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Challenges in Implementing One Health Globally
1. Laura H. Kahn, MD, MPH, MPP
Research Scholar, Princeton University
Co-founder, One Health Initiative
GRF One Health Summit 2012
Davos, Switzerland
2. Since 2008, One Health Initiative website has been serving as a
global
repository for all news and information pertaining to One Health.
http://www.onehealthinitiative.com
Disclaimer: Opinions expressed in this talk are my own and n
necessarily those of my OHI colleagues.
3. • Wrong!
• Different institutions
• Different missions
• Different priorities
• Different funding
sources and levels
• Different education
and training
• Different attitudes
6. • Human and agriculture/animal health
infrastructures separate
• Different missions/different priorities
• Human health focused on disease
surveillance, control, and prevention.
• Agriculture/animal health focused on
promoting agriculture and livestock.
10. • Funding determines
programs and
activities.
• Funds allocated to
specific agencies for
specific purposes.
• Agencies fight for a
piece of the pie.
• One Health requires
inter-agency
communication and
cooperation.
12. Research Budget
30
20
10
$29B NIH
NIFA
0 $1B
NIH
NIFA
DHHS NIH $29 billion for biomedical research (FY 2013) 94% of 30.9
billion
http://www.hhs.gov/budget/budget-brief-fy2013.pdf
USDA NIFA $1061 million FY 2013 for ARS research and education; $0 for animal
health and disease; http://www.obpa.usda.gov/budsum/FY13budsum.pdf
14. Paucity of funds for animal
disease
surveillance, control, prevention,
and research makes implementing
One Health difficult.
15.
16. Disproportionate number of medical schools
compared to veterinary medical schools.
US Global
483 in
101 countries
28 Vet Vet
Medical Medical
136 2218 in 177
countries
17. 46,000 DVMs treat pets
59,700 total
Pet Vet
Other Vet
Practicing MD
556,000 MDs in solo,
group, or hospitals
2007 and 2008 US Bureau Labor Statistics
19. • A need for professionals that span
human, animal, and environmental health.
• Schools of public health should offer master’s
and doctoral degree programs in One Health.
• In addition to biostatistics and
epidemiology, subjects would include:
• food and water safety and security,
• ecosystem and environmental health,
• land degradation and urban development,
• agriculture and sustainability,
• biodiversity and zoonotic diseases
20.
21. • Survey of 4897 physicians and 4144
veterinarians across 4 U.S. states in
2003-2004.
• Response rate: 602 physicians (12%)
and 1070 veterinarians (26%)
• Asked if willing to work with
medical/veterinary medical
colleagues.
22. How often do you communicate with your
local medical/veterinary medical colleagues
regarding emergence of any unusual
human/animal diseases/behaviors that might
impact humans/animals in your area?
Never 80%
DVM
45% Never2 45%
MD
80%
0 50 100
23. • If “Never” how interested would you be in
participating in a forum (e.g. seminar, Internet
chat site) in which you could exchange such
information with your veterinary colleagues?
50
DVMs 20%
MDs 44%
0
No No
24. • “As an ophthalmologist, I would be very
unlikely to see an infectious disease outbreak
or other public health calamity.”
• “…Radiologists do not (usually) contact public
health professionals.”
• “As a psychiatrist I rarely or never deal with
infectious diseases, especially rare ones.”
• “The lack of interest I have in this is due to the
massive time constraints I have in trying to
keep up with diseases/illnesses as well as
medical/legal with coding issues.”
25. • More interaction between veterinary and
human medical doctors concerning recognition
and treatment of zoonotic diseases would be
helpful.”
• “…It should be mandatory that
VMDs, DVMs, and MDs attend local seminars
given on potential public health diseases and
bioterrorism.”
• “In general, physicians in clinics and practice
have little respect for veterinarians and show
little interest in potential zoonotic diseases.”
27. • Unified, interdisciplinary mission
• Priorities:
human, animal, environmental
health
• Disease
surveillance, control, prevention, an
d research for humans, animals, and
the environment
28. UN
One Health OIE
WHO FAO
Human Animal Environment
29. College of One Health
School of
School of Veterinary
School of Medicine School of Nursing Public/Environmental
Medicine
Health
30. • Shared learning
experiences
• Shared professional
language
• Shared literature
• Open to collaborative
35. Acknowledgements:
• Bruce Kaplan, DVM, Dipl. Aves (hon)
• Tom Monath, MD
• Jack Woodall, PhD
• Lisa Conti, DVM, MPH
www.onehealthinitiative.com
36. • Improved Food Safety and Security
• Reduction of Zoonotic Disease Emergence
• Enhanced Biosecurity and Biodefense
• Sustainable Urban Development
• Sustainable Agriculture
• Improved Clean Water Availability
• Improved Hygiene and Sanitation
• Enhanced Biomedical Research Discoveries for the
Health of all Species
• Preserved Ecosystems for Improved
Human, Livestock, and Wildlife Health
Editor's Notes
Almost 5 to 1.Not all are accredited. AVMA accredits 45 schools in U.S., Canada, Australia, England, Ireland, Scotland, Mexico, The Netherlands, New Zealand, West Indies.Somewhere between 192 to 196 countries. Anywhere from 91 to 95 countries lack any veterinary medical schools. 98 countries have organizations that recognize/accredit their medical schools. Only a handful of schools in U.S. share a common campus.ECFVG is not a comprehensive list. Brazil has 46 vet med colleges listed, but as of Sept. 2009, there are more than 108 schools. May be case forOther countries as well.FAIMER: Foundation for the Advancement of International Medical Education and Research.
Veterinarians working in solo or group practices. 77% of them treat pets
Four U.S. states NH, NY, NJ, PA
Vast majority of physicians respondents were subspecialists who felt that these issues were not relevant to their practice.
Western University of the Health Sciences in Southern California
