One Health approachesto prevent and control zoonoses

Jeffrey Gilbert, ILRICIAT-Asia, Vientiane

Agriculture, Fisheries & Conservation Department (AFCD) Workshop on “One Health: Past, Present, and Future”

Hong Kong, 27 September 2011

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

ILRI: Resources

IAR4D

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’) Objective – to harmonize 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

EcoHealth v OneHealth

• Definitions open to debate: range from quite rigid to very flexible!

• One-Health – biomedical focus: human + animal + wildlife;

• EcoHealth: environment & socio-economic aspects – pioneered outside ‘traditional’ health

• Personal opinion: OneHealth more theoretical, conceptual; EcoHealth more tangible?

• Maybe it’s not so important … which ‘cola’

Human healthHuman

health

One Medicine

SocietiesEconomiesInstitutions

Agroecosystem health

Animalhealth

VetPubH.

EcoHealth

One world – one health

Adapted from Esther Schelling, STPH

O n e h e a l t h

EcoHealth

EcoHealth

EcoHealth ‘Pillars’

Trans-disciplinary: inclusive vision, full involvement of Researchers, community & decision-makers;

Participation: consensus and cooperation not only within community, scientific & decision-making groups, but among them;

Equity: gender, ethnic group; Sustainability.

EcoHealth: transdisciplinarity

EcoZD: Overview

‘EcoHealth Approaches to the Better Management of Zoonotic Emerging Infectious Diseases in the Southeast Asia Region’

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;

‘Learning by Doing’ approach 4 years 2008 – 2012; extended to Aug 2013 6 countries in SE Asia region;

Cambodia, China (Yunnan), Laos, Viet Nam, Indonesia, Thailand

One of IDRC’s EcoHealth initiatives in SE Asia: APAIR/APEIR, EcoEID, BECA, FBLI

EcoZD: gestation

The donor – IDRC www.idrc.ca & EcoHealth ILRI’s capacity Building on previous specific EID (EZD)

initiative in the SE Asia region: APAIR Identify partners, point of contact, link to

others Formation of research teams Develop and finalise research studies

(incorporating aspects of EH) Mechanisms of implementation, funds

transfer etc.

EcoZD: Components

Country Teams choices for research:Cambodia: zoonotic risks for acute dysenteryChina (Yunnan): Brucellosis & ToxoplasmosisIndonesia: 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?

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•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:•Originally priority ranking of zoonoses, initial expert opinion, retrospective phase to analyse surveillance data, cross-sectional survey in pilot areas to ascertain community priorities

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/ methodololgy / 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

EcoZD: Some of the Solutions

Cambodia: champions identified, Govt senior level support

China: silo syndrome, local expert to provide technical assistance, EH training materials in Chinese

Indonesia: multiple champions, finding niche - focus on dog ecology, complementing other initiatives

Lao PDR: pooling inputs/outputs with ACIAR project Thai-Viet: reduced to 2 countries, local experts

identified to provide technical assistance, link to EHRC-CMU

Viet Nam: 3 research contracts and individual priorities, difficulties deciding on priority, change approach/angle

‘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.

Yet more challenges

Definitions/ Standardisation for curriculum development

One Health / One Medicine / EcoHealth Who’s right? Eg ILRI & USAID at CMU

Biomedical v Social Sciences Who leads? Quantitative v Qualitative – do they really mix? Will decision-makers & communities be convinced

Case studies & publications Vital to get peer-reviewed publications as well

as local language articles

Beyond EcoZD

• EHRCs– Long term capacity building at various levels– No MSc or PhD of EcoHealth/OneHealth envisaged– Beyond communicable diseases– Own working definition and approach – refined as per

context– Approach accepted – importance of ‘branding’

• Country Research Teams– Case studies fully synthesized (and lots of lessons

learned will surely emerge)– Maintain relationships & potential further

collaboration