Delivering one health Asia/ASEAN

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Emergency Centre for Transboundary Animal Diseases for Asia and the Pacific

Food and Agriculture Organization of the United Nations

ECTAD - RAPAGA-TCE

Delivering “One Health”in Asia/ASEAN

Emergency Center for Transboundary Animal DiseasesFood and Agriculture Organization of the United Nations

Regional Office for Asia and the Pacific



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Outline

• What is “One Health”?• Why do we need it?• Delivering “One Health”



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Lessons learned from HPAI...• Disease is a multi-factoral

problem• Economic development and

disease occurrence• Roles of wild life in disease

transmission and being disease reservoirs

• Understanding disease epidemiology and foresight assists in disease control planning



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Lessons learned from HPAI...• Impacts from disease and cost-

benefit as well as consequences of disease control

• Political commitment• Countries’ capacity is additional

problem to financial aspect• Risk communication and public

awareness• Disease control requires multi-

sectoral and multi-disciplinary approach



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What is “One Health”?



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Definition of “One Health”• The collaborative effort of multiple disciplines working locally,

nationally, regionally and globally to promote optimal health of humans, animals and the environment (Lonnie King)



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Scope of “One Health” according to FAO• Transboundary Animal Diseases• Zoonoses• Emerging and Reemerging Infectious Diseases• Environmental health including wildlife health• Livelihoods • Food security and safety• Multidisciplinary approach• Prevention• Ability to deal with unknown• Proactive rather than responsive



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Chronology of Key One Health Events

Wildlife Conservation Society, 2004 – One World One Health ConceptManhattan Principles

Recommendations from International Ministerial Conference for Avian and Pandemic Influenza (IMCAPI), New Delhi, 2007

Several planning meetings 2008

Several events in 2009-10

Several events in the past 12 months

IMCAPI 2008Sharm el

Sheikh

STRATEGIC FRAMEWORKwith key concepts

IMCAPI 2010Hanoi

FAO-OIE-WHO Collaboration Concept Note on health risks at the human-animal interface

Meetings at country level, ICVS, UNSIC, APEC, FAVA, Melbourne



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Key points being raised and discussed in previous meetings related to “One Health”

• Different understanding of “One Health” (OH) • Importance of OH is not recognized by all

stakeholders and varying support for implementation at all levels

• Managing trans-sectoral collaboration and coordination is a challenge,– Scientific evidence especially those related to emerging

diseases is not available to support decision making and to implement OH, If available, no capacity of the concerned authority to apply

• Countries request for guidance to operationalize OH



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Why do we need it?



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Changing World • Increasing human populations• Rapid economic development • Rapid urbanization

• Huge demand for livestock products

• Rapid evolution of farming systems

• Bush meat consumption• Pathogen adaptation• Different in socioeconomic

development and traditional livelihood

• Climate change• Deforestation



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• Forest encroachment– close proximity between livestock,

human and wildlife (Nipah, Hendra and Ebola...)

• Consumption of bush meat• Eating behavior and hygiene• Exotic animal farming• Climate change

– Vector ecology and distribution (RVF, Bluetongue, Malaria, Dengue, Chikungunya )

– Invading pathogen adaptation in new vectors

– Migratory patterns

Risks



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Asia: A major hotspot of disease • Two areas in Asia, GMS and Gangetic plain being identified as hotspots for

emerging infectious diseases related to domestic and wildlife animals, vector-borne diseases and drug resistant problems (Nature, February 2008)

a – Zoonotic/wild, b – Zoonotic/domestic, c – Drug resistant, d – Vector-borne



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Zoonotic diseases of interest for Asia

Status Diseases of interestEndemic diseases Anthrax, Brucellosis, JE,

Parasitic zoonoses, Rabies,

Reemerging diseases from previously endemic

Leptospirosis, TB,

Parasitic zoonoses (Cysticercosis, Trichinosis, )

Potential emerging disease from importation and wildlife origin

Nipah virus, BSE, Ebola Reston, West Nile virus

Potential pandemic Other influenza???

Drug resistance



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Delivering “One Health”?



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Issues being concerned

• Recognition of OH importance for support

• Challenge in managing tran-sectoral collaboration and coordination

• Insufficient decision-making based on scientific evidence

• Not enough capacity to apply OH• Countries request for guidance to

operationalize OH

• Advocacy• Strengthening coordination and

collaboration across sectors and disciplines– Country, regional and global

• Capacity building– Long-term approach– Immediate to produce scientific

evidence for prevention purpose

3 major areas in focus

Pilot projects at country level



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Specific Activities in 2011 Advocacy• Encouraging OH dialogue among sectors at country and

regional level: Expanding from HPAI work –involve not only animal and human health but also relevant wildlife and eco-health sectors– At regional and international levels, Collaboration among

ASEAN, SAARC, OIE, WHO, FAO as well as major development partners is required to address gaps and needs of member countries.

– Global public good should also be recognized by member countries.



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Specific Activities in 2011 Strengthening coordination and collaboration

across sectors and disciplines• Epidemiology and Laboratory Networks

– Principle of networking is to share expertise and information as well as enhancing collaboration and cooperation

– Expanding scope from HPAI to cover other priority diseases – Linking to other networks at global level such as OFFLU

(OIE/FAO Animal Influenza Network)• Developing an Action Plan for promoting One Health

and increasing its understanding, acceptance and adoption across key sectors of government and society



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Example of community networks that can be used as platform for “One Health”



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Specific Activities in 2011 Capacity building in veterinary epidemiology• Regional Field Epidemiology Training Program for

Veterinarian (FETPV)– Thai Department of Livestock Development (DLD) is

hosting in collaboration with Ministry of Public Health with support from a few international organizations

– Regional strategy is being developed for longer-term purpose

– Integrating other components related wildlife, socio-economic and communication

– Benchmarking with other existing epidemiology training programs in the region

– Expanding FETPV to country level –China, India– Need to link with Regional Epidemiology Network



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Specific Activities in 2011 Capacity building in laboratory diagnosis• Capacity building at the country level for agreed set

of diseases at regional level– Human resource and laboratory facilities

• Regional program for quality assurance and control for laboratory testing to improve capacity

• Need to link with Regional Laboratory Network– Strengthening the ability of country to deal with unknown

• Referral system to World Reference Laboratory• Establishing appropriate sample bank for necessary

retrospective studies especially for wildlife



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Specific Activities in 2011 Key/more formal pilot projects(case studies at country level)• Thailand

– Linkage of Thai FETPV and FETP with possibility to expand to involve wildlife group and private livestock producing sectors

– Partnerships with Government Research Funding Agencies and Thai universities to study “Animal-Human-Ecosystem Interface” using bats and Nipah Virus Infection as a model

• Involve 3 sectors –animal, human and wild life health• Participatory learning process using multi-disciplinary approach at

community level for veterinary student at undergraduate level

• Indonesia– “Rabies Control in Bali”-FAO TCP

• More to come from the country proposals

Technology

Delivering one health Asia/ASEAN