International Conference on Applied EpidemiologyPOSTGRADUATE INSTITUTE OF SCIENCE (PGIS)

University of Peradeniya, Sri Lanka March 3, 2011

Challenges, experience and possible interventions in mainstreaming one health within state sponsored animal health sector in Sri Lanka from developing country perspective

Tikiri Wijayathilaka

• DAPH - established September 1978• Within the scope - eight objectives identified• “Provide animal health services (both preventive

and curative) indicated as the first• Animal health activates - implemented under

Animal Health and Extension Division • Legal provisions - Animal Diseases Act No 59/92• AIPRP – TF 091200 – Resource base for

strengthening AH Sector capacity (2008 – 2011)

Background

Expected outcome

One Health

AH Sector Capacity building

Developing interest group forums

Networking

• Describe relevant challenges identified• Sharing experience in relation to

interventions• Presenting proposals for possibilities to

overcome some identified challenges

Objectives of the paper

• Literature review• Compare organizational structures of

DAPH with identified needs in literature • Non structured discussions carried out at

the field training • Post evaluation feedbacks of training &

awareness programs

Methods

• WHO - identified as the component of public health devoted to the application of professional veterinary skills, knowledge and resources to protect and improvement of human health

• WHO consultation on “future trends in VPH” Teramo Italy-1999 , defined as “the sum of all contributions to the physical, mental and social wellbeing of humans through an understanding and application of veterinary science”

What is Veterinary Public Health

• As per WHO - core domains of - veterinary public health – zoonoses - diagnosis, surveillance, control

and prevention– food protection – management of health aspects of laboratory

animal facilities – health education and extension– production and control of biological products

and medical devices

Expected role of veterinarian in public health and food safety

• As per OIE Terrestrial Animal Health Code– implementation of risk based recommendation for

regulatory systems – assure food safety & quality (as SPS agreement)

– early detection, surveillance and treatment of animal diseases including conditions of pubic health

– minimizing the risk of developing antimicrobial resistance and unsafe levels of veterinary drug residues

– ensure effective implementation of ante-mortem and post-mortem inspection procedures

Role of veterinary services in food safety

• As per OIE Terrestrial Animal Health Code– animal identification and animal traceability systems – ensuring health certification for international trade

complies with the animal health and food safety standards

– foods contamination with zoonotic agents -investigating outbreaks - remedial measures

– creating awareness within producers - assuring food safety

Role of veterinary services in food safety cont.

• Inadequacy of organizational arrangements responsible for VPH issues within DAPH

• Deficiency of trained manpower in the discipline of epidemiology within AH sector

• Non existence of higher educational opportunities for epidemiology within the country

Challenges

• Inadequacy of institutionalized joint technical efforts for handling zoonotic diseases at peripheral levels

• Inadequate responsiveness to field calls from the centre

• Inadequate diagnostic facilities for suspected conditions at field level

Challenges cont.

• Bridging the gap of manpower deficiency • Assist in creating in country opportunities

for higher education• Assist in developing peripheral joint

forums for zoonotic disease handling• Enhancing regional & central capability of

diagnosis• Enhancing stakeholder awareness

Interventions within the scope

Results of interventions

Manpower development

49 locally qualified professionals in Epidemiology

Educational Opportunities

Applied Epidemiology Course at PGIS

Assistance to develop joint forums

Country wide joint awareness programsHPAI – 21 prog.TTE – 11 prog.

Enhancing Lab. capacity

Establishing 2 VICRefurbishing 2 Labs - VRI

Enhancing stakeholder awareness

Refurbish 3 training centersRefurbish 1 audio visual unitAwareness prog.

Networking with relevant stakeholders

MoHDMCDWLC

• First in Sri Lanka• Planning since mid

2009• Launching on January

23, 2010• With 28 Veterinary

Graduates• Assistance – DAPH,

MoH, PGIS, FoM, FVM&AS, World Bank

Course in Applied Epidemiology

• Sri Lanka Epidemiology Association for One Health

• Established on February 14, 2010

• Cluster initiated with– Participants of App. Epid. Course– Members of Teaching panel– MPH/MVM participants

• Represent medical & veterinary professions

Creating interest group forums

Sri Lanka Epidemiology

Association for One Health

• Creating a forum to practice the discipline with a unique identify

• Assist in advancement of the discipline• Creating an environment for the young epidemiology

professionals to develop the capacity• Assist state agencies in mainstreaming “One Health” • Develop a forum to discuss issues in zoonotic disease

handling and program development• Develop communication method for a wider group –

local and overseas – “South Asian Journal of Epidemiology”

Objectives

What needs to be done

• Bringing resources together• Institutionalize what operates in informal

ways• Rational re-organization• Necessary reforms to the existing laws

and regulations

Rational re-organization

• Possibilities for short term interventions– Incorporate zoonotic disease control, food

safety, health education, emergency response to present mechanism

– Linking regional laboratory network with central lab and elevate capacity

– Affiliate already developed epidemiology group to regional laboratory network

Rational re-organization

Rational re-organization

Strengths Opportunities Availability of trained manpower Availability of modern equipment Availability of diagnostic methods for

important disease Recently improved infrastructure Existance of connectivity Already established links with regional

investigation laboratories

Interest of DAPH, Ministry and development partners in mainstreaming one health

Recommendations of OIE PVS report related to public health

Interest of development partners in investing on one health related activities

Weaknesses Threats Not an accredited laboratory to

function as a reference laboratory Non existance of species identification

facilities for meat Deficiencies in waste disposal system Deficiencies in biosecurity standards

Possible delays in administrative procedures

Risk of non recognizing the importance of intervention

SWAT on CVIC - VRI

Are we there ?

One Health

AH Sector Capacity building

Developing interest group forums

Networking

Acknowledgement

My familyMy Superiors – Former DG/DAPH, Present DG/DAPH, D/HRDDr. SLA Daniel, Dr. Sarath ArambawelaWorld Bank, AHI Trust Fund, Massey UniversityAIPRP Project Team DAPH, Epid Unit, PGIS, FoM – Community Medicine, FVMASMy friends

Thanks for all of you for listening to me