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One Health – What It Means, Why It Is Vital

Zoonotic diseases such as leptospi­rosis, COVID-19 and other commu­nicable diseases have only recently made governments across the world acknowledge the importance of the One Health concept.
11 Sep 2022 13:08
One Health – What It Means,  Why It Is Vital
The One Health concept recognises that the health and wellbeing of humans, animals and the environment are all interconnected, says the Pacific Community. Photo: Ronald Kumar

Zoonotic diseases such as leptospi­rosis, COVID-19 and other commu­nicable diseases have only recently made governments across the world acknowledge the importance of the One Health concept.

One Health encourages multisec­toral and transdisciplinary collabo­ration to promote effective policies that relate to the “three health’s”: animal, public and environmental.

The aim of this focus is to build an understanding of why everyone’s (and everything’s) health is interde­pendent.

 

The Ministry of Health (MOH), Ministry of Agriculture and other stakeholders have held several dia­logues focused on setting up the One Health concept.

But there has been no formal and legal recognition of the One Health coordination mechanism in Fiji at the national level.

Cows

 

However, there have been pockets of engagements among stakehold­ers and ministries. The MOH is work on the community level to help address zoonotic dis­eases – diseases that are transmitted between animals and humans and vice-versa.

But this is still not enough. The need to have a national approach in addressing zoonotic diseases is paramount now more than ever, in the wake of the global COVID-19 pandemic and the leptospirosis out­break in Fiji.

 

WHAT’S WORKING IN FIJI?

 

Having a One Health set-up as an early warning system is not simple, says Simon Reid, an Associate Pro­fessor Global Disease Control at the University of Queensland.

The current taskforce, spearhead­ed by the MOH, holds collaborative meetings across the Biosecurity Au­thority of Fiji, veterinary service, Ministry of Agriculture and MOH.

However, it is understood that these collaborative meetings are not consistent.

 

“These meetings are really open­ing communication between them (stakeholders), so they develop an understanding of each other, and they build trust, and they build that ability to communicate,” Mr Reid said.

“That is valuable so that when there is a problem, the communi­cation between the partner is more likely to happen, and when it does happen it’s more likely to be produc­tive because they understand each other.”

 

Mr Reid said it would be difficult to justify directing resources towards something like a zoonotic disease programme unless there’s evidence that the burden of the disease in people was so high.

“The burden of other diseases, particularly non-communicable dis­eases, is so high that’s where bulk of the resources go, and I guess it’s really looking at the benefits to the community of having these activi­ties.

 

“I think, even though I advocate for One Health, I wouldn’t advocate for money to be diverted. I think to run network where people come to­gether and talk about problems and are willing to work together, that’s a very low cost, and that alone is a valuable resource.

“In a situation like Fiji, it wouldn’t be the right decision to divert re­sources away from the critical care that’s required for people with heart disease and NCDs.”

 

WHY IS THE ONE HEALTH CONCEPT IMPORTANT FOR FIJI?

 

For a small island nation like Fiji, having the One Health concept is important to tackle any pandemic, zoonotic disease or health challeng­es that arise.

Having a One Health framework established would mean that stake­holders and line ministries can syn­ergise their resources in promoting a healthier population more widely.

 

The Ministry of Agriculture’s Per­manent Secretary, Vinesh Kumar, said the One Health Concept avoid­ed information asymmetry and al­lowed one team to work towards the same goal and advocate on the same wavelength.

“The One Health concept allows relevant stakeholders to form com­plementary policies where we can work together for a common goal, healthier animals, livestock, food sources, and population,” Mr Ku­mar said.

 

COVID-19 and existing zoonotic diseases has clearly shown that Fiji needs to have a resilient health in­frastructure and an effective multi­sectoral approach in tackling these challenges.

In response to emailed questions, the Pacific Community (SPC) says global funding has been increased to help improve animal health and pro­mote One Health priorities around the world.

 

“There is growing understanding of the One Health concept, which recognizes that the health and well­being of humans, animals and the environment are all interconnect­ed,” SPC said.

The World Health Organization (WHO) regional office echoed simi­lar sentiments, saying it was vi­tal that governments continue to strengthen their health systems.

 

“As the COVID-19 pandemic has shown, the travel industry, educa­tion system and overall economy all rely on good health,” WHO said.

“So, we need to make the most of the unprecedented level of financial and political support that is cur­rently available for the pandemic response to make sure that health systems across the Pacific are ready to face current and future health threats.”

 

THE RELEVANCE OF ONE HEALTH FOR FIJI

Before the outbreak of the COVID-19 pandemic, Fiji and the globe were already dealing with diseases that directly relate to the relationship between animal and human health.

Studies have shown that up to 60 per cent of the world’s human diseases – and 75 per cent of new and emerging diseases – are zoonotic in origin.

 

Leptospirosis is one of these pathogens, a bacterium that spreads to humans through water and soil contaminated by infected animal urine. This zoonotic disease has claimed hundreds of lives in Fiji, and it continues to do so.

For this year, data released as of May 17 indicated that there have been 2068 laboratory-confirmed cases, 681 hospitalizations and 36 deaths because of leptospirosis.

 

Every year leptospirosis continues to threaten Fiji. Hence, the urgent need for a better way to undertake a multisectoral approach, including surveillance of emerging disease threats. The One Health concept can help to bridge the gap on integrated surveillance between human health and animal health.

 

FOCUS AREAS FOR ONE HEALTH

These include food safety, control of zoonosis and combating antibiotic resistance through plants and animals.

At the 8th Asia-Pacific World Workshop on Multisectoral Collaboration at the Animal-Human-Ecosystems Interface held in Bangkok, Thailand in April 2019, Fiji had listed five priority zoonotic diseases. They were:

  1. Leptospirosis;
  2. Tuberculosis (TB);
  3. Brucellosis (cases in humans are often neglected);
  4. Arboviral diseases (dengue, chikungunya, zika); and
  5. Influenza.

 

WHAT DO THESE ZOONOTICDISEASES HAVE IN COMMON?

They are transmitted from animals to humans.

Outbreaks of these zoonoses affect animal food production, welfare, and human morbidity, and mortal­ity.

 

In the case of leptospirosis, it is spread through pathogenic leptospi­ra excreted in the urine of infected animals.

 

These infected animals include ro­dents, domestic pets, livestock, and wildlife.

In their response, WHO said: “Lep­tospirosis can spread when bacteria from the urine of an infected ani­mal – such as a dog, cow, pig, or rat – gets into someone’s body. This can happen if the drinking water is con­taminated or if dirty water splashes on someone’s eyes, nose, or mouth, or on a cut or scratch.”

 

RELEVANCE OF CLIMATE CHANGE

 

SPC says incidence of diseases such as leptospirosis have been known to increase during flooding and heavy rainfall.

With increased heavy rain and flooding in certain places, people tend to relocate. Most times, reloca­tion means moving further inland where contact with feral animals is inevitable, SPC said.

 

This increases chances of con­tracting zoonotic diseases such as leptospirosis.

Two severe floods in 2012, led to Fiji recording the highest number of leptospirosis outbreaks and fatali­ties to date. There were 576 reported cases and 40 deaths.

 

Seasonal rains and flooding pro­vide ideal conditions for leptospiro­sis outbreak. Fiji’s tropical climate provides ample opportunity for bacteria to reproduce in mammals, including livestock, rats and domes­tic pets, which act as reservoirs for leptospirosis.

 

WHY THE URGENT NEED FOR ONE HEALTH?

 

Zoonotic diseases are spreading quickly, and most are not confined to their country of origin, for in­stance the outbreak of monkey pox in Australia that has now emerged as a pandemic.

It is important to note that about 70 per cent-80 per cent of infectious dis­eases are caused by animals.

These diseases emerge because their en­vironments are being impacted by human encroachment, or because more wild animals are being taken away from their native habitats and are coming into direct contact with humans and domesticated animals, such as livestock.

Stray dogs are a common sight around the country. Photo: Ronald Kumar

Stray dogs are a common sight around the country. Photo: Ronald Kumar

There is also a growing concern that bacteria are increasingly be­coming resistant to antibiotics be­cause the medicine has been over­prescribed and over consumed for even maladies. These AMR bacteria may infect humans and animals, and the infections they cause are harder to treat compared to non-resistant bacteria.

 

The WHO contends that approxi­mately 700,000 people a year die be­cause of AMR; that number could increase to 10 million people a year by 2050 if the situation isn’t brought under control.

The One Health framework could help Fiji effectively counter these outbreaks and antibiotic resist­ant bacteria, by providing a robust health system, as well as policies that complement the roles of all stakeholders and ministries. But it needs the support of the Govern­ment – the policy makers, politi­cians.

 

At the 8th Asia-Pacific World Work­shop on Multisectoral Collaboration at the Animal-Human-Ecosystems Interface member countries, includ­ing Fiji, were encouraged to seek high level political commitment for One Health.

Mr Kumar said there were chal­lenges because One Health required a multisectoral approach and keep­ing ministries and stakeholders en­gaged was, at times, difficult.

But for now, work related to One Health in Fiji has been exclusively driven by the MOH.

 

The working group set up by the MOH operates on the powers vested in the Minister and Permanent Sec­retary for Health. But this formal level of structure may not work for some ministries and stakeholders.

Hence the need for an effective mechanism such as One Health to ensure a healthy human population, healthy animal population and a healthy environment.

 

Feedback: ivamere.nataro@fijisun.com.fj

 



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