Promoting One Health : the international perspective OIE Integrating Animal Health & Public Health: Antimicrobial Resistance SADC SPS Training Workshop (Animal Health) 29-31 January 2014 Gaborone, Botwana Neo J. Mapitse OIE Sub Regional Representative for Southern Africa
PROMOTING ONE HEALTH: WHAT DOES IT TAKE? Requires strong partnerships among players who may have different perspectives and different levels of resources. Partnerships include international organisations, governments, civil society and donors and the partnership must be coordinated to minimize the burden of multiple monitoring, reporting and delivery systems, and to avoid duplication of efforts and fragmented outcomes. A framework for collaboration is necessary at national and international levels, with clear definition of roles and responsibilities.
OIE Fifth Strategic Plan (2011-2015) Approved by Member Countries in May 2010 A major new element application of the One Health concept for the reduction of risks of high impact diseases at the animal-humanecosystems interface. Main contribution achieved through the prevention, control and eradication of animal diseases, including zoonoses. Will require enhancement of work in certain non-traditional areas for the national VS 3
The FAO-OIE-WHO Tripartite Concept Note Vision A world capable of preventing, detecting, containing, eliminating, and responding to animal and public health risks attributable to zoonoses and animal diseases with an impact on food security through multisectoral cooperation and strong partnerships. recent efforts have underscored the fact that successful and sustained results are possible when functional collaborations are established
Expanding the scientific basis for effective One Health approaches OIE Global Conference on Wildlife Animal Health and Biodiversity, Paris (France), 2011 OIE Global Conference on Rabies Control, Incheon Seoul (Republic of Korea) 2011 OIE Global Conference on Responsible and Prudent Use of Antimicrobial Agents for Animals, Paris (France), 2013 High Level Technical Meeting to Address Health Risks at the Human- Animal-Ecosystems Interfaces, Mexico City, Mexico, 2011 Translate principles in the Tripartite Concept Note into national/regional actions Priorities: Zoonotic Influenzas, Rabies and AMR OIE-PVS Pilot One Health Evaluation Missions Data Sharing OFFLU and GLEWS Laboratory Capacity Building and Networking
Context 6 Global demand for food security Global Population: 1950-2015 Total Billions 8 7 6 5 4 3 2 1 0 1950 55 60 65 70 75 80 85 90 95 2000 05 10 15 Source: US Bureau of the Census +1 billion people by 2050 Demand for animal protein, notably milk and eggs will increase by more than 50% Focus on developing / transition countries
300 Million tonnes World meat production (milion tonnes) Source: FAOSTAT World production 700 Million tonnes World milk production (million tonnes) Source: FAOSTAT 7 250 200 150 100 Meat Other Central & South America North America Europe 600 500 400 300 200 Milk Other E. Europe Central & S. America N. America W. Europe East Asia 50 East Asia 0 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010 80 Million tonnes 70 World eggs production (million tonnes) Source: FAOSTAT 100 South Asia 0 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010 60 50 40 30 20 10 Eggs Other Central & S. America N. America Europe East Asia Source: FAOSTAT 0 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010
8 Globalisation Unprecedented movements of commodities and people are used by pathogens to colonise the planet There is nowhere in the world from which we are remote and no one from whom we are disconnected Resistant bacteria travel with humans, animals and commodities and ignore boarders and oceans «THE 5 T S» Trade, Travel, Transport, Tourism, Terrorism
9 Need for common actions A stronger collaboration between WHO, FAO and OIE Sharing responsibilities and coordinating global activities to address health risks at the animal-human-ecosystems interfaces Three flagship topics: Zoonotic influenza Rabies Antimicrobial resistance (AMR)
Why is antimicrobial resistance (AMR) a global concern? 10 Antimicrobial agents are essential to ensure human health, animal health and welfare, and food security. AMR challenges control of infectious diseases AMR increases care costs AMR compromises health security and damages economies There is a lack of coherent global approaches to prevention and containment The human, animal and plant sectors have a shared responsibility to prevent or minimise the development of antimicrobial resistance by both human and non-human pathogens.
The implementation of the FAO-OIE-WHO Tripartite Agreement/Vision 11 High Level Technical Meeting, Mexico October 2011 Jointly addressing AMR (HLTM meeting report) (http://www.oie.int/fileadmin/home/eng/media_center/docs/pdf/hltm_exec_summary.pdf )
12 The problem Inappropriate use of antimicrobial agents in human and veterinary medicine has led to AMR, resulting in prolonged illness and increased costs HLTM meeting report
13 The solution A holistic and coordinated management across the animal, food and human sectors in different ecosystems and geographic locations Improved intersectoral collaboration where regulations of medicines are managed by different entities HLTM meeting report
14 Needs (1) International standards (to harmonise protocols and methodologies) to monitor AMR and antimicrobial usage Surveillance data on AMR and antimicrobial usage to support AMR risk analysis Technical capacity (for surveillance of AMR and antimicrobial usage and AMR risk analysis) HLTM meeting report
15 Needs (2) Coordinated research on effectiveness of policies to achieve AMR risk reduction R&D new drugs Legislation on access to quality drugs and restricted use Good governance of all sectors related to authorisation and use of antimicrobials (lab expertise, international standards and legislation development and implementation, surveillance and monitoring) HLTM meeting report
16 Steps for action at country level (1) Formal mechanisms of collaboration between ministries/authorities involved (health, agriculture, livestock, food, environment) Concordance between veterinary and human medicines regulation, approval, prescription control and monitoring of use Development and adoption of international standards and protocols to facilitate information sharing and harmonisation in surveillance of AMR and antimicrobial use in humans and animals Surveillance programmes to monitor current and emerging AMR patterns involving animal and human health sectors HLTM meeting report
17 Steps for action at country level (2) Institutional and technical capacities for AMR and antimicrobial usage monitoring and surveillance; and AMR risk analysis Multidisciplinary task forces of Authorities involved to act on surveillance data Joint evaluation programmes on the effectiveness of management actions to reduce the prevalence of AMR in human and animal sectors Common messages and outreach HLTM meeting report
18 Conclusions: actions at national level Governance Legislation Good quality information Capacity building Risk assessment Close cooperation HLTM meeting reprt
Antimicrobial Resistance OIE Standards and Guidelines WHO and FAO participate in the ad hoc Group on AMR Terrestrial and Aquatic Code Chapters cover: Harmonisation of national antimicrobial resistance surveillance programmes Monitoring of the quantities and usage patterns Responsible and prudent use Risk assessment (linked to the use of antimicrobial agents in animals): under review
Antimicrobial Resistance OIE List of Antimicrobial Agents of Veterinary Importance: Adopted in 2013 to take into account concerns for human health (WHO and FAO participated in this task) VCIA: Veterinary Critically Important Antimicrobials VHIA: Veterinary Highly Important Antimicrobials VIA: Veterinary Important Antimicrobials
Situation worldwide OIE Survey OIE developed a questionnaire in 2012 on monitoring the quantities of antimicrobial agents used in animals Results presented at the OIE Global Conference on the Responsible and Prudent Use of Antimicrobial Agents for Animals held in March 2013 in Paris, France
OIE Survey - Objectives to enhance the OIE s engagement in the initiative to prevent antimicrobial resistance; to conduct a survey of the implementation by OIE Member Countries of OIE Terrestrial Animal Health Code Chapter 6.8. Monitoring of the quantities and usage patterns of antimicrobial agents used in food producing animals ; to improve awareness and provide an overview of antimicrobial use in animals by OIE Member Countries; to determine what actions are needed and to help the OIE to develop its strategy in this field.
Availability of the data - in Africa OIE Member Countries without an official system for collecting quantitative data on antimicrobial agents used in animals No 25% Yes 75% Qualitative data Quantitative data
Laboratory Capacity Building and Networking USAID Emerging Pandemic Threats (EPT) Program
Encourage Data Sharing OFFLU joint OIE-FAO network of expertise on avian influenza, established in 2005 Resolution XXVI at the 76 th OIE General Session Expanded to OIE-FAO network of expertise on animal influenza in 2009 GLEWS joint FAO/OIE/WHO Global Early Warning System and Response for Major Animal Diseases and Zoonoses
The OIE PVS Tool Evaluation of the Performance of Veterinary Services a tool for Good Governance of Veterinary Services 4 Fundamental Components Human, physical and financial resources Technical authority and capability Interaction with stakeholders Access to markets
One Health and the PVS Pathway The objective and scope of the pilot OIE PVS One Health missions is to assess the quality of the National Veterinary Services relevant to the OIE Code, with special emphasis on collaboration activities with the Public Health and other relevant stakeholders at the animal-human interface. OIE-PVS One Health pilot missions were conducted in: Philippines, Costa Rica and Kenya Enrich the 2013 Edition of the PVS Manual to further develop indicators of 14 PVS critical competencies of the PVS Tool Joint work between OIE and WHO (with WB): OIE-WHO project on National Human and Animal Health Systems Assessment Tools and Bridges (EU funded).
International Standards and Guidance 28
Technical Item Survey of Delegates 12 questions (including multiple embedded questions) Distributed to 178 OIE Delegates in the three official languages of the OIE (English, French, and Spanish) 29
Barriers to Implementing One Health Lack of resources Collaboration is complex Inadequate capacity within the VS Lack of adequate legislation, policy or guidance Lack of political will or support Technical or other challenges 30
Veterinary Services* Interest in Technical Capacity Building Initiatives * Of the 100 Member Countries where the VS needs more technical capacity building on One 31 Health approaches
32 Thank you for your attention