Practical Operationalization_One Health_WVA_2017

PRACTICAL OPERATIONALIZATION OF THE ONE HEALTH APPROACH

UNITIVE MODEL FOR ATTAINING OPTIMAL HEALTH

2nd Global Conference on One Health

From One Health Concept to One Health Approach

10-11 November 2016 | Japan

Basic One Health Problem Analysis

FOCAL PROBLEM

EFFECTS

CAUSES

Zoonoses Px & Cx divided among disciplines/systems (Health, Agriculture, Environment….)

Silos of disciplinary & system domains for managing cross-cutting (wicked) problems

Poor response to emerging pandemic threats

Slow response to EID outbreaks

Overlaps in program activities

Unpreparedness for emergence of

zoonoses

Discipline/System-specific approaches (issue-specific)

Separate Agencies & HeadsDifferent interests/priorities- conflicting

Competition in sourcing for funds and engaging donors

One Health Approach Constraints: viewpoint

• Sectoral and disciplinary boundaries continue to exist• Cross-sectoral/disciplinary collaborations remain largely ad hoc,

short-lived and sometimes arbitrary, triggered only during disease outbreaks.

• Silo-mentality and disciplinary marginalization prevail

• Our aim is to institutionalise and sustain integrative cross-sectoral and transdisciplinary collaborations (field/community-based) • To enable continuing EID program formulation and implementation

One Health Plus | One Health and Resilience• While the main thrusts of One Health may appear as primarily

health sector concerns, lessons learned argue for the organization of more holistic ‘Beyond Health’ approaches to infectious disease prevention and control, and impact mitigation.

• Practical operationalization of One Health means there should exist Interconnected All-Level Transdisciplinary Interventions directed at empirical and theoretical infectious disease outbreak problems.

Resilience- The capacity of systems to overcome threats e.g. Through safe farming, food and clean water sources

One Health Definition Re-examined

• Collaborative effort of multiple disciplines to attain optimal health for people, animals, and our environment (The American Veterinary Medical Association)

“Addressing health risks at the human-animal-ecosystem interface requires strong partnerships among all stakeholders.”- WHO, FAO, OIE

One Health within Transdisciplinarity

• Transdisciplinarity or transdisciplinary collaborations enable effective solutions to “wicked problems”- wicked problems require creative solutions that move beyond discipline-specific approaches to address a common problem. Disease outbreaks and emerging pandemic threats and impacts are among wicked problems.

EPTs and impacts as wicked problems

IOM Global Forum on Innovations in Health Professional Education Definitions (2013)• Unidisciplinary = those from a single discipline work together to address a

common problem

• Multidisciplinary = those from different disciplines work independently, each from a discipline-specific perspective, with a goal of eventually combining efforts to address a common problem

• Interdisciplinary = an interactive process; work jointly, each from a discipline-specific perspective, to address a common problem

• Transdisciplinary = an integrative process; synthesizes and extends discipline-specific theories/concepts/methods to create new models/language to address a common problem

• Adapted from Rosenfield, 1992

Education is Key:Towards Transdisciplinary Collaborations

http://www.greenwichschools.org/page.cfm?p=6697

“Transdisciplinarity”

"Being a transdisciplinarian is like being an essential ingredient in a gourmet dish- where each ingredient focuses on the making of the gourmet dish, and not just on being the most

essential ingredient-- to attain this state requires a gourmet chef who understands well

his ingredients and sees the value in All."

Innovative OHR Higher Education Paradigm

Transdisciplinary/Trans-systems Solutions to Wicked Problems

For ExampleThe University of the Philippines System is innovating on curricula and teaching and learning methods- i.e.

field, community and response-based learning making use of FGDs and TTXs

Pillars of a Transdisciplinary One Health and Resilience Education

Emerging Disease

Epidemiology

Management and Policy

Disaster Response &

Preparedness

One Health & Resilience Education Program

• Enable focused field-based collaborations among multiple disciplines and systems• To attain optimal health for people, animals, and our environment

• Impart transdisciplinary knowledge necessary for managing wicked problems and complex systems• Strategically change mindset of leaders, civil servants and all actors

(generation of Transdisciplinarians)• Support leadership development

• Competencies in One Health and Resilience systems development, implementation and management.

“Unitive Education”– Expertise that can unite efforts

How to get there (Optimal Health)?- Key Steps

• Substantiate disciplinary interconnectedness through thorough documentation of the perspectives and actual experiences of concerned disciplines in dealing with disease causalities and cascading impacts, and the drivers of risks and vulnerabilities

• Map multi-faceted and multi-disciplinary insights on the identified problems

• Assign corresponding transdisciplinary collaborative solutions or interventions

• Evidence gained will allow for clear identification of disciplinary roles, and where and how these roles intersect in effecting collaborative and interdependent interventions

Transdisciplinary and Trans-systems Interdependencies: Understanding how disciplinary domains or security systems are able to support each other (Synergy Metrix)• Each system and disciplinary domain maps out its key essential functions or roles, and the

enabling functions or elements- e.g. for biosecurity to effectively prevent infectious disease emergence and outbreaks, this must be enabled by numerous elements including providing families with means to acquire food and earn livelihood

Identify Transdisciplinary Collaborative Solutions vis. the problem domains - For instance- How food security-resilience relates to biosecurity? How does one impact on the other?

Step 3

Identify Disciplinary Solutions vis. the problem domains

Step 2

Identify the Problems (Disease/disaster causes and impacts/ risks and vulnerabilities)

Step 1 • Actualize actions through policies and institutional changes, and strategic plans.

• Instill in everyone the ‘Crisis Mentality’- people naturally unite when faced with life and death situations- the continuing state of poverty is a persisting and pestering crisis.

System Drivers and Enablers:• Integrative Management and Communication Platforms• Integrative Education and R & D Platforms

*Formulate a Field Guide on Fostering Transdisciplinary Collaborations at Grassroots- e.g. with rabies and Reston Ebola virus as focal diseases

Functional systems that have not been effectively synergized, or have traditionally operated in silos:• Biosecurity (including One Health)• Health security (Referring to primary health care and

universal health coverage)• Food security• Energy security• Environmental security (including conservation)• Social security (all aspects of poverty reduction,

education, social services)• Protection security (referring to peace and order) • Disaster security

Transdisciplinary Interventions: Problem Domains

• Health-Medical | Ecological-Industrial | Socio-Cultural | Governance

• Within these domains are the fine elements of the Art and Science of One Health:• Integrative governance and management platforms• Mindset-change education and training• Discipline-specific technical competencies• Integrative research and development

All-level Interconnected Disaster Interventions

GovernancePolicies-Regulations

Multi-sector Management PlatformsLeadership & Response Teams

Technical Education/TrainingCommunication

Resources-Tools-LogisticsPreparedness

ImpactsCausesEcological-Industrial

Environmental ProtectionPollution Control

Agro-Industrial Practices ChangeClimate Change Adaptation

Urban PlanningLand and Extraction Control

Socio-culturalBehavior Change

EducationLivelihood

Food SourcePower Source

Protection from harmPopulation Management

Poverty Alleviation

Health-WellbeingEarly Detection-SurveillanceBiosecurity-Infection Control

Quarantine-ContainmentHealth Products

Vaccination-TreatmentNutrition-Water

Emergency Management

Integrative Education-Research & Development

Integrative Management and Communication

HAZARDS

RISKS/VULNERABILITIES

GOVERNMENT

INDUSTRYACADEMIA

NGOs / CSOs

All Level = National - Subnational - Local/Community

All-Hazards Approach

Transdisciplinary Disease Outbreak Interventions










EducationLivelihood



Poverty Alleviation





Integrative Education- Research & Development



GOVERNMENT

INDUSTRYACADEMIA

NGOs / CSOs

DISEASE OUTBREAKS

Basic One Health Disciplinarity

1. Health and Biomedical Sciences (human and animal health)

2. One Health Management-Governance3. Risk Assessment-Communication-Management and

Research4. Communication, Information and Logistics Systems5. Multi-sectoral/ transdisciplinary Approaches6. One Health Education and R&D7. Field Social Sciences- e.g. economics, medical

anthropology, sociology8. Environmental-Ecological, Agricultural, Industrial and

Engineering Sciences

ImpactsCauses


DISEASE OUTBREAK

Recognizing the Wicked Problems

• Disasters• Climate change• Land use change• Hunting• Markets/trade• Food and water insecurity• Extraction• Pollution• Global travel• Over population• Population displacement• Conflict (war)• POVERTY

Disease risks lurk in our ecosystem

ImpactsCauses






Health Sector- All-level Interventions

Non-medical contributors• Local leaders• Police• Food and water

suppliers• Health product technologists• Social scientists• Community workers• Educators• Engineers• Military• Environmentalists

Scientific Expertise

• Physicians• Veterinarians• Nurses• Medical Technologists• Biotechnologists• Pharmacists• Public Health Workers• Epidemiologists• Biosecurity Experts• Nutritionists• Vaccinologists• Sanitation• Biologists• Chemists

DISEASE OUTBREAKS

ImpactsCausesRISKS/

VULNERABILITIES

Environmental Sector- All-level Interventions

Contributors• Medical• Local leaders• Police• Social scientists• Educators• Communication


• Industrialists• Engineers• Geologists• Environmentalist

s

Ecological-IndustrialEnvironmental Protection

Pollution ControlAgro-Industrial Practices Change

Climate Change AdaptationUrban Planning

Land and Extraction Control

DISEASE OUTBREAKS

• Climatologists• Agriculturists• Urban Planners• Toxicologists• Foresters

ImpactsCausesRISKS/

VULNERABILITIES

Governance- All-level Interventions

Contributors• Medical• Social workers• Engineers• Industrialists• Environmentalists

Expertise• National-Local leaders• Legislators• Educators• Communication• Logisticians• Strategic planners• Various technical

experts• Military• Police• Social scientists• Community organizers

DISEASE OUTBREAKS


Multi-sector Management Platforms

Leadership & Response TeamsTechnical Education/Training

CommunicationResources-Tools-Logistics

Preparedness

ImpactsCausesRISKS/

VULNERABILITIES

Socio-Cultural Sector- All-level Interventions

Contributors• Medical• Local leaders• Police• Private groups• Agriculturists • Environmentalists• Religious groups


• Social/community workers• Anthropologists• Human ecologists• Economists• Educators

DISEASE OUTBREAKS

• Communication• Urban Planners• Business

managers• Housing experts• Gender experts


EducationLivelihood



Poverty Alleviation

Key Concepts – Fostering and Managing Focused Transdisciplinary Collaborations

One Health and Resilience System Management

• Good OHR Governance Structures and Platforms• Good OHR Leaders• Good OHR Field Workforce• Good Understanding of Principles and Practices for

Effective Execution of Collaborative OHR Field and Community-based Actions/Responses

All sectors across security systems need to collaborate

Integration of Whole-of-Society Approaches

Multi-sectors to Multi-systems

One Health-Resilience Transdisciplinarity










EducationLivelihood



Poverty Alleviation





Integrative Education-Research & Development


HAZARDS


GOVERNMENT

INDUSTRYACADEMIA

NGOs / CSOs

One Health and Resilience• One Health must be operationalized within the broader One Resilience Approach, where the ultimate goal is the ‘unity of humanity in mind and action’– Comprehensive Security

• Stakeholders should be able to naturally overcome traditional barriers impeding valuable transdisciplinary collaborations toward wicked problems-- hazards, disasters and social disruptions

Framework for Integrated Security Systems

The integration of all disciplinary domains and security systems capacities along areas of sectoral interdependencies and synergies for the unitive attainment of health, food/water, energy, social, environmental and disaster resilience. • By this approach, multi-systems and stakeholders impacted

by a human health problem (e.g. Ebola virus infection outbreaks) are expected to work better together to address the common "wicked" problem.

• Under this unitive model for attaining optimal health for humanity and the ecosystem, the word ONE must operationally translate to true transdisciplinarity.

Our Calling as OHR Transdisciplinarians

“Let us encourage variable One Health disciplinary centrality* in relation to

multifaceted “wicked problems”. Let us encourage the transdisciplinary aspiration for All to commonly understand, perceive, appreciate and weigh problems, and provide solutions to our common problems in a unitive manner.”

• Inter-operability of Individuals, Agencies, Sectors and Systems

An advocacy for us to “Think and Work as ONE”

All should ask:

• What concern of mine is also your concern?

• What concern of yours is also my concern?

Disciplines and Sectors should naturally support and depend on each other

Unity of Humanity in Mind and Action

One Health and Resilience

http://www.rugbyabp.com

http://livingwatersphilippines.org

What compels us to think and work as One?

• Appreciate the failed state• No First and No Last• Change how we think and do• Crisis mentality for humanity• Interconnectedness and Interdependence• Desire the Oneness

By Heart and Mind We Shall Rightly Live

Oh, is it not that our reflections should be pure and true?And should not our good intentions be what we do?That all our cares we can easily let go?Is it not by Heart and Mind that we shall rightly live?If so, let us then think with our heart and feel with our mind.Oh, should we not always want to pour out all of our good selves?Are we not to love others, friends or foes?That true forgiveness we must possess?We must then think with our heart and feel with our mind.We must never think of ourselves.But to think of others so that from our hearts streams will flow.That to love others we may live ever rightly so.Let us not compete or live with pride.Let us just let out the sweetness from our Hearts and Minds.

“Think and Work as ONE”

For further discussion please contact the proponents:

Noel Miranda- [email protected]

Peter Cowen- [email protected]

mailto:[email protected]

mailto:[email protected]

Documents

Practical Operationalization_One Health_WVA_2017