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Miller LN, Saadawi WK, Hamouda WB, Elgari AS, Abdulkarim EA, Lmrabet AMM, Elbukhmari AE, Harabech K, Jemai AA, Farhat M, Al-Azab R, Zorgani A, Elamher O, Al Sanouri T, Standley CJ, Sorrell EM. Assessing One Health capacities for transboundary zoonotic diseases at the Libya-Tunisia border. ONE HEALTH OUTLOOK 2024; 6:3. [PMID: 38504381 PMCID: PMC10953064 DOI: 10.1186/s42522-024-00101-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/09/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND The dynamic nature of zoonotic emergence, spillover and spread necessitates multisectoral coordination beyond national borders to encompass cross-boundary and regional cooperation. Designated points of entry (POEs), specifically ground crossings, serve as critical locales for establishing and maintaining robust prevention, detection, notification, coordination, and response mechanisms to transboundary emerging and re-emerging disease threats. In order to better assess One Health capacities for transboundary zoonotic diseases (TZD) prevention, detection and response we adapted an existing tool, One Health Systems Assessment for Priority Zoonoses (OHSAPZ), for a cross-border, POE setting in North Africa. METHODS The One Health Transboundary Assessment for Priority Zoonoses (OHTAPZ) tool was used to support prioritization of transboundary zoonoses and analyze operational capacities between national and subnational-level human and animal health stakeholders from Libya and Tunisia. Country partners jointly identified and prioritized five TZDs of concern. Case study scenarios for each priority pathogen were used to elicit current disease operations, as well as multisectoral and bilateral engagement networks. Finally, a gap analysis was performed to determine bilateral strengths and weaknesses to TZDs. RESULTS The five priority TZDs jointly confirmed to undergo One Health assessment were avian influenza (low and high pathogenic strains); brucellosis; Rift Valley fever; Crimean-Congo hemorrhagic fever; and rabies. Using the qualitative information collected, a transboundary systems map schematic was developed outlining the movement of human patients, animals, diagnostic samples, and routes of communication and coordination both within and between countries for zoonotic diseases. CONCLUSIONS Analysis of current operations (prevention, detection, surveillance, laboratory capacity, quarantine/isolation, and response) and the resulting transboundary systems map schematic helped identify existing capacity strengths for certain priority pathogens, as well as challenges to timely information-sharing and coordination. We developed targeted recommendations to address these limitations for joint action planning between Libya and Tunisia.
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Affiliation(s)
- Lauren N Miller
- Center for Global Health Science and Security, Georgetown University Medical Center, Washington, DC, USA
| | | | - Wafa Ben Hamouda
- General Directorate for Veterinary Services, Ministry of Agriculture, Water Resources and Fisheries, Tunis, Tunisia
| | | | | | | | | | | | - Ammar Ali Jemai
- CDRA, Ministry of Agriculture, Water Resources and Fisheries, Tunis, Tunisia
| | - Milad Farhat
- National Centre for Animal Health, Tripoli, Libya
| | - Rasha Al-Azab
- Eastern Mediterranean Public Health Network, Amman, Jordan
| | | | - Omar Elamher
- National Centre for Disease Control, Tripoli, Libya
| | | | - Claire J Standley
- Center for Global Health Science and Security, Georgetown University Medical Center, Washington, DC, USA
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Erin M Sorrell
- Center for Health Security, Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
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Singh S, Sharma P, Pal N, Sarma DK, Tiwari R, Kumar M. Holistic One Health Surveillance Framework: Synergizing Environmental, Animal, and Human Determinants for Enhanced Infectious Disease Management. ACS Infect Dis 2024; 10:808-826. [PMID: 38415654 DOI: 10.1021/acsinfecdis.3c00625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
Recent pandemics, including the COVID-19 outbreak, have brought up growing concerns about transmission of zoonotic diseases from animals to humans. This highlights the requirement for a novel approach to discern and address the escalating health threats. The One Health paradigm has been developed as a responsive strategy to confront forthcoming outbreaks through early warning, highlighting the interconnectedness of humans, animals, and their environment. The system employs several innovative methods such as the use of advanced technology, global collaboration, and data-driven decision-making to come up with an extraordinary solution for improving worldwide disease responses. This Review deliberates environmental, animal, and human factors that influence disease risk, analyzes the challenges and advantages inherent in using the One Health surveillance system, and demonstrates how these can be empowered by Big Data and Artificial Intelligence. The Holistic One Health Surveillance Framework presented herein holds the potential to revolutionize our capacity to monitor, understand, and mitigate the impact of infectious diseases on global populations.
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Affiliation(s)
- Samradhi Singh
- ICMR - National Institute for Research in Environmental Health, Bhopal Bypass Road, Bhouri, Bhopal-462030, Madhya Pradesh, India
| | - Poonam Sharma
- ICMR - National Institute for Research in Environmental Health, Bhopal Bypass Road, Bhouri, Bhopal-462030, Madhya Pradesh, India
| | - Namrata Pal
- ICMR - National Institute for Research in Environmental Health, Bhopal Bypass Road, Bhouri, Bhopal-462030, Madhya Pradesh, India
| | - Devojit Kumar Sarma
- ICMR - National Institute for Research in Environmental Health, Bhopal Bypass Road, Bhouri, Bhopal-462030, Madhya Pradesh, India
| | - Rajnarayan Tiwari
- ICMR - National Institute for Research in Environmental Health, Bhopal Bypass Road, Bhouri, Bhopal-462030, Madhya Pradesh, India
| | - Manoj Kumar
- ICMR - National Institute for Research in Environmental Health, Bhopal Bypass Road, Bhouri, Bhopal-462030, Madhya Pradesh, India
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Standley CJ, Fogarty AS, Miller LN, Sorrell EM. One Health Systems Assessments for Sustainable Capacity Strengthening to Control Priority Zoonotic Diseases Within and Between Countries. Risk Manag Healthc Policy 2023; 16:2497-2504. [PMID: 38024504 PMCID: PMC10676109 DOI: 10.2147/rmhp.s428398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023] Open
Abstract
One Health is increasingly recognized as an important approach for health systems, particularly with respect to strengthening prevention, detection and response to zoonotic and other emerging disease threats. While many global health security frameworks reference the importance of One Health, there are fewer existing methodologies, tools, and resources for supporting countries and other regional or sub-national authorities in systematically assessing their One Health capabilities. We describe here two methodologies, One Health Systems Assessment for Priority Zoonoses (OHSAPZ) and One Health Transboundary Assessment for Priority Zoonoses (OHTAPZ), which have been developed to assist with creating consensus lists of priority zoonotic diseases for cross-sectoral consideration; identification of current strengths and gaps in One Health communication and coordination between sectors (and, in the case of OHTAPZ, between countries); and the development and dissemination of prioritized recommendations for future capacity strengthening. Implemented to date in seven diverse countries in Africa and the Eastern Mediterranean regions, these tools provide a modular, flexible and easily adaptable approach to One Health systems assessment that can support national capacity strengthening, regional epidemic preparedness, and compliance with international frameworks.
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Affiliation(s)
- Claire J Standley
- Center for Global Health Science and Security, Georgetown University, Washington, DC, USA
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Alanna S Fogarty
- Center for Global Health Science and Security, Georgetown University, Washington, DC, USA
| | - Lauren N Miller
- Center for Global Health Science and Security, Georgetown University, Washington, DC, USA
| | - Erin M Sorrell
- Center for Health Security, Johns Hopkins University; Department of Environmental Health and Engineering, Bloomberg School of Public Health & Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA
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Sitawa R, Tenge E, Chepkorir K, Nanyingi M, Okuthe S, Lockhart C, Oyas H, Njagi O, Agutu MT, Omolo J, Okumu T, Bebay C, Fasina FO. Building subnational capacities in animal health to deliver frontline cross-sectoral health services in Kenya. Front Vet Sci 2023; 10:1150557. [PMID: 37601759 PMCID: PMC10436308 DOI: 10.3389/fvets.2023.1150557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 07/19/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction Operationalizing effective subnational veterinary services as major contributor to disease surveillance, reporting, diagnoses and One Health requires resources and mindset change. Here we describe workforce capacity building in animal health in Kenya and an approach that can be used to skill-up this workforce to respond beyond animal health challenges to emergent One Health realities and public health emergencies. Furthermore, triggering a paradigm shift has been identified for impactful delivery of health services, thus mindset change are important for learning new skills, but they also affect the way that we think about everything, for instance training in field epidemiology. Emphasis was therefore placed on skills, beliefs, and mindset shift. Methods Contextualized within the Kenyan environment, this description identifies problems likely to be found elsewhere: They are (a) The limited programs that offer structured and routine on-the-job training for animal health workers; (b) Unequal distribution and inadequate quantity and quality of highly skilled workforce with appropriate technical training and scientific skills to combat public (and animal) health challenges at the frontline; (c) Health challenges occasioned by climate change and drought, including feed, and water scarcity; and (d) Inadequate contingency, preparedness, and response planning for effective deployment of ready-to-trigger workforce capacity. In-Service Applied Veterinary Epidemiology Training (ISAVET) is a four-month long training program targeted at capacity building of frontline animal health professionals. The training, which is currently implemented in 17 African countries, is innovative and a customized field epidemiology program, which responds to specific needs in animal health and contribute to approaches utilizing One Health. Results Several trainees have marked mindset change as shown in the outputs and outcomes. Positive attitudes towards improving animal health surveillance were noted during the evaluation process. Discussion and Conclusion Most existing workforce capacities in the animal and public health systems were built for specific fields, and hardly respond optimally for cross-sectoral purposes. We proposed customised in-service applied veterinary epidemiology training that bypasses narrow-scoped workforce development but meets multifunctional, multidisciplinary and multisectoral needs before and during emergencies.
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Affiliation(s)
- Rinah Sitawa
- Emergency Center for Transboundary Animal Diseases (ECTAD), Food and Agriculture Organization of the United Nations (FAO), United Nations Office in Nairobi (UNON), Nairobi, Kenya
| | - Evans Tenge
- Emergency Center for Transboundary Animal Diseases (ECTAD), Food and Agriculture Organization of the United Nations (FAO), United Nations Office in Nairobi (UNON), Nairobi, Kenya
| | - Khadija Chepkorir
- Directorate of Veterinary Services, Ministry of Agriculture and Livestock Development, Nairobi, Kenya
| | - Mark Nanyingi
- Emergency Center for Transboundary Animal Diseases (ECTAD), Food and Agriculture Organization of the United Nations (FAO), United Nations Office in Nairobi (UNON), Nairobi, Kenya
- Department of One Health, Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
| | - Sam Okuthe
- Emergency Center for Transboundary Animal Diseases (ECTAD), Regional Office for Eastern Africa, Food and Agriculture Organization of the United Nations (FAO), United Nations Office in Nairobi (UNON), Nairobi, Kenya
| | - Caryl Lockhart
- Food and Agriculture Organization of the United Nations (FAO), Rome, Italy
| | - Harry Oyas
- Directorate of Veterinary Services, Ministry of Agriculture and Livestock Development, Nairobi, Kenya
| | - Obadiah Njagi
- Directorate of Veterinary Services, Ministry of Agriculture and Livestock Development, Nairobi, Kenya
| | | | - Jack Omolo
- Department of Agriculture, Livestock Development and Fisheries, Kilifi, Kenya
| | - Tequiero Okumu
- University of Nairobi College of Agriculture and Veterinary Sciences, Nairobi, Kenya
| | - Charles Bebay
- Emergency Center for Transboundary Animal Diseases (ECTAD), Regional Office for Eastern Africa, Food and Agriculture Organization of the United Nations (FAO), United Nations Office in Nairobi (UNON), Nairobi, Kenya
| | - Folorunso O. Fasina
- Emergency Center for Transboundary Animal Diseases (ECTAD), Food and Agriculture Organization of the United Nations (FAO), United Nations Office in Nairobi (UNON), Nairobi, Kenya
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Pungartnik PC, Abreu A, dos Santos CVB, Cavalcante JR, Faerstein E, Werneck GL. The interfaces between One Health and Global Health: A scoping review. One Health 2023; 16:100573. [PMID: 37363235 PMCID: PMC10288129 DOI: 10.1016/j.onehlt.2023.100573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 05/15/2023] [Accepted: 05/25/2023] [Indexed: 06/28/2023] Open
Abstract
One Health (OH) and Global Health (GH) are interconnected perspectives that may contribute to subsidizing GH policies. This scoping review aims to map the volume, nature, and characteristics of studies focused on the interface of OH and GH concepts. We used PubMed (MEDLINE), Embase, Scopus, and The Virtual Health Library (BVS) as the literature data sources for the review. The search strategy used the descriptors "one health", "one health concept", "one medicine", "global health", "international health", and "planetary health" in title and abstracts. We included original research presented as articles in scientific journals, book chapters or conference papers written in English, Spanish, or Portuguese, exploring the intersections between OH and GH concepts, not necessarily as their primary objectives, and published up to December 31, 2021. A total of 1.060 references were identified in the databases after removing duplicates, 139 publications selected for full-text evaluation and 45 publications were included for analysis. All included publications were published between 2011 and 2021, with the highest concentration in 2014 (22.2%). First authors were most frequently from the United States (35.6%), followed by the United Kingdom (15.6%). Overall, seven key themes were identified zoonosis, emerging infectious diseases, antimicrobial resistance, food safety, policy, human resources, and Sustainable Development Goals (SDG). The majority of the included publications employed OH concepts based on the United States Centre for Disease Control and Prevention, and the American Veterinary Medical Association definitions. We observed a common understanding of OH as an area of knowledge involving multiple disciplines and professionals and recognizing that both humans' and animals' health and the environment are interdependent. Although most authors demonstrated that health issues transcend national boundaries, a formal definition for GH was frequently not clearly identified. OH and GH interfaces are essential for accomplishing the 2030 Agenda and its SDG.
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Affiliation(s)
- Paula Cristina Pungartnik
- Institute of Colletive Health Studies, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Ariane Abreu
- Public Health School, University of São Paulo (USP), São Paulo, Brazil
| | | | - João Roberto Cavalcante
- Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Eduardo Faerstein
- Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Guilherme Loureiro Werneck
- Institute of Colletive Health Studies, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
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Ndoungué VF, Bello D, Kameni JMF, Lamtoing AD, Epee CED, Abdou S, Mouliom MMM, Njajou OT, Tieblé T, Wango RK, Belot G, Kouadio SA, de La Rocque S. IHR-PVS National Bridging Workshop in Cameroon: An interactive and participatory approach to engage stakeholders in the development of a One Health road map. One Health 2023; 16:100552. [PMID: 37363237 PMCID: PMC10288074 DOI: 10.1016/j.onehlt.2023.100552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 04/23/2023] [Accepted: 04/24/2023] [Indexed: 06/28/2023] Open
Abstract
Introduction Stakeholders involved in the implementation of the One Health (OH) welcome support for the operationalization of the approach and advice on how to address OH collaboration challenges. The IHR/PVS National Bridging Workshop (NBW) is an operational and outcome-oriented tool approach that allows animal health, human health and other relevant sectors to focus on their coordination. This paper describes how Cameroon leveraged on the NBW success factors to engage stakeholders in strengthening multisectoral collaboration. Methods Stakeholder's engagement was implemented in two phases. Phase one consisted of engaging the multisectoral national task team for the preparation of the workshop. Phase two consisted of the bridging exercise itself during a three day workshop. The WOAH-WHO standardized IHR/PVS NBW toolkit was used throughout the workshop. Results A total of 66 participants took part in the exercise. In total, 36% each came from human and animal health sectors with 23% and 5% from the environmental health and other sectors respectively. A total of 55% participants came from the national level and 39% from the regional level. The joint roadmap contained 55 activities and 13 objectives. Priority objectives were the establishment of a OH platform at all levels (62% of the vote) and building stakeholder's capacity on the OH approach (56% of the vote). A total of 67% of the activities required low or moderate cost and 87% would have a high impact on multisectoral collaboration. Conclusion The NBW allowed consensus on operational activities to fill the gaps in coordination to build health security capacities. It enabled Cameroon to create a joint road map for enhanced multisectoral collaboration for health security. The output will be integrated in the National Action Plan for Health Security operational plan and support operational One Health activities. It would be crucial to develop global capacity assessment frameworks for environmental health, which could be included in the NBW, to incorporate interconnections with environmental sector. This should allow for a stronger multisectoral linkage of sectors all together for a more the robust OH approach in responding to emerging public health threats.
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Affiliation(s)
| | - Djamilla Bello
- National Public Health Observatory, Ministry of Health, Yaounde, Cameroon
| | - Jean Marc Feussom Kameni
- Animal Disease Epidemiology Surveillance Network (RESCAM), Ministry of Livestock, Fisheries, and Animal Industries, Yaounde, Cameroon
| | - Antoine Damou Lamtoing
- Ministry of the Environment, Nature Protection and Sustainable Development, Yaounde, Cameroon
| | | | - Salla Abdou
- Food and Agriculture Organization of the United Nations, Yaounde, Cameroon
| | | | - Omer T. Njajou
- Tackling Deadly Diseases in Africa Program, DAI Global Health, London, UK
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Traore T, Shanks S, Haider N, Ahmed K, Jain V, Rüegg SR, Razavi A, Kock R, Erondu N, Rahman-Shepherd A, Yavlinsky A, Mboera L, Asogun D, McHugh TD, Elton L, Oyebanji O, Okunromade O, Ansumana R, Djingarey MH, Ali Ahmed Y, Diallo AB, Balde T, Talisuna A, Ntoumi F, Zumla A, Heymann D, Socé Fall I, Dar O. How prepared is the world? Identifying weaknesses in existing assessment frameworks for global health security through a One Health approach. Lancet 2023; 401:673-687. [PMID: 36682374 DOI: 10.1016/s0140-6736(22)01589-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 01/21/2023]
Abstract
The COVID-19 pandemic has exposed faults in the way we assess preparedness and response capacities for public health emergencies. Existing frameworks are limited in scope, and do not sufficiently consider complex social, economic, political, regulatory, and ecological factors. One Health, through its focus on the links among humans, animals, and ecosystems, is a valuable approach through which existing assessment frameworks can be analysed and new ways forward proposed. Although in the past few years advances have been made in assessment tools such as the International Health Regulations Joint External Evaluation, a rapid and radical increase in ambition is required. To sufficiently account for the range of complex systems in which health emergencies occur, assessments should consider how problems are defined across stakeholders and the wider sociopolitical environments in which structures and institutions operate. Current frameworks do little to consider anthropogenic factors in disease emergence or address the full array of health security hazards across the social-ecological system. A complex and interdependent set of challenges threaten human, animal, and ecosystem health, and we cannot afford to overlook important contextual factors, or the determinants of these shared threats. Health security assessment frameworks should therefore ensure that the process undertaken to prioritise and build capacity adheres to core One Health principles and that interventions and outcomes are assessed in terms of added value, trade-offs, and cobenefits across human, animal, and environmental health systems.
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Affiliation(s)
- Tieble Traore
- WHO Emergency Preparedness and Response Cluster, WHO Regional Office for Africa, Dakar Hub, Dakar, Senegal.
| | - Sarah Shanks
- Institute of Zoology, Zoological Society of London, London, UK
| | - Najmul Haider
- Royal Veterinary College, University of London, London, UK; School of Life Sciences, Keele University, Keele, UK
| | - Kanza Ahmed
- Global Operations, UK Health Security Agency, London, UK
| | - Vageesh Jain
- Institute for Global Health, University College London, London, UK
| | - Simon R Rüegg
- Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Ahmed Razavi
- Global Operations, UK Health Security Agency, London, UK
| | - Richard Kock
- Royal Veterinary College, University of London, London, UK
| | - Ngozi Erondu
- O'Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC, USA
| | | | - Alexei Yavlinsky
- Infectious Disease Informatics, Institute of Health Informatics, University College London, London, UK
| | - Leonard Mboera
- Southern African Centre for Infectious Disease Surveillance Foundation for One Health, Morogoro, Tanzania
| | - Danny Asogun
- Ekpoma and Irrua Specialist Teaching Hospital, Ambrose Alli University, Irrua, Nigeria
| | - Timothy D McHugh
- Centre for Clinical Microbiology, Division of Infection and Immunity, University College London, London, UK
| | - Linzy Elton
- Centre for Clinical Microbiology, Division of Infection and Immunity, University College London, London, UK
| | - Oyeronke Oyebanji
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Rashid Ansumana
- School of Community Health Sciences, Niala University, Bo Campus, Bo, Sierra Leone
| | - Mamoudou Harouna Djingarey
- WHO Emergency Preparedness and Response Cluster, WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Yahaya Ali Ahmed
- WHO Emergency Preparedness and Response Cluster, WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Amadou Bailo Diallo
- WHO Emergency Preparedness and Response Cluster, WHO Regional Office for Africa, Dakar Hub, Dakar, Senegal
| | - Thierno Balde
- WHO Emergency Preparedness and Response Cluster, WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Ambrose Talisuna
- WHO Emergency Preparedness and Response Cluster, WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Francine Ntoumi
- Fondation Congolaise pour la Recherche Médicale, Brazzaville, Republic of the Congo; Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Alimuddin Zumla
- Department of Infection, Division of Infection and Immunity, University College London, London, UK; National Institute for Health and Care Research Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK
| | - David Heymann
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Osman Dar
- Global Operations, UK Health Security Agency, London, UK; Global Health Programme, Royal Institute of International Affairs, London, UK
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de la Rocque S, Errecaborde KMM, Belot G, Brand T, Shadomy S, von Dobschuetz S, Aguanno R, Carron M, Caya F, Ding S, Dhingra M, Donachie D, Gongal G, Hoejskov P, Ismayilova G, Lamielle G, Mahrous H, Marrana M, Nzietchueng S, Oh Y, Pinto J, Roche X, Riviere-Cinnamond A, Rojo C, Scheuermann L, Sinclair J, Song J, Skrypnyk A, Traore T, Wongsathapornchai K. One health systems strengthening in countries: Tripartite tools and approaches at the human-animal-environment interface. BMJ Glob Health 2023; 8:bmjgh-2022-011236. [PMID: 36707093 PMCID: PMC9884856 DOI: 10.1136/bmjgh-2022-011236] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 12/29/2022] [Indexed: 01/29/2023] Open
Abstract
Unexpected pathogen transmission between animals, humans and their shared environments can impact all aspects of society. The Tripartite organisations-the Food and Agriculture Organization of the United Nations (FAO), the World Health Organization (WHO), and the World Organisation for Animal Health (WOAH)-have been collaborating for over two decades. The inclusion of the United Nations Environment Program (UNEP) with the Tripartite, forming the 'Quadripartite' in 2021, creates a new and important avenue to engage environment sectors in the development of additional tools and resources for One Health coordination and improved health security globally. Beginning formally in 2010, the Tripartite set out strategic directions for the coordination of global activities to address health risks at the human-animal-environment interface. This paper highlights the historical background of this collaboration in the specific area of health security, using country examples to demonstrate lessons learnt and the evolution and pairing of Tripartite programmes and processes to jointly develop and deliver capacity strengthening tools to countries and strengthen performance for iterative evaluations. Evaluation frameworks, such as the International Health Regulations (IHR) Monitoring and Evaluation Framework, the WOAH Performance of Veterinary Services (PVS) Pathway and the FAO multisectoral evaluation tools for epidemiology and surveillance, support a shared global vision for health security, ultimately serving to inform decision making and provide a systematic approach for improved One Health capacity strengthening in countries. Supported by the IHR-PVS National Bridging Workshops and the development of the Tripartite Zoonoses Guide and related operational tools, the Tripartite and now Quadripartite, are working alongside countries to address critical gaps at the human-animal-environment interface.
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Affiliation(s)
| | | | | | - Tianna Brand
- World Organisation for Animal Health Headquarters, Paris, France
| | - Sean Shadomy
- Food and Agriculture Organization of the United Nations Headquarters, Rome, Italy
| | | | - Ryan Aguanno
- Food and Agriculture Organization of the United Nations Headquarters, Rome, Italy
| | - Maud Carron
- World Organisation for Animal Health Headquarters, Paris, France
| | - Francois Caya
- World Organisation for Animal Health Headquarters, Paris, France
| | - Shanlong Ding
- World Health Organization Headquarters, Geneva, Switzerland
| | - Madhur Dhingra
- Food and Agriculture Organization of the United Nations Headquarters, Rome, Italy
| | - Daniel Donachie
- World Organisation for Animal Health Headquarters, Paris, France
| | - Gyanendra Gongal
- World Health Organization Regional Office for South-East Asia, New Delhi, Delhi, India
| | - Peter Hoejskov
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Gunel Ismayilova
- Food and Agriculture Organization of the United Nations Headquarters, Rome, Italy
| | - Gael Lamielle
- Food and Agriculture Organization of the United Nations Headquarters, Rome, Italy
| | - Heba Mahrous
- World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Mariana Marrana
- World Organisation for Animal Health Headquarters, Paris, France
| | - Serge Nzietchueng
- Food and Agriculture Organization of the United Nations, Kenya Representation, Nairobi, Kenya
| | - Yooni Oh
- Food and Agriculture Organization of the United Nations, Regional Office for Asia and the Pacific, Bangkok, Thailand
| | - Julio Pinto
- Food and Agriculture Organization of the United Nations Headquarters, Rome, Italy
| | - Xavier Roche
- Food and Agriculture Organization of the United Nations Headquarters, Rome, Italy
| | - Ana Riviere-Cinnamond
- Pan American Health Organization / World Health Organization Regional Office for the Americas, Washington, District of Columbia, USA
| | - Cristina Rojo
- Food and Agriculture Organization of the United Nations Headquarters, Rome, Italy
| | | | - Julie Sinclair
- World Organisation for Animal Health Headquarters, Paris, France
| | - Junxia Song
- Food and Agriculture Organization of the United Nations Headquarters, Rome, Italy
| | - Artem Skrypnyk
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Tieble Traore
- Regional Office for Africa, World Health Organization Regional Office for Africa, Dakar-Hub, Dakar, Senegal
| | - Kachen Wongsathapornchai
- Food and Agriculture Organization of the United Nations, Regional Office for Asia and the Pacific, Bangkok, Thailand
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Sharp A, Jain V, Alimi Y, Bausch DG. Policy and planning for large epidemics and pandemics - challenges and lessons learned from COVID-19. Curr Opin Infect Dis 2021; 34:393-400. [PMID: 34342301 PMCID: PMC8452318 DOI: 10.1097/qco.0000000000000778] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The COVID-19 pandemic is a global catastrophe that has led to untold suffering and death. Many previously identified policy challenges in planning for large epidemics and pandemics have been brought to the fore, and new ones have emerged. Here, we review key policy challenges and lessons learned from the COVID-19 pandemic in order to be better prepared for the future. RECENT FINDINGS The most important challenges facing policymakers include financing outbreak preparedness and response in a complex political environment with limited resources, coordinating response efforts among a growing and diverse range of national and international actors, accurately assessing national outbreak preparedness, addressing the shortfall in the global health workforce, building surge capacity of both human and material resources, balancing investments in public health and curative services, building capacity for outbreak-related research and development, and reinforcing measures for infection prevention and control. SUMMARY In recent years, numerous epidemics and pandemics have caused not only considerable loss of life, but billions of dollars of economic loss. The COVID-19 pandemic served as a wake-up call and led to the implementation of relevant policies and countermeasures. Nevertheless, many questions remain and much work to be done. Wise policies and approaches for outbreak control exist but will require the political will to implement them.
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Affiliation(s)
- Ashley Sharp
- UK Public Health Rapid Support Team, Public Health England/London School of Hygiene & Tropical Medicine
| | - Vageesh Jain
- Institute for Global Health, University College London, London, UK
| | - Yewande Alimi
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Daniel G. Bausch
- UK Public Health Rapid Support Team, Public Health England/London School of Hygiene & Tropical Medicine
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Steele SG, Toribio JALML, Mor SM. Global health security must embrace a One Health approach: Contributions and experiences of veterinarians during the COVID-19 response in Australia. One Health 2021; 13:100314. [PMID: 34485671 PMCID: PMC8397892 DOI: 10.1016/j.onehlt.2021.100314] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/18/2021] [Accepted: 08/18/2021] [Indexed: 01/03/2023] Open
Abstract
SARS-CoV-2, a betacoronavirus of likely zoonotic origin, was first reported in December 2019. Its rapid worldwide spread precipitated a range of interventions, including by veterinarians, due to impacts on human health and well-being as well as animal health and welfare. We conducted 36 key informant interviews to explore the responses of Australian veterinarians, their engagement in One Health collaboration and cooperation, and their existing and developed insights to the COVID-19 pandemic. Responses were analysed using thematic analysis. Australian veterinarians provided valuable contributions to the national COVID-19 response by protecting animal welfare, maintaining local food security, providing essential veterinary services while mitigating human health risks in clinical settings and providing both key skills and surge capacity to the human health response. This was all guided by skills in scientific literacy and evidence-based communication. Informants identified a clear and urgent need for greater One Health coordination during pandemic prevention, preparedness, and response, even in the case of a disease which largely only affects humans. Veterinarians provided key skills and surge capacity in epidemiology and laboratory analysis within the national COVID-19 response. Maintenance of veterinary services assisted pet owners, many of whom saw their pets as a source of emotional and physical support during the pandemic. Veterinarians identified an urgent need for improved One Health coordination to strengthen preparedness and response to future pandemic. Both intra- and inter-professional silos were recognised as perpetual obstacles to operationalising One Health.
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Affiliation(s)
- Sandra G Steele
- The University of Sydney, Faculty of Science, School of Veterinary Science, NSW 2006, Australia
| | - Jenny-Ann L M L Toribio
- The University of Sydney, Faculty of Science, School of Veterinary Science, NSW 2006, Australia
| | - Siobhan M Mor
- University of Liverpool, Institute of Infection, Veterinary and Ecological Sciences, Merseyside L3 5RF, United Kingdom
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de la Rocque S, Belot G, Errecaborde KMM, Sreedharan R, Skrypnyk A, Schmidt T, Isla N, Traore T, Talisuna A, Gongal G, Samhouri D, Caya F, Carron M, Kandel N, Xing J, Chungong S. Operationalisation of consensual One Health roadmaps in countries for improved IHR capacities and health security. BMJ Glob Health 2021; 6:bmjgh-2021-005275. [PMID: 34210688 PMCID: PMC8252684 DOI: 10.1136/bmjgh-2021-005275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/22/2021] [Accepted: 04/24/2021] [Indexed: 11/24/2022] Open
Abstract
The COVID-19 pandemic is a devastating reminder that mitigating the threat of emerging zoonotic outbreaks relies on our collective capacity to work across human health, animal health and environment sectors. Despite the critical need for shared approaches, collaborative benchmarks in the International Health Regulations (IHR) Monitoring and Evaluation Framework and more specifically the Joint External Evaluation (JEE) often reveal low levels of performance in collaborative technical areas (TAs), thus identifying a real need to work on the human-animal-environment interface to improve health security. The National Bridging Workshops (NBWs) proposed jointly by the World Organisation of Animal Health and World Health Organization (WHO) provide opportunity for national human health, animal health, environment and other relevant sectors in countries to explore the efficiency and gaps in their coordination for the management of zoonotic diseases. The results, gathered in a prioritised roadmap, support the operationalisation of the recommendations made during JEE for TAs where a multisectoral One Health approach is beneficial. For those collaborative TAs (12 out of 19 in the JEE), more than two-thirds of the recommendations can be implemented through one or multiple activities jointly agreed during NBW. Interestingly, when associated with the WHO Benchmark Tool for IHR, it appears that NBW activities are often associated with lower level of performance than anticipated during the JEE missions, revealing that countries often overestimate their capacities at the human-animal-environment interface. Deeper, more focused and more widely shared discussions between professionals highlight the need for concrete foundations of multisectoral coordination to meet goals for One Health and improved global health security through IHR.
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Affiliation(s)
| | | | - Kaylee Marie Myhre Errecaborde
- Health Emergencies Programme, WHO, Geneva, Switzerland,Veterinary Population Medicine, University of Minnesota, St. Paul, Minnesota, USA
| | | | - Artem Skrypnyk
- Country Health Emergency Preparedness & IHR, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Tanja Schmidt
- Country Health Emergency Preparedness & IHR, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Nicolas Isla
- Country Health Emergency Preparedness & IHR, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Tieble Traore
- Emergency Preparedness, WHO Regional Office for Africa, Brazzaville, Congo
| | - Ambrose Talisuna
- Emergency Preparedness, WHO Regional Office for Africa, Brazzaville, Congo
| | - Gyanendra Gongal
- Healthier Populations & Noncommunicable Diseases, WHO Regional Office for South-East Asia, New Delhi, India
| | - Dalia Samhouri
- Country Health Emergency Preparedness & IHR, WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - François Caya
- Capacity Building Department, World Organisation for Animal Health, Paris, France
| | - Maud Carron
- Capacity Building Department, World Organisation for Animal Health, Paris, France
| | - Nirmal Kandel
- Health Emergencies Programme, WHO, Geneva, Switzerland
| | - Jun Xing
- Health Emergencies Programme, WHO, Geneva, Switzerland
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Thomas LF, Rushton J, Bukachi SA, Falzon LC, Howland O, Fèvre EM. Cross-Sectoral Zoonotic Disease Surveillance in Western Kenya: Identifying Drivers and Barriers Within a Resource Constrained Setting. Front Vet Sci 2021; 8:658454. [PMID: 34169106 PMCID: PMC8217437 DOI: 10.3389/fvets.2021.658454] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 05/05/2021] [Indexed: 12/05/2022] Open
Abstract
Background: Collaboration between the human and animal health sectors, including the sharing of disease surveillance data, has the potential to improve public health outcomes through the rapid detection of zoonotic disease events prior to widespread transmission in humans. Kenya has been at the forefront of embracing a collaborative approach in Africa with the inception of the Zoonotic Disease Unit in 2011. Joint outbreak responses have been coordinated at the national level, yet little is currently documented on cross-sectoral collaboration at the sub-national level. Methods: Key informant interviews were conducted with 28 disease surveillance officers from the human and animal health sectors in three counties in western Kenya. An inductive process of thematic analysis was used to identify themes relating to barriers and drivers for cross-sectoral collaboration. Results: The study identified four interlinking themes related to drivers and barriers for cross-sectoral collaboration. To drive collaboration at the sub-national level there needs to be a clear identification of “common objectives,” as currently exemplified by the response to suspected rabies and anthrax cases and routine meat hygiene activities. The action of collaboration, be it integrated responses to outbreaks or communication and data sharing, require “operational structures” to facilitate them, including the formalisation of reporting lines, supporting legislation and the physical infrastructure, from lab equipment to mobile phones, to facilitate the activities. These structures in turn require “appropriate resources” to support them, which will be allocated based on the “political will” of those who control the resources. Conclusions: Ongoing collaborations between human and animal disease surveillance officers at the sub-national level were identified, driven by common objectives such as routine meat hygiene and response to suspected rabies and anthrax cases. In these areas a suitable operational structure is present, including a supportive legislative framework and clearly designated roles for officers within both sectors. There was support from disease surveillance officers to increase their collaboration, communication and data sharing across sectors, yet this is currently hindered by the lack of these formal operational structures and poor allocation of resources to disease surveillance. It was acknowledged that improving this resource allocation will require political will at the sub-national, national and international levels.
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Affiliation(s)
- Lian Francesca Thomas
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, United Kingdom.,International Livestock Research Institute, Nairobi, Kenya
| | - Jonathan Rushton
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, United Kingdom.,Centre of Excellence for Sustainable Food Systems, University of Liverpool, Liverpool, United Kingdom
| | - Salome A Bukachi
- Institute of Anthropology, Gender & African Studies, University of Nairobi, Nairobi, Kenya
| | - Laura C Falzon
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, United Kingdom.,International Livestock Research Institute, Nairobi, Kenya
| | - Olivia Howland
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, United Kingdom.,International Livestock Research Institute, Nairobi, Kenya
| | - Eric M Fèvre
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, United Kingdom.,International Livestock Research Institute, Nairobi, Kenya.,Centre of Excellence for Sustainable Food Systems, University of Liverpool, Liverpool, United Kingdom
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