THE ROLES OF VETERINARIANS TO ACHIEVE “ONE WORLD ONE HEALTH”
by-DR. RAJESH KUMAR SINGH, (LIVESTOCK & POULTRY CONSULTANT), JAMSHEDPUR, JHARKHAND,INDIA 9431309542, rajeshsinghvet@gmail.com
One the occasion of Doctors day i.e 1st July, it is necessary to correlate the role of Medical professionals with their counterpart , Veterinarians in “one world one health” mission.
The veterinary profession has the independence, integrity, knowledge and skills to provide the consumer with reassurance that their expectation of high food safety, human and animal welfare as well as environmental standards has all been met – all the way from farm to fork.
One Health is the integrative effort of multiple disciplines working locally, nationally, and globally to attain optimal health for people, animals, and the environment. Because of their expertise, veterinarians play critical roles in the health of animals, humans, and even the environment, but these roles are often overlooked or unrecognized. Nonetheless, veterinary medicine is the only profession that routinely operates at the interface of these three components of One Health.
The term ‘One Health’ could be defined as the interdisciplinary approaches and actions involving strong cooperation primarily between physician and veterinarian so that health of people and animals could be ensured including the safety of the environments through with improved cooperation between physicians and veterinarians. The concept of ‘One Health’ represents a unique and significant opportunity for veterinary medicine to be in a leadership role and to work collaboratively for ecosystem health (a community of humans, animals, and plants interacting with one another and with their physical environment) for the greater good of sense. According to the American Veterinary Medical Associate , about 75% of the emerging human infectious diseases are directly or indirectly linked to animal e.g., zoonotic in nature. This phenomenon highlighted the importance of health scientists (veterinarians, physicians, etc.) working together as co-equal teams. Dealing with the implications of this information requires nothing less than a holistic, collaborative approach among all scientific disciplines involved. Due to urbanization, globalization, deforestation, changes in human ecology and behavior, animal has come more closely and close to people resulting transmission and emergence of infections in both directions. Faced with these complexes, it is crucial for two health professions (Physicians and Veterinarians) to work more closely together for better animal and human health, Better education should be provided to the next generation veterinarians and physicians to improve knowledge of ecosystem health and an understanding of the intricate and sometimes delicate relationship between animals, humans, and the environment. In addition, leadership training for veterinarians and physicians is needed to prepare both professions for greater roles in influencing policy development and fulfilling the needs of society.
BRIEF HISTORY OF ‘ONE HEALTH’
‘One Health’ is a new phrase, but the concept was originated as far back as to the time of Aristotle in 500 BC and Hippocrates of Cos in 340 BC. Aristotle wrote the ‘Historia Animalium’ to elaborate on the natural zoonotic history of animals. Effect of environmental factors on human health could be traced by the Greek physician Hippocrates (c. 460 BCE – c. 370 BCE) in his text ‘On Airs, Waters and Places’. Hippocrates provided insight on other possible causations for disease in the human body, not just from ‘humor’ imbalances. The Italian Physician Giovani Maria Lancisi (1654– 1720) also talked on the role the environment in the spread of disease in animals and humans. Lancisi is one of those few people who first suggested on the mosquito nets for prevention malaria in humans (Drake, 1832) but was also a pioneer in the control of rinderpest in cattle. Later on, Louis-René Villerme (1782–1863) and Alexandre Parent-Duchatelet (1790– 1835) talked about linkages of human and animal health with environment and developed the specialty of concept of public hygiene (LaBerge, 1992). Although human medicine developed many years back, the veterinary medicine appeared as a distinct discipline in China during the dynasty of Zhou between 11th to 13th century (Driesch and Peters, 2003). However, in 1762, the first veterinary school was established in Lyon, France. The term ‘zoonosis’ was first sued by the German physician and pathologist Rudolf Virchow (1821–1902) in 19th century. Canadian physician Sir William Osler (1849–1919) was one of the pioneers appointed as faculty combindly to work in the
Montreal Veterinary College and the Medical School of McGill University (Kahn et al., 2007). In USA, James H. Steele, a veterinarian with DVM (Doctor of Veterinary Medicine) degree first established the veterinary public health section at the CDC (Waddy, 2009) in 1947. The term ‘One Medicine’ was developed and promoted by veterinary epidemiologist and parasitologist Calvin W. Schwabe (1927–2006) in 1984. The work of visionaries like Steele and Schwabe began to slowly influence veterinary medical and medical school curricula and public policy, as well as the approach to research of both groups. Among the many ‘One Health’ research models in the early 21st century, veterinarian orthopedist Dr. James L. Cook and physician orthopedist Dr. Sonny Bal at the University of Missouri have collaborated for over eight years on efforts to develop knee and hip replacements for humans and animals. Indeed, Dr. Cook’s original development of using laboratory-grown cartilage for knee and joint replacement in dogs is being studied by Cook and Bal for adaptation to humans. In 2003, the term ‘One Health’ draw the attention across the globe since it was mentioned in Washington Post by Dr. William Karesh to describe the outbreaks of Ebola hemorrhagic fever in Africa. He said, ‘Human or livestock or wildlife health can’t be discussed in isolation anymore. There is just One Health. And the solutions require everyone working together on all the different levels’ (Weiss, 2003). This was followed by a series of conferences across the glove with the theme of ‘One World – One Health’.
THE ROLE OF VETERINARY PROFESSIONALS TO ACHIEVE “ONE HEALTH”
In the last 30 years, the prevalence of infectious disease has increased such that 75% of the emerging infectious diseases in humans are of animal origin. The increasing occurrence of emerging infectious diseases indicates that bridging animal, human and environmental health through the ‘One Health’ concept is becoming even more critical. Veterinarians can ideally provide this bridge with their in-depth understanding of biological systems, knowledge of disease processes and epidemiology, experiences with diagnosing and managing diseases in large populations of animals, and success in eliminating and preventing infectious diseases . Veterinarians can be, and often are, the first line of defense for zoonotic diseases as well as for various toxicants that occur naturally or by intentional terrorist attack. Veterinarians are in contact with a wide variety of domestic and free-ranging animals, effective and efficient diagnostic systems, and local and national regulatory systems for animal health, food safety, and public health . Besides the role of veterinarians to control zoonotic diseases, a more integrated approach would identify the factors that promote infectious disease emergence as well as non-infectious diseases like cancer, cardiovascular disease, obesity, orthopedic conditions like osteoarthritis; more specifically, human joint prostheses developed primarily by veterinarians in animals continue to serve as significant models for human surgical replacements of knees, hips and other joints. Also, the first flexible coil balloon expandable intracoronary stent was developed for humans by a research team including an interventional physician cardiologist (a former veterinarian) and a pathologist veterinarian in the early 1990s. Nearly 100 percent of patients undergoing balloon angioplasty for ‘heart attacks’ from heart vessel blockages receive stent. One Health approach provides the opportunity for the veterinarian to collaborate intimately with the physician, public health officials, wildlife and environmental health professionals for better understanding of diseases affection human being and animals
Veterinarian and public health—————
More than half of all human diseases are animal originated, caused by multi-host pathogens. Effective prevention and control of infectious diseases at the animal-human-ecosystems interface is the key to prevent the spread of diseases in animals and humans, enhancing food security and fostering poverty reduction. Increased transparency in the animal health situation contributes to better public health. All activities of animal science affect human health either directly through biomedical research and public health or indirectly by addressing domestic animal, wildlife, or environmental health. The Veterinary research transcends species boundaries and includes the study of spontaneously occurring and experimentally induced models of both human and animal disease and research at human-animal interfaces, such as food safety, wildlife and ecosystem health, zoonotic diseases and public policy (Mazet et al., 2009). By its nature, veterinary science is comparative and gives rise to the basic science disciplines of comparative anatomy, comparative physiology, comparative pathology, and so forth; but its ability to reach its peak potential relies on adequate infrastructural, financial, and human resources. These veterinarians partner with zoologists and conservationists, and are often at the fore of emergency relief to treat animals affected by forest fires, oil spills, and other natural disasters, which not only affect wildlife, but also farm and companion animals. Trained veterinary professionals, such as those in Public Service and Food Inspection, work to promote food security and ensure that food from animals is safe to ship and eat (Institute of Medicine, 2012). Through stringent inspections and controls prior and after slaughtering, meat safety is continuously checked. At all phases of the production and distribution of food from animal origin they are involved in preserving its hygiene and safety. The veterinarian is committed professionally and morally with the community, whether rural or urban. Since a born volunteer, he forwards his knowledge to the community as a whole to improve his environmental education and health, to improve the quality of our life. Globally, veterinary service literally means the difference between life and death not only for animals but also for humans as majority of world’s poor population depends on animals for food, income, social status or cultural identification, companionship, security, where there is nothing more important than taking care of the animals that allow adults to work, families to earn and children to eat. This situation became evident when Hurricane Katrina devastated New Orleans, those rescuers were surprised when people from flooded houses refused to leave without their pets. Here the veterinarians intervened in this third world life style and in getting their household improved through innovation in their livestock rearing by providing them technical, financial and moral support.
DEVELOPING COLLABORATION
The emerging of various infectious diseases worldwide resulting from the changing in ecology, agriculture practice, climatic conditions, animal migration, virulence, host resistance etc. poses an increasing threat to people, livestock and wildlife (Pal, 2013). Most of these pathogens are bacteria or virus that over the period of time somehow gets more virulence to trigger such diseases. Many of these are moreover zoonotic in nature. A strong collaboration between the veterinarians and physicians are essential along with other expertise to combat such emerging infections under the umbrella of ‘One Health’. Various organizations organized meetings, conferences and workshops to promote such collaboration among the concerned veterinarian, physician, environmental professionals and so on. For example, in 1999, the Wildlife Diseases Association and the Society for Tropical Veterinary Medicine and organized a series of conferences under the banner ‘Working Together to Promote Global Health’. Later on, in 2001, the second series of these conferences were organized at Pilanesberg, South Africa on animal disease control, conservation, sustainable food production and emerging diseases . The resolutions of the conferences were known as ‘Pilanesberg Resolution’. The details of the resolutions published by Kaersh et al. (2002) are available now. Lee and Brumme (2013) later on mentioned as ‘Pilanesberg Resolution’ as one of the key events to the early development of ‘One Health’. Around that time in New York, the WCS (Wildlife Conservation Society) organized another conference to focus the importance of understanding wildlife diseases and ecology to address the emergence of new diseases, and introduced the term ‘One World-One Health’ which embraced both the ecosystem health and medicine. The recommendation of this meeting to promote human and animal health is now known as the ‘Manhattan Principles’ because that the meeting was hosted by Rockefeller University in Manhattan area at New York (Gibbs, 2014). The scopes of ‘One Health’ are vast and there are opportunities to develop cooperations among many disciplines under the umbrella of ‘One Health’.
CHALLENGES AHEAD
There are several challenges ahead that need to be addressed carefully to ensure the implementation of ‘One Health’ concept. Several veterinary and related concerned professionals have already expressed their concerns over the effective implementation of ‘One Health’ as ‘One Health’ is also discussed under direct or indirect influence of burning global issues e.g., climate change and poverty. ‘One Health’ has attracted the attentions of health policy analysts, social scientists, and humanities scholars . In addition, joint collaboration among the various disciplines has been recognized as the core of ‘One Health’ concept. To overcome the challenges more close association among the veterinarians, physicians, other related professionnals, and all the stakeholders are needed. In addition, the complex interrelated ecosystem of animal and human also needs to be preserved in such a way that none of its components are disturbed. Moreover, it will also be necessary to develop improved tools and models to predict where and when outbreaks are most likely to occur . The aboves will require significant research activities that will involve microbiologists. It will be necessary to develop point-of-contact techniques for diagnosing and treating endemic diseases to ensure that the appropriate biologic samples are transferred to reference laboratories in a timely manner. Systems analysis will also need to be developed and applied to improve identification and movement of samples. Predictive models using human and animal biologic samples would have to be tested if we are to properly identify risk factors for zoonotic disease spread and ways to combat emerging infectious diseases . But, all these challenges could be addressed for a better world if sufficient fund are made available from Government, Private, National, Regional and International organizations.
CONCLUSION
The main concept of ‘One Health’ is based on multidimensional integrated collaborative efforts involving various disciplines working locally, nationally, regionally and globally to generate optimal health for humans, animals, and the environment. Without an integrated approach involving humans, pet animals, livestock, wildlife and their social and ecological environment, it is not possible to ensure their optimum performance, Despite several achievements of ‘One Health’ for example control of Avian Influenza HPAI H5N1, more collaborations are crucial to connect subject matter experts from different disciplines originating from local, regional, national and global level for better ‘One Health’ activities to ensure safe health and a better world.
