Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

One Health for the Real World: partnerships and pragmatism

398 views

Published on

Presentation by Professor Sarah Cleaveland of the University of Glasgow at the One Health for the Real World: zoonoses, ecosystems and wellbeing symposium, London 17-18 March 2016

Published in: Health & Medicine
  • Be the first to comment

  • Be the first to like this

One Health for the Real World: partnerships and pragmatism

  1. 1. One Health for the Real World: partnerships and pragmatism Sarah Cleaveland Institute of Biodiversity, Animal Health and Comparative Medicine University of Glasgow sarah.cleaveland@glasgow.ac.uk One Health for the Real World, ZSL, March 18th 2016
  2. 2. Hampson et al. (2015) PLoS NTD,9(4): e0003709 ; Lembo et al. 2010. PLoS NTD 4: e626; Costa et al. (2015) PLoS Negl Trop Dis 9(9): e0003898; http://www.who.int/csr/disease/ebola/en/ Emerging zoonosesEndemic zoonoses Connecting health priorities 0 10,000 20,000 30,000 40,000 50,000 60,000 70,000 Estimatedannualhumandeaths affecting mainly poor and neglected communities with potential to affect high-income countries
  3. 3. “A global surveillance and control system that is established primarily for emerging infectious zoonotic diseases with pandemic potential can be readily improvised to address the endemic diseases that are a priority in many developing countries….” Juergen Voegele, Director, Agriculture and Rural Development, The World Bank
  4. 4. “A global surveillance and control system that is established primarily for emerging infectious zoonotic diseases with pandemic potential can be readily improvised to address the endemic diseases that are a priority in many developing countries….” Juergen Voegele, Director, Agriculture and Rural Development, The World Bank A global surveillance and control system that is established primarily for endemic diseases that are a priority in many developing countries can be readily improvised to address the emerging infectious zoonotic diseases with pandemic potential …. Halliday et al. (2012) Phil. Trans. R. Soc. B 367: 2872-3880
  5. 5. Rabies surveillance: lessons learned • Engaging frontline health workers – Incentivisation and empowerment – Effective response that provides an immediate benefit – Building trust and motivation….. “which comes from a sense of common good” Mtema et al. (in press) Mobile phones as surveillance tools: implementing and evaluating a large-scale intersectoral surveillance system in Tanzania. PLoS Medicine
  6. 6. Novel Lyssaviruses • Surveillance of endemic rabies allowed detection of a novel lyssavirus ??? Marston et al. (2012) Emerg Infect Dis 18(4):664-7. Horton et al. (2014) Gen Virol. 95: 1025–1032. To date, no serological evidence of infection in bats in Kenya or Tanzania (n= 483 sera from 11 bat species) ?
  7. 7. Zoonotic Disease Unit, Kenya Vision A country with reduced burden of zoonotic diseases and better able to respond to epidemics of emerging and re-emerging infectious diseases Priority zoonoses: Anthrax, trypanosomiasis, rabies, brucellosis, Rift Valley Fever
  8. 8. Brucellosis (5.3%) Leptospirosis (10.1%) Q fever (7.9%) Spotted fever group rickettsiosis (8.7%) Typhus group rickettsiosis (1.0%) Malaria – Overall 1.9% ALL INFECTIONS Causes of febrile illness in adults and adolescents Moshi, Tanzania Biggs et al., 2011; Prabhu et al., 2011; Crump et al., 2013 Malaria (61.6%) Other (38.4%) Clinical diagnosis No diagnosis (33.2%) Fungal (18.8%) Mycobacterial (12.5%) Bacterial (61.6%) Bloodstream infections (27.8%) Chikungunya (5.7 %)
  9. 9. Bacterial zoonoses awareness among healthcare providers in Moshi, Tanzania, 2014–2015 Zhang HL et al. (2016) PLoS Negl Trop Dis 10(3): e0004476
  10. 10. MANYARA REGION KCMC Hospital Which populations to target: Leptospirosis Manyara region: 7.6% PCR positive Arusha Region: 14.2% PCR positive Kilimanjaro region: 0% PCR positive Moshi abattoir Jo Halliday Kath AllanDivine Ekwem Rodents: 0% PCR positive (n=393)
  11. 11. Large, mobile, dynamic, highly-connected livestock populations
  12. 12. Changing livestock systems – Shifts from traditional pastoralism with greater reliance on crops – Increasing pressure on grazing lands – Changing patterns of demand for meat and milk – Increasing complexity of milk and meat value changes
  13. 13. Exploring cross-species transmission: brucellosis Viana et al. (2016) Parasitology Sheep and goat contribute more to human infection than cattle Rudovick Kazwala and Jo HallidayMafalda Viana
  14. 14. How do perceptions of livestock status influence policy and practice? How do understandings of ‘milk’ affect public health messages? “The poor man’s cow…” Georgia Ladbury Jo Sharp
  15. 15. Photo: Felix Lankester
  16. 16. Investments in dog vaccination can provide a cost-effective and equitable approach to human rabies prevention $0.15 PEP $0.34 PEP $0.24 PEP Data from Hampson et al. (2015) PLoS NTD,9(4): e0003709
  17. 17. Pragmatic Interventions • Many tools already exist for effective control of endemic and neglected zoonoses – Design of interventions to mitigate on-going burden of disease – Strengthening institutions, leadership, building trust through common good – Interventions that prevent infection at source likely to provide a broader ‘safety net’ than reliance on clinical management of human cases alone
  18. 18. Acknowledgements Supported by the Zoonoses and Emerging Livestock Systems Initiative: -Social, Economic and Environmental Drivers of Zoonoses in Tanzania (SEEDZ) -Molecular Epidemiology of Brucellosis in northern Tanzania -Hazards Associated with Zoonotic enteric pathogens in Emerging Livestock meat pathways (HAZEL) http://livestocklivelihoodsandhealth.org @Zoonoses_TZ

×