One Health Symposium 17-18 March 2016

ZSL, London Zoo

Session III

Jan Slingenbergh

“The FAO/OIE/WHO Tripartite: an institutional void?”

WHO/FAO/OIE Tripartite

Jointly operating at the human-animal health interface:

- WHO, FAO, and OIE seek to build the capacity of member countries to detect, assess, notify and respond to the nexus of public health, food safety and animal health threats.

- WHO international health regulations are designed to protect public health

- FAO/WHO Codex Alimentarius develops harmonised international food standards toprotect the health of consumers

- FAO undertakes animal disease control campaigns, and addresses biosafety concerns in the food chain

- OIE, the World Animal Health Organisation, sets animal health standards in support of safe and fair livestock trade practices

- OIE and Codex both address food safety and other veterinary public health issues

World Health Organization, brief history Main disease concerns

1851 - first International Sanitary Conference cholera1892 – International Sanitary Convention cholera1897 – International Sanitary Convention plague1902 – International Sanitary Bureau

(forerunner of PAHO)1907 – L’Office International d’Hygiene Publique1919 – Health Organisation of the League of Nations1926 – International Sanitary Convention smallpox, typhus

1946 – Constitution of the World Health Organization1948 – World Health Organization First Assembly malaria, tuberculosis,

(budget of US$ 5 million) veneral diseases,maternal and child health

- 1960s - campaigns againstyaws, endemic syphilus, leprosy, and trachoma

- 1970s - smallpox eradication

- 1980s - polio eradication launch- river blindness

Ref. THE LANCET Vol 360, October 12, 2002 www.thelancet.com

Late 20th century shifting from existing to new diseases:

- HIV/aids- SARS- Bird flu- Pandemic flu- MERS- Ebola- Zika

New era:Animal viruses newlyshowing up in humans andposing pandemic threats

Food and Agriculture Organization, brief history Main concerns

- 1904 David Lubin traveled from the US to Italy agricultural researchto meet King Vittorio Emanuele III intergovernmental body

- 1905 International Institute of Agriculture founded support to farmers- 1906 forty states signed up

IIAforerunnerofFAO

Food and Agriculture Organization, brief history

President Theodore Roosevelt

June 1906

transmitted to the Senate, message on

International Institute of Agriculture

referring to the Convention signedJune 1906 at Rome

Sir John Boyd Orr, First FAO Director General, Winner of the Nobel Peace Prize

In the years preceding the Second World War, one third of the population of the United Kingdom suffered from poverty-induced malnutrition, with poor health caused byinsufficient consumption.

16 October, 1945

Representatives of 34 nations signed the constitution of the

Food and Agriculture Organization of the United Nations

May 1946, World Food Board

FAO convened a special Meeting on Urgent Food problems,upon request by Sir John Boyd Orr, Director General.

The Food Board would end hunger through a three pronged system- credits- price regulation & buffer stocks- distribute famine relief

Failure of the World Food Board

The Conference did not follow up on any Boyd Orr’s Substantive recommendations

Boyd Orr was acutely disappointed

He resigned the post of FAO Director General

cold war?

Instead, the preamble to the FAO constitution:

- Raising levels of nutrition

- Efficient production and distribution food and agricultural products

- Bettering conditions rural populations

- Still, 20 years later,

- Freedom from hunger for all mankind was (re-)inserted

Freedom from Hunger

remained the ultimate objective

Short history of the OIE Ref. http://web.oie.int/eng/OIE/en_histoire.htm

1920 – rinderpest occurred unexpectedly in Belgium, Antwerp port

1924 – International agreement obtained by 28 states on Office International des Epizooties

1927 – Agreement had been ratified by 24 countries and first General Session held in Geneva,Prof. Leclainche appointed first Director

1928 – First General Session, Geneva, 8 experts established basis for international sanitary police

The United Nations established FAO in 1946 and WHO in 1948.

“Their aims partially covered those of the Office. The presence of these two Agencies called the existenceof the OIE into question and the possibility of simply dissolving the organisation was envisaged in 1946, and again in 1951. Thanks to the opposition of numerous OIE Member Countries and Delegates, thefunctions of the Office were kept alive. “

1952 - OIE / FAO Agreement

1960 – OIE / WHO Agreement

On the issue of Animal Health and FAO vs OIE

Excerpts from FAO/55/6/3897 Report of Meeting of an ad hoc Committee on Animal Health

Notes on FAO Veterinary Meeting held in London 13-15 August 1946

“Important point stressed:

The Paris Bureau of Epizootics came under serious discussion.

1. Leclainche thinks it should remain free from FAO control but have the support and assistance of that body. He suggests that an effort be made to have as many other countries as possiblebrought into the Bureau ranks and so strengthen the Bureau. (USA and Canada are at present not included). Several members feel it would be advisable to have the Bureau placed under thedirect jurisdiction of FAO or under a Standing Committee to be formed by FAO. They hesitate tohurt LeClainche who has for so long headed the Bureau.

2. A permanent Standing Committee which would control all animal health matters was recommended. This committee would probably take charge of the Bureau….

…..

4. Rinderpest was discussed as an example of a serious disease requiring worldwide control.”

Major disease campaigns supported by FAO:

1954 – European Commission for the control of foot-and-mouth disease, vested in FAO HQs in Rome,one of FAO’s oldest Commissions, continues till today, operating globally;

1960s – Field programme support for rinderpest prevention and control in Africa and Asia;

1970s – Tsetse and trypanosomiasis control in Africa;

1980s – Ticks and tick borne diseases in East and Southern Africa; control of CBPP, brucellosis, helminths

1992 - launch progressive control rinderpest;

1994 - Global Rinderpest Eradication Programme (GREP)

Some of the inter-continental scale novel disease dynamics:

1980s – BSE, new prion disease in cattle1980s - first introduction Old World Screewworm myiasis in Gulf countries1988 – 1992 Screwworm Emergency Campaign North Africa (SECNA),

first introduction New World Screwworm myiasis in the Old World1990S - introduction of Rift Valley Fever into arabian peninsula1999 – first flare up West Nile Virus in USA, to assume subcontinental scale proportions2004 – first major epizootic H5N1 avian influenza South-East Asia2005 – first H5N1 avian influenza panzootic wave2000s – Bluetongue viruses newly encroaching Mediterranean basin and Europe

rabies newly spreading with wild carnivores across eastern Europefirst outbreaks Henipah viruses Asia and Oceania

2007 – African Swine Fever starting to spread across Caucasian countries, Russian Federation and eastern parts of Europe

2009 – new, pH1N1 re-assortment of avian, swine and seasonal flu genes2011 – Schmallenberg virus first encroaching Europe2014 – new MERS-CoV found to be widespread in camels in Kingdom of Saudi Arabia

New geographic invasions, species and virulence jumpers

OIE adapting to the emergence of novel diseases…

FAO/OIE (WHO) Animal Health Year Book 1955 – 1995 series

Containing information on the occurrence of major, classical livestock and zoonoticinfections and diseases as reported by countries from around the world to FAO and OIE

By mid 1990s the AHYB had turned obsolete and OIE undertook to revise the system and, eventually, create a novel, World Animal Health Information Database (WAHIS) Interfacefor realtime reporting of old and new diseases.

Human

living

environment

Food

and

agriculture

Natural

ecosystems

Three “animal” typehost domains

with species jumpsand microbialexchanges goinginto 6 directions

4620 mammal spp

17 main livestock spp

Medical and veterinaryhealth protection bias

Changing Disease LandscapesWorld Livestock 2013

Forestedareasconvertedintopastureandcroplandfrom2005 – 2050

Viruses out of African forests

Yellow feverDengueHIVChikungunyaEbolaZika

inner-body virusesinfected carriersarbo transmission endemicityno livestock

Unlike Asia…..

Virus life history

Diseasedrivers

infection – transmissiondynamics

Disease emergence out of Asia…..food & agriculture / livestock

Avian influenzaSwine influenzaPandemic influenza

SARS CoVMERS CoV

NipahHendra

epithelial viruseshoriz. transmissionerratic epidemicslivestock involvement

Virus life history

Diseasedrivers

infection – transmissiondynamics

Major strengthening? YesBroadening up? YesMore focus? Yes

Still, more is needed at the animal – human interface

In order to stop pandemics from happening.

Drivers are currently not considered; mitigation is not even on the table!

Nobel prize winning institution: Intergovernmental Panel on Climate Change

Conclusion

Drivers- nrm, land use and ecohealth (Africa)- safer pig and poultry production (Asia)- address food, health and income as nexus (developing world)- safer trade and travel (global)- less global warming (global)- ……

DRIVERS

Afford shift to the left, progressively reducingboth endemic diseasesprevalence in resource poor settings andpandemic threats.

The IPCC 2 degrees Celsius equivalent

Intergovernmental Panel on Pandemic Threats

IPPT PlenaryIPPT Bureau

IPPT Executive Committee

IPPT Secretariat

Task Forceon

NationalAnimalVirus

Inventories

WorkingGroup I

The Life andSocial Science

Basis

WorkingGroup III

Mitigation of Pandemic

Threats

WorkingGroup II

PandemicImpact and

Preparedness

40% 30% 1% 5%

= estimated current coverage of what may be required globally