One Health Movement in : Its progression & way forward Nitish C. Debnath FAO ECTAD Measuring Impact of Cross-sectoral Collaboration Prince Mahidol Award Conference 2013 Emergency Center for Transboundary AI Technical Animal Diseases Unit
Outline of the Presentation Sharing the progression of the One Health movement in Measuring the impact of One Health activities Challenges Way forward
Definition of One Health : Harnessing the creative power of diversity Human Health 3 Animal Environment
A team of randomly selected agents outperforms a team of the best-performing agents... The best-performing agents necessarily become similar in the space of problem solvers. Their relatively greater ability is more than offset by their lack of problem-solving diversity. Innovative banks are managed by teams who are diverse with respect to their functional areas of expertise
Why One Health for? Population density Fragile ecology Hotspots for EID & reid 5 Vulnerable food security & safety 50% tube well exceed WHO recom. level Close contact to human-animal
One Health Informal discussion on One Health approach began at Chittagong Veterinary & Animal Sciences University in 2007 at the emergence of HPAI IEDCR & icddr,b showed keen interest as human health partners Positive responses from professionals working in Livestock, Agriculture & Forestry sectors, civil society, universities and Research Institutes. One Health was formed, Chittagong declaration on One Health and organized six conferences on OH since 2008. Membership criteria: Physicians, vets, agriculturists, environmentalists, wildlife experts, ecologists, anthropologists, economists, allied scientists, practitioners & activists, now has more than 200 members..
Areas of One Health Practices Communication, Advocacy & Networking Collaborative Practices Research Collaboration Educational & Training One Health Country Strategy
A collaborative investigation team DLS Epidemiologists IEDCR Clinicians icddr,b Veterinarians Anthropologists FAO 8
Food and Agriculture Organization of the United Nations Outbreak Investigation & Response Avian Influenza Anthrax Nipah Rabies Emergency Center for Transboundary Animal Diseases AI Technical Unit
Multi-disciplinary research to curb Nipah at icddrb& IEDCR Food and Agriculture Organization of the United Nations
Food and Agriculture Organization of the United Nations 11
Strategic Framework for the One Health Approach to Infectious Diseases 2012 Collaborative: Govt., UN agencies, Research Inst, Universities, Civil Societies and NGOs were involved Comprehensive: Goals, vision, attributes, components identified with specific objectives Persuasive: Five year action plan developed 12 Indicative: Key indicators for measuring impact of each activities AI Technical identified Unit
Vision & Goals The consequences of emerging, re-emerging & high impact infectious diseases are minimized through: institutionalizing the One Health Approach, so contributing to food security, food safety & a healthy population in thriving ecosystems Establish institutional arrangement Develop necessary capacity 13 Application of sound environmental principles
Where One Health is applicable? Strategic framework One Health Food Safety Key Themes Human Health Animal Health Environment Agriculture Interface Areas Focal Area Infectious Diseases 14 Medium & Long-term Goals
Components (1.) Institutional governance & Programme management (2.) Coordinated surveillance (8.) Social & economic aspects of diseases (3.) Coordinated outbreak, preparedness, prevention & response (9.) Wildlife & ecology (4.) Applied research 15 (7.) Capacity building (6.) Strategic communication & advocacy (5.) Networks & partnerships
Assessing the Impact Component 1: Institutional governance and programme management Outcome: Institutional arrangements for facilitating the One Health approach Objective Indicators Means of Verification Assumption To ensure institutional arrangements, policy frameworks and management mechanisms of One Health. 1) O H approach to at least one disease functioning with effective collaboration 2) Policy frameworks developed 3) Management in place 1) Documented MOU arrangement to establish processes 2) Documented evidence of policy frameworks 3) Project management outputs Institutional will and commitment to resolving constraints Component 2: Coordinated Surveillance Outcome: Coordinated surveillance for EIDs under One Health approach Objective Indicators Means of Verification To undertake coordinated One Health surveillance activities Coordinated surveillance system for EIDs with contribution from and sharing among sector partners 1) Reports showing joint surveillance activities, 2) Pooling of data from different sectors. Assumptions 1) Institutional arrangements in place, 2) Resources available to build necessary capacity across sectors.
Challenges for One Health As an emerging field, One Health is still an amorphous entity Educational & research in One Health still to be further defined Relationship between the different disciplines still to be further developed Collaborative practices are still evolving, at different rates, in varying ways in different parts of the world
Difficulties with diverse teams Dissent & disagreement arouse negative feelings Social networks tend to be homogenous Diverse teams have less cohesion & longevity
Professional & institutional barriers Different Ministries MOHFW MOFL MOA MOEF Different objectives Different lines of authorities Different professional backgrounds Separate personal backgrounds Political will & commitment Proof of success Economic benefit Cultural Change
Impact of One Health Before H5N1 Zoonoses H5N1 Since H5N1 Other zoonoses Communication - +++ +/- Coordination - ++ +/- Collaboration +/- ++ + Integration _ + _
Key Supporting Elements Assess Political will & high-level commitment ++ Attributes for enhancing One Health Trust + Key Operational Elements Assess Common objectives & priorities +++ Joint cross-sectoral coordination ++ Shared benefits +++ Routine communication + Strong governance structures, aligned legal frame works & recognition of existing international standards +/- Joint simulation exercises - Data sharing +/- Adequate & equitably distributed resources +/- Joint risk assessment + Identification & involvement of all relevant partners ++ Joint risk assessment +/- Guidance on implementation of crosssectoral collaborations + Active cooperation on diseases + Capacity development +
Way Forward Implementation of One Health action plan & strategy Transforming One Health into a think tank for One Health Continuing advocacy for inter-sectoral collaboration, cooperation, coordination & integration Ensure One Health practices at community level Transform One Health as a Whole-Of-A-Society Movement
Albert Einstein once said: We can t solve problems using the same kind of thinking we used when we created them.
Acknowledgements Department of Livestock Services & MOFL Institute of Epidemiology and Disease Control Research (IEDCR) & MOFW&H Department of Forestry & MOE&F ICDDRB FAO UNICEF WHO One Health Chittagong Veterinary and Animal Sciences University 24