Stark K.D.C.,Royal Veterinary College |
Stark K.D.C.,SAFOSO Inc. |
Arroyo Kuribrena M.,World Organisation for Animal Health |
Dauphin G.,Food and Agriculture Organization of the United Nations FAO |
And 4 more authors.
Preventive Veterinary Medicine | Year: 2015
One Health surveillance describes the systematic collection, validation, analysis, interpretation of data and dissemination of information collected on humans, animals and the environment to inform decisions for more effective, evidence- and system-based health interventions. During the second International Conference on Animal Health Surveillance (ICAHS) in Havana, Cuba, a panel discussion was organised to discuss the relevance of One Health in the context of surveillance. A number of success stories were presented which generally focused on the obvious interfaces between human and veterinary medicine such as zoonoses and food safety. Activities aimed at strengthening inter-sectoral networking through technical collaboration, conferences, workshops and consultations have resulted in recommendations to advance the One Health concept. There are also several One Health educational programmes offered as Masters programmes. Continuing challenges to One Health surveillance were identified at both technical as well as organisational level. It was acknowledged that the public health sector and the environmental sector could be engaged more in One Health activities. Legal issues, hurdles to data sharing, unclear responsibilities and structural barriers between ministries prevent integrated action. Policy makers in the health sector often perceive One Health as a veterinary-driven initiative that is not particularly relevant to their priority problems. Whilst some funding schemes allow for the employment of scientists and technicians for research projects, the development of a sustainable One Health workforce has yet to be broadly demonstrated. Funding opportunities do not explicitly promote the development of One Health surveillance systems. In addition, organisational, legal and administrative barriers may prevent operational implementation. Strategies and communication across sectors need to be aligned. Whilst at the technical or local level the formal separation can be bridged, separate funding sources and budgets can jeopardise the overall strategy, especially if funding cuts are later required. To overcome such challenges, a strong business case for One Health surveillance is needed. This should include the costs and benefits of One Health activities or projects including consequences of different strategies as well as risks. Integrated training should also be further promoted. Future ICAHS conferences should continue to provide a platform for discussing surveillance in the One Health context and to provide a forum for surveillance professionals from all relevant sectors to interact. © 2015 Elsevier B.V. Source
Bruckner G.K.,World Organisation for Animal Health
Journal of the South African Veterinary Association | Year: 2014
The historical evolution of veterinary services in South Africa is closely linked to the colonial history of the past and the eventual political formation of the Union of South Africa in 1910, as well as the establishment of a fully democratic South Africa in 1994. The majority of the early pioneering veterinarians had close links to military activities and were originally mostly of British origin. The appointment of the first colonial chief veterinary officers occurred in the late 1800s. These appointments were dictated by the need to combat devastating animal diseases, such as rinderpest and African horse sickness, mainly because they affected draught oxen (used for travel) and horses (used in combat). Veterinary field services was established in 1962 as a separate functional entity within government services when M.C. Lambrechts became Director of Veterinary Services of South Africa. In the context of this article, veterinary field services refers to that sphere of veterinary service delivery conducted by government-appointed or seconded veterinarians applying disease control and prevention, as required by animal health legislation. Paging through the history of veterinary field services in South Africa confirms that the problems faced by the veterinary services of today were just as real during the times of our pioneers. The pioneers of veterinary services transformed unknown animal diseases into textbook descriptions still used today and also demonstrated the important link to, and use of, the observations made by farmers, as well as the need for continued basic and applied research on animal diseases. This article provided a brief overview of the evolution of veterinary field services and the important role played by pioneers over the last two centuries to make South Africa relatively free and safe from the most important trade-sensitive and economically important animal diseases. © 2014. The Authors. Source
Machalaba C.C.,Ecohealth Alliance |
Elwood S.E.,Ecohealth Alliance |
Forcella S.,World Organisation for Animal Health |
Smith K.M.,Ecohealth Alliance |
And 9 more authors.
Emerging Infectious Diseases | Year: 2015
Wild birds play a major role in the evolution, maintenance, and spread of avian influenza viruses. However, surveillance for these viruses in wild birds is sporadic, geographically biased, and often limited to the last outbreak virus. To identify opportunities to optimize wild bird surveillance for understanding viral diversity, we reviewed responses to a World Organisation for Animal Health–administered survey, government reports to this organization, articles on Web of Knowledge, and the Influenza Research Database. At least 119 countries conducted avian influenza virus surveillance in wild birds during 2008–2013, but coordination and standardization was lacking among surveillance efforts, and most focused on limited subsets of influenza viruses. Given high financial and public health burdens of recent avian influenza outbreaks, we call for sustained, cost-effective investments in locations with high avian influenza diversity in wild birds and efforts to promote standardized sampling, testing, and reporting methods, including full-genome sequencing and sharing of isolates with the scientific community. © 2015, Centers for Disease Control and Prevention (CDC). All rights reserved. Source
Day M.J.,University of Bristol |
Breitschwerdt E.,North Carolina State University |
Cleaveland S.,University of Glasgow |
Khanna C.,U.S. National Cancer Institute |
And 9 more authors.
Emerging Infectious Diseases | Year: 2012
The One Health paradigm for global health recognizes that most new human infectious diseases will emerge from animal reservoirs. Little consideration has been given to the known and potential zoonotic infectious diseases of small companion animals. Cats and dogs closely share the domestic environment with humans and have the potential to act as sources and sentinels of a wide spectrum of zoonotic infections. This report highlights the lack of a coordinated global surveillance scheme that monitors disease in these species and makes a case for the necessity of developing a strategy to implement such surveillance. Increasingly, the concept of One Health is recognized as a valuable paradigm for global health management. One Health is an initiative that seeks greater integration of human and veterinary medicine in areas as diverse as infectious disease control and comparative and translational medical research. A major focus of One Health has been on infectious diseases shared by humans, production animals (e.g., cattle, sheep, pigs, and poultry), companion animals, and wildlife in the context of ecosystems and the physical environment. An area of One Health that has garnered much attention has been the emergence or reemergence of infectious disease, and the finding that ≈75% of newly reported human infections have emerged, and are therefore likely to continue to emerge, from an animal reservoir (1). Such zoonotic infections could be of the following types: infections transmitted directly from animals to humans; vector-borne infections in which an animal or human is infected by the vector; or infections in which animals act as a reservoir for disease transmission, including having the potential for contaminating human food and water sources. A key goal of the evolving One Health paradigm includes surveillance of infectious diseases in domestic and wild animals to anticipate emergence of new zoonoses and protect humans. To achieve this goal, it is essential that global resources be allocated for more effective disease surveillance and reporting schemes that incorporate environmental, human, and veterinary health professionals. Many systems are in place nationally or globally to monitor human and production animal (and to a lesser extent, wild animal) disease (2), but major gaps in surveillance remain, particularly the lack of a surveillance infrastructure that includes companion animals. From a One Health perspective, companion animals can serve as sources of zoonotic infections, as intermediate hosts between wildlife reservoirs and humans, or as sentinel or proxy species for emerging disease surveillance (3). The aims of this review are to define and quantify the role of companion animals in the human domestic and peridomestic environment, highlight the major companion animal zoonoses and the potential for emergence of new human infections transmitted from these species, emphasize the lack of global infectious disease surveillance in these species against the current background of human and production animal surveillance, and suggest how to address this major One Health deficiency in the future. Source
The effectiveness of antibiotics has been waning since they were introduced into modern medicine more than 70 years ago. Today, our inability to treat infections ranks alongside climate change as a global threat1, 2. New classes of antimicrobial drugs are unlikely to become widely available any time soon1; if and when they do, bacteria, viruses and other microbes will again evolve resistance3. In any case, waging war on microbes is not tenable3 — our bodies and planet depend on them4 (see Supplementary Information). Addressing resistance requires global collective action. Like the ozone layer, a stable climate or biodiversity, the global population of susceptible microbes is a common pool resource — one shared by all. But no individual or country has a strong enough incentive to conserve this 'commons'. It has been depleted by the massive use of antimicrobial compounds and the growing competitive advantage of resistant microbes. It is a classic 'tragedy of the commons'. This intimate relationship with microorganisms predates modern humans. It is the result of many millions of years of co-evolution. Our bodies need particular kinds of microbes for digestion, immune function and general health. Equally, microbes support planetary health, for example, through nutrient cycles, including those that maintain soil and water quality4. In other words, microbes sustain human civilization. Yet our understanding of the complex interactions and uncertainties that govern the relationships between humans and microbes is limited. The 2015 Global Action Plan on Antimicrobial Resistance, drafted by the World Health Organization (WHO) with support from the United Nations Food and Agricultural Organization (FAO) and the World Organisation for Animal Health (OIE), recognizes the need for multisectoral cooperation to address resistance (see go.nature.com/2bbijap). But, in our view, it does not go far enough in recognizing the life support we receive from the global microbiome. Tackling resistance urgently requires the scaling back of the massive overuse of antibiotics to secure the liveability of Earth in the long term. On 21 September, heads of state will meet to take further action at the United Nations high-level meeting on antimicrobial resistance in New York City. A UN declaration currently under discussion must set global targets, accelerate implementation of the global action plan, plug its gaps and ensure stronger accountability and interagency coordination. It must emphasize the many benefits of microbes. Parties should aim to build the resilience of society and the microbiome. In our opinion, this is the way to maintain low levels of resistance amid the many surprises of a rapidly changing planet. Advances from studying resilience in other common pool resources such as fisheries and forests5 suggest key steps for antimicrobial resistance, which we set out below. Achieving these will require changes to institutions, regulations, education, community norms and expectations, notably in medicine and agriculture. Until now, political and financial investments have focused largely on creating incentives to fuel drug innovation and new or faster diagnostics. Currently, such technological fixes appeal to and benefit mainly rich nations in the 'global north'. Incentives must be targeted to benefit not only large pharmaceutical companies in the north, but also to enlist research and development efforts globally. One of the most important outcomes of the UN meeting should be national commitments to the broadest and most creative participatory education campaigns about resistance2 and the importance of the microbial world. Why? Because the level of ignorance about the calamity that is antimicrobial resistance is staggering. A 2015 WHO survey across 12 countries found that 64% of the public think that antibiotics also work for, for instance, viral infections such as influenza and colds (see go.nature.com/2c7zvfu). Such basic knowledge gaps lead patients and physicians to reach for antibiotics without appreciating the costs. Instead, institutions and citizens must understand the central facts, context and risks in a way that allows them to learn more independently. This goal requires awareness campaigns to be revised and scaled up by orders of magnitude2, as well as investment in new communication tools. Initiated in 2007, Thailand's Antibiotics Smart Use project sets a direction for upscaling. It enables patients in pharmacies to self-diagnose on the basis of the appearance of their sore throat to verify whether they need antibiotic treatment6. For further learning, citizen-science programmes in which participants monitor their own microbiomes should be extended to cover, for example, self-testing for resistance in various parts of the body7. Such campaigns could engage communities and change norms about how and when to use antibiotics. Campaigns will need to be coordinated internationally for quality and impact, and adapted to suit regional perspectives. Engagement can be spread through schools, mass media and social media. Resistance affects animal and environmental health as well as human health, and so requires coordinated action across economic sectors. No single concern exemplifies this better than the high rate of antibiotic use in agriculture (largely as growth promoters or disease prevention). In the United States, 70–80% of all antimicrobials consumed are given to livestock; agricultural use in the BRICS emerging economies (Brazil, Russia, India, China and South Africa) is expected to double by 2030, as compared to 2010 levels8 (see 'Farm forecast'). As a result, antibiotics and resistance genes enter the food chain, soil and the water table, threatening human health. The European Union has phased out the use of medically important antibiotics for growth promotion in agriculture. Other countries, including Mexico and Taiwan9, have sought to reduce it. In the United States, a directive discourages the use of antibiotics for growth promotion through voluntary measures and stronger veterinary oversight of therapeutic use. However, the powerful industrial farming lobby and a lack of perceived urgency have so far stalled stronger mandates. Stronger political action to change how we use antibiotics, whether by humans or animals, requires citizens to be better informed. For instance, the public should have online access to surveillance that tracks how human resistance increases in settlements near farms. In the meantime, consumer groups play a crucial part by calling on retail chains to switch where their meat is sourced. For example, US food chains Chipotle, McDonald's and Chick-fil-A have responded (to varying degrees) to public demands with stricter limits on antibiotic use in the meat they sell. A particularly worrying issue that is not confined to the use of antimicrobials in food production is the international spread of resistance genes, especially those conferring resistance to many drugs of 'last resort'. Most recently, a mobile plasmid gene carrying resistance to the last-resort antibiotic colistin has been found in Asia, Europe and North America. Clearly, countries cannot act alone to deal with the problem without jeopardizing the benefits of globalization. Much better surveillance and containment is needed of the most dangerous multiresistant strains in people and food2. A global routine-surveillance initiative could help to prevent the spread of resistance. It could screen medical tourists or patients returning from hospitals abroad to identify carriers of multiple resistant strains. Hospitals that are centres of international travel for medical treatment must lead the way; funding and learning mechanisms must be increased for other hospitals to follow suit. The International Health Regulations, revised by WHO member states in 2005, are a legally binding instrument that aims to provide global surveillance and response. Properly financed, they could be effective10. Yet the resources needed to respond to emerging diseases do not flow commensurately to low- and middle-income countries as they do in the global north — a key lesson of the recent Ebola outbreak. All governments have a collective responsibility to improve capacities for rapid response to resistance. Greater support by donor countries to new and existing funding mechanisms such as the Global Fund to Fight AIDS, Tuberculosis and Malaria is needed in low- and middle-income countries. International and national coalitions must be broadened. The global action plan strengthens the established collaboration between the WHO, FAO and OIE. This should be extended to cover other relevant sectors, including trade, development and environment. The model set up by UNAIDS (the Joint United Nations Programme on HIV/AIDS) in 1996 serves as an example of how to intensify collaboration, leverage resources, involve more parties and reduce barriers. The UN meeting must commit to driving learning between institutions. Global platforms are needed for sharing best practices and the latest data about resistance levels and antibiotic consumption, for instance, among national agencies. Such exchange happens in Europe for resistant human bloodstream infections, and human and veterinary antimicrobial consumption. This must be scaled up to monitor resistance in communities, food industry and the environment. A relevant model for exchange at the global level is the WHO's Pandemic Influenza Preparedness Framework. To engage the public effectively, more-frequent updating, vivid visualizations and engaging communications are needed. As in the Paris climate agreement, countries should submit to the UN voluntary but monitored targets on limiting resistance. Parties may go further by making shortfalls subject to potential sanctions. A key priority is to establish measurable indicators at the country level, such as the median yearly consumption of antibiotics per person. As for the climate issue, non-state actors from business to civil society can be central to societal transformations. Such stakeholders were consulted during the development of the WHO global action plan. But their participation in the long run must become more integral to the global coalition responsible for tackling resistance. Available governance instruments range from binding treaties to guidelines, with each approach having pros and cons. A first step to holding companies accountable would be an international code on the promotion of antibiotics (promotional spending in the United States in 1998 amounted to US$1.6 billion), akin to that adopted by the WHO in 1981 on the marketing of breast-milk substitutes. The complexity and gravity of resistance call for the immediate mass mobilization of society. Maintaining the susceptibility of microbes to drugs for global health is a matter of sustainable development. Improving understanding about humankind's dependence on the global microbiome should lead to action on many other important issues involving microorganisms. These issues include infectious diseases, food security, natural resources and environmental conservation. Action here could, in turn, lead to more-equitable forms of national progress across the sustainable-development goals3. Building global resilience to resistance is a long game. But changes can be surprisingly fast when the time is ripe and a plan is ready. This month's UN high-level meeting is a rare opportunity for global collective action on human interactions with microbes. It must protect both the lifesaving power of antibiotics and the ability to use them when necessary.