Regional consultation on One Health/Ecohealth: Identifying the challenges

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Presented by Delia Grace and Johanna Lindahl at a National One Health Symposium, New Delhi, India, 25 November 2013.

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Regional consultation on One Health/Ecohealth: Identifying the challenges

  1. 1. Regional consultation on Onehealth/Ecohealth Session one: Identifying the challenges National One Health Symposium November 25, 2013 Hotel Royal Plaza, New Delhi Delia Grace & Johanna Lindahl International Livestock Research Institute CGIAR Research Program on Agriculture for Nutrition and Health (A4NH)
  2. 2. Overview • Zoonoses: the lethal gifts of livestock – Emerging infectious disease – Neglected zoonoses • Other agriculture associated disease – Under and over nutrition – Diet associated disease: diabetes, cancer, CVD – Food borne disease (many zoonotic) • Challenges in managing agriculture associated diseases – Multiple burdens and multi-sectoral management – Lack of evidence for prioritisation and management – Lack of incentives for surveillance and control
  3. 3. Human health in the 21st century • 7 billion people 2011 30 25 Deaths (millions) – 1 billion hungry; – 2 billion with hidden hunger; – 1.5 billion overweight / obese 20 15 • In 2011 55 million died – 18 million from infection – 7 million deaths in under fives (2/3 infectious) – One in four of the deaths in under five children occur in India 10 5 0 04 15 30 High-income 04 15 30 04 15 30 Middle-income Low-income
  4. 4. Where do we get our diseases? • Few are Legacies – Paleolithic baseline: yaws, staph, pinworms, lice, typhoid, tb • Most are Earned – Degenerative diseases: heart failure, stroke, diabetes, cancer – Allergies, asthma, autoimmune diseases – Sexually transmitted infections such as HSV-2, gonorrhea • Many are Souvenirs – Around 60% of human diseases shared with animals – 75% of emerging infectious disease zoonotic
  5. 5. • One billion PLK depend on 19 billion livestock • 4 countries have 44% of PLK • 75% rural, 25% urban poor depend on livestock • Livestock contribute typically 2-33% income • Livestock contribute typically 6-36% protein
  6. 6. Spillover! Pathogen flow Secondary Host (livestock) Spill-over Habitat change Biodiversity Host density Sylvatic cycle Vector density Reservoir Host (wildlife) Type of pathogen: mutation, heterogeneity, host specificity •Increasing human population and density •Human behaviour •Expansion of agriculture •Intensification of livestock production Spill-over Vector Spill-over Secondary Host (human) Sustained transmission: - peri-domestic or urban cycle - sub-clinical, epidemic, pandemic
  7. 7. Greatest burden of endemic zoonoses falls on on billion poor livestock keepers • Unlucky 13 zoonoses sicken 2.4 billion people, kill 2.2 people and affect more than 1 in 7 livestock each year
  8. 8. Hotspots • Poor livestock keepers: South Asia 600 m, sub-saharan Africa 300 m • Zoonoses burden: India, Myanmar, Bangladesh, Pakistan • Emerging disease risk: West Europe, West USA • BIG SIX Countries for all risk factors – S Asia: India, Bangladesh, Pakistan – Africa: Ethiopia, Nigeria, Congo
  9. 9. Mortality: global projection, 2004-2030 30 Intentional injuries Other unintentional Road traffic accidents Deaths (millions) 25 20 Other NCD 15 Cancers 10 CVD Mat//peri/nutritional 5 Other infectious HIV, TB, malaria 0 2004 2015 2030 High-income countries 2004 2015 2030 Middle-income countries 2004 2015 2030 Low-income countries
  10. 10. Fungal toxins in maize, peanuts, rice, sorghum, milk AB1 Corn/feed purchased Treatments AB1-> AM1 AB1 Corn/feed produced at farm AM1 AB1 AM1 Farmer Milk produced at farm Consumer
  11. 11. Overview • Zoonoses: the lethal gifts of livestock – Emerging infectious disease – Neglected zoonoses • Other agriculture associated disease – Under and over nutrition – Diet associated disease: diabetes, cancer, CVD – Food borne disease (many zoonotic) • Challenges in managing agriculture associated diseases – Multiple burdens and management in multiple sectors – Lack of evidence for prioritisation and management – Lack of incentives for surveillance and control
  12. 12. •International organisations •Regional organisations Human health Animal health Plant health AgroEcosystems •Private sector health provision •Public health •Veterinary public health •NGOs & CBOs •Conservation •Environment Agriculture associated human disease International agricultural health research 13
  13. 13. Top Zoonoses (multiple burdens) • Assessed 56 zoonoses from Deaths - annual 6 listings: responsible 2.7 billion cases, 2.5 million deaths • “Unlucky 13” responsible for 2.2 billion illnesses and 2.4 million deaths 2000000 1800000 140000 1600000 120000 1400000 100000 1200000 80000 1000000 800000 600000 – All 13 have a wildlife interface – 9 have a major impact on livestock – All 13 amenable to on-farm intervention 60000 40000 400000 200000 20000 0 0 Top 13 zoonoses Next 43
  14. 14. PRIORITY DISEASES 1: Avian influenza 2: Rabies 3: Leptospirosis Priority diseases don’t reflect importance ability to control Driven by media, donors, misperceptions
  15. 15. Official reporting systems Reporting Zoonoses Scope system WAHID 33 Animal TAD Info 2 Animal Pro Med All All GLEWS 19 All Health Map All All Source: HealthMap Africa • • • • 253 million SLU 25 million lost annually 12-13 million from notifiable disease 80,000 reported == 99.8% un-reported
  16. 16. Overview • Agriculture associated disease – A major health problem in developing countries – South Asia a hot spot for zoonoses & diet associated disease • Need for solutions that: – Are multi-sectoral and multi-disciplinary – Are evidence and science-based – Include incentives for surveillance and control
  17. 17. Agriculture Associated Diseases http://aghealth.wordpress.com/

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