The document summarizes Kenya's efforts to institutionalize a One Health (OH) approach through the establishment of the Zoonotic Disease Unit (ZDU) in 2012. The ZDU is a structural office located between the ministries of human and animal health. It has 2 epidemiologists and support from other experts as needed. The ZDU aims to strengthen surveillance and control of zoonotic diseases, establish OH structures and partnerships, and conduct applied research. Some successes include joint surveillance and responses to zoonotic disease outbreaks. Challenges include limited resources, coordination between sectors, and operationalizing OH at local levels. Lessons learned include identifying region-specific OH drivers and taking a sustainable systems approach to implementation.

1. Institutionalizing One
Health: Lessons from
Kenya
DR ATHMAN MWATONDO

2. The Zoonotic Disease Unit
 Kenya’s OH office formed between line ministries of human and animal health
 Established in 2012 through a MOU
 Structural office in Kenyatta National Hospital Grounds (MOH grounds)
 Two epidemiologists, one admin, support from Field Epidemiology and Laboratory
Training Program (FELTP) residents
 Other experts co-opted on a need to be basis

3. The ZDU office
ZDU/ Athman Mwatondo

4. Jan 05
Formation of National
Influenza Taskforce (NIT) in
response to global H5N1 threat
Dec 06
Renaming of NIT to Zoonosis
Technical Working Group
(ZTWG)
Aug 08
ZTWG start quarterly meeting
Sep10
Multi-sectoral workshop to discuss
formation of OH Office
Aug 11
MOU between MOPHs and
MOLD signed to form ZDU
Oct 12
Deployment of staff
Official opening
Launch 5 year SP
The journey to establishment of the ZDU

5. Head,
Veterinary
Epidemiology
and
Economics
Unit (VEEU)
Other experts on a need
be basis
- Wildlife ecologists
- Zoologists
- NEMA
ZDU
2 Epidemiologists
County Animal/Human Health
Coordinators
Director of Veterinary
Services (MALF)
Director of Medical
Services (MoH)
Zoonotic Technical Working Group
A committee of OH stakeholders in Kenya (both
international and national)
ZDU Organogram
Head,
Department of
Preventive and
Promotive
health

6. ZDU OH SP
1.Strengthen surveillance, prevention and
control of zoonoses
2. Establish structures and partnerships to
promote OH
3. Conduct and promote Applied Research
ZDU MISSION
To establish and maintain active collaboration at the animal,
human, and ecosystem interface towards better
prevention and control of zoonotic diseases

7. Success of the OH approach in Kenya

8. 1. Joint Surveillance and response
Joint priority ZD list
1. Anthrax
2. Human trypanosomiasis
3. Rabies
4. Brucellosis
5. RVF
Severity of disease in humans and animals
Amenability to control
Epidemic potential
Disease burden
Socio-economic impact

9. Case study - Joint response to ZD events

10. Surveillance and response
- Joint disease CPs, guidelines
-Brucellosis*
-anthrax*
-RVF
-Rabies
-A.Influenza,
-Outbreak guidelines,
-PHEIUE response guidelines
* Awaiting validation and dissemination

11. One health in Covid-19 response
Clinical officer
Dental officer
Laboratory professional
MO
Nursing
Nutritionist
Other
Pharmacist
Public health officer
Veterinary Officer
Proportion of respondents primary profession n=102
• Material support to MOH response

12. 2. Establishment of structures to
promote OH
• Policy level engagement
• FETP training
• County level trainings on OH
• Regional collaboration – E. Africa
network, Africa OH Congress
• Event specific technical working
groups

13. County level OH units
- Outbreak
investigation
- Data sharing
-Joint risk
assessment
County
veterinary
officer
Regional
wildlife
coordinator
County
Disease
surveillance
coordinator
Map of Kenya showing trained County One Health
Units
Munyua, Peninah M et al. “Successes and challenges of the One Health approach in
Kenya over the last decade.” BMC public health vol. 19,Suppl 3 465. 10 May. 2019,
doi:10.1186/s12889-019-6772-7

14. 3. Operational research
-Promote and support zoonotic disease research to improve data
availability

15. Co-infection project – example of OH
collaboration

16. Using zoonoses to drive awareness on OH
Mathew Muturi/ZDU

17. Challenges in implementation OH in Kenya
 Resources
◦ Financial and technical structures are sector-specific
 Devolved governance system
◦ Independent governance structure
 Limited data on key drivers of OH
◦ Low awareness among policy makers,
◦ Cost-benefit analysis of OH
◦ From manuscripts to health policy
 Involvement of the environmental sector
◦ Diverse specialties, limited expertise at lower levels
 Need for stronger policy framework
◦ Long bureaucratic process, shift in governance

18. Challenges in implementation OH in
Kenya
 Operationalization of OH at
county and community level
◦ High staff turnover
◦ Specific health programs – Tb,
Malaria, HIV programs
 Coordination of multiple
partners
◦ Lack of synergy

19. Lessons learnt
1. Identify region-specific drivers of OH
2. Understand and adapt – No one size fits all approach
3. Sustainability – away from project vs systems approach to
implementation
• Need for “genuine” government involvement
• Support for capacity development
4. Operational research – from manuscripts to policy statements
• Focus on approaches to solve PH problems

20. What exactly is OH to ZDU at local and
national level?
• Better coordination between sectors
• Routinely sharing surveillance and outbreak data
• Develop integrated (human/animal) plans for preventing and controlling
priority zoonotic diseases.
• Structured and routine communication
• Improving the capacity in animal and environmental health for better
detection, prevention, and control of OH related events
• Research at the human-animal-environmental interface

21. Thank you….