One Health approaches
to prevent and control zoonoses
Jeffrey Gilbert, ILRI
CIAT-Asia, Vientiane
Agriculture, Fisheries & Conservation Department (AFCD) Workshop on
“One Health: Past, Present, and Future”
Hong Kong, 27 September 2011

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

ILRI: Resources
IAR4D

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

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’

EcoHealth v OneHealth
• Option to discuss history of EH/OH

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
Institutions
Adapted from Esther Schelling, STPH

EcoHealth

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.

EcoHealth: transdisciplinarity

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

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.

EcoZD: Components
Country 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 poultry
slaughterhouses
Viet Nam: zoonoses priority ranking
‘EcoHealth’ Resource Centres:
Chiang Mai University
University of Gadjah Mada

Cambodia
Partners:
•Centre for Livestock Development (CelAgrid, NGO)
•Department of Animal Health & Production
•Department of Communicable Disease Control
Research
•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 with
laboratory sampling
•Expected outputs – to ascertain proportion of acute dysentery
in rural households attributable

China – Yunnan province
Partners:
•Academy of Grassland & Animal Sciences
•Animal Science & Veterinary Institute
•Agriculture University
•Institute of Endemic Disease Control & Prevention
Research:
•Determine Brucellosis prevalence and priority in pilot
areas by compiling retrospective data, undertaking cross-
sectional surveys.
•Toxoplasmosis?

Indonesia
Partners:
•Centre for Veterinary & Analytical Studies (CIVAS)
•Disease Investigation Centre Denpasar
•Other experts
Research:
•Dog ecology: behaviour, demography , movement,
fecundity
•Socio-cultural relationship between people & dogs
•Community Engagement (dog registration, sterilisation)

Lao PDR
Partners:
•Department of Livestock Production, MAF
•Department of Hygiene & Prevention, MoH
•National Agriculture & Forestry Research Institute
Research:
•Prioritising pig diseases – both zoonoses & non-
zoonoses, by questionnaire and sampling 30 villages in
northern & southern provinces
•Building on earlier research by ACIAR, and indeed
followed by further ACIAR project

Thailand-Vietnam
Partners:
•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 poultry
slaughterhouses, beyond the upgrade hygiene produces
better quality of product - issues of sustainability, policy
implications
•Interview of slaughter-house owners, workers, market
traders etc

Vietnam
Partners:
•Pasteur Institute
•Nong Lam University
•Department of Animal Health
Research:
•Originally priority ranking of zoonoses, initial expert
opinion, retrospective phase to analyse surveillance
data, cross-sectional survey in pilot areas to ascertain
community priorities

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, Communities
Novel approaches to holistic integrated approaches
 One Health
 One Medicine
 EcoHealth
 Inexact / broad interpretation v H5N1
Case studies & publications

Challenges: Resource & Scope
Human 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

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

‘EcoHealth Resource Centres’
Partners:
•Chiang Mai University, Thailand
•Gadjah Mada University, Yogyakarta, Indonesia
Development
•Need for local capacity building
•Target audience of undergraduates/postgrads – more
open-minded(?)
•Need to engage senior academics
•Multiple disciplines (faculties) ‘under one roof’

‘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.

Yet more challenges
Definitions/ Standardisation for curriculum development
 One Health / One Medicine / EcoHealth
 Who’s right?
 Eg ILRI & USAID at CMU
Biomedical v Social Sciences
 Who leads?
 Quantitative v Qualitative – do they really mix?
 Will decision-makers & communities be convinced
Case studies & publications
 Vital to get peer-reviewed publications as well as local
language articles

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