2. PLAN OF PRESENTATION
• Introduction
• History
• Why One Health
• Strategic framework
• Agencies working
• One Health initiatives in India
• SWOT analysis
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3. INTRODUCTION
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A HEALTHY INDIVIDUAL does not exist in ISOLATION, we
are all a part of larger communities!
We all have different interactions with
different types of animals
Urbanization/ Migration
Wildlife habitats are disappearing and climate
is changing
Global trade is easy and global travel is fast
Giving previously isolated outbreaks pandemic
potential
6. 6
• Emerging and reemerging infectious diseases- According to estimates, there are
one million vertebrate viruses of which only 2000 are known: this represents a
―large potential for zoonotic emergence
• According to WHO, ―in 2005 alone 1.8 million people died from food-borne
diarrheal diseases like E-coli or Salmonellosis
• Even less known is that ―more than 55,000 people die of rabies each year
• An estimated 2 to 8% of the 1.6 million annual human deaths from tuberculosis
are from bovine origin
IMPACT ON HUMANS
7. 7
ENVIRONMENTAL HEALTH
HUMAN
HEALTH
DOMESTIC
HEALTH
WILDLIFE
HEALTH
One Health in action:
•Foster collaborative relationship
between human health, animal health
and environmental health partners
•Improve communication between
sectors
•Coordinate disease surveillance
activities
•Develop uniform messaging to the
public
9. Definition
• “One Health is the collaborative effort of multiple health science
professions, together with their related disciplines and institutions –
working locally, nationally, and globally – to attain optimal health for
people, domestic animals, wildlife, plants, and our environment.’
One Health Commission, 2011
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10. One Health approach – an integrated response to
“what needs to be done?” -- as opposed to the
classical approach based on “what can I do?”
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11. Hippocrates- Father of
Modern Medicine
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One Health takes inspiration from the
Greek father of medicine and is based
on his approach which recognizes that
human health, animal health and
environmental health are part of a
whole body
HISTORY
12. Rudolf Virchow- Father of
Modern Pathology
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Coined the term ‘Zoonosis’
Between animal and human medicines there are no dividing lines
– nor should there be. The object is different but the experience
obtained constitutes the basis of all medicine
HISTORY
13. James Harlan Steele- Father of
veterinary public health
13
Led some of the first efforts to prevent the
spread of disease from animals to humans
Calvin Schwab- coined and promoted the phrase
"One Medicine", a veterinary epidemiologist and
parasitologist in his textbook "Veterinary
Medicine and Human Health"
HISTORY
14. 14
2004
• Wildlife Conservation Society- One World One Health
• 12 recommendations- Manhattan Principles
2007
• One Health Approach was recommended by AMA for Pandemic Preparedness
• The AMA collaborated with AVMA & passed the One Health Resolution
promoting partnership between human and veterinary medicine
2008
• FAO, OIE, WHO collaborate with UNICEF,UNSIC and the World Bank to develop
joint Strategic framework
2009
• USAID launched the Emerging Pandemic Threats Program
• The One Health Office was established at CDC
15. 2010
• The Tripartite concept published
• UN and World Bank recommended adoption to One Health Approach
2011
• One Health Commission
• The 1st One Health Conference in Africa
• ICOPHAI -Ethopia
2012
• First One Heath Summit
2013-17
• ICOPHAI- Brazil
• ICOPHAI- Thailand
• ICOPHAI- Qatar
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16. Interaction Web of SDGs
Queenan K, Garnier J, Nielsen LR, Buttigieg S, Meneghi D, Holmberg M, et al. Roadmap to a One Health Agenda 2030.
CAB Reviews. 2017 ;12 (14): 5-17.
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18. Delays increase costs
Adapted from IOM and World Bank (2009)
Exposure in
animals
Clinical signs in
animals
Exposure in
humans Clinical signs
in humans
Humans seek
medical care
Cost of control
outbreak
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20. Disease outbreaks where poor coordination and
integration were shown between sectors and the impact
this had on the human and animal sectors
20
COUNTRY DISEASE KEY DELAYED ACTION RESULT
Malaysia Nipah Lack of interaction between human, veterinary,
and wildlife services caused delay in
understanding role of fruit tree habitat for
bat-to-swine transmission
More than 100 people died and over
1 million pigs culled
Netherlands Q Fever Lack of interaction between veterinary and
human health services
Likely increased disease spread
(more than 2,000 human cases) and
over 40,000 goats culled
USA West Nile
Fever
Delayed interaction linking human cases with
dead birds, and refusal of CDC to check birds,
because of its mandate Restrictions
Delayed and initial erroneous
control program of intermediate
host
21. EFFICIENT AND EFFECTIVE CONTROL OF ZOONOTIC DISEASES-
ONE HEALTH
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COUNTRY DISEASE ACTION QUANTIFIABLE RESULTS NON-QUANTIFIABLE
RESULTS
Chad Pasteurellosis,
blackleg, and CBPP in
livestock; diphtheria,
pertussis tetanus (DPT)
and polio in Children
Joint vaccination
campaigns
Costs of joint Campaign
reduced by 15% compared
with separate
campaigns, cost
per vaccinated child
reduced from €30.3 to €11.9
Increased vaccination
coverage in both
humans and livestock
;Increased awareness
of pastoralists of public
health services
India
(Jaipur)
Rabies Vaccination and
sterilization
campaign for dogs
Human cases declined to
zero, vs. increase in other
states; stray dog population
declined 28%
-
Kyrgyzstan Brucellosis On-farm visits
detecting
brucellosis in humans
and Animals
Reduced surveillance
costs
Other zoonotic or
livestock diseases
assessed
at the same time (e.g.,
echinococcosis)
22. 22
COMPONENTS OF ECONOMIC COSTS DUE TO ZOONOTIC DISEASE
OUTBREAKS
OUTBREAK IN ANIMALS OUTBREAK IN HUMANS
DIRECT IMPACT Death from disease Medical Cost
Control measures Mortality
Lower productivity (farm losses) Morbidity
INDIRECT IMPACT Reduced demand Illness and absenteeism
Spill over effects in other sector Avoidance behaviour
25. 25
•High levels of antibiotic resistant pathogens in chickens being raised for eggs and
meat in poultry farms in Punjab
•Researchers from the US-based Center for Disease Dynamics, Economics and Policy
(CDDEP) collected samples from 530 birds in 18 poultry farms in Punjab and tested
them for resistance to a range of antibiotic medications critical to human medicine.
•Two-thirds of the farms reported using antibiotic factors for growth promotion,
according to the researchers.
•Samples from the farms, which reported using antibiotic factors, were three times
more likely to be multidrug- resistant than samples from farms that did not use
antibiotics to promote growth
•Meat farms had twice the rates of antimicrobial resistance that egg-producing
farms had, as well as higher rates of multidrug resistance.
26. Bioterrorism
• Intentional or deliberate release of viruses,
bacteria, or other agents used to cause illness
or death in people, animals, or plants
• Ex:
• Anthrax
• Small pox
• Nipah
• Botulinum toxin
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•Bioterrorism Act of 2002- According to this law, there is an essential
element of national preparedness against bioterrorism and the focus is
on safety of drugs, food, and water from biological agents and toxins
•India is yet to have a law on bioterrorism
32. A Strategic Framework for Reducing Risks of
Infectious Diseases at the
Animal–Human–Ecosystems Interface
2008
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33. One World, One Health- Manhattan Principles
1. Recognize the essential link between human, domestic animal and wildlife health and the threat disease poses
2. Recognize that decisions regarding land and water use have real implications for health
3. Include wildlife health science as an essential component of global disease prevention, surveillance,
monitoring, control and mitigation
4. Recognize that public health programs can greatly contribute to conservation efforts
5. Devise adaptive, holistic and forward-looking approaches to the prevention, surveillance, monitoring, control
and mitigation of emerging and resurging diseases that take the complex interconnections among species into
full account
6. Integrate biodiversity conservation perspectives and human needs when developing solutions to infectious
disease threats
7. Reduce demand for and better regulate the international wildlife and bush meat trade
8. Restrict the mass culling of wildlife species for disease control
9. Increase investment in the global human and animal health infrastructure
10. Form collaborative relationships among governments, local people, and the private and public sectors
11. Provide adequate resources and support for global wildlife health surveillance
12. Invest in educating and raising awareness among the world's people 33
34. Goal- Six Strategies
1. More preventive action at the animal–human–ecosystems interface.
2. Building more robust public and animal health systems compliant with
the IHR 2005 and OIE international standards, with a shift from short
term to long-term intervention
3. Strengthening the national and international emergency response
capabilities to prevent and control disease outbreaks.
4. Better addressing the concerns of the poor by shifting focus from
developed to developing economies
5. Promoting institutional collaboration across sectors and disciplines
6. Conducting strategic research to enable targeted disease control
programmes.
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35. Objectives
1. Develop surveillance capacity, including the development of standards,
tools and monitoring processes at national, regional and global levels
2. Strengthen public and animal health capacity, including communication
strategies to prevent, detect and respond to disease outbreaks at
national, regional and international levels
3. Strengthen national emergency response capability, including a global
rapid response support capacity
4. Promote inter-agency and cross-sectoral collaboration and partnerships
5. Control HPAI and other existing and potentially reemerging infectious
diseases
6. Conduct strategic research
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36. Role of international agencies in addressing global public
goods
• WHO, FAO, UNICEF and other UN agencies, and OIE have explicit
mandates to deal with global public goods
• IHR - to prevent, protect against, control and provide a public health
response to the international spread of disease
• FAO and WHO share the Codex Alimentarius Commission for food and
feed standards
• FAO, OIE and WHO also define and regularly update guidelines for good
practices, methods, tools and strategies for infectious diseases, focusing
on developing countries and/or endemic areas
• Mediterranean Zoonosis Control Programme 36
37. Obligation of National Authorities
• Government authorities are obliged to contribute to the
control of infectious diseases, and this is reflected in the IHR
and OIE standards.
• All Member States of WHO and OIE are bound to participate
in global efforts to contain animal and public health risks of
international concern, including working towards full
implementation of IHR and strengthening their national
veterinary.
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42. • The CDC is implementing both 3-month and 2-year Field Epidemiology Training Programs for
public health and laboratory personnel in Pakistan, India, and Bangladesh
• FAO is implementing Field Epidemiology Training Programs programmes for veterinarians
• The USAID funded PREDICT programme led by the University of California, Davis is
implemented in Nepal, Bangladesh, and India with the aim of developing an early warning
system to detect, track, and predict the emergence of new zoonotic pathogens in animals
that could pose a threat to human health
• In India, the PHFI leads initiatives and advocacy for an integrated OH approach to research
and policy formulation for controlling zoonotic diseases
• While national multi sectoral committees have been established in India, these have not yet
translated into effective collaborative research or policy formulation
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McKenzie JS, Dahal R, Kakkar M, Debnath N, Rahman M, Dorjee S, et al. One Health research and training and government support for One
Health in South Asia. Infection Ecology & Epidemiology. 2016; 3 (1).
INITIATIVES
46. Missed opportunity
• 460 medical colleges and 46 veterinary colleges in India, but most do
little or no research
• The Indian subcontinent is a ‘hotspot’ for zoonotic, drug-resistant and
vector-borne pathogens. But we know little about the key threats
• Governance structure and inter-sectorial coordination is also
problematic, with human, animal and environmental health controlled
by different ministries, with little cross-talk
• National Health Policy approved recently is also a missed opportunity. It
fails to even mention “zoonoses” and “emerging infectious diseases”
Emerging infectious diseases, One Health and India- The Hindu
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48. Roadmap to Combat Zoonoses in India
• Roadmap to Combat Zoonoses in India Initiative (RCZI)- June 2008
• Public Health Foundation of India (PHFI) - Nodal Agency
• Core technical partners- University of North Carolina (UNC)
Chapel Hill, North Carolina State University (NCSU) & RTI
International
• Part of several national and international networks working on
Zoonoses control and promotion of One Health approaches:
– National Standing Committee on Zoonoses
– Connecting Health Organizations for Regional Disease Surveillance (CHORDS)
– ASEF Europe Network of Public Health
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54. METRICS
HOW TO MEASURE ONE HEALTH
• DALYs (Disability Adjusted Life Years) are meaningful for public
health in that they measure the overall human disease burden,
but they convey no information about ecosystem impacts or
poverty.
• Similarly, disease incidence and prevalence in either animals or
people do not indicate the severity and distribution of a
disease
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57. THREATS
• Lack of reporting
• Sporadic collection and presentation of One Health metrics
• Stakeholder behavior
• Avoidance behavior
• Cultural practices
• Funding
• leadership and human resources
• governance and infrastructure
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58. OPPORTUNITIES
• Partnership potential
• Xenotransplantation
• Climate change research
• Planetary health
• Institutional Care and Use Committee (IACUC) and Institutional
Review Board(IRB)
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59. COHERE standards
• designed to strengthen the quality of reporting of One Health
observational or interventional epidemiological studies that
integrate knowledge and expertise from all three domains.
• This process challenges authors, editors, and readers to
support efforts to break down publication silos, improve
collaborative reporting, and foster innovation
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