GRF 2nd One Health Summit 2013: Presentation by Katey Pelican, «USAid

1. Pathogens and Populations:
One Health in an Era of
Change
One Health Conference, Davos, Switzerland
November 2013
Emerging Pandemic Threats Program
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2. Figure 1
The Lancet 2012; 380:1956-1965 (
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3. Disease in Livestock
• Bovine Spongiform
Encephalopathy
• Porcine Reproductive and
Respiratory Syndrome
• Bovine Tuberculosis
• Bluetongue
• Rift Valley Fever
Emerging Pandemic Threats Program
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4. Disease in Wildlife
• White nose syndrome
–bats
• Canine Distemper
– Lions
– Black-footed ferrets
• Fibropapilloma
– Sea turtles
• Chytridiomycosis
– Amphibians
• Chronic Wasting Disease
– Cervids
• Tazmanian Devil Facial Tumour Dz
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5. 100 years ago: An Era of
Collections Informing Ecology
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6. Vertebrate Species on Planet
(57,739 species)
Birds
9,917
17%
Fish
28,500
9%
49%
Mammals
5,416
14%
10%
Reptiles
8,163
Amphibians 5,743
Emerging Pandemic Threats Program
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7. What we don’t know – IUCN Red List
1150 Species
18% data deficient
Guardian.co.uk
2258 Species
16% data deficient
USDA Forest service
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8. Microbiome
• 5 1030 bacteria on Earth
• ~13,500 bacteria characterized of an
estimated 107 – 109
• 50 billion/g and > 1 million species in one soil
sample (Gans et al 2005)
• 100 trillion microbes of up to 1000 species
in gut
• 10 times more microbes than cells in body
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9. A NEW era of Collections
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10. Metagenomics can be used to profile
the totality of microbes in a sample
From Tim Johnson, UMN. Funded by Turkey Growers Association
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11. Emerging Pandemic Threats Program
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12. USAID PREDICT has found:
• 250 new viruses in wildlife: corona, boca,
herpes, retro, adeno, rhabdo
• 45,000 individual animals from families
known to harbor zoonoses (bats, rodents,
birds, carnivores, primates, and ungulates)
Emerging Pandemic Threats Program
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13. In Minnesota Alone
• > 10 novel viruses found in fish populations.

14. And NOT just Microbial
“Collections”
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15. How to increase the likelihood of
success?
1. A risk-based and long term approach
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16. Emerging Pandemic Threats Program
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17. Risk based
• Host species
• Families of concern
• ?? What makes a microbe risky?
– Reservoir Host species?
– Spillover host?
– Biodiversity or not?
– Host-microbe interaction?
– Receptors it acts on?
– Microbial population ecology!!

18. Emerging Pandemic Threats Program
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19. How to increase the likelihood of
success?
1. A risk-based approach and long-term
approach
2. Capacity building across health sectors
where it is needed
Emerging Pandemic Threats Program
PREDICT • RESPOND • PREVENT • IDENTIFY

20. Ebola and One Health
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21. USAID‟s Emerging Pandemic Threats Program (EPT)
Pre-empting the threats from zoonotic diseases
Wildlife pathogen
detection
• Surveillance to
identify specific
microbes that may
cause serious disease
in humans
Risk determination
• Characterize risk that
a microbe may pose
to humans and its
method of
transmission from
animals to humans
Two important aspects
of the EPT strategy
•Promotes a One
Health approach that
builds first on existing
platforms
•Focus in on
strengthening country
capacities
Outbreak response
capacity
• Strengthen country
capacity to detect and
respond to outbreaks in
animals and humans
Risk reduction
• Develop and
implement behavior
change interventions
to minimize disease
threat for specific
high-risk populations

22. Some professions are
overlooked
Rwanda
• CHW: 59,364
• Nurses: 6,543
• Doctors: 571
• CAHW: 906
• Veterinarians: 90
• Wildlife veterinarians: 5
Kenya
• CHW: 44,432
• Nurses: 23,512
• Doctors: 4,711
• CAHW: 906
• Animal health officers: 3860
• Veterinarians: 1,828
• Wildlife veterinarians: 11
Emerging Pandemic Threats Program
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23. Emerging Pandemic Threats Program
PREDICT • RESPOND • PREVENT • IDENTIFY

24. How to increase the likelihood of
success?
1. A risk-based and long term approach
2. Capacity building across health sectors
3. Understand what drives cross-sectoral
collaboration to improve coordination.
Emerging Pandemic Threats Program
PREDICT • RESPOND • PREVENT • IDENTIFY

25. One Health Systems
Analysis
• Stone Mountain Meeting groups
• Interviews
• Mapping interactions/response

26. Key Themes-OH Culture
• “Natural” (intuitive) way of working
• Relationships that are well established and personal
– Some stem from relationship with UMN (previous
students  employees, employee  faculty or
student)
– Can also be considered a challenge (especially
when leadership changes)
• Good communication skills
• Strong leadership
– Innovation/creativity/visionary
• Trust
• Long histories of addressing infectious disease
outbreaks (especially zoonoses)
• Regular social interactions (e.g. inter-agency
mixer/“happy hour”

27. Key Themes-OH
Infrastructure
• Same building/location (of
MDA/MDH/BAH) contributes to better
collaboration
• MOU’s, contracts, requirements – but
limited
• Required reporting
• Working Groups
– Federal Inter-Agency, Commissioner’s
Meeting, Risk Communication, CAHFS
• Incident Command System

28. MDA-Lean Production: Map the
Known/Improve the Future
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29. Emerging Pandemic Threats Program
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30. Identified “Best Practices”
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Institute a Multiagency Committee
– Meet when a multiagency response is needed.
– Meet quarterly at 7:30
– Review multiagency systems and collaborations (possibly
as part of required systems reviews and table tops)
– After action reviews
Create a reporting agreement/policy in state.
– Build off of existing requirement for reporting of „diseases
of public health concern‟ to State Public Health
Veterinarian.
– Create parallel policy to report „diseases of livestock
trade/health concern‟ to Board of Animal Health.
• Create a case definition of „concern‟
• Create list of diseases of concern
Use map to improve systems
– Create Position Descriptions for key personnel that
includes cross-agency responsibilities
– Use to inform agency leadership and staff of the role of the
various agencies and staff.
– Create Standards of Practice for Interagency collaboration.
– Create position descriptions that fit real responsibilities
Expand Incident Command System to include a cross-agency
„all hands on deck‟ similar to approach of Minnesota
Department of Health.
Create a list of key contacts across agencies in the state with
alternates

31. How to increase the likelihood of
success?
1. A risk-based and long-term approach
2. Capacity building across health sectors
3. Understand what drives cross-sectoral
collaboration to improve coordination.
4. More knowledge- this will come!
Emerging Pandemic Threats Program
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32. Acknowledgments
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USAID Emerging Pandemic Threats
Program
UMN One Health Partnerships Grant
World Bank
Stone Mountain Working Groups
Carol Rubin, CDC
Minnesota Department of Health
Minnesota Department of Agriculture
Minnesota Department of Natural
Resources
Minnesota Board of Animal Health
Minnesota Veterinary Diagnostic
Laboratory
Emerging Pandemic Threats Program
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