Inter-Agency Donor Group meeting Hunger, Health and Climate Change: prioritizing research effort in the livestock sector

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1 Inter-Agency Donor Group meeting Hunger, Health and Climate Change: prioritizing research effort in the livestock sector "Integrated Control of Neglected Zoonotic Diseases" By F.X. Meslin Leader, Neglected Zoonotic Diseases (NZD) Department of Neglected Tropical Diseases (NTD) WHO Headquarters, Geneva Switzerland May 2009 Institute of Tropical Medicine Antwerp, Belgium Department of neglected Tropical Diseases HTM Cluster WHO Headquarters

2 Ebola, Marburg Lassa Fever Plague Nipah & other paramyxoviruses BSE/TSE Salmonellosis Echinococcosis Taeniasis/Cysticercosis Nipah Rabies Brucellosis Campylobacteriosis Escherichia coli & foodborne viruses infections Toxoplasmosis Anthrax leptospirosis Anthrax Rift Valley Fever, CCHF Cryptosporidiosis Giardiosis Zoonotic trematodosis Zoonotic trypanosomiasis Zoonotic leishmaniosis H5N1 Tuberculosis H5N1 New, emerging, zoonotic agents Food/waterborne diseases & agents Endemic zoonoses (epidemic prone)

3 "Attributes" of Neglected Zoonotic Diseases NZD affect mostly populations of the tropical and subtropical areas of the world which are the poorest and most vulnerable. NZD largely affect livestock and animal owners and their families so that their prevention and control will benefit both human and animal health. Prevention and control of NZDs,, by simultaneously saving lives and securing livelihoods, offers a very real and highly cost- effective opportunity for alleviating poverty especially in remote rural and marginalized peri-urban communities. NZD occupy a unique position at the interface between human and animal health as they require very strong collaboration and sustained commitment

4 A disproportionate burden is borne by the poor Poor prognosis once infected More at risk of acquiring a zoonosis Greater Burden borne More vulnerable to illness From A. Shaw in her presentation made to the Consultation on Integrated Control of NZDs, Nairobi, November 2007.

5 Major neglected zoonoses & WHO Regions WHO/OMS AMR Rabies Echinococcosis Cysticercosis Leptospirosis Brucellosis B.Tuberculosis EUR Brucellosis Multilocular Echinococcosis Rabies EMR Echinococcosis Brucellosis Rabies ZCLeishmaniasis AFR Rabies Echinococcosis Cysticercosis, Brucellosis B.Tuberculosis Z. Trypanosomiasis SEAR/WPR Rabies Echinococcosis Trematodoses Cysticercosis Leptospirosis

6 Overlap of zoonotic diseases WHO/OMS Overlap of five selected neglected zoonotic diseases (NZDs)* at the country level in Africa. More than 30% of countries have three or more of these NZDs in various combinations. *The NZDs are cutaneous leishmaniasis (anthroponotic and zoonotic), zoonotic trypanosomiasis, echinococcosis, cysticercosis and rabies.

7 TB HIV/AIDS Malaria Neglected Tropical Diseases "Previously Neglected Diseases" Neglected Tropical Diseases GLOBAL PLAN TO COMBAT NEGLECTED TROPICAL DISEASES Soil transmitted helminthiasis Schistosomiasis Lymphatic filariasis Onchocerciasis Leprosy Trachoma Dengue Leishmaniasis Buruli ulcer Chagas disease Human African trypanosomiasis World Health Organization Geneva, November 2006 Cysticercosis Anthrax Echinococcosis Neglected Zoonotic Diseases Bovine tuberculosis Brucellosis Zoonotic trypanosomiasis Rabies

8 "Attributes" of Neglected Zoonotic Diseases There is a lack of: information and awareness about the extent of the problem, suitable diagnostic and management capacity, and appropriate and sustainable prevention and control strategies. There is a false perception that their burden and impact on society is low, such that they neither attract the health resources nor the research needed to control them.

9 Neglected Tropical and Zoonotic Diseases DALY scores (DALYs x 1000) Lymphatic filariasis intestinal nematode infections Echinococcosis Leishmaniasis Schistosomiasis Rabies Trypanosomiasis Dengue Chagas leprosy 0

10 Comparing DALYs of NZDs and NTDs WHO/OMS Lymphatic filariasis Neglected zoonoses Trachoma Leishmaniasis* Ascariasis Trichuriasis Trypanosomiasis* Schistosomiasis* Chagas Onchocerciasis Leprosy Hookworm * Anthroponotic transmission only for Visceral and cutaneous (Data was not available for Buruli ulcer and Dracunculiasis) DALYs x10 6 From Wendy Harrison, Report to WHO, 2008.

11 Integrated control of NZDs: : from WHO/OMS Concept to Action Recent WHO initiative: Concept and "labelling" of integrated NZD dates back to Report of the Meeting of Sept very well received. Attracted attention of funding agencies e.g EU Research Directorate. Report of the 2007 consultation now available WHO is currently tackling some of the practical, institutional, political and resources related issues associated with this initiative.

12 Integrated control of neglected zoonotic diseases in Africa Applying the one health concept Report of a Joint WHO/EU/ILRI/DBL/FAO/OIE/AU Meeting ILRI headquarters, Nairobi, Kenya November 2007

13 "Challenges" of Neglected Zoonotic Diseases In many of the most affected countries the veterinary public health infrastructure is poor or nonexistent, leading to indecision ion as to which sector(s) ) should take responsibility for investigation and control of NZDs (i.e. veterinary/agriculture versus health) This situation has led to NZDs control falling into the gap between veterinary responsibilities and medical needs. Interventions to control NZDs require concerted action between veterinary, livestock and human health sectors and thus a comprehensive and integrated interdisciplinary approach is needed to address the major obstacles for effectively combating them.

14 To achieve success combating the NZDs Provide global and regional forums to promote One Health integrated approach Conduct and maintain inventories of control activities and tools Develop guidelines for implementing NZDs and other VPH- related activities Promote advocacy efforts to inform about NZDs and create demand for their control Develop and test practical, cost-effective surveillance and control strategies

15 Overview of ICONZ Activities and Work Packages WHO/OMS EU FP7-funded 5 year project on Integrated control of neglected zoonoses in Africa (ICONZ): improving human health and animal production through scientific innovation and public engagement Comprehensive and integrated approach to NZDs in the region most affected Involves 22 partner institutes in Europe and Africa (8) Major role to women Provide technology transfer and training to affected countries Inception meeting on May 2009

16 Thank you

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