Ecosystem approaches to the better management of zoonotic emerging infectious diseases in

Southeast Asia (EcoZD)

Jeffrey Gilbert, ILRICIAT-in-Asia NAFRI, Vientiane

EcoEID Launch WorkshopVientiane, Lao PDR, 12 March 2012

ILRI: Overview

• One of 15 international research centers of CGIAR (Consultative Group on International Agricultural Research)

• Individual Centres set up in 1960s (IRRI 1960, ILRAD 1973, ILCA 1974)

• CGIAR 1971: 19 northern Govts + IGO (FAO,WB,ADB …)• ILRI founded 1994; headquarters in Nairobi, Kenya• ILRI focus – livestock, livelihoods, IAR4D

• ILRI: organized in 4 research ‘themes’: markets, biotechnology, people-livestock-environment, poverty-gender-impact

• CG reform & ‘CGIAR Research Programmes’

CG Reform

To overcome the challenges and exploit the opportunities, the CGIAR has undergone reform. A new Strategy and Results Framework (SRF) will, for the first time, allow the CGIAR centers to function as a unified system, working together to pursue shared goals

The 7 CGIAR Research Programmes* (formerly ‘mega-programmes’) Vision: Reduce poverty and hunger, improve human health and nutrition, and enhance

ecosystem resilience through high-quality international agricultural research, partnership and leadership.

CRP-4: ‘Agriculture for Improved Health and Nutrition’• This research program aims to accelerate progress in improving the

nutrition and health of poor people by exploiting and enhancing the synergies between agriculture, nutrition, and health through four key research components: value chains, biofortification, control of agriculture-associated diseases, and integrated agriculture, nutrition, and health development programs and policies. With IFPRI and ILRI as co-Lead Centers, this program will also involve 10 other CGIAR Centers. It has an initial 3-year budget of US$191.4 million.

* http://www.cgiarfund.org/cgiarfund/research_portfolio

Project Inception

6 countries in SE Asia region; Cambodia, China (Yunnan), Laos, Viet Nam, Indonesia,

Thailand Increase the knowledge, skills and capacity of

research and infectious disease control personnel in Southeast Asia to understand the risks and impacts of Emerging Infectious Diseases and how feasible options can best be implemented and adapted;

wide scope of specific objectives & outcomes – ‘ecohealth’

At outcome level Better network and influencing skills (challenge dialogue) Better capacity in ‘frontline health workers’ Better decision-making based on risk assessment/mitigation Bettter skills among teams in each country to assess EID risks –

including environmental & socio-economic drivers (scenario development)

Project Adaptation

Increase the knowledge, skills and capacity of research and infectious disease control personnel in Southeast Asia to understand the risks and impacts of Emerging Infectious Diseases and how feasible options can best be implemented and adapted;

Focus on‘Learning by Doing’ approach – Forming the country teams – extended period of

planning & finalising research proposals & contracts EcoZEID >> EcoZD 2D capacity building EH/OH v intra-disciplinary

Less focus on risk (driven by partners preferences) Less direct focus on ‘frontline health workers’ Challenge Dialogue & Scenario Development Outcome Mapping chosen as M&E Need for local EcoHealth Resource within SE Asia

EcoHealth Resource Centres CMU & UGM

Project Consolidation

This will no-cost extension period from 1st March – for 18 months

Central to all of EcoZD is ‘Learning by Doing’ approach

Outputs anticipated by all 8 components Research Training Communications

Synthesis of 8 components Resource Mobilisation

EcoZD: Components

Country Teams choices for research:Cambodia: zoonotic risks for acute dysenteryChina (Yunnan): Brucellosis (& Toxoplasmosis)Indonesia: Rabies - BaliLao PDR: pig zoonoses (& non zoonoses)Thai-Viet: hygiene in small-scale poultry slaughterhousesViet Nam: zoonoses priority ranking

‘EcoHealth’ Resource Centres:Chiang Mai UniversityUniversity of Gadjah Mada

Cambodia

Partners:•Centre for Livestock Development (CelAgrid, NGO)•Department of Animal Health & Production•Department of Communicable Disease ControlResearch•Review of public health data: diarrhoea reporting by SMS•Choice of various low & high incidence areas (pilot sites)•Household surveys: Questionnaires & PRA•Longitudinal survey will follow selected households with laboratory sampling•Expected outputs – to ascertain proportion of acute dysentery in rural households attributable

China – Yunnan province

Partners:•Academy of Grassland & Animal Sciences•Animal Science & Veterinary Institute•Agriculture University•Institute of Endemic Disease Control & PreventionResearch:•Determine Brucellosis prevalence and priority in pilot areas by compiling retrospective data, undertaking cross-sectional surveys.•Toxoplasmosis surveys

Indonesia

Partners:•Centre for Veterinary & Analytical Studies (CIVAS)•Disease Investigation Centre Denpasar•Other expertsResearch:•Dog ecology: behaviour, demography , movement, fecundity•Socio-cultural relationship between people & dogs•Community Engagement (dog registration, sterilisation)

Lao PDR

Partners:•Department of Livestock Production, MAF•Department of Hygiene & Prevention, MoH•National Agriculture & Forestry Research InstituteResearch:•Prioritising pig diseases – both zoonoses & non-zoonoses, by questionnaire and sampling 30 villages in northern & southern provinces•Focus Group Discussions to add to cross-sectional survey•Communications & feedback•Building on earlier research by ACIAR, and indeed followed by further ACIAR project

Thailand-Vietnam

Partners:•Chiang Mai University, Veterinary Faculty•Department of Livestock Development•National Institute of Veterinary Research, Hanoi•Sub-department of Animal Health, Hanoi•(Originally China involved)Research:•Improving hygiene in small-scale poultry slaughterhouses, beyond the upgrade hygiene produces better quality of product - issues of sustainability, policy implications•Interview of slaughter-house owners, workers, market traders etc

Vietnam

Partners:•Pasteur Institute•Nong Lam University•Department of Animal HealthResearch:•Original focus priority ranking of zoonoses•initial expert opinion for priorities•determination of ‘hotspots’; cross-sectional to compare hotspot & other areas, but limited data•cross-sectional surveys in pilot areas to ascertain community priorities, challenges on how to focus•Focus now on leptospirosis

Challenges: What language are we talking?

Lingua franca Eg Latin America/ EcoSalud ‘Lost in translation’

Biomedical v Social Sciences Medics & Vets (clinical / laboratory / epidemiology) Quantitative v Qualitative (ranking, dual health burden) Researchers, Decision Makers, Communities

Novel approaches to holistic integrated approaches One Health One Medicine EcoHealth Inexact / broad interpretation v H5N1

Case studies & publications

Challenges: Resource & Scope

Human ResourcesSupply & Demand

Language Technical – including proposal writing/ methodology / analysis /paper-writing Market forces operating

Identifying Champions (including to implement & to mentor)Level of counterparts (senior v junior)Scope of EcoZD‘Carte blanche’ v prescriptiveLearning by doing (& making mistakes!)Priority zoonoses +/- EIDEcoHealth approach – new ‘paradigm’Two-dimensional capacity-building requirementGreek temple analogyEHRC concept

‘EcoHealth Resource Centres’

Partners:•Chiang Mai University, Thailand•Gadjah Mada University, Yogyakarta, Indonesia

Development•Need for local capacity building•Target audience of undergraduates/postgrads – more open-minded(?)•Need to engage senior academics•Multiple disciplines (faculties) ‘under one roof’

‘EcoHealth Resource Centres’

• Provision of relevant training for staff, students and outside participants;

• Promotion of knowledge sharing and assimilation through making available books and peer-reviewed publications;

• Conducting multi/trans-disciplinary EcoHealth research activities involving post-graduate students;

• Preparing publications – from desktop/retrospective and prospective research; also position papers;

• Providing advocacy for EcoHealth – other universities, government and communities.

International Livestock Research InstituteBetter lives through livestock

Animal agriculture to reduce poverty, hunger and environmental degradation in developing countries

www.ilri.org

e-mail: J.Gilbert@CGIAR.ORG