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To generate and employ scenarios of sentinel human and animal outbreak cases in local contexts that integrate human and animal health interests and practices and facilitate outbreak risk management readiness.
Methods
We conducted a scoping review of past outbreaks and the strengths and weaknesses of response efforts in USAID STOP Spillover program countries. This information and iterative query-and-response with country teams and local stakeholders led to curated outbreak scenarios emphasizing One Health human:animal interfaces at sub-national levels.
Results
Two core scenarios were generated adapted to each of 4 countries’ pathogen priorities and workflows in Africa and Asia, anchoring on sub-national outbreak response triggered by either an animal or human health event. Country teams subsequently used these scenarios in a variety of local preparedness discussions and simulations. The process of creating outbreak scenarios encourages discussion and review of current country practices and procedures. Guideline documents and lessons learned do not necessarily reflect how workflows occur in outbreak response in countries at highest risk for spillover events.
Conclusions
Discussion-based engagement across One Health stakeholders can improve sub-national coordination, clarify guidelines and responsibilities, and provide a space for interagency cooperation through use of scenarios in tabletop and other exercises.
From its beginnings in the 1978 Declaration of Alma-Ata, universal health coverage (UHC) has been constantly evolving, notably so within the last ten years. Although the 2015 Sustainable Development Goals, which identify both UHC and social protection among its targets, represent an important juncture in this evolution, several States are unlikely to meet the 2030 target deadline. This article traces the history of UHC and social (health) protection in global health law, focusing on their development over the past ten years. It concludes by reflecting on what the future of UHC and social (health) protection should look like and what is needed to fully realize their potential to achieve equity and to meaningfully contribute to the betterment of people and planet, highlighting human rights, One Health, legal and financial considerations as key for the future.
There are over 200 known zoonotic diseases. Over half of all recognized human pathogens are currently or originally zoonotic, as are 60%-76% of recent emerging pathogens, yet a few are coded in International Classification of Diseases-11 (ICD-11). The practice of animal health estimates is fragmented. The numbers and categorization of animals are not consistent across different organizations or over time. The coding attributes of ICD-11 on morbidity, mortality, and zoonoses don’t exist in WAHIS. An innovation in methodology to adopt ICD-11 in World Animal Health Information System (WAHIS) and code for zoonoses is required. To meet the key principles of One Health High-Level Expert Panel (OHHLEP) and translate the One Health approach into actionable policies, there is a compelling need to estimate the magnitude of all human and animal diseases, particularly zoonoses, using the refined codes of ICD-11.
The One Health framework has gained more importance in recent years, especially in the wake of the COVID-19 outbreak and the rise of other zoonotic diseases. However, complexities arise in the application of the One Health approach within the context of a global public health disease outbreak, especially in a culturally rich, as well as economically and politically distinctive region such as the Middle East and North Africa (MENA) region. Against this background, the chapter asks: What are the limits of the effective implementation of the One Health framework in the MENA region? This chapter examines this question through the theoretical lens of Substantive Legal Effectiveness (SLE), which suggests that law’s failure to reflect the diverse identities, needs, and contexts of all subject to the law, especially those who are already socially, economically, ethnically and/or historically marginalized, affects law’s effectiveness. While SLE offers a comprehensive and distinctive overarching framework to examine the limits of the One Health Framework in the MENA region, the chapter also draws upon the theoretical contributions of decolonial studies, specifically on the subject of decolonization of health and ecological knowledges.
The effect of reservoir construction on medically important parasites is well known worldwide but lacks information in Vietnam. With 385 active hydropower plants and numerous water reservoirs, Vietnam provides an ideal setting for studying this issue. This study investigated trematode infection in snail first intermediate hosts from three hydropower reservoirs: Hoa Binh, Son La, and Thac Ba. In total, 25,299 snails representing 16 species were examined, with 959 individuals (8 species) shedding identifiable cercariae. Infection prevalence was highest in thiarid snails (5.4%–15.4%), followed by bithynid snails (2.9%–5.8%). Other snail species showed infection prevalence ranging from 0.3% to 2.9%. Infection prevalence varied significantly across regions, with the highest prevalence in Son La, followed by Hoa Binh and Thac Ba reservoirs. However, no significant differences were observed between snails collected from reservoirs versus canals and paddy fields. Morphological identification resulted in nine cercarial morphotypes, with pleurolophocercaria, xiphidiocercariae, and echinostome being the most common types, accounting for 89.2% of all cercarial infections. Echinostome cercariae were found in seven snail species, while the other cercarial morphotypes were shed by two to five species. Gabbia fuchsiana, Parafossarulus manchouricus, and Melanoides tuberculata were the most common hosts, each harboring five cercarial morphotypes, while Radix auricularia only released echinostome type. In conclusion, our findings highlight the endemic presence of trematodes in hydropower reservoirs and emphasize the need to consider the human-environment interaction around these reservoirs for a better understanding of disease transmission risks.
There is a pressing need for novel approaches to help address climate change and for a workforce that is equipped with a combination of new and different types of knowledges. The One Health (OH) core competencies perhaps offer the new knowledges, skills and attitudes that will be needed in a future generation of practitioners that does not shy away from complexity. The objective of this research was to identify overlapping and transferable OH-climate change competencies that are needed of professionals working to address climate change. Using focus groups and qualitative content analysis, 23 professionals from across Canada whose employment positions had a key focus on climate change were brought together across five sessions. Participants agreed that the OH competencies were applicable to their employment roles and responsibilities, but they identified four key missing areas that are important for graduates: evaluative and reflective practice, personal resilience, turning knowledge into action and having an openness to other knowledges (particularly Indigenous and non-Western viewpoints). This work also provided a first iteration of a process that should be continually used to bridge the gap between theory and practice, as employer needs are a key consideration during the development of educational programs.
In 2022, the largest ever virgin soil outbreak of Japanese encephalitis (JE) occurred in Australia resulting in 45 reported human cases of JE, with seven fatalities. Japanese encephalitis virus (JEV) was detected in 84 piggeries across Australia. In response, states implemented targeted vaccination programs for those individuals at the highest risk of JEV exposure. A mixed methods approach, including geospatial mapping of JEV vaccine distribution in Queensland, a case series of Queensland human cases and interviews with Queensland Health staff, assessed the JEV vaccination response program. Five notified human cases were reviewed, with three having occupational outdoor risk and local travel-related exposure. Vaccine coverage ranged from 0 to 7.4 doses per 100 people after 12 months of the program. The highest uptake was in southern Queensland, where 95% of the state’s commercial pig population is located. The vaccination program was limited by a heavy reliance on general practitioners, vast geographical distribution of eligible populations, difficulties mobilising and engaging eligible cohorts, and suboptimal One Health collaboration. Population and climate factors make it possible for the virus to become endemic. Targeted vaccination programs remain an important strategy to protect people at the highest risk of exposure, however, program improvements are required to optimize vaccine accessibility.
Gastrointestinal infections constitute a significant global health concern, particularly in tropical and subtropical regions, caused by various pathogens. Among these, Cryptosporidium spp. and Giardia duodenalis are noteworthy due to their zoonotic potential. In Algeria, molecular epidemiological data on cryptosporidiosis and giardiasis are limited. To fill this gap, the present study aimed to examine the transmission dynamics of Cryptosporidium spp., and Giardia duodenalis in various households. A total of 216 samples were collected from the rural Guelma and Souk Ahras provinces, located in the eastern part of Algeria. These included human and animal faeces, as well as water and soil samples. DNA was extracted, followed by nested PCR targeting the SSU rRNA gene to detect Cryptosporidium spp., while the gp60 gene was amplified for subtyping. Detection of G. duodenalis was performed by qPCR targeting the SSU rRNA gene, followed by amplification of tpi, bg and gdh genes for genotyping and subtyping. Several Cryptosporidium species, including C. bovis, C. ryanae, C. andersoni and C. parvum, were identified in human, animal and environmental samples. The zoonotic C. parvum subtype IIaA17G2R1 was detected in human, animal and soil samples. Giardia duodenalis assemblage B was detected in a human sample, while assemblage E was found in cattle and sheep. The current investigation underscores the importance of the One Health approach in addressing issues related to intestinal parasites, highlighting the need for improved surveillance and control measures in rural settings.
Reducing antimicrobial use (AMU) in livestock may be one of the keys to limit the emergence of antimicrobial resistance (AMR) in bacterial populations, including zoonotic pathogens. This study assessed the temporal association between AMU in livestock and AMR among Campylobacter isolates from human infections in the Netherlands between 2004 – 2020. Moreover, the associations between AMU and AMR in livestock and between AMR in livestock and AMR in human isolates were assessed. AMU and AMR data per antimicrobial class (tetracyclines, macrolides and fluoroquinolones) for Campylobacter jejuni and Campylobacter coli from poultry, cattle, and human patients were retrieved from national surveillance programs. Associations were assessed using logistic regression and the Spearman correlation test. Overall, there was an increasing trend in AMR among human C. jejuni/coli isolates during the study period, which contrasted with a decreasing trend in livestock AMU. In addition, stable trends in AMR in broilers were observed. No significant associations were observed between AMU and AMR in domestically produced broilers. Moderate to strong positive correlations were found between the yearly prevalence of AMR in broiler and human isolates. Reducing AMU in Dutch livestock alone may therefore not be sufficient to tackle the growing problem of AMR in Campylobacter among human cases in the Netherlands. More insight is needed regarding the population genetics and the evolutionary processes involved in resistance and fitness among Campylobacter.
The One Health High-Level Expert Panel’s definition of One Health includes optimizing the health of people, animals (wild and domestic) and ecosystems. For many One Health practitioners, wildlife that can spread zoonoses are the focus, particularly if they can come in contact with people. However, ecosystem health is often best-indicated by less-encountered species, for instance, amphibians and reptiles. This review highlights how these taxa can benefit human health and well-being, including cultural significance, as well as their impact on plant, animal and environmental health. We highlight current challenges to the health of these species and the need to include them in the One Health Joint Action Plan. We conclude with a call to action for inclusion of amphibians and reptiles in a One Health approach.
Knowledge about One Health approach and its importance among the practitioners and the community in addressing health threats is of paramount important. This study aimed to assess knowledge of One Health actors on multi-sectoral coordination in addressing health risks in selected regions of Tanzania. A descriptive study was conducted from June to August 2023 in selected regions of Arusha, Iringa and Dodoma where quantitative and qualitative data were collected from 101 participants representing the line ministries and sub-national regional and district levels. Descriptive analysis was done using EPI INFO 7.2.5.0 statistical software and Microsoft excel. Results showed a decreasing proportion of participants reporting to be aware of One Health approach at the National level with 100.0% awareness and only 32.3% awareness at the district level. It was also revealed that 76.9% of the participants at the national level had received One Health training through short courses, workshops meetings, and Continuous Professional Development (CPD) courses compared to the varying proportions of 57.7% and 19.4% at the regional and district level, respectively. Limited awareness of different professional disciplines on One Health approach is the major challenge in its operationalisation and institutionalisation at sub-national levels. Awareness creation to One Health actors and advocacy to policy and decision-makers at all levels will enhance implementation, multi-sectoral coordination and collaboration among key actors in addressing health risks emergencies.
In 2020, the Kuujjuaq Dog Project (KDP) was operationalized in the Northern Village of Kuujjuaq (Québec, Canada) to mitigate issues at the human–dog interface. Differing from previous interventions in its EcoHealth approach, it provided veterinary services, educational components (school workshops and Facebook posts) and strengthened local dog control measures. In 2022, an implementation evaluation assessed its quality of its delivery, differentiation, adaptations and the community’s responsiveness. The study followed key principles of the One Health approach and a mixed-methods design, combining a survey of 74 participants and individual interviews with 10 key stakeholders and 25 other community members. Analysis confirmed the relevance of the KDP, highlighting its innovative nature compared to previous dog-related interventions in northern Québec. Awareness of and exposure to the KDP’s components varied considerably between veterinary services (89%), Facebook posts (55%) and school workshops (27%). Global exposure to both the veterinary services and educational components was lower among Inuit, men and non-dog owners (not statistically significant). Barriers and facilitators to implementation included long-term engagement of stakeholders and building meaningful partnerships with local stakeholders. Beside supporting the future evolution of the KDP, this study fills knowledge gaps on how to successfully implement integrated, participatory interventions in northern Indigenous communities.
We aimed to estimate the overall apparent prevalence, true prevalence, and the spatial, temporal, and test-specific burden of bovine tuberculosis in Bangladesh. PubMed, Web of Science, Scopus, Google Scholar, and BanglaJOL were searched for bovine tuberculosis publications in Bangladesh from 1 January 1970 to 23 June 2023. Of 142 articles screened, systematic review and meta-analysis were performed on 22 (15.5%) articles. The apparent estimated bovine tuberculosis prevalence was 7%. The apparent Bayesian pooled mean bovine tuberculosis prevalences based on caudal fold test and single intradermal comparative tuberculin test were 7.83% and 9.89%, respectively, and the true pooled mean prevalences were 10.39% and 10.48%, respectively. Targeted interventions are recommended for districts with higher prevalence to effectively reduce the bovine tuberculosis burden in those areas. Current diagnostic practices employed in Bangladesh may not accurately reflect the bovine tuberculosis burden. Our findings highlight the need for better diagnostic tools and supplemental testing methods to ensure accurate diagnosis and surveillance. Efforts should prioritize obtaining ‘true’ prevalence estimates corrected for misclassification bias, rather than relying solely on apparent prevalence. Underestimating the bovine tuberculosis burden could result in inadequate resource allocation and hinder the implementation of effective control measures.
Multidisciplinary One Health (OH) collaboration coupled with information communication and technology provides an avenue for combating and avoiding emerging and reemerging diseases. In 2020, AFROHUN-Kenya organized a OH App development hackathon to build an application for frontline community health workers to respond to OH challenges. This article describes the purpose, process, benefits and challenges of this hackathon. Forty-nine participants, divided into eight groups took part in the hackathon. The teams ranged from four to eight members, with 55% female. A total of eight applications were developed during the hackathon all of which are in the process of patenting, before deployment as open-source applications. In the post-hackathon survey, 95% of participants indicated that they had a better grasp of the topic because of the team members’ diverse perspectives and that working in multidisciplinary teams had resulted in new friendships and partnerships. In total, 72% of respondents indicated they would be interested in participating in another hackathon. However, 65% of the respondents suggested that the training time be lengthened. This study demonstrates that multidisciplinary hackathons effectively enhance learning, significantly impact communities and improve students’ soft skills, including project and time management, interpersonal communication, motivational strategies and problem-solving.
The need for a planetary approach to healthcare is widely recognised at national and international levels. Social prescribing is becoming an increasingly popular strategy for meeting contemporary social, physical and mental health needs as well as tackling health inequalities. As this is a relatively new and emerging healthcare intervention, a comprehensive and accurate understanding of its impact is essential to support continued improvements in care, develop strategies for scale-up and delivery and justify further funding and investment. Nature-based Social Prescribing (NBSP) has unique potential to affect animal and environmental outcomes as well as human health. The One Health perspective can be used to operationalise and evaluate NBSP. This article presents the Nature-based Social Prescribing Impact Pathways (NaBSPIP) framework, which can be used to guide NBSP design and evaluation to leverage maximum benefit for humans, animals and the environment that we share.
One Health emerges from the contingent scientific, social, and political realities of environmentalism. The concept mixes the land, sea, and sky with geopolitics on the global stages of the United Nations and World Health Organization. It inspires new investment in conservation and public health, motivates interdisciplinary collaboration, and in practice implicates green economies and animal law as well. This Element does not tackle all of this but attempts to situate One Health in the catastrophe of COVID-19; a socio-ecological upheaval prophetic of the inevitable next pandemic evolving from planetary climate crisis of our own making. One Health Environmentalism argues that humanity's future depends upon extending an olive branch to biotic communities, by being less speciesist and less blind to the rights in nature.
Ross River virus (RRV), the most medically and economically important arbovirus in Australia, has been the most prevalent arbovirus infections in humans for many years. Infected humans and horses often suffer similar clinical symptoms. We conducted a prospective longitudinal study over a 3.5-year period to investigate the exposure dynamics of RRV in three foal cohorts (n = 32) born in a subtropical region of South East Queensland, Australia, between 2020 and 2022. RRV-specific seroconversion was detected in 56% (n = 18) of foals with a median time to seroconversion, after waning of maternal antibodies, of 429 days (95% CI: 294–582). The median age at seroconversion was 69 weeks (95% CI: 53–57). Seroconversion events were only detected between December and March (Southern Hemisphere summer) over the entire study period. Cox proportion hazards regression analyses revealed that seroconversions were significantly (p < 0.05) associated with air temperature in the month of seroconversion. Time-lags in meteorological variables were not significantly (p > 0.05) associated with seroconversion, except for relative humidity (p = 0.036 at 2-month time-lag). This is in contrast to research results of RRV infection in humans, which peaked between March and May (Autumn) and with a 0–3 month time-lag for various meteorological risk factors. Therefore, horses may be suitable sentinels for monitoring active arbovirus circulation and could be used for early arbovirus outbreak detection in human populations.
Trauma is a common cause of morbidity and mortality in humans and companion animals. Recent efforts in procedural development, training, quality systems, data collection, and research have positively impacted patient outcomes; however, significant unmet need still exists. Coordinated efforts by collaborative, translational, multidisciplinary teams to advance trauma care and improve outcomes have the potential to benefit both human and veterinary patient populations. Strategic use of veterinary clinical trials informed by expertise along the research spectrum (i.e., benchtop discovery, applied science and engineering, large laboratory animal models, clinical veterinary studies, and human randomized trials) can lead to increased therapeutic options for animals while accelerating and enhancing translation by providing early data to reduce the cost and the risk of failed human clinical trials. Active topics of collaboration across the translational continuum include advancements in resuscitation (including austere environments), acute traumatic coagulopathy, trauma-induced coagulopathy, traumatic brain injury, systems biology, and trauma immunology. Mechanisms to improve funding and support innovative team science approaches to current problems in trauma care can accelerate needed, sustainable, and impactful progress in the field. This review article summarizes our current understanding of veterinary and human trauma, thereby identifying knowledge gaps and opportunities for collaborative, translational research to improve multispecies outcomes. This translational trauma group of MDs, PhDs, and DVMs posit that a common understanding of injury patterns and resulting cellular dysregulation in humans and companion animals has the potential to accelerate translation of research findings into clinical solutions.
We used a narrative literature review to identify attributes of One Health practitioners who can close the gap between intention and action to protect and promote health in this era of polycrises. The intention in this essay was to instigate discourse that challenges the current state of One Health teaching and practice, thus helping us reflect on how to future-ready One Health. One Health researchers and practitioners must become agents of change who accelerate and amplify innovations that promote One Health as a settings-based approach to advance interspecies and intergenerational health equity. This essay outlines how future readiness and disruption are intertwined and proposes that One Health training needs to cultivate curiosity, agility and convergence thinking to create future-ready researchers and practitioners. Institutional systems that can support future-ready One Health agents of change will need to be attentive to mechanisms that close the knowing-to-doing gap and promote crossing barriers. Game changing One Health requires greater investment in cross-cutting capacities and ideas that will make it easier to see what is working and for whom. At the heart of this issue is the need to mainstream concepts of fairness and redistribution of the health resources between people, animals, and settings.
Climate change significantly impacts our planet’s health, ecosystems, plants, animals and humans, increasing extreme weather events and the incidence and prevalence of infectious diseases, including zoonotic diseases. We reviewed the environmental changes affecting human, animal and planetary health and conducted a bibliometric analysis from 2012 to 22 that included these components. We identified 448 publications published on the topic throughout that period. Then, we reflected on the Research Directions question: How can we improve and facilitate multi-sectoral collaboration in warning and response systems for infectious diseases and natural hazards to account for their drivers, interdependencies and cascading impacts? The bibliometric analysis of planetary health has shown increasing interest among researchers since 2017, peaking in 2022. Lancet Planetary Health was the journal with more published articles; The London School of Hygiene and Tropical Medicine was the best-placed institution, and The United States led in topic-related publications. On the other hand, the climatic and pandemic global environmental crises demand fostered surveillance, which should concentrate on the drivers of disease, giving signals that account for human and animal health and environmental degradation. In response to global crises, higher education curricula should integrate One Health and Planetary Health approaches to achieve transdisciplinary thinking, allowing transcend knowledge, research and observation into action.