Insights into Editorial: A ‘One Health’ approach that targets people, animals

Introduction:

The father of modern pathology, Rudolf Virchow, emphasised in 1856 that there are essentially no dividing lines between animal and human medicine.

This concept is ever more salient as the world continues to grapple with the COVID-19 pandemic.

Discussions that took place around World Veterinary Day, on April 24, 2021, focused on acknowledging the interconnectedness of animals, humans, and the environment, an approach referred to as “One Health”.

One Health Approach:

One Health recognizes that the health of humans, animals and ecosystems are interconnected.

One Health was initiated as a concept, was upgraded to an approach and is recently being considered as a movement.

It involves application of a coordinated, collaborative, multi-disciplinary and cross-sectoral approach to address potential or existing risks that originate at the animal-human-ecosystems interface.

It also encourages synergistic collaboration to achieve common public health goals.

Therefore, exploring collaboration in One Health (including system resilience) is vital prior to implementing a countrywide One Health Collaboration (OHC) policies and strategies.

Across the species barrier viral outbreaks:

1. Studies indicate that more than two-thirds of existing and emerging infectious diseases are zoonotic, or can be transferred between animals and humans, and vice versa, when the pathogen in question originates in any life form but circumvents the species barrier.
2. Another category of diseases, “anthropozoonotic” infections, gets transferred from humans to animals.
3. The transboundary impact of viral outbreaks in recent years such as the Nipah virus, Ebola, Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS) and Avian Influenza has further reinforced the need for us to consistently document the linkages between the environment, animals, and human health.

India’s framework, plans:

1. India’s ‘One Health’ vision derives its blueprint from the agreement between the tripartite-plus alliance comprising the Food and Agriculture Organization of the United Nations (FAO), the World Organisation for Animal Health (OIE), the World Health Organization (WHO) and the United Nations Environment Programme (UNEP), a global initiative supported by the United Nations Children’s Fund (UNICEF) and the World Bank under the overarching goal of contributing to ‘One World, One Health’.
2. In keeping with the long-term objectives, India established a National Standing Committee on Zoonoses as far back as the 1980s.
3. In the revised component of assistance to States/Union Territories, there is increased focus on vaccination against livestock diseases and backyard poultry.
4. To this end, assistance will be extended to State biological production units and disease diagnostic laboratories.
5. WHO estimates that rabies (also a zoonotic disease) costs the global economy approximately $6 billion annually.
6. Considering that 97% of human rabies cases in India are attributed to dogs, interventions for disease management in dogs are considered crucial.
7. DAHD has partnered with the Ministry of Health and Family Welfare in the National Action Plan for Eliminating Dog Mediated Rabies.
8. This initiative is geared towards sustained mass dog vaccinations and public education to render the country free of rabies.

Action plan in Health sector:

Multi-sectoral action in health has been categorised into four broad types:

1. One, where the health sector is a minimal actor (e.g. ensuring children attend school);
2. Two, where the health sector has a supporting role (e.g. in cross-sectoral policies to address health disparities);
3. Three, where the health sector is a bilateral or trilateral partner to produce joint or “co-benefits” and maximise health benefits (e.g. tobacco taxation to improve both health and revenues); and
4. Four, where the health sector takes the lead where collaboration is essential for it to deliver its core mandate (for example, ensuring adequate water and energy supplies to health facilities).

There are already several cross-cutting efforts operating in India to develop protocols for a database of research into zoonotic diseases.

But to date, there is no single agency or framework that embraces all interdisciplinary sectorial players under a single umbrella to carry forward the ‘One Health’  agenda even in this difficult time.

Inarguably, the National Expert Group has a tough mandate: To “promote multi-sectoral, transdisciplinary collaboration and cooperation.”

Accountability, transparency and trust are essential to drive such action, but can remain elusive.

Way Forward: Need for coordination from various departments:

1. Scientists have observed that there are more than 1.7 million viruses circulating in wildlife, and many of them are likely to be zoonotic, which implies that unless there is timely detection, India risks facing many more pandemics in times to come.
2. To achieve targets under the ‘One Health’ vision, efforts are ongoing to address challenges pertaining to veterinary manpower shortages, the lack of information sharing between human and animal health institutions, and inadequate coordination on food safety at slaughter, distribution, and retail facilities.
3. These issues can be remedied by consolidating existing animal health and disease surveillance systemsg., the Information Network for Animal Productivity and Health, and the National Animal Disease Reporting System developing best-practice guidelines for informal market and slaughterhouse operation (e.g., inspections, disease prevalence assessments), and creating mechanisms to operationalise ‘One Health’ at every stage down to the village level.

Conclusion:

The recently announced Prime Minister Atmanirbhar Swasth Bharat Yojana (PM-ASBY), supported by a Rs 3,500 crore loan from the Japan International Cooperation Agency (JICA), to boost the fight against the COVID-19 pandemic in India shall hopefully use One Health as a foundational principle.

India being home to a large portion of the world’s livestock farmers, the absence of a policy framework that ratifies the ‘One Health’ approach in development and health policies is a major hurdle in eliminating poverty and poverty-related diseases.

Now, as we battle yet another wave of a deadly zoonotic disease (COVID-19), awareness generation, and increased investments toward meeting ‘One Health’ targets is the need of the hour.

We await a vision, a strategy and a roadmap for India’s ‘One Health’ agenda.