Veterinary public health -building a One World-One Health framework and way of working Dr Wayne Lees, Chief Veterinary Officer Manitoba Agriculture, Food

Veterinary public health

-building a One World-One Health framework and way of working

Dr Wayne Lees, Chief Veterinary Officer

Manitoba Agriculture, Food and Rural Initiatives

In One World we share:

- Air

- Water

- Land

- Food

- Pathogens

- Toxins

Spot the potential hazards:

ChickensSalmonella enteritidisAvian tuberculosis

GoatsBrucella melitensis

CattleE.coli O157:H7Campylobacter jejuni

Swine InfluenzaTrichinella spiralis

MiceHantavirus

DogsRabies

HumansCysticercus bovis/Taenia saginata






MiceHantavirus

DogsRabies







MiceHantavirus

DogsRabies







MiceHantavirus

DogsRabies







MiceHantavirus

DogsRabies







MiceHantavirus

DogsRabies







MiceHantavirus

DogsRabies

HumansCysticercus bovis/Taenia saginataInfluenza (pH1N1)

Emerging issues are bringing us together

• Zoonotic disease threats

• Food safety threats

• Public interest issues– Animal welfare– Agricultural use of antimicrobials– Land and water protection in rural Canada

• Other forces driving change

Recent zoonoses in Canada• SARS• HIV/AIDS• West Nile Virus• Rabies• Trichinella• Lyme disease• Listeriosis• E.coli• Salmonellosis• MRSA in swine• Cryptosporidia• Giardiasis• Avian influenza • Tularemia• pH1N1 influenza

Emerging zoonoses: increasing speed and complexity of challenges

On average, there is a new, emerging disease every 8 months. Most of these involve multiple species. About 70% of emerging diseases are zoonotic.

Three seminal events: #1

• Zoonotic disease from environmental contamination

• Walkerton – 2000– Canada’s wake-up call to

OWOH environmental issues

– 7 deaths, 2500 illnesses

Other recent environmental threats

• North Battleford – Cryptosporidia– 5800 affected

• Lake Winnipeg – blue-green algae

• Northern communities – water, Hg


• Zoonotic disease from food animal origin

• BSE -2003– Canada’s wake-up call to

animal health issues that affect human health

– Massive trade disruption– Total cost to date…$7-8 B

Other recent animal health issues affecting human health

• Antimicrobial use in food animals

• MRSA

• Salmonella enteritidis

• Bovine tuberculosis

• Dog attacks in northern communities

And last year …pH1N1 influenza

• Triple reassortment– Swine– Avian– Human

• Human risk to animals– not previously

considered


• A zoonotic food-borne illness

• Listeriosis - 2008– Canada’s wake-up call

to food safety contamination

– 22 dead– nation-wide recall

Other recent food safety threats

• E.coli in hamburger (Wpg, Topps meats)• E.coli in spinach (North America wide)• Botulism in carrot juice• Listeria in cheese (Quebec), meat (Canada)• Melamine in pet foods, infant formula from China• Salmonella enteritidis in poultry products

(Canada and US)

Weatherill report on Listeriosis

• Food safety is a multi-jurisdictional, multi-disciplinary issue

• Four broad themes:– Insufficient focus on food safety by senior management

– Lack of a state of readiness to respond – surge capacity, outbreak response

– Lack of a sense of urgency to respond quickly

– Communications was deficient – interagency & with public

Other issues of public interest:

• Animal welfare – higher standards being demanded for food

animals (now OIE chapter on welfare)– egg layer standards in MB

• Agricultural use of:– antimicrobials, pesticides, fertilizers– land and water resources

Looming forces driving change

• Peak oil – 5 yr– Starting now

• Peak food – 5-20 yr– End of the green revolution

• Peak water – 30-40 yr

Population growth by level of development

Population growth by region

NFF warns of food scarcity

July 13, 2010• National Farmers’ Federation President David Crombie

today warned that food scarcity is a reality that all Australians will need to face.

• In fact, the United Nations tells us that farmers need to produce 70% more food over the next 40 years just to keep pace with population growth.

• To put this in perspective, that is more food than has been produced over the entire course of human history.

Physical forces driving change

• Population growth

• Emerging middle classes • Peak oil, peak food, peak water

• 20% reduction in arable land

• Climate change agriculture change

Can we feed ourselves?

You are here

Other societal forces driving change

– Public aversion to risk from zoonoses & food-borne illness – Love-hate relationship with “big agriculture”– Poor economic returns to primary producer, focus on

commodity exports, leading to continued emergency subsidies, farm stress

Public reactiondisconnection from rural roots, organics, buy-local

100 mile diet, anti-GMO lobby, veganism, environmental concerns, urban farming, emerging animal disease / animal welfare concerns

The new reality

• There will be increasing pressure on agriculture to produce food.

• Threats will come from unexpected quarters (eg. monkeypox)

• The “infection pressure” will be constant

• Some threats will get through; some bad things will happen– Economics can no longer be the sole determiner of agricultural decisions

• We need to adopt multiple risk reduction strategies

• We need a nimble, flexible, collaborative framework

One World – One Health

Recognizes interconnectedness of:

Humanhealth

Environmentalhealth

Animal health

One World-One Health: A Strategic Framework for Reducing Risks of Infectious Diseases at the Animal–Human–Ecosystems Interface

Six priority objectives • Develop surveillance capacity • Ensure adequate capacity in public and animal health—including

communication strategies—to prevent, detect and respond to disease outbreaks

• Ensure functioning national emergency response capacity• Promote inter-agency and cross-sectoral collaboration & partnership • Control HPAI and other existing and potentially re-emerging infectious

diseases • Conduct strategic research.

Key principles• multidisciplinary, multinational and multisectoral approach • the integration of technical, social, political, policy and regulatory issues• the establishment of broad-based partnerships across sectors and along

the research-to-delivery continuum. They will include engagement of wildlife and ecosystems interests, the human and veterinary medical community, and advanced research institutions (ARI).

The OWOH way of thinking

• promotes interdisciplinary, cross-sectoral approach to complex issues

• fosters nimble, proactive, flexible way of working

• focuses on surveillance, monitoring, prevention, control and mitigation of emerging diseases

• recognizes the linkages between animal, human and ecosystem health domains.

• Broadly stated, the OWOH concept provides a framework for preventing emerging infectious diseases of animal origin, instead of simply responding to them once they have occurred.

One World One Health

• Adopted internationally

• Developing nationally

• How do we implement locally?

OWOH international consultation

Winnipeg, 2009

A brief look back at the original OWOH:

Historical roots of public & veterinary public health

The One Health forerunner:“One medicine”

Dr. R.L.K. Virchow

Dr. Calvin W. Schwabe

Recognizing the role of veterinary public health

• 1099 CDC investigations (1988-1999)Ashford et al, Emerging Infectious Diseases 2003; 9 (5):515 – “veterinarians may be the first to see evidence of bioterrorism

because pets and livestock may be more susceptible than humans to agents released in the environment, or because susceptible animal population density may be high in the affected area.”

• Flu Finding Supports ‘One World, One Health’ View of People and Animals -Andrew C. Revkin NY Times, 2009– A new study of the evolution of the H1N1 strain of influenza virus

that moved from pigs to people this spring and has since spread worldwide reveals the need for taking a “one health” approach to humans and the animals around us, experts suggest.

http://dotearth.blogs.nytimes.com/author/andrew-c-revkin/

http://dotearth.blogs.nytimes.com/author/andrew-c-revkin/

http://www.nature.com/nature/journal/vnfv/ncurrent/abs/nature08182.html

Today: some baby steps toward OWOH Viewing the animal health-food safety continuum

Producers

Processors

ConsumersManufacturers

National Farmed Animal Health and National Farmed Animal Health and Welfare StrategyWelfare Strategy

• Links animal health, animal welfare, human health, ecosystem health and food safety - OWOH approach

• Emphasizes foresight, preparedness

• Collaborative mechanism for decision-making - Animal Health Council

• Build and support the Infrastructure & Systems (CAHSN-CNPHI linkages)

Federal

ProducersProv-terr

OWOH: our national approach to pH1N1?

• Joint CVO-CMOH WGs– On-farm investigation template– Human surveillance for swine

exposure and vice versa

• Recognized significance (and challenges) of working together

• Further resolution at joint CCVO-CCMOH meeting, Oct 2010

Provincial steps towards OWOH in MBCVO Office: Protecting Animals, Food and People

Our strategy applies to:– Animal health and welfare of

animals under the control of people.

– Food products grown, processed, distributed or offered to the public, whether sold or not

– Veterinary public health hazards resulting from exposure to animals or animal products

Office of the CVO - Strategic outcomes

Priority 1.

Protect people from zoonotic diseases

Priority 2.

Protect food safety and security

Priority 3.

Protect animal health & welfare

Priority 4.

Protect trade

Manitoba’s Animal Emergency Committee – an OWOH-like response mechanism to H5N1

Putting OWOH into practice: MB’s next steps – a formal framework

– 6 provincial departments • health, healthy living, agriculture, labour (OSH), water

stewardship, conservation

– Developing a new way of working • Collaboration= sharing resources, data, personnel• Actively assist each other• Proactive think tank plus issue-specific working groups• Resolve issues at a “lower temperature”• Tackle complex issues that cross two or more departments

Draft collaborative OWOH framework in Manitoba

Steering Committee

DM DM DM DM

Issue WG

Issue WG

Issue WG

Issue WG Issue

WG

Joint recommendations (policy, technical)

Technicalexperts

ADM /

Exec dirThink tank

Down the road issues to address

• Zoonotic disease surveillance (expand to all species, including pets)

• Food protection (work from the front end)

• Develop tools for joint surveillance

• Animal welfare issues will increase

• Environmental issues will increase

• Work together at the national level to effect change…

Key messages

• The speed and complexity of issues is increasing

• We cannot predict when or from where future threats will arise

• No one agency, department or organization can do it all

• The public expects us to be ready and to work together.

• One World One Health offers a framework

“The significant challenges we face cannot be solved at the same level of thinking we were at

when we created them.” A. Einstein

Documents

Veterinary public health -building a One World-One Health framework and way of working Dr Wayne Lees, Chief Veterinary Officer Manitoba Agriculture, Food