Two years after the start of the pandemic, the Republic of Congo has begun to apply the genomic sequencing capacities developed in the fight against COVID-19 to other pathogens, including those responsible for malaria, tuberculosis or diarrhoeal diseases in young children.

“Thanks to genomic sequencing, the authorities are informed almost immediately of the circulation of variants of COVID-19 in the country,” explains Professor Francine Ntoumi, president of the Congolese Foundation for Medical Research (FCRM), based in the capital, Brazzaville. “Now we want to use these sequencing capabilities to monitor other pathologies.”

FCRM has already established a sequencing protocol to describe the genes in staphylococcus responsible for the bacteria's resistance to antibiotics, which will make it possible to better treat patients.

“We should have a sufficiently significant sampling by the end of the year,” enthuses Dr Armel Btachi Boyou, a researcher at FCRM and at the Albert Leyono municipal clinic, the centre specializing in the management of serious COVID-19 cases in Brazzaville. “We will then be able to adapt the treatments in order to circumvent this resistance.”

A similar approach will be applied to a battery of parasites responsible for widespread diseases in Congo.

"The development of genomic sequencing in the Congo has highlighted the importance of research, and of having molecular biology laboratories and trained personnel, to effectively fight against diseases,” underlines Professor Ntoumi.

The country now produces its own genomic sequences of the virus that causes COVID-19, circumventing the long, expensive process of sending the samples abroad.

“Best of all, we are now getting more accurate results corresponding to the exact situation in the country. We can thus describe the situation at home, without extrapolating from what is happening elsewhere,” adds Professor Ntoumi.

As the only organization with sequencing capabilities in the Republic of Congo, the FCRM quadrupled its daily sequencing capacity between 2020 and 2022, from 24 to 96 genomic sequences per day. A collaboration with the German Embassy enabled the Foundation to bring its equipment up to standard, to acquire reagents necessary for genomic sequencing and, to send two of its seven employees on a three-month training course in the University of Tübingen. Having trained personnel allowed for optimal use of the equipment on hand.

The FCRM is also implementing a project, supported by World Health Organization (WHO), to strengthen national capacities around clinical trials, with the aim of preparing the ground to introduce new treatments against COVID -19. In a similar vein, Congo’s National Public Health Laboratory is anticipating support from the World Bank to develop its own genomic sequencing capacities.

"Strengthening genomic sequencing capacities contributes to the empowerment of the country, in terms of disease surveillance and patient care – and therefore to the fight against epidemics,” says Dr Lucien Manga, WHO Representative in Congo.

During the first two years of the COVID-19 pandemic, the information provided by genomic sequencing helped policy makers to understand the circulation of variants in the country, to adapt response measures according to their contagiousness, and to anticipate waves of infections.

"By making it possible to know which variants are in circulation, sequencing allows for a precise response and for optimizing use of resources, which is essential for countries where those resources are limited,” confirms Dr Gilbert Ndziessi, technical coordinator of the National COVID-19 Response Committee. “When the Delta variant, which was more lethal than the others, was detected in Congo, we were able to direct our response activities towards hospitals for optimal patient care. With the Omicron variant, we focused on community outreach instead.”

The country's genomic sequencing capabilities are still in early stages of development. Reagents needed to sequence samples, for instance, may not always be available. Nonetheless, researchers are optimistic.

“It’s true that our sequencing capacities remain limited, but they are significant enough to know which variants are circulating and which are the majority in the country,” says Dr Boyou, who was among those trained in Germany. “It has allowed us to adapt the treatment of patients, as not all variants cause the same symptoms or have the same virulence.”