One health adoption within prevention, preparedness and response to health threats: Highlights from a scoping review

Overview of global governance, capacity, and health systems implication of pandemic prevention, preparedness, and response: A narrative review and descriptive analysis of open-source data

The COVID-19 pandemic has highlighted the importance of pandemic prevention, preparedness, and response (PPPR) in global health. This review first examined global health governance (GHG) for PPPR, identifying its core-satellite structure. Key GHG functions include rule-setting, resource mobilization, medical countermeasures (MCMs) supply, surveillance and data/pathogen sharing with rapid response, and One Health. Major gaps exist in global collaboration, enforcement of the International Health Regulations (IHR), and the World Health Organization's (WHO) capacity. The most urgent issue is pathogen access and benefit-sharing (PABS). Second, the PPPR capacity across world regions were assessed using two public datasets: eSPAR and GHS Index. Sub-Saharan Africa requires urgent support to strengthen most PPPR aspects, while epidemiological and laboratory surveillance, infection prevention and control (IPC), and regulatory functions need improvement in low- and middle-income countries (LMICs) in various regions outside Europe. Japan, with its strong PPPR capacity, is well-positioned to assist. Lastly, the review explored the link between PPPR and health systems strengthening (HSS). PPPR must be firmly integrated into HSS to ensure resilience, equity, inclusiveness, continuity of care, and sustainability. Core health system components - service delivery, workforce, health information systems, MCMs access, and governance - along with communication and trust-building, effectively contribute to PPPR. However, pandemic exceptionalism and the over-securitization of PPPR and health security may hinder coordination. The enhanced GHG for PPPR, led by the empowered WHO, should effectively facilitate and coordinate technical assistance to LMICs to strengthen their PPPR capacities and promote PPPR-HSS integration by bringing together the often-divided health security and HSS communities.

Qualitative assessment of the scale-up of COVID-19 testing network in Armenia: turning adversities into opportunities

BACKGROUND

The COVID-19 pandemic reaffirmed the importance of high-quality laboratory services in the face of elevated demand for timely COVID-19 laboratory diagnosis. We explored the scale-up experience of the laboratory system in Armenia as well as the successes and challenges it brought to the overall laboratory system with the aim to identify lessons that can serve as opportunities for improvement.

METHODS

We conducted a qualitative study to explore the experiences concerning the process of scale-up of the COVID-19 testing network through in-depth interviews with policymakers/experts (n = 6), heads (n = 6) and physicians (n = 3) of private and public laboratories conducting COVID-19 testing. Eight domains of the WHO Laboratory Assessment Tool System (S-LAT) questionnaire guided the study and directed the content analysis.

RESULTS

According to the findings, within the COVID-19 testing network, numerous advancements were documented across all essential elements of the S-LAT as a result of the COVID-19 response. The most vivid improvements were related to the newly established network of public and private laboratories for COVID-19 testing and related coordination mechanisms, new laboratory information management practices, improved compliance with biosafety measures, novel quality assurance mechanisms as well as improved technical and human resources. However, suboptimal coordination of the COVID-19 testing network and the whole laboratory system, the gap between existing and proper biosafety management and quality control practices, and insufficient training of laboratory professionals were mentioned as potential challenges for the laboratory system in the future.

CONCLUSION

The assessment revealed challenges and achievements of the laboratory system during the COVID-19 response. Enhancement of coordination and cooperation mechanisms within and beyond the COVID-19 testing network, continuous improvement of human resources as well as quality and biosafety control practices throughout the whole system are crucial for sustaining the achievements and for strengthening future preparedness of the laboratory system to infectious disease outbreaks.

Perceived Harm to Pet Health Associated with Human Quality of Life After a Public Health Disaster

This study's goal was to evaluate associations of human exposure to unfiltered tap water during the Flint water crisis (FWC) with perceived harm to pets from exposure to contaminated water. We also explored the associations of perceived pet harm with participants' self-reported general, physical, and mental health, as well as quality of life. Adult (n = 3264) pet owners from a public health registry reported unfiltered tap water exposure, perceived pet health, and general health/quality of life at baseline, as well as health/quality of life 1 year later (n = 1172). Using frequencies, percentages, and odds ratios, we evaluated associations of unfiltered tap water consumption with perceived pet health (cross-sectional) and perceived pet health with general health and quality of life (cross-sectional and longitudinal). Daily unfiltered tap water drinkers were 3.12 (95% CI: 2.33-4.23) times more likely to report the FWC had made their pet ill compared to participants who never drank unfiltered water. Participants who reported Flint water made their pet ill had approximately a two-fold increase in odds of reporting poor/fair across all four health/quality-of-life measures compared to those who did not. Both animals and humans were exposed and impacted by the FWC. This study supports the interconnectedness between human and animal health, especially regarding environmental disaster exposure and outcomes.

Multi-country case study on school health policy and its implementation in relation to COVID-19 control in Micronesia Small Islands Developing States

INTRODUCTION

The COVID-19 pandemic caused school closures and rises in mental illness and non-communicable disease among school children worldwide. The Pacific Small Islands Developing States (SIDS) were also affected, but school health activities, which can effectively reduce negative effects of COVID-19, were not widely implemented compared to other Asia-Pacific countries. This study examined current school health implementation and related policies at national, local, and school levels in the Micronesia SIDS according to phases of COVID-19 control.

METHODS

Multi-country case study targeted the Federated States of Micronesia (FSM), Republic of the Marshall Islands (RMI), and Republic of Palau (ROP). These studies focused on school health implementation periods according to the PPR (Prevention, Preparedness, and Response) concept: Phase #1: prevention/preparedness, #2: early phase response, and #3: chronic phase response/recovery phase. Data were collected through policy document reviews that identified school health policies related to COVID-19 controls in the three phases and key informant interviews (KIIs) with 44 key informants (FSM, n = 14; RMI, n = 18; ROP, n = 12) whose work related to school health. The collected data were analyzed using content analysis methods according to the conceptual framework in this study.

RESULTS

This study identified three factors of school health implementation related to COVID-19 controls: promotion of decentralized education (FSM), implementation of COVID-19 controls in the school community (RMI), and disaster management for the protection of students including response to infectious disease (ROP). In Phase #1, no country had established a school health policy. In Phase #2, three enablers were identified in FSM and ROP, as reflected in COVID-19 controls by the education and health sectors. In Phase #3, RMI implemented COVID-19 controls in the school community. Documents on youth policy and disaster management in ROP were updated to reflect the chronic phase response and response to future public health crises.

CONCLUSIONS

A decentralized education was instrumental in immediately implementing COVID-19 control measures in schools at national and local levels for coordination between education and health sectors. Despite each county's multi-sectoral approach to engage COVID-19 controls in schools, local government organization requires strengthening and implementation of the formulated school health policy. In preparation for the next public health crisis, school health should be promoted that is integrated into both infection control and disaster management.

Assessing the Adoption of One Health Approaches in National Plans to Combat Health Threats: The Pilot of a One Health Conceptual Framework in Armenia

Due to several factors, such as environmental and climate changes, the risk of health threats originating at the human-animal-environment interface, including vector-borne diseases (VBDs) and zoonoses, is increasing. Low-resource settings struggle to counter these multidimensional risks due to their already-strained health systems and are therefore disproportionally affected by the impact caused by these changes. Systemic approaches like One Health (OH) are sought to strengthen prevention and preparedness strategies by addressing the drivers of potential threats with a multidisciplinary and multisectoral approach, considering the whole system at the human-animal-environment interface. The integration of OH in national plans can be challenging due to the lack of effective coordination and collaboration among different sectors. To support the process of knowledge coproduction about the level of OH integration in prevention and preparedness strategies against health threats in Armenia, a situation analysis was performed on Crimean-Congo hemorrhagic fever/virus and anthrax (identified by local stakeholders as priorities to be addressed with the OH approach), and actions to strengthen the national OH system were identified with the support of a OH conceptual framework. The study highlighted that multidisciplinary and multisectoral efforts towards prevention and preparedness against VBDs and zoonoses threats need to be strengthened in Armenia, and priority actions to integrate the OH approach were identified.

Analyzing One Health governance and implementation challenges in Mexico

Establishing a robust One Health (OH) governance is essential for ensuring effective coordination and collaboration among human, animal, and environmental health sectors to prevent and address complex health challenges like zoonoses or antimicrobial resistance. This study conducted a mixed-methods environmental scan to assess to what extent Mexico displays a OH governance and identify opportunities for improvement. Through documentary analysis, the study mapped OH national-level governance elements: infrastructure, multi-level regulations, leadership, multi-coordination mechanisms (MCMs), and financial and OH-trained human resources. Key informant interviews provided insights into enablers, barriers, and recommendations to enhance a OH governance. Findings reveal that Mexico has sector-specific governance elements: institutions, surveillance systems and laboratories, laws, and policies. However, the absence of a OH governmental body poses a challenge. Identified barriers include implementation challenges, non-harmonised legal frameworks, and limited intersectoral information exchange. Enablers include formal and ad hoc MCMs, OH-oriented policies, and educational initiatives. Like other middle-income countries in the region, institutionalising a OH governance in Mexico, may require a OH-specific framework and governing body, infrastructure rearrangements, and policy harmonisation. Strengthening coordination mechanisms, training OH professionals, and ensuring data-sharing surveillance systems are essential steps toward successful implementation, with adequate funding being a relevant factor.