FIMDP 2013

DEPT OF COMMUNITY MEDICINE

SRM MEDICAL COLLEGE ,SRM UNIVERSITY

&

UNSW AUSTRALIA

9TH & 10TH JAN 2013

One Health – Bridging the gap

Dr. P. ThangarajuPro Vice-Chancellor (Medical)

SRM University

Between animal and human medicine there are no dividing line … nor should there be

Rudolf Virchow (Father of Cellular Pathology)

Background

• It is a movement of collaboration between physicians, veterinarians, dentists nurses and other scientific health and environmentally related disciplines

• Concept in existence from the period of Hippocrates (400 BC)

• Major contributors include Rudolf Virchow, William Osler, Louis Pasteur, Robert Koch, Rachel Carson, James Steele and Calvin Schwabe

• The term One Medicine was coined by Calvin Schwabe

Background

• One health is a broad and holistic paradigm that addresses and frames the complex interaction between human, livestock, pet and wild life health, climatic eco system, agriculture, food systems and human development

• It includes

– Nutrition, agriculture, safety and security of food supplies, management of natural resources , ecosystem etc.

Why this concept?• Out of 1461 diseases recognized 60% are due to multi host

pathogens characterized by their movement across species lines.

• In the last three decade 75% of new emerging human infections are zoonotic

• Nearly 80% of the microbes used as bio-terrorism agents are zoonotic

• Over 21 billion food animals are produced to feed 6.5 billion people. Animal protein demand expected to increase by 50%

• There are 335 emerging diseases since 1940

Why this concept?

• Threats posed by microbes

– Global transportation and travel

– Varying host susceptibility

– Anti microbial resistance

– Climatic change

– Inequalities among different societies and poverty

– Breakdown of public health mechanism

http://www.onehealthinitiative.com/index.php

The recent threats

• The recent outbreaks of following diseases justify the need for One health concept

• West Nile fever

• Ebola haemorrhagic fever

• Sever Acute Respiratory Syndrome – SARS

• Monkey Pox

• Mad cow disease

• Bird flu – H5N1

• Swine flu – H1N1

• Nipah and Hendra virus infections

Components of this concept

http://www.grforum.org/userfiles/onehealth_circle(6).png

Components of this concept

http://www.infectionecologyandepidemiology.net/index.php/iee/article/viewFile/18667/html/67699

Global partners in one health

• Food and Agricultural Organization – FAO

• World Health Organization – WHO

• Organization des international epizootics – OIE

• World Bank

• UN organizations– UNDP, UNDPI, UNESCO, UNEP, UNICEF

• The three major organizations FAO, WHO and OIE have agreed to safeguard the farmers, animals and other living creatures

Global partners

http://www.grforum.org/userfiles/onehealth_circle(6).png

Possible areas of integration

• Cross cutting programmes in food borne, water borne, zoonotic and vector borne diseases– Eg. E.coli infection, Rift valley fever

• Emerging and re-emerging diseases– Hanta virus, plague, leptospirosis, West Nile fever, Lyme disease

• Bio and agro terrorism and Risk assessment

• Electronic record keeping and tracking system

• Food system and water sanitation system

Integrative approach

Role of veterinarians

• As per Senator Allard– Veterinarians are first line of defense in protecting human health

through early detection and response to unusual disease events that could be linked to

• Emerging infectious diseases

• Bioterrorism agents

• Acute demand for public health veterinarians

• Veterinarians are taught about one health from day one

Relevance of veterinary oath

Being admitted to the profession of veterinary medicine I

solemnly swear to use my scientific knowledge and skills for

the benefit of society through the protection of animal health

and welfare, the prevention and relief of animal suffering, the

conservation of animal resources, the PROMOTION OF

PUBLIC HEALTH, and the advancement of medical

knowledge.

Challenges

• Not a widely understood concept

• Not clear about ownership of the space (Vets – Medicos –Others)

• No training to produce Renaissance man scientists

• No significant support to study disease ecology

• Lack of interdisciplinary integrated research in one health

• Regulatory guidelines on animal and clinical trials

Challenges

• Different institutions with different missions and priorities– Human health – Focus towards surveillance, control and

prevention– Animal health – Focus towards augmenting promotion

• Scope for funding

• Lack of education and training

• Attitude of partners

Challenges – Human Vs. Animal Health

Challenges – Human Vs. Animal Health

What is required

• Educational courses – Human animal health educational programmes and research centres as in Edinburgh University, University of Cambridge, Iowa State University

• Establishment of multidisciplinary research centre involving medicos and veterinarians

• Conference as organized by AMA, AVMA and EU

• Scientific journals and websites promoting one health

• Motivation through public and private funding

What is required

• Professionals who could span human, animal, and environmental health.

• Schools of public health offering master’s and doctoral degree programs in One Health.

• In addition to biostatistics and epidemiology, subjects would include: – Food and water safety and security

– Ecosystem and environmental health,

– Land degradation and urban development

– Agriculture and sustainability,

– Biodiversity and zoonotic diseases

• Joint KTO (as Provax, Belgium) and One health clinics

Benefits of One health• Provide value added improved food safety and security

• Reduction of zoonotic diseases

• Enhanced biosecurity and biodefense

• Sustainable urban development– Sanitation, cleanliness

• Sustainable agriculture

• Sustainable eco-system with improved human, livestock and wild animal health

One Health shall be achieved through

• Collaborative education efforts between human medical, veterinary schools and schools of public health and the environment.

• Communication efforts in journals, at conferences and via allied health networks

• Efforts in clinical care through the assessment, treatment and prevention of cross –species disease transmission

• Cross- species disease surveillance and control efforts in public health

• Efforts in better understanding of cross –species disease transmission through comparative medicine and environmental research

• Efforts in the development and evaluation of new diagnostic methods, medicines and vaccines for the prevention and control of diseases across species and

• Efforts to inform and educate political leaders and the public sector through accurate media publications.

Conclusion

• One Health Initiative will unite human and veterinary medicine

Let’s go forward together- Winston Churcill

Thank You