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One Health approach to address zoonotic and emerging infectious diseases and antimicrobial resistance issues in low- and middle-income countries

  1. Better lives through livestock One Health approach to address zoonotic and emerging infectious diseases and antimicrobial resistance issues in low- and middle-income countries Hung Nguyen-Viet, Hu Suk Lee, Fred Unger, Arshnee Moodley, Eric Fèvre, Barbara Wieland, Bernard Bett, Michel Dione, Edward Okoth, Johanna Lindahl, Sinh Dang-Xuan and Delia Grace 9–10 November 2020
  2. 2 Reduce poverty Improve food and nutrition security Improve natural resources and ecosystem services ILRI’s mission is to improve food and nutritional security and to reduce poverty in developing countries through research for efficient, safe and sustainable use of livestock — ensuring better lives through livestock. CGIAR and ILRI mandates Livestock contribute to all 17 of the SDGs and directly to at least 8 of the goals.
  3. 3 Why focus on livestock health?  Animal health o Animal diseases cost several billion dollars a year and represent a major constraint to increasing productivity; many tropical diseases represent neglected problems.  Human health o Most animal source food in developing countries is sold in wet markets and most is unsafe; foodborne disease causes over 2 billion people to fall ill every year. o Animal health products are used widely, often unwisely or are not available, e.g. drugs, antimicrobials and vaccines. More antimicrobials are used in animals than in humans.  Ecosystem health o One new disease emerges every four months: 75% of new human diseases emerge from animals; many have a wildlife–livestock interface
  4. Gender and socio-economics: incentives, value chains, impacts, livelihoods etc. Management unit Graduate fellowships: fellowship program; science communication Field practitioners: community-based surveillance; value chain actors; lab technicians Policymakers and mitigation agents: simulation exercises (link to international health regulations; action plans, contingency plans, disease control policies EMERGING INFECTIOUS DISEASES NEGLECTED ZOONOTIC DISEASES FOOD SAFETY & INFORMAL MARKETS ANTIMICROBIAL RESISTANCE Thematic areas Applied research Biomedical science: epidemiology, surveillance and diagnostics, disease control etc. Environment: climate and other environment drivers, animal waste management etc. Capacity building Integration of thematic areas Work in common systems, integrated surveillance systems, common tools, environment, strengthening of One Health units One Health Research, Education and Outreach Centre in Africa
  5. 5 One Health • Understanding the linkages • Adding values: • More knowledge • Better health (human or animal) • Economical benefits CGIAR is uniquely positioned and actively promoting One Health in low- and middle-income countries human environment animal One Health
  6. Animal and Human Health program: Goal and activities To manage effectively or eliminate livestock, zoonotic and foodborne diseases that matter to poor people through generation and utilization of new knowledge, technologies and products Herd health Food safety and antimicrobial resistance Zoonoses and emerging infectious diseases Vaccines and diagnostics Program activities centre around two fundamental objectives: 1. To increase the productivity of tropical livestock through better health 2. To reduce the negative impacts of livestock and their products on human health and the environment
  7. 7 Locations of project countries Animal and Human Health program at ILRI Location of program partners
  8. 8 by: Sonja Niederhumer A portfolio of product lines, focusing on products with clients and a delivery system  Farmer training to improve herd health and livestock productivity  A package of technologies, incentives and governance to improve food safety in informal markets  Risk maps for zoonoses and pandemic surveillance, prevention and progressive control  Vaccines for priority diseases
  9. 9 Insights on disease priorities in Ethiopia • Differences in disease priorities between policymakers and farmers o Parasites and respiratory diseases most important to farmers o Reproductive diseases neglected in the past • Division of labour results in different zoonoses risks for men and women o Limited knowledge on zoonoses in general o Low awareness of risky behaviour More emphasis needed on production diseases SARI ARARI OARI
  10. 10 • Integration of interventions at community level • Strong community participation, with other interventions by the CGIAR Research Program on Livestock • Parasite control • Vaccination for production diseases • Clinical diagnosis and monitoring • Responsible antimicrobial use • Mobile app to facilitate herd health and productivity data recording over time • Synergies of animal welfare and agroforestry Intervention highlights in Ethiopia SARI ARARI OARI
  11. Urban livestock keeping in Hanoi city, Vietnam: Systems and vector-borne diseases 1. Knowledge, attitudes and practices among urban inhabitants regarding risks and benefits of urban agriculture, and current knowledge on mosquito- borne disease transmission 2. The distribution of mosquitoes and Flaviviruses (dengue, Japanese encephalitis, and Zika virus) present in urban mosquitoes and its relationship to livestock keeping. 4. Intervention package • On-site training • Given fans with simple key messages • Weekly reminders through text messages  3. Risk factors of mosquito- borne flavivirus by investigating febrile patients in a national hospital
  12. Work on zoonoses and emerging diseases in Africa: Early warning and forecasting • Studies on Rift Valley fever, a mosquito-borne viral zoonosis mainly affecting cattle, sheep, goats and camels • Outputs o Risk maps o Improved understanding on drivers, e.g. climate change variability o Livestock vaccination strategies o Influencing policy in Kenya and Uganda
  13. Surveillance of influenza virus in live bird markets in Hanoi and three highland border provinces in northern Vietnam - Monthly collection of swabs, faeces, bioaerosol, poultry worker nasal wash samples in the live bird markets in three border provinces: H7N, emerging infectious diseases, pigs and poultry - Weekly collection of samples in the biggest live bird markets in Hanoi
  14. One Health work in Kenya Surveillance design Agriculture interventions for human health ‘Classical’ zoonoses epidemiology Landscape epidemiology and disease transmission Emerging virus research Wildlife interface Antimicrobial resistance: population genetics, antimicrobial use Training in One Health Food chains and disease transmission Health of low-income urban populations Urban disease emergence Intensification of farming Policy development Contact: Eric Fèvre, ILRI Nairobi www.zoonotic-diseases.org @ZoonoticDisease
  15. 15Foodborne disease: A new priority, most probably from animal-source food Million disability-adjusted life years (DALYs) lost per year (global) 0 2,000,000 4,000,000 6,000,000 8,000,000 10,000,000 12,000,000 14,000,000 16,000,000 18,000,000 20,000,000 Asia Africa Other developing Developed Other toxins Aflatoxins Helminths Microbial Havelaar et al. (2015) 31 hazards • 600 mio illnesses • 420,000 deaths • 33 million DALYszoonoses non zoonoses Burden in low- and middle-income countries Cost estimates for 2016 (US$ billion) Productivity loss 95 Illness treatment 15 Trade loss or cost 5 to 7 Domestic costs may be 20 times trade costs
  16. 16 Research approach: what do we do to understand and improve food safety? Key content Grid slaughter Frequent washing (and disinfection) Training Separation (clean/dirty) Branding Key content Easy to clean surface Frequent washing (and disinfection) Separation (fresh/cooked) Training Hygienic cutting board Branding Approach: • Situational analyses of food safety • Capacity building on risk-based approaches • Proof of concept: participatory risk assessment • Pilot testing interventions
  17. Policy impact: translational research for interventions in modernizing food system • CGIAR/ILRI niche: risk assessment and policy/regulatory analysis for fresh foods in domestic markets • World Bank convenes overall support to government: ILRI led technical work • Upcoming projects based on World Bank report we led will improve food safety for 20 million people in major cities of Vietnam
  18. COVID-19 response at ILRI • One Health COVID-19 testing at ILRI for Kenya by the BMZ-funded One Health Centre in Africa • Continue to produce evidence-based scientific assessments (e.g. active surveillance) • Policy options (e.g. raise awareness and improve health governance) • A One Health approach is the optimal method for preventing and responding to pandemics
  19. www.cgiar.org Partners: CGIAR COVID-19 Hub http://a4nh.cgiar.org/covidhub/ The CGIAR COVID-19 Hub provides a coordinated research response to the global pandemic threatening health systems worldwide, along with posing serious risks to food security; local businesses and national economies; and hard-fought progress by stakeholders at all levels towards the Sustainable Development Goals. Launched 23 June 2020, the hub focuses on the four research pillars making up the core of CGIAR’s response to COVID-19: 1. Food systems 2. One Health 3. Inclusive public programs 4. Policies and investments CGIAR COVID-19 Hub will focus on four primary work areas: 1. Addressing value chain fractures 2. Integrating a One Health approach to COVID-19 responses 3. Supporting country COVID-19 responses 4. Addressing food system fragility and building back better
  20. Partnerships Antimicrobial use and value chains Transmission dynamics Interventions Enabling policy Capacity Key partners Key projects amr.cgiar.org
  21. • Antimicrobial use and knowledge, attitudes and practices surveys • Antimicrobial resistance prevalence and transmission at human–animal interfaces • Interventions including economic impact • Capacity development (laboratory capacity and mentorship) Studies conducted in different value chains New activities in West Africa Burkina Faso (poultry, food) Benin (aquaculture) Other antimicrobial resistance projects • Antimicrobial use and antimicrobial resistance in crop production • Fate and transport of antimicrobial resistance in water bodies • Antimicrobial resistance in wildife and bushmeat Antimicrobial resistance activities amr.cgiar.org
  22. Collaborative initiatives between ILRI and Korea • MAFRA: Third ODA forum • RDA–NIAS: African swine fever projects in Vietnam; development of disease resistance in chicken in Africa • APQA: International workshop on veterinary epidemiology • Korea Telecom: Livestock Epidemic Prevention Platform in Southeast Asia
  23. RDA–NIAS: Identification of environmental risk factors on African swine fever-infected farms (ongoing project) Farm sampling Pig samples Blood Rectal swab Nasal swab Oral swab Conjunctiva Environmental samples Mosquitoes & flies Rat Soil, water Aerosol
  24. Partnership with Korean researchers Universities and institutes: Vaccine and diagnostic kits
  25. Take-home messages 1. Livestock plays a key role in food security and in addressing the Sustainable Development Goals. 2. Animal health, human health and ecosystem health are closely interconnected, and One Health is a useful approach to address complex health issues. 3. ILRI’s Animal and Human Health program has a portfolio of product lines in zoonoses, emerging infectious diseases, antimicrobial resistance, food safety and herd heath, focusing on products with clients and a delivery system. 4. Collaborations with Korea are being developed including African swine fever research and information and communication technology for animal health surveillance and response, among others.
  26. THANK YOU

Editor's Notes

  1. Promote a trans-disciplinary approach to health: To increase the productivity of tropical livestock through better animal health To reduce the negative impacts of agriculture on human health (To improve animal, human and ecosystem health = one health) This directly leads to higher incomes for farmers and better health and nutrition for consumers and livestock keepers.
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