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Delivering one health Asia/ASEAN


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Presented by Sothyra Tum (FAO) to the Progress Meeting on Ecosystem Approaches to the Better Management of Zoonotic Emerging Infectious Diseases in the South East Asian Region, Bangkok, 10-13 December 2011.

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Delivering one health Asia/ASEAN

  1. 1. Delivering “One Health” in Asia/ASEAN Emergency Center for Transboundary Animal Diseases Food and Agriculture Organization of the United Nations Regional Office for Asia and the Pacific
  2. 2. Outline <ul><li>What is “ One Health ” ? </li></ul><ul><li>Why do we need it? </li></ul><ul><li>Delivering “ One Health ” </li></ul>
  3. 3. Lessons learned from HPAI... <ul><li>Disease is a multi-factoral problem </li></ul><ul><li>Economic development and disease occurrence </li></ul><ul><li>Roles of wild life in disease transmission and being disease reservoirs </li></ul><ul><li>Understanding disease epidemiology and foresight assists in disease control planning </li></ul>
  4. 4. Lessons learned from HPAI... <ul><li>Impacts from disease and cost-benefit as well as consequences of disease control </li></ul><ul><li>Political commitment </li></ul><ul><li>Countries ’ capacity is additional problem to financial aspect </li></ul><ul><li>Risk communication and public awareness </li></ul><ul><li>Disease control requires multi-sectoral and multi-disciplinary approach </li></ul>
  5. 5. What is “ One Health” ?
  6. 6. Definition of “ One Health ” <ul><li>The collaborative effort of multiple disciplines working locally, nationally, regionally and globally to promote optimal health of humans, animals and the environment </li></ul><ul><li>(Lonnie King) </li></ul>
  7. 7. Scope of “ One Health ” according to FAO <ul><li>Transboundary Animal Diseases </li></ul><ul><li>Zoonoses </li></ul><ul><li>Emerging and Reemerging Infectious Diseases </li></ul><ul><li>Environmental health including wildlife health </li></ul><ul><li>Livelihoods </li></ul><ul><li>Food security and safety </li></ul><ul><li>Multidisciplinary approach </li></ul><ul><li>Prevention </li></ul><ul><li>Ability to deal with unknown </li></ul><ul><li>Proactive rather than responsive </li></ul>
  8. 9. Chronology of Key One Health Events Wildlife Conservation Society, 2004 – One World One Health Concept Manhattan Principles Recommendations from International Ministerial Conference for Avian and Pandemic Influenza (IMCAPI), New Delhi, 2007 Several planning meetings 2008 Several events in 2009-10 Several events in the past 12 months <ul><ul><li>IMCAPI 2008 </li></ul></ul><ul><ul><li>Sharm el Sheikh </li></ul></ul>STRATEGIC FRAMEWORK with key concepts IMCAPI 2010 Hanoi FAO-OIE-WHO Collaboration Concept Note on health risks at the human-animal interface Meetings at country level, ICVS, UNSIC, APEC, FAVA, Melbourne
  9. 10. Key points being raised and discussed in previous meetings related to “ One Health ” <ul><li>Different understanding of “ One Health ” (OH) </li></ul><ul><li>Importance of OH is not recognized by all stakeholders and varying support for implementation at all levels </li></ul><ul><li>Managing trans-sectoral collaboration and coordination is a challenge, </li></ul><ul><ul><li>Scientific evidence especially those related to emerging diseases is not available to support decision making and to implement OH, If available, no capacity of the concerned authority to apply </li></ul></ul><ul><li>Countries request for guidance to operationalize OH </li></ul>
  10. 11. Why do we need it ?
  11. 12. Changing World <ul><li>Increasing human populations </li></ul><ul><li>Rapid economic development </li></ul><ul><li>Rapid urbanization </li></ul><ul><li>Huge demand for livestock products </li></ul><ul><li>Rapid evolution of farming systems </li></ul><ul><li>Bush meat consumption </li></ul><ul><li>Pathogen adaptation </li></ul><ul><li>Different in socioeconomic development and traditional livelihood </li></ul><ul><li>Climate change </li></ul><ul><li>Deforestation </li></ul>
  12. 13. <ul><li>Forest encroachment </li></ul><ul><ul><li>close proximity between livestock, human and wildlife (Nipah, Hendra and Ebola...) </li></ul></ul><ul><li>Consumption of bush meat </li></ul><ul><li>Eating behavior and hygiene </li></ul><ul><li>Exotic animal farming </li></ul><ul><li>Climate change </li></ul><ul><ul><li>Vector ecology and distribution (RVF, Bluetongue, Malaria, Dengue, Chikungunya ) </li></ul></ul><ul><ul><li>Invading pathogen adaptation in new vectors </li></ul></ul><ul><ul><li>Migratory patterns </li></ul></ul>Risks
  13. 14. Asia: A major hotspot of disease <ul><li>Two areas in Asia, GMS and Gangetic plain being identified as hotspots for emerging infectious diseases related to domestic and wildlife animals, vector-borne diseases and drug resistant problems </li></ul><ul><li>(Nature, February 2008) </li></ul>a – Zoonotic/wild, b – Zoonotic/domestic, c – Drug resistant, d – Vector-borne
  14. 15. Zoonotic diseases of interest for Asia Status Diseases of interest Endemic diseases Anthrax, Brucellosis, JE, Parasitic zoonoses, Rabies, Reemerging diseases from previously endemic Leptospirosis, TB, Parasitic zoonoses (Cysticercosis, Trichinosis, ) Potential emerging disease from importation and wildlife origin Nipah virus, BSE, Ebola Reston, West Nile virus Potential pandemic Other influenza??? Drug resistance
  15. 16. Delivering “One Health” ?
  16. 17. Issues being concerned <ul><li>Recognition of OH importance for support </li></ul><ul><li>Challenge in managing tran-sectoral collaboration and coordination </li></ul><ul><li>Insufficient decision-making based on scientific evidence </li></ul><ul><li>Not enough capacity to apply OH </li></ul><ul><li>Countries request for guidance to operationalize OH </li></ul><ul><li>Advocacy </li></ul><ul><li>Strengthening coordination and collaboration across sectors and disciplines </li></ul><ul><ul><li>Country, regional and global </li></ul></ul><ul><li>Capacity building </li></ul><ul><ul><li>Long-term approach </li></ul></ul><ul><ul><li>Immediate to produce scientific evidence for prevention purpose </li></ul></ul>3 major areas in focus Pilot projects at country level
  17. 18. Specific Activities in 2011 <ul><li>Advocacy </li></ul><ul><li>Encouraging OH dialogue among sectors at country and regional level: Expanding from HPAI work –involve not only animal and human health but also relevant wildlife and eco-health sectors </li></ul><ul><ul><li>At regional and international levels, Collaboration among ASEAN, SAARC, OIE, WHO, FAO as well as major development partners is required to address gaps and needs of member countries. </li></ul></ul><ul><ul><li>Global public good should also be recognized by member countries. </li></ul></ul>
  18. 19. Specific Activities in 2011 <ul><li>Strengthening coordination and collaboration across sectors and disciplines </li></ul><ul><li>Epidemiology and Laboratory Networks </li></ul><ul><ul><li>Principle of networking is to share expertise and information as well as enhancing collaboration and cooperation </li></ul></ul><ul><ul><li>Expanding scope from HPAI to cover other priority diseases </li></ul></ul><ul><ul><li>Linking to other networks at global level such as OFFLU (OIE/FAO Animal Influenza Network) </li></ul></ul><ul><li>Developing an Action Plan for promoting One Health and increasing its understanding, acceptance and adoption across key sectors of government and society </li></ul>
  19. 20. Example of community networks that can be used as platform for “One Health”
  20. 21. Specific Activities in 2011 <ul><li>Capacity building in veterinary epidemiology </li></ul><ul><li>Regional Field Epidemiology Training Program for Veterinarian (FETPV) </li></ul><ul><ul><li>Thai Department of Livestock Development (DLD) is hosting in collaboration with Ministry of Public Health with support from a few international organizations </li></ul></ul><ul><ul><li>Regional strategy is being developed for longer-term purpose </li></ul></ul><ul><ul><li>Integrating other components related wildlife, socio-economic and communication </li></ul></ul><ul><ul><li>Benchmarking with other existing epidemiology training programs in the region </li></ul></ul><ul><ul><li>Expanding FETPV to country level –China, India </li></ul></ul><ul><ul><li>Need to link with Regional Epidemiology Network </li></ul></ul>
  21. 22. Specific Activities in 2011 <ul><li>Capacity building in laboratory diagnosis </li></ul><ul><li>Capacity building at the country level for agreed set of diseases at regional level </li></ul><ul><ul><li>Human resource and laboratory facilities </li></ul></ul><ul><li>Regional program for quality assurance and control for laboratory testing to improve capacity </li></ul><ul><li>Need to link with Regional Laboratory Network </li></ul><ul><ul><li>Strengthening the ability of country to deal with unknown </li></ul></ul><ul><ul><ul><li>Referral system to World Reference Laboratory </li></ul></ul></ul><ul><ul><ul><li>Establishing appropriate sample bank for necessary retrospective studies especially for wildlife </li></ul></ul></ul>
  22. 23. Specific Activities in 2011 <ul><li>Key/more formal pilot projects </li></ul><ul><li>(case studies at country level) </li></ul><ul><li>Thailand </li></ul><ul><ul><li>Linkage of Thai FETPV and FETP with possibility to expand to involve wildlife group and private livestock producing sectors </li></ul></ul><ul><ul><li>Partnerships with Government Research Funding Agencies and Thai universities to study “Animal-Human-Ecosystem Interface” using bats and Nipah Virus Infection as a model </li></ul></ul><ul><ul><ul><li>Involve 3 sectors –animal, human and wild life health </li></ul></ul></ul><ul><ul><ul><li>Participatory learning process using multi-disciplinary approach at community level for veterinary student at undergraduate level </li></ul></ul></ul><ul><li>Indonesia </li></ul><ul><ul><li>“ Rabies Control in Bali”-FAO TCP </li></ul></ul><ul><li>More to come from the country proposals </li></ul>