One World, One Health: Prevent Zoonoses
Dr. Anita Tewari
Assistant Professor, Department of Veterinary Public Health & Epidemiology,
College of Veterinary Sci. & Ani. Husbandry, Rewa (NDVSU), Madhya Pradesh
Abstract
The increased incidence of emerging and re-emerging zoonotic diseases in the past three decades and the more recent COVID-19 pandemic have clearly shown that pathogens know no boundaries. Thus, we must adopt an approach that unifies human and animal health beyond borders. Sensing the need, the Joint Tripartite WHO-FAO-OIE plus UNEP introduced the “One Health” concept. One Health allows recognizing shared interests, setting common goals, and moving toward teamwork to benefit global health. Moreover, with 75% of emerging infectious diseases being zoonotic, a transdisciplinary, multi-sectoral “One World-One health” approach is a key strategy for their effective prevention and control. Battling with zoonoses needs to focus on animal, human, and ecosystem interface with commitment at all levels –international, regional, national, and local.
Keywords; One Health, zoonoses, human health, animal health, WHO, OIE, FAO
THE RISK OF ZOONOSES:
Animals have played an essential role in the evolution of humans. Since the stone age, animals and humans have depended on each other for food, transportation, agriculture, security, war or recreational activities, etc. However, at present, globalization and industrialization have led to the spread of infections/ diseases shared between humans and animals. In the nineteenth century, physician Rudolf Virchow recognized the resemblances between animal and human medicine and coined the term ‘zoonosis’ for infections acquired from animals (Mackenzie et al., 2014).
As defined by World Organization for Animal Health (OIE), zoonoses are those diseases which naturally transmitted from vertebrate animals to humans and vice-versa. The pathogens responsible for causing zoonotic diseases can be viruses, bacteria, parasites, fungi, toxins, prions, or other agents. According to the Centers for Disease Control and Prevention (CDC, 2021), 60% of all existing infectious diseases have zoonotic potential, of which almost 75% of emerging infectious diseases originate from animals. Unfortunately, almost 80% of potential bioterrorism agents are also of animal origin with zoonotic nature (Gonzalez & Macgregor-Skinner, 2014). According to the International Livestock Research Institute, in India, mainly thirteen zoonotic diseases are responsible for causing 2.4 billion cases of human disease and 2.2 million deaths per year (Kumar et al., 2020).
In recent decades, the rising interdependence of humans on animals and their products and close association with pets led to emerging and re-emerging zoonoses (Kumar et al., 2020). The past three decades have witnessed the emergence of severe and readily transmissible novel diseases, including SARS, Ebola, Marburg, monkeypox, AMR staphylococcus, MDR TB, HPAI H5N1and many more (Baker et al., 2022). We, particularly, recognized the role of wildlife as the source of potential pathogens. Therefore, to generate awareness among common people, World Zoonoses Day is celebrated every year on July 6th, remembering the historical day when Louis Pasteur’s first rabies vaccine was first administered to a human in 1885 (Rappuoli, 2014).
Since zoonosis includes animals and humans, the “one health” approach addresses both animal and human health in an integrated manner. Therefore, the Honorary Director General of the OIE, Dr. Bernard Vallart, once said, “We must bear in mind that the fight against zoonoses begins with the elimination of the pathogen at its animal source of infection.”
THE EMERGENCE OF ONE HEALTH CONCEPT:
The one health concept is not new; our ancestors already knew that the health of people, animals, and the environment are intimately connected since their origin (Mackenzie et al., 2014). However, recently, zoonotic diseases, being a global problem without borders, have gained urgent attention from the World Health Organization (WHO) and other international organizations such as the Food and Agricultural Organization of the UN (FAO), and the World Organization for Animal Health (OIE). In a global summit, Dr. A.G. Tedros, WHO Director General, stated, “Any effort in human health is ‘doomed’ without animal health.” Therefore, in 2008, the three chief international organizations associated with animal and human health – the UN FAO, OIE, and WHO – collaborated with the World Bank, UNEP, and other important Coordinator to develop a joint strategic framework to tackle the ever-increasing risk of emerging and re-emerging zoonotic diseases (WHO, 2017; CDC, 2022). The Joint Tripartite WHO-FAO-OIE plus UNEP introduced the “One Health” concept.
The extent and scope of One Health are so wide that it is difficult to find a suitable definition that covers all aspects of this concept. However, according to CDC, “One Health is a collaborative, multisectoral, and transdisciplinary approach-working at the local, regional, national, and global levels-with the goal of achieving optimal health outcomes recognizing the interconnection between people, animals, plants, and their shared environment.”
In India, there is also a dynamic effort to reinforce surveillance for early diagnosis and efficient and timely containment of infection. The National Centre for Disease Control (NCDC) plays a vital role in capacity building nationwide and teaming up epidemiologists, veterinarians, microbiologists, medical doctors, entomologists, etc., to effectively launch required multi-sectoral action to address zoonotic diseases.
REDUCING RISKS OF ZOONOSES AT THE ANIMAL-HUMAN-ECOSYSTEMS INTERFACE:
As we know, 335 emerging infectious diseases were identified between 1940 and 2004 (Baker et al., 2022). The influence of global warming and climate change also affects the epidemiology of zoonotic disease. Therefore, a collaboration between veterinary, medical, public health professionals and ecologists is a must to understand the ecological interactions for interpreting the impacts of climate change on environmental, animal, and human health.
Targets to achieve by “One Health” approach to prevent zoonoses: The preventive measures, early detection, and containment methods of the disease need to be integrated into planning at the local level, i.e., state program execution plans should start from the district level to the top level such as National Health Mission. Besides, it also requires robust public health facilities, trained frontline workers, IEC (information, education, and communication) activities, quick diagnosis, treatment, prevention, control, and management of zoonotic diseases. The goals to combat threats to life (animal, human, and plant) are as follows:
- Distinctly recognize the link between human and animal health and the hazards that diseases pose to food supplies and economies.
- Inclusion of wildlife health as an essential component of global disease prevention, surveillance, monitoring, control, and mitigation.
- Promoting integrated disease surveillance for zoonotic disease, prevention, and response in terrestrial and aquatic animals, mainly at intersections of domestic and wildlife, humans, agriculture, animal husbandry, and aquaculture;
- Introducing Social determinants of health approach in One Health;
- Developing policies focusing on land use, water access, pollution, urban setup, waste management, and deforestation;
- Diminishing risky contact between humans, domestic, and wildlife through protecting habitats;
- Developing safe agricultural practices and appropriate consumption of animal-source food through legally controlled food markets.
- National disease registry of zoonotic diseases- it can be obtained by merging the disease surveillance system for humans (IDSP) and animals (NADRS) to create a national disease database for zoonotic diseases and emerging infectious diseases (Dasgupta et al., 2021).
Core strategies to follow under the One Health approach to combat zoonoses– The core strategies to pursue should include:
- Enhancing cross-boundary (across the nation, states, and districts) exchange of relevant data;
- Strengthening community surveillance and sustainable food production system;
- Developing inter-sectoral epidemiological capacities;
- Strengthening information and communications technologies;
- Rapid grading up of Integrated Public Health Laboratories comprising both human and veterinary laboratories;
- Strengthening risk communication and community engagement processes;
- Conducting policy research and adopting the outputs, and ensuring that stakeholders are engaged at all stages of the roadmap;
- The alignment of policy making with basic and translational technical research.
SOME SUCCESSFUL STORIES OF THE ONE HEALTH COLLABORATION:
- Controlling Rocky Mountain spotted fever (RMSF) in the southwestern U.S. and Mexico- Outbreak of RMSF (tick-borne disease) was reported in humans and dogs in the southwestern U.S. and Mexico. Public health and animal health officials used tick collars on dogs, regular pesticide applications around homes, community education, and provided free spay and neuter clinics for dogs. After only four months, 99% of dogs were tick-free in the community. The incidence rate of RMSF also went down in the community.
- Successful rabies control programs in Bali, Indonesia– The combination of approaches employing the principle of One Health results in successful Rabies control programs in Bali. It involved local communities, stakeholders, and multisectoral experts, and they followed culturally acceptable and effective control activities to effectively control Rabies (Purwo Suseno et al., 2019)
- One Health approach to provide human, animal and environmental health security in Kenya- The FAO of the United Nations, in collaboration with the government of Kenya, the Zoonotic Diseases Unit (ZDU), and other One Health sector stakeholders, launched three One Health strategies to control various zoonotic disease (FAO, 2022). The strategies are;
- One Health Strategic Plan for the Prevention and Control of Zoonotic Diseases in Kenya (2021-2025),
- The National Strategy for the prevention and control of anthrax in humans and animals in Kenya (2021-2036)
- The National Strategy for the prevention and control of brucellosis in humans and animals in Kenya (2021-2040).
- A recent example of how India has controlled the emergence of monkeypox by adopting one health concept- India reported nine cases of monkeypox infection in August 2022 after the first case of monkeypox in Kerala via international traveling. As Kerala’s health department realized the severity of the situation, they ramped up all precautionary measures to screen all international travelers. The central government deployed a multidisciplinary team to support the state health authorities. Vital measures were taken to enhance surveillance, promote rapid identification, and encourage isolation to reduce the risk of human-to-human transmission throughout the country. Several research and diagnostics laboratories across the country were strengthened to ensure early virus detection. Ultimately, one health approach helped control the monkeypox outbreak and its further transmission before taking dangerous consequences.
CHALLENGES IN PUTTING IDEAS INTO ACTION:
Although the application of holistic and forward-looking approaches helping many countries to fight off global issues such as zoonotic diseases; however, there is still a considerable gap that brings challenges for putting One Health into Practice. Some of the critical challenges are as follows:
- Shortage of trained personnel in the rural and urban areas;
- Lack of health promotion, especially in rural areas;
- Scarcity of interventions, innovations and technologies;
- Absence of resource allocation;
- Omission of One Health concept from national and State health policies.
- Lack of coordination among local, state, national, and global level pandemic preparedness and response
CONCLUSION:
Extensive changes in attitude, action, and institution are required to support the One World- One Health concept. The outcome of cutting-edge research and training must be integrated with zoonotic disease control policies to see the effect on the ground level. Significant progress has been made in some countries; however, there is still a long way to go to meet the challenges associated with implementing One Health. It is crucial that national and international agencies continue to bring together professionals from different sectors to build understanding and respect for the roles and expertise of professionals from different sectors to generate a transdisciplinary conceptual framework to address common problems such as zoonoses.
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