The complex links between human, animal and environmental health require coordinated multidisciplinary and multipronged collaboration to address the threats from zoonotic diseases, and the global public health community needs to act decisively now.
This can be done through One Health – an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems – which is key to addressing zoonotic public health threats, environmental issues and neglected tropical diseases (NTDs).
This is one of the main messages that surfaced from a webinar hosted by the World Health Organization (WHO) last Wednesday, with more than 800 people following live the discussions on Zoom.
The webinar formally launched the One Health companion document to the NTD road map for 2021-2030. In their comments, both Bernadette Abela-Ridder, Veterinary epidemiologist, WHO Department of Control of Neglected Tropical Diseases, and Wendy Harrison, Chief Executive Officer, Schistosomiasis Control Initiative Foundation, commented on One Health and the objectives of the document.
Ending the neglect to attain the sustainable development goals. One health: approach for action against neglected tropical diseases 2021-2030 aims to support the health community to achieve the 2030 targets through transdisciplinary, cross-cutting approaches that include:
- building networks and increasing communication within and among sectors;
- finding common ground to coordinate and identifying opportunities to get started;
- recognizing that integration can take place at different levels, and will not be appropriate for everything;
- distributing resources equitably, and investing in prevention at the source; and
- leading change, while recognizing and encouraging individual contributions.
Unlocking political will to drive progress
Onyeka Erobu, Senior Health Advisor to Yvonne Aki-Sawyerr OBE, Mayor of Freetown, Sierra Leone
Onyeka shared how Freetown prioritized NTDs and the challenges they encountered applying One Health to address endemic zoonotic diseases.
Almost every district in Sierra Leone is endemic for at least two NTDs and the burden is high. Considering the Ebola outbreak in Sierra Leone during 2014-2016, One Health is not a new concept and many lessons have been learnt in how it can be applied.
Political commitment led to the establishment of the National One Health Platform in 2019, followed by the development of the National Strategic Plan for One Health.
Freetown is now focusing on integrated approaches for action against NTDs, demonstrating their impact beyond the health sector, and emphasizing the links between human, animal and environmental sectors for development in accordance with the Sustainable Development Goals. For example, Freetown’s newly established multisectoral rabies control strategy goes beyond rabies interventions to include deworming, treatment of skin diseases and other animal health issues in dogs.
One Health financing to support sustainable change
Franck Berthe, Senior Livestock Specialist, World Bank, Washington DC, USA
Franck emphasized that NTDs and affected, marginalized communities are at the heart of the World Bank’s goals to end extreme poverty within a generation and boost shared prosperity.
He referred to the example of the Onchocerciasis Control Programme, funded by the World Bank in the early 1970s, which illustrated how financing a disease programme can benefit health and the environment.
He said that using a One Health approach can increase benefits tremendously compared to their costs, but sectors often compete for financing instead of having shared financing as a national investment. In addition, funding can be diverted by outbreaks and events, leaving NTDs in a cycle of panic and neglect as attention is directed to other issues.
Franck added that to support sustainable change, the World Bank has included One Health in the 20th replenishment process of the International Development Association.
Environmental interventions for One Health
Lee Ching Ng, Director, National Environment Agency’s Environmental Health Institute, Singapore
Lee Ching explained how environmental interventions are used to mitigate the risks of vector-borne diseases in Singapore, where improved living conditions, piped drinking-water and waste management have significantly reduced the incidence of dengue and malaria. However, environmental risk factors for dengue infections have persisted and are largely due to standing water sources such as containers (particularly in older buildings), while construction sites and vegetation, combined with a humid climate, offer perfect breeding grounds for mosquitoes.
In Singapore, these risks are being addressed through intersectoral collaboration to implement biological controls; and alert systems to detect changes in vector numbers.
Engaging the veterinary sector to strengthen surveillance
Harena Rasamoelina, Coordinator, SEGA One Health Network, Indian Ocean Commission, Mauritius
Harena discussed the ways in which the SEGA One Health Network supports disease surveillance in a network of countries of the Indian Ocean Commission comprising the Comoros, Madagascar, Mauritius, Reunion and the Seychelles.
This has enabled the establishment of a surveillance and response mechanism across sectors where health data are shared to strengthen capacity.
The network supports efforts to control and eliminate several NTDs, including rabies, taeniasis and cysticercosis, and arboviral diseases such as dengue and chikungunya. Other NTDs are included at the request of members forming part of the Indian Ocean Commission.
Harena highlighted the benefits of One Health approaches and the importance of involving communities.