurance.
“[Because of this] we still must work hard and strengthen health education in non-communicable diseases which are mostly linked to lifestyle,” she says, calling on the government to invest more in health professionals through better wages and working conditions, so that the country is better able to attract and retain talent. “There is also a need to invest in research that can inform better clinical and medical decisions as well as improve the health system.”
One way that Maseng has chosen to contribute is through Sister-Sister, an organisation she founded in 2021 for underprivileged children of all ages in remote areas of Botswana to help them take up science, technology, engineering, and mathematics (STEM) subjects. She says that the objective was to break barriers and stereotypes surrounding females in the sciences.
“Our first symposium, held in 2021, had two female STEM mentors speak, followed by a brief tour of academic and professional poster presentations to encourage mentor-mentee interactions,” she says.
As for covid-19, it’s still a major focus of her research. The general pandemic situation is better than it was, thanks to vaccinations and Botswana’s residents continuing to take precautionary measures seriously. But Maseng insists that this doesn’t mean that people should rest on their laurels.
She concludes, “A lot still needs to be done in terms of awareness, in case of a future pandemic and to educate people on health and wellness in general—particularly where hygiene and immune resistance are concerned.”
Competing interests: None to declare.
Provenance and peer review: Commissioned; not externally peer reviewed.
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