One Health approaches to prevent and control zoonoses

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Presented by Jeffrey Gilbert at the Workshop on One Health: Past, Present, and Future, Hong Kong, 27 September 2011

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  • Esther DVM
  • Learning by doing: JG
  • Senior level buy-in Selection of priority .. Syndromic surveillance; D ysentery versus ac watery diarrhoea
  • H igh prevalence across N.China & Mongolia – internal spread ? R uminant movement W hich species Justification for adding toxoplasma
  • S election M ore on
  • S election M ore on
  • One Health approaches to prevent and control zoonoses

    1. 1. One Health approaches to prevent and control zoonoses Jeffrey Gilbert, ILRI CIAT-Asia, VientianeAgriculture, Fisheries & Conservation Department (AFCD) Workshop on “One Health: Past, Present, and Future” Hong Kong, 27 September 2011
    2. 2. ILRI: Overview• One of 15 international research centers of CGIAR (Consultative Group on International Agricultural Research)• Individual Centres set up in 1960s (IRRI 1960, ILRAD 1973, ILCA 1974)• CGIAR 1971: 19 northern Govts + IGO (FAO,WB,ADB …)• ILRI founded 1994; headquarters in Nairobi, Kenya• ILRI focus – livestock, livelihoods, IAR4D• ILRI: organized in 4 research ‘themes’: markets, biotechnology, people-livestock-environment, poverty-gender-impact
    3. 3. ILRI: Resources IAR4D
    4. 4. CG Reform To overcome the challenges and exploit the opportunities, the CGIAR has undergone reform. A new Strategy and Results Framework (SRF) will, for the first time, allow the CGIAR centers to function as a unified system, working together to pursue shared goals The 7 CGIAR Research Programmes* (formerly ‘mega-programmes’) Objective – to harmonize CRP-4: ‘Agriculture for Improved Health and Nutrition’• This research program aims to accelerate progress in improving the nutrition and health of poor people by exploiting and enhancing the synergies between agriculture, nutrition, and health through four key research components: value chains, biofortification, control of agriculture-associated diseases, and integrated agriculture, nutrition, and health development programs and policies. With IFPRI and ILRI as co- Lead Centers, this program will also involve 10 other CGIAR Centers. It has an initial 3-year budget of US$191.4 million.* http://www.cgiarfund.org/cgiarfund/research_portfolio
    5. 5. EcoHealth v OneHealth• Definitions open to debate: range from quite rigid to very flexible!• One-Health – biomedical focus: human + animal + wildlife;• EcoHealth: environment & socio-economic aspects – pioneered outside ‘traditional’ health• Personal opinion: OneHealth more theoretical, conceptual; EcoHealth more tangible?• Maybe it’s not so important … which ‘cola’
    6. 6. EcoHealth v OneHealth• Option to discuss history of EH/OH
    7. 7. EcoHealth One world – one health EcoHealth Human One Animal health Human Medicine health health Vet Pub O H. e n h e a l t h Agroecosystem health Societies Economies InstitutionsAdapted from Esther Schelling, STPH
    8. 8. EcoHealth
    9. 9. EcoHealth ‘Pillars’ Trans-disciplinary: inclusive vision, full involvement of Researchers, community & decision-makers; Participation: consensus and cooperation not only within community, scientific & decision-making groups, but among them; Equity: gender, ethnic group; Sustainability.
    10. 10. EcoHealth: transdisciplinarity
    11. 11. EcoZD: Overview ‘EcoHealth Approaches to the Better Management of Zoonotic Emerging Infectious Diseases in the Southeast Asia Region’ Increase the knowledge, skills and capacity of research and infectious disease control personnel in Southeast Asia to understand the risks and impacts of Emerging Infectious Diseases and how feasible options can best be implemented and adapted; ‘Learning by Doing’ approach 4 years 2008 – 2012; extended to Aug 2013 6 countries in SE Asia region;  Cambodia, China (Yunnan), Laos, Viet Nam, Indonesia, Thailand One of IDRC’s EcoHealth initiatives in SE Asia: APAIR/APEIR, EcoEID, BECA, FBLI
    12. 12. EcoZD: gestation The donor – IDRC www.idrc.ca & EcoHealth ILRI’s capacity Building on previous specific EID (EZD) initiative in the SE Asia region: APAIR Identify partners, point of contact, link to others Formation of research teams Develop and finalise research studies (incorporating aspects of EH) Mechanisms of implementation, funds transfer etc.
    13. 13. EcoZD: ComponentsCountry Teams choices for research:Cambodia: zoonotic risks for acute dysenteryChina (Yunnan): Brucellosis & ToxoplasmosisIndonesia: Rabies - BaliLao PDR: pig zoonoses (& non zoonoses)Thai-Viet: hygiene in small-scale poultryslaughterhousesViet Nam: zoonoses priority ranking‘EcoHealth’ Resource Centres:Chiang Mai UniversityUniversity of Gadjah Mada
    14. 14. CambodiaPartners:•Centre for Livestock Development (CelAgrid, NGO)•Department of Animal Health & Production•Department of Communicable Disease ControlResearch•Review of public health data: diarrhoea reporting by SMS•Choice of various low & high incidence areas (pilot sites)•Household surveys: Questionnaires & PRA•Longitudinal survey will follow selected households withlaboratory sampling•Expected outputs – to ascertain proportion of acute dysenteryin rural households attributable
    15. 15. China – Yunnan provincePartners:•Academy of Grassland & Animal Sciences•Animal Science & Veterinary Institute•Agriculture University•Institute of Endemic Disease Control & PreventionResearch:•Determine Brucellosis prevalence and priority in pilotareas by compiling retrospective data, undertaking cross-sectional surveys.•Toxoplasmosis?
    16. 16. IndonesiaPartners:•Centre for Veterinary & Analytical Studies (CIVAS)•Disease Investigation Centre Denpasar•Other expertsResearch:•Dog ecology: behaviour, demography , movement,fecundity•Socio-cultural relationship between people & dogs•Community Engagement (dog registration, sterilisation)
    17. 17. Lao PDRPartners:•Department of Livestock Production, MAF•Department of Hygiene & Prevention, MoH•National Agriculture & Forestry Research InstituteResearch:•Prioritising pig diseases – both zoonoses & non-zoonoses, by questionnaire and sampling 30 villages innorthern & southern provinces•Building on earlier research by ACIAR, and indeedfollowed by further ACIAR project
    18. 18. Thailand-VietnamPartners:•Chiang Mai University, Veterinary Faculty•Department of Livestock Development•National Institute of Veterinary Research, Hanoi•Sub-department of Animal Health, Hanoi•(Originally China involved)Research:•Improving hygiene in small-scale poultryslaughterhouses, beyond the upgrade hygiene producesbetter quality of product - issues of sustainability, policyimplications•Interview of slaughter-house owners, workers, markettraders etc
    19. 19. VietnamPartners:•Pasteur Institute•Nong Lam University•Department of Animal HealthResearch:•Originally priority ranking of zoonoses, initial expertopinion, retrospective phase to analyse surveillancedata, cross-sectional survey in pilot areas to ascertaincommunity priorities
    20. 20. Challenges: What language are we talking?Lingua franca  Eg Latin America/ EcoSalud  ‘Lost in translation’Biomedical v Social Sciences  Medics & Vets (clinical / laboratory / epidemiology)  Quantitative v Qualitative (ranking, dual health burden)  Researchers, Decision Makers, CommunitiesNovel approaches to holistic integrated approaches  One Health  One Medicine  EcoHealth  Inexact / broad interpretation v H5N1Case studies & publications
    21. 21. Challenges: Resource & ScopeHuman ResourcesSupply & Demand  Language  Technical – including proposal writing/ methodololgy / analysis /paper-writing  Market forces operatingIdentifying Champions (including to implement & to mentor)Level of counterparts (senior v junior)Scope of EcoZD‘Carte blanche’ v prescriptiveLearning by doing (& making mistakes!)Priority zoonoses +/- EIDEcoHealth approach – new ‘paradigm’Two-dimensional capacity-building requirementGreek temple analogyEHRC concept
    22. 22. EcoZD: Some of the Solutions Cambodia: champions identified, Govt senior level support China: silo syndrome, local expert to provide technical assistance, EH training materials in Chinese Indonesia: multiple champions, finding niche - focus on dog ecology, complementing other initiatives Lao PDR: pooling inputs/outputs with ACIAR project Thai-Viet: reduced to 2 countries, local experts identified to provide technical assistance, link to EHRC-CMU Viet Nam: 3 research contracts and individual priorities, difficulties deciding on priority, change approach/angle
    23. 23. ‘EcoHealth Resource Centres’Partners:•Chiang Mai University, Thailand•Gadjah Mada University, Yogyakarta, IndonesiaDevelopment•Need for local capacity building•Target audience of undergraduates/postgrads – moreopen-minded(?)•Need to engage senior academics•Multiple disciplines (faculties) ‘under one roof’
    24. 24. ‘EcoHealth Resource Centres’• Provision of relevant training for staff, students and outside participants;• Promotion of knowledge sharing and assimilation through making available books and peer-reviewed publications;• Conducting multi/trans-disciplinary EcoHealth research activities involving post-graduate students;• Preparing publications – from desktop/retrospective and prospective research; also position papers;• Providing advocacy for EcoHealth – other universities, government and communities.
    25. 25. Yet more challengesDefinitions/ Standardisation for curriculum development  One Health / One Medicine / EcoHealth  Who’s right?  Eg ILRI & USAID at CMUBiomedical v Social Sciences  Who leads?  Quantitative v Qualitative – do they really mix?  Will decision-makers & communities be convincedCase studies & publications  Vital to get peer-reviewed publications as well as local language articles
    26. 26. Beyond EcoZD• EHRCs – Long term capacity building at various levels – No MSc or PhD of EcoHealth/OneHealth envisaged – Beyond communicable diseases – Own working definition and approach – refined as per context – Approach accepted – importance of ‘branding’• Country Research Teams – Case studies fully synthesized (and lots of lessons learned will surely emerge) – Maintain relationships & potential further collaboration

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