One Health: Bridging the Gaps for a Holistic Approach to Global Well-being

1. ONE HEALTH
No Health without A Healthy planet
Dr. ROBIN THURUTHEN VAVACHAN MD
COMMUNITY AND FAMILY MEDICINE

2. • It is actually humanity’s destruction of biodiversity that creates the conditions for new viruses
and diseases such as Covid-19, the viral disease that emerged in China in December 2019, to arise
– with profound health and economic impacts in rich and poor countries alike.

3. • We invade tropical forests and other wild landscapes, which harbour so many species of animals
and plants – and within those creatures, so many unknown viruses,” David Quammen, author of
Spillover: Animal Infections and the Next Pandemic, recently wrote in the New York Times. “We
cut the trees; we kill the animals or cage them and send them to markets. We disrupt ecosystems,
and we shake viruses loose from their natural hosts. When that happens, they need a new host.
Often, we are it.”

4. • Hidden cost of human economic development. There are just so many more of us, in every
environment. We are going into largely undisturbed places and being exposed more and more.
We are creating habitats where viruses are transmitted more easily, and then we are surprised
that we have new ones.

5. • There’s misapprehension among scientists and the public that natural ecosystems are the source
of threats to ourselves. It’s a mistake. Nature poses threats, it is true, but it’s human activities that
do the real damage. The health risks in a natural environment can be made much worse when
we interfere with it.

6. • Markets are essential sources of food for hundreds of millions of poor people, and getting rid of
them is impossible. Bans force traders underground, where they may pay less attention to
hygiene.

7. In conclusion
• Pandemics emerge from the microbial diversity found in nature ( 70% zoonotic)
• Human ecological disruption and unsustainable consumption drive pandemic risk
• Reducing anthropogenic global environmental change may reduce pandemic risk
• Land-use change, agricultural expansion and urbanization cause more than 30% of emerging
disease events
• The trade and consumption of wildlife is a globally important risk for future pandemics
• Current pandemic preparedness strategies aim to control diseases after they emerge. These
strategies often rely on, and can affect, biodiversity
• Escape from the Pandemic Era requires policy options that foster transformative change towards
preventing pandemics
• Invasive alien species introduction has been linked to disease emergence
• Protected area systems to conserve biodiversity could also reduce risk of disease emergence

8. ONE HEALTH (OH)
• Integrated, unifying approach to balance and optimize the health of people, animals and the
environment.
• Government officials, researchers and workers across sectors at the local, national, regional and
global levels should implement joint responses to health threats. This includes developing shared
databases and surveillance across different sectors, and identifying new solutions that address
the root causes and links between risks and impacts.
• Community engagement is also critical to promote risk-reducing habits and attitudes, and to
support early detection and containment of disease threats.
• Ebola , Zika , Covid 19 …. Recently
• Influenza in USA
• Crimean-Congo Hemorrhagic Fever in Kazakhstan
• Rabies one health Model :WHO

9. ONE HEALTH IN INDIA
• Dedicated Centre under ICMR to contain zoonotic diseases in 2019.
— THE CENTRE FOR OH AT NAGPUR , it constituted a ‘National Expert Group on One Health’
Epidemiological surveillance of selected zoonotic diseases in Central India.
Tuberculosis, Brucellosis, listeriosis, scrub Typus

10. OH Consortium
• National Institute Of Animal Biotechnology , HYD.
• Principle :Health Is Integrated and Interconnected paradigm
• Approach : Multisectoral and converging approach
• Surveillance : All Zoonotic Infections and
Transboundary pathogens in India
27 organisations –
10
Surveillance
New method
Tackle
Understanding
Existing
Diagnostic
AIIMS Delhi
AIIMS Jodhpur
GADVASU Ludhiana
TANUVAS, Chennai
MAFSU, Nagpur

11. OH High Level Expert Panel- WHO
• The Panel intends to meet 5-6 times a year in plenary session, where all aspects of the different
working groups will be reviewed together to develop a portfolio of key issues, knowledge and
evidence gaps.
• These will be further prioritized according to their potential for making a difference in the
prevention of emerging zoonoses, and as part of the development of a research agenda.
• The Panel will give guidance and inputs to the four partner agencies, FAO, OIE, UNEP and WHO
related to their work of generating knowledge and evidence on OH, including the potential
development of a roster of additional external experts and resources on One Health.
• The Panel will develop evidence-based recommendations for global, regional, national and local
action, to be summarized in an annual panel report.

12. • The panel will also have a role in investigating the impact of human activity on the environment
and wildlife habitats, and how this drives disease threats.
• Critical areas include food production and distribution, urbanization and infrastructure
development, international travel and trade, activities that lead to biodiversity loss and climate
change, and those that put increased pressure on the natural resource base – all of which can
lead to the emergence of zoonotic diseases.

13. OH focuses on
• Global health at the human-animal-ecosystem interface: the need for intersectoral approaches
• Emerging infectious diseases
• Neglected tropical diseases
• Social anthropology of zoonoses
• Identification of animal threats
• Antimicrobial resistance and zoonotic food borne infectious diseases
• Conflicts and injuries
• Innovation and opportunities
• Pandemic preparedness and response
• Global health security and capacity building

14. The tripartite collaboration WHO-OIE-FAO
Supported by unicef and world bank.
The three partners enlarged the scope of their collaboration to include:
• the reinforcement of national services in human health, animal health and food safety;
• the strengthening and modernisation of early warning and surveillance/monitoring
systems;
• the foresight, preparedness and response to emerging, re-emerging and neglected
infectious diseases;
• the encouragement and the promotion of coordinated research and development to
achieve a common understanding of the highest priority zoonotic diseases;
• the challenge that represents food safety requiring a multi-sector approach in the
context of reinforcing food security.

15. Cross-Sectoral, Multidisciplinary Risk Assessment for
Health Threats at the Human-Animal Interface-
Tripartite Zoonosis Guide (TZG)
• First step – understand them – we need opinion from experts of respective fields
• Public health sector and the animal health sector do their risk assessments separately and then
they do a joint risk assessment
• To do this the support of the governments are necessary
• FAO, OIE, and WHO together, we have identified three areas of priority for collaboration.. –rabies,
animal influence and anti-microbial resistance
• Must have information- the epidemiological information and the virological information of both
animal and public health sectors
• the results of the risk assessment can be used to build policy, to build risk management options,
and to build risk communication messages

16. A. Scope
The TZG applies to:
• priority existing (endemic and emerging) zoonotic diseases;
• zoonotic disease events and emergencies;
• other shared health threats at the human-animal-environment interface such as AMR,
food safety, and food security.
B. Regional considerations
The TZG can also help address regional challenges. These challenges may arise from
differences among production and marketing systems, climate change, armed conflict,
voluntary or forced movement of people or animals, and political dynamics. Whichever
options countries adopt from the TZG, aligning their efforts with existing regional or
subregional initiatives can result in better outcomes

17. C. Difference in the assessment systems
• public health risk assessments have historically been used to decrease exposure to
a pathogen, for example, or to ensure that there's enough hospital
capacity. Clinically based outcomes for the risk assessment.
• Whereas animal health has traditionally wanted outcomes that relates to the safety
of food or the safety of trade. And because these are different outcome, we see
that the processes are different.

18. D. Process
• The process that we use here at WHO and that we will use jointly with the animal health sector
has several steps. The first is the development of risk questions, and then the assessment of
qualitative information about the hazard, the potential for exposure, and also the context in
which the event is happening.
• And then we qualitatively estimate a likelihood and an impact as well as an uncertainty for each
of the risk questions based on the information that we've evaluated

19. E. Risk questions
• Risk questions need to be very specific in order to allow practical targeting of the management
options and communication options that come from the assessment.
• For example, a good risk question for an interface issue would be, what is the likelihood and impact
that an avian influenza H7N9 virus will be identified in a commercial poultry worker in country X
within the next month?
• It's very specific, but it will allow us to target our interventions. For example, we may want to
increase or maybe even decrease the urgency of implementing surveyance in commercial poultry
workers. Or the animal health sector may want to provide more advocacy or more ideas about how
to decrease the risk that a virus will come into the poultry sector in the first place.

20. How OH align with existing international and regional
frameworks?
• international Health Regulations
• OIE standards
• Sustainable Development Goals
• regional frameworks
• Global Health Security Agenda
• Codex Alimentarius
• Antimicrobial resistance frameworks
• International Food Safety Authorities Network (INFOSAN);

21. The Sustainable Development Goals, zoonotic diseases and the One Health approach
• The Sustainable Development Goals (SDGs) , entitled “Transforming our world: the 2030 Agenda
for Sustainable Development”, aim to eradicate poverty and achieve sustainable development.
These goals take an integrated approach, stress equity and sustainability, and are relevant to all
countries. At national, regional and global levels, indicators for measuring progress towards
achieving the SDGs have become a priority for national governments.
• Taking a multisectoral, One Health approach for zoonotic diseases that addresses the
interconnectedness of health and its social and economic determinants aligns with the SDG
framework. Health is a critical consideration in achieving the 17 goals, and taking a One Health
approach in health activities will support making progress in achieving the SDGs. The SDGs
themselves reflect a One Health approach, ensuring that healthy people and animals live on a
healthy planet.
• Countries developing their zoonotic disease strategies will benefit from greater awareness and
understanding of the synergies among zoonotic diseases, One Health, and the SDGs, and of linking
of SDG activities with planning processes, strategic plans, and M&E frameworks related to zoonotic
diseases.

22. INFOSAN encourages a One Health approach to food safety emergency response
• Launched in 2004, the International Food Safety Authorities Network (INFOSAN) is a global network
of national food safety authorities from 188 Member States, managed jointly by FAO and WHO. The
goal of INFOSAN is to prevent the international spread of contaminated food and foodborne
disease, and strengthen food safety systems globally by taking a multisectoral, One Health
approach. This is done by:
• • promoting the rapid exchange of information during food safety events;
• sharing information on important food safety issues of global interest; • promoting partnership and
collaboration between sectors, countries and networks; • helping countries to strengthen their
capacity to manage food safety emergencies.
• Taking a One Health approach, the INFOSAN Secretariat encourages Member States to designate
one emergency contact point from the national authority responsible for coordination during a
national food safety emergency, as well as additional focal points from other national authorities that
have a role in ensuring food safety. Today, the network includes more than 600 members from
across a broad range of relevant sectors (eg. human health, animal health, environmental health,
industry and trade, tourism). Active engagement with INFOSAN is one way to bolster preparedness
for food safety emergency response, including emergencies involving outbreaks of foodborne
zoonotic diseases.

23. Relevant International Regulations and Treaties
• International Health Regulations(IHR) 2005 WHO
• Sendai Framework For Disaster Risk Reduction
• Convention On Biological Diversity
• United Nations Convention To Combat Desertification
• CITES
• SPS
• Berlin And Manhattan Principles on OH
• WTO Agreement on Sanitary and Phytosanitary Measures

24. Costs and benefits
• Taking a multisectoral, One Health approach to zoonotic diseases makes the best use of limited
resources of money and personnel, improving the efficiency and effectiveness of zoonotic disease
management, so that costs are reduced. (Results may be measured simply as reduced morbidity and
mortality, or by cost-benefit analyses using economic data. In addition to improved public health
outcomes, strengthening systems and coordination across the human health, animal health and
environment sectors can provide a strong return on investment. Costs are reduced by avoiding
duplication of activities and performance may improve by improving synergies – e.g. sharing of
laboratory facilities by multiple sectors. Reduced risks from zoonotic diseases also reduce indirect
societal losses such as impacts on livelihoods of small producers, poorer nutrition, and restriction of
trade and tourism that, when included, bring the global costs of some recent zoonotic disease
events to tens of billions of dollars.
• A multisectoral, One Health approach makes it easier to advocate for interventions that benefit all
sectors but impose costs on only one (e.g., costs of vaccinating dogs against rabies are borne by the
animal health sector, but provide major public health benefits). The value added for each of the
sectors can justify investment in this approach to zoonotic diseases, serve as an advocacy tool, and
help policy-makers understand how costs and benefits are shared across sectors.

25. OPTIONS TO CONSIDER WHILE
IMPLEMENTING OH STRATEGY

26. 1. Multi-sectoral, OH coordination mechanisms
• A multisectoral, OH coordination mechanism (MCM) 9 for zoonotic diseases refers to any formalized,
standing, group that acts to strengthen or develop collaboration, communication, and coordination
across the sectors responsible for addressing zoonotic diseases and other health concerns at the
human-animal-environment interface. An MCM has routine, ongoing functions and is responsible for
coordination, leadership, and governance of efforts among the relevant sectors to achieve jointly
determined and agreed common goals
• Benefits : efficient coordination and communication from a single group representing all relevant
sectors; • ensuring a multisectoral, OH approach is taken in planning and prioritizing activities; •
activities are consistent, stable, and not solely dependent on personal relationships among individuals.
• Inter-ministerial leadership and coordination: supports coordination, collaboration, and
communication among sectors at the leadership level, and advocates for a multisectoral, One Health
approach to policy making, strategic planning, and resource allocation 10.
• Technical coordination: supports coordination of technical activities to ensure that a multisectoral,
One Health approach is taken and that there is alignment across existing governmental structures and
across the technical activities addressing zoonotic disease

27. 2. Mapping of existing coordination
mechanisms
• Depending on how government is structured, the body or agency convening the MCM is ideally: • a high-
level ministry or coordinating ministry; (IN1) • the prime minister’s or governor’s office.
• Other options include convening the MCM by: • a single technical ministry (e.g. the ministry responsible
for animal health, human health, or the environment); (BH2) • sharing responsibility among a group of
ministries.
• No matter what sector is leading or convening the MCM, balance and equity in representation and
responsibility a
• Fostering trust - Building and maintaining trust is a top priority of any MCM. Any positive or negative
impacts on trust among the MCM members and among the MCM and all external partners are key
considerations when establishing the MCM (e.g. when deciding within which agency the MCM is located)
(BD4)
• MCMs established by legislation, with clearly defined mandate and authority: • are more sustainable;
• are more accountable;
• are more likely to function despite changes in government or in technical staff; • can advocate more
effectively for resources.
• If formally establishing the MCM within the government is impossible, having the MCM operate at a
technical level without formal establishment allows multisectoral, One Health activities to continue, and, if
circumstances change, transition to a formally established MCM is easier. members should be ensured.

28. 3. Communication among and between
stakeholders
• The solutions start with education and awareness. Educate community health workers,
programme managers and policy-makers about the most pressing social influences on zoonotic
disease prevention and control within each country. The solution starts with education and
awareness
• Trustworthy, transparent and consistent communication establishes credibility with national and
international stakeholders and partners.
• Modern technology allows people to receive information about zoonotic disease outbreaks from
many sources, which may result in misinformation and confusion. Preparedness and response
teams should include specialists in communication so that stakeholders receive accurate, timely,
comprehensive, and consistent messages. Identifying and training spokespeople from all sectors,
and from communities, can ensure messages are delivered and build trust with all audiences.
• establish partnerships with and engage social scientists (sociologists, anthropologists and
demographers, among others), in the planning, implementation and evaluation of policies,
programmes, research and training
• develop communication strategies which consider gender, indigenous and minority populations
and diverse cultural practices

29. 4. Communication Plan
The MCM should have a structured communication plan, whose objectives may include:
• • raising awareness of the MCM and its functions; • building trust and confidence to
increase engagement and support and facilitate implementation of policies and
programmes; • establishing the MCM as the primary source of expertise, information,
and guidance in zoonotic disease policy; • advocacy for taking a multisectoral, OH
approach to zoonotic diseases.
The MCM communication plan may address:
• • mechanisms for routine communication among member agencies, subgroups, and
subnational structures; • identification of target audiences and plans for stakeholder
engagement; • development and use of an agreed core set of messages relating to
priority zoonotic diseases, including the process for effective communication during
events or emergencies • ensuring alignment with other plans to provide information to
the public, including affected communities; • monitoring and evaluation of the MCM’s
communication activities

30. 5. Consider social determinants of health
• Taking a multisectoral, OH approach to address zoonotic diseases means considering the
conditions in which people are born, grow, live, work and age. These conditions of daily life are
influenced by factors such as politics, cultural norms, values, and beliefs, the economy, the
distribution of power, gender, and whether people live in an urban or rural community. The same
factors influence zoonotic disease risks, and should be considered when undertaking the activities
in the TZG. The social context of zoonotic disease transmission, and its implications for vulnerability
among different groups of people should also be considered.
• consider gender in the development, implementation and evaluation of country plans and education
and training programmes for zoonotic diseases;
• use available research to explore and understand social determinants of health in their country, and
integrate knowledge and behaviour change into all aspects of zoonotic disease control.

31. 6. Enabling mechanisms
• Launching a high-level intergovernmental council on pandemic prevention, that would provide for
cooperation among governments
1) provide policy-relevant scientific information on the emergence of diseases, predict high-risk
areas, evaluate economic impact of potential pandemics, highlight research gaps; and
• 2) coordinate the design of a monitoring framework, and possibly lay the groundwork for an
agreement on goals and targets to be met by all partners for implementing the OH approach. A
broad international governmental agreement on pandemic prevention would represent a
landmark achievement with clear benefits for humans, animals and ecosystems
• Institutionalizing OH in national governments to build pandemic preparedness, enhance
pandemic prevention programmes, and to investigate and control outbreaks across sectors.
• Integrating (“mainstreaming”) the economic cost of pandemics into consumption, production,
and government policies and budgets.
• Generating new green corporate or sovereign bonds to mobilize resources for biodiversity
conservation and pandemic risk reduction.
• Designing a green economic recovery from COVID-19 as an insurance against future outbreaks

32. 7. Policies to reduce the role of land-use change in pandemic
emergence:
• Developing and incorporating pandemic and emerging disease risk health impact assessments in
major development and land-use projects. Reforming financial aid for land-use so that benefits
and risks to biodiversity and health are recognized and explicitly targeted.
• Assessing how, effective habitat conservation measures including protected areas and habitat
restoration programmes can reduce pandemics, and trade-offs where disease spillover risk may
increase. Developing programmes based on these assessments.
• Enabling transformative change to reduce the types of consumption, globalized agricultural
expansion and trade that have led to pandemics (e.g. consumption of palm oil, exotic wood,
products requiring mine extraction, transport infrastructures, meat and other products of
globalized livestock production). This could include modifying previous calls for taxes, or levies on
meat consumption, livestock production or other forms of high pandemic risk consumption.

33. 8. Policies to reduce pandemic emergence related to the
wildlife trade
• Building a new intergovernmental health and trade partnership to reduce zoonotic disease risks in
the international wildlife trade, building on collaborations among FAO, IUCN and others.
• Educating communities from all sectors in emerging infectious diseases hotspots regarding the
health risks associated with wildlife use and trade that are known to pose a pandemic risk.
• Reducing or removing species in wildlife trade that are identified by expert review as high-risk of
disease emergence, testing the efficacy of establishing market clean-out days, increased cold
chain capacity, biosafety, biosecurity and sanitation in markets.
• Conducting disease surveillance of wildlife in the trade, and of wildlife hunters, farmers, and
traders.
• Enhancing law enforcement collaboration on all aspects of the illegal wildlife trade.

34. ONLY REGULATION - CITES
• The only legislation, or the only regulations worldwide, that cover these trade in non-food animals, is through
the Convention on International Trade in Endangered Species, or the CITES, as it's referred to, C, I, T,E,S. It
currently has 186 member states and provides some protection to about 35,000 species. And it only protects
those animals that are listed as endangered species by the convention.
• CITES operates a licensing system in which the import and export of animals on this list are authorized by
member nations through this licensing system. So, it maintains a database of endangered animal species
movements. And in this database, there have been recorded movements for 585 different bird species, 484
different reptile species, and 114 different mammal species. It's important to remember that this convention
only covers endangered species, it doesn't cover non-endangered species.
• And it does not do anything about the movement of pathogens across this network.
• And there are also illegal movements of animals and animal products, which we have no idea about.
• So legal, and illegal trade in exotic pets, is also a large and vast international, worldwide network, that
connects ecosystem interfaces around the world, but movement of pathogens across this network is totally
unregulated.

35. 9. Closing critical knowledge gaps
• Supporting OH scientific research to design and test better strategies to prevent pandemics.
• Improving understanding of the relationship between ecosystem degradation and restoration and
landscape structure, and the risk of emergence of disease.
• Economic analyses of return-on-investment for programmes that reduce the environmental
changes that lead to pandemics.
• Key risk behaviours – in global consumption, in rural communities on the frontline of disease
emergence, in the private sector, in national governments – that lead to pandemics.
• Valuing Indigenous Peoples and Local Communities’ engagement and knowledge in pandemic
prevention programmes.
• Undiscovered microbial diversity in wildlife that has potential to emerge in future, or to be used
to develop therapeutics or vaccines.
• Analysing the evolutionary underpinnings of host shifts that are involved in zoonotic disease spill
over and the adaptation of emerging pathogens to new host species.
• Climate change impacts and related extreme weather events (eg. flooding and droughts) on
disease emergence, to anticipate future threats
• Obtaining data on the relative importance of illegal, unregulated, and the legal and regulated
wildlife trade in disease risk

36. • 2013 - The Gates Foundation calls for One Health research through the Grand Challenge program

37. 10. Foster a role for all sectors of society to engage in
reducing risk of pandemics
• Climate change impacts and related extreme weather events (e.g. flooding and droughts) on disease emergence,
to anticipate future threats.
• Obtaining data on the relative importance of illegal, unregulated, and the legal and regulated wildlife trade in
disease risk.
• Educating and communicating with all sectors of society, and especially the younger generations, about the origins
of pandemics.
• Identifying, ranking, and labelling high pandemic risk consumption patterns (e.g. use of fur from farmed wildlife)
to provide incentives
for alternatives.
• Increasing sustainability in agriculture to meet food requirements from currently available land, and subsequently
reduced land areas.
• Promoting a transition to healthier and more sustainable and diverse diets, including responsible meat
consumption.
• Promoting sustainable mechanisms to achieve greater food security and reduce consumption of wildlife.
• Where there is a clear link to high pandemic risk, consideration of taxes or levies on meat consumption,
production, livestock production or other forms of consumption, as proposed previously by a range of scientific
organizations and reports.

38. 11. Understanding animal behavior for global health
• Animal psychology and animal behavior eg: snakes, dogs (rabies), tigers, elephants to prevent
attack from these animals
• bird migration and avian influenza, Lyme virus disease, West Nile disease, bacterial infections like
salmonella
• Parasites and pathogens can cause behavioral changes in hosts. eg: plasmodium, dracunculosis

39. 12. Progressive implementation
• Countries may progressively implement a multisectoral, One Health approach by starting with
one or a few activities or only for a few zoonotic diseases identified as of high priority. The
process can then be expanded as improved results build support, and as infrastructure and
resources accumulate.
• Example of progressive implementation : An informal review of the national infrastructure reveals
an existing ad hoc committee of representatives from animal health and public health working on
response to zoonotic disease threats. This small group may then be asked to map infrastructure in
additional sectors, such as the environment sector, allowing the establishment of a multisectoral
coordination mechanism.
• Department of Animal Husbandry and Dairying launches ‘One Health’ pilot project in
Uttarakhand. The ‘One Health India’ program initiated by the Department will work with
stakeholders from various sectors to improve livestock health, human health, wildlife health, and
environmental health through technology and finance. The pilot in Uttarakhand will support the
creation of the One Health Framework for India and help build strong social infrastructure that
supports the health of the people and the planet.

40. 13. One Health As A Pillar For A Transformative Pandemic
Treaty
Embedding Essential OH Elements in a Pandemic Treaty
• PREVENTION - OH approach uses a similar strategy, but expands it to include risk factors at the
human-animal-environment interface. To reduce the impact of these risk factors, a global
pandemic treaty must strengthen the coherence between existing environmental treaties and the
IHR and animal health regulations, to render existing legal regimes more effective.
Food systems need to be a focal point for prevention. knowledge that this has been the source of
previous pandemics, highlights the need for an interdisciplinary OH approach also to biosecurity,
based on increasing awareness and capacity among all actors along food value chains, from the
producer to the consumer. Since the spillover and spread of infectious agents are driven by specific
key risk factors, these should be monitored such that disease emergence risk or vulnerability maps can
be produced and interventions to reduce risk implemented accordingly.
These risk factors might include, for example, weather conditions related to climate change;
deforestation; changes in land use and distribution of animal populations; human and animal
behaviour changes (possibly linked to climate change and encroachment into natural habitats);
movement of animals and vectors; and food consumption behaviours. Such data could be combined
with Indigenous knowledge and other situated expertise, including that contained at the community
level, about the importance of these factors for the emergence, spillover, and spread of disease.

41. • MONITORING AND SURVEILLANCE - Integrated OH surveillance systems should include and connect
data that identify risk factors for disease emergence in wildlife, companion animals, livestock, the
environment (e.g., soil and water), and humans.
There is also a need to develop a more globally integrated OH monitoring system and to ensure access to
surveillance data through data sharing agreements between governments and others, including the
private sector.
• The WHO Hub for Pandemic and Epidemic Intelligence that was launched on September 1, 2021 in
Berlin represents the latest example of a collective and collaborative intelligence endeavour with a focus
on reducing inequities and developing evidence-based solutions for better preparedness through open
science, partnership, and solidarity. The planned collaborative efforts should lead to better data,
superior analytics, and improved decision-making. The WHO, during the launch of the Hub, stated that
the main limitation in surveillance systems currently is local surveillance capacity, which needs to be
strengthened and, additionally, connected globally in an unbreakable, interlinked system
• The Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) represents an
example of a successful OH surveillance system that integrates data from the human, animal, and
environmental sectors. CIPARS monitors trends in antimicrobial use and antimicrobial resistance in
selected bacterial organisms from human, animal, and food sources across Canada. It is based on several
representative and methodologically unified surveillance components, which can be linked to examine
the relationship between the antimicrobials used in food animals and humans and the associated health
impacts. This information supports the creation of evidence-based policies to control antimicrobial use
in hospital, community, and agricultural settings, as well as the identification of appropriate measures to
contain the emergence and spread of resistant bacteria between animals, food, and people in Canada.

42. • Preventive approach to surveillance should also include OH risk assessment focused on monitoring
the presence and distribution of infectious agents in several species and the environment to predict
and prevent their spillover across species . Such risk assessments could be conducted by OH expert
networks, such as the WHO Hub for Pandemic and Epidemic Intelligence, and could be connected to
the permanent global One Health structure. The environment must be a key element in surveillance,
because several infectious agents can survive and evolve outside of their natural hosts. Thus,
monitoring their presence in key locations (for example water) can be a tool to monitor the distribution
of the infection in animal species, including humans . An integrated surveillance system would also
enable the early detection of new pathogen reservoirs after a pandemic (“reverse spillover”).
Advancements in artificial intelligence (AI) tools and increasingly powerful computers capable of
handling large amounts of data from a range of sources should also be used to improve our ability to
detect unusual events more quickly. There is evidence that using a OH approach to diversify data
sources can improve the ability of surveillance systems to appropriately and accurately rank threats by
more comprehensively and extensively accounting for environmental, animal, and socio-demographic
factors. In addition, social media data have been used to detect health emergencies and are
increasingly being considered as additional sources for event-based surveillance in early warning
systems.

43. 14. Economics And Financing
• This should include fully embedding OH in the funding architecture for pandemic prevention,
preparedness, and response, which implies, for example, financing the establishment of national OH
platforms and initiatives, as well as the operational costs of the permanent global One Health
structure. The funding architecture should contain a redistributive element, with HICs(hIgh income
countries) providing most of the seed capital. In addition, innovative funding solutions should be
pursued, such as collective issuance of OH pandemic preparedness bonds (expanding current World
Bank programming in the area).
• IMPORTANCE OF PRIVATE SECTOR- Another important aspect of OH funding is the involvement of the
private sector, which could contribute directly by investing in established OH funding mechanisms or
indirectly by: 1) investing in OH knowledge exchange and training, thus supporting the development of
academic infrastructure; 2) building OH infrastructure and capacity in affected communities, such as by
supporting the establishment of OH reference centres for prevention, surveillance, and diagnosis and/or
treatment; 3) participating in public-private partnerships related to OH product development and on-
the-ground implementation, including vaccine development, testing capacity, and the study of risk
factors to enable targeted prevention; and 4) advancing solidarity by, for example, sharing much-needed
intellectual property for diagnostic tools and vaccine development. Finally, and in addition to the
financial contributions already mentioned, it is essential that the private sector actively participates in
ongoing and forthcoming multisectoral coordination at both national and international levels. The road
to successful prevention and preparedness for, and response to, emerging threats requires that the
private sector embed OH approaches in their respective business models in the years to come

44. 15. Universal Metrics For Evaluating OH Implementation And
Success
• the Sustainable Development Goal (SDG) evaluation systems incorporate some OH-relevant
metrics, including with respect to SDG 13 (“Climate Change”) and SDG 15 (“Life on Land”).
However, there are no SDGs or indicators that integrate OH sectoral synergies or ways to measure
such progress. As such, OH evaluation could also integrate OH specific deliverables within
relevant SDG targets, requiring countries to integrate these into existing monitoring systems and
to report the impact of the multi-/interdisciplinary and multi-/intersectoral approach. It has also
been proposed that the World Bank set lending and performance targets for pandemic
prevention and preparedness, and that the International Monetary Fund include pandemic
preparedness assessment in its existing Member States consultations, both of which are
potentially relevant measures for a monitoring and preparedness framework under a prospective
pandemic treaty