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Promoting one health

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THE concept of ‘one world, one health, one medicine’ has so much to commend it that it is surprising that it has not caught on more quickly. Nevertheless, the idea that by working together doctors, vets and scientists can do more to tackle the disease and other health challenges facing the world than they can ever achieve separately, continues to gather momentum. A recent tripartite document from the Food and Agriculture Organization (FAO), the World Organisation for Animal Health (OIE) and the World Health Organization (WHO) provides a significant and welcome example of this.

Despite its somewhat cumbersome title – ‘The FAO-OIE-WHO collaboration: sharing responsibilities and coordinating global activities to address health risks at the animal-human-ecosystems interfaces’* – the document addresses a hugely important issue. Most of the new and emerging infectious diseases affecting humans originate in animals, and it looks specifically at how efforts at the interface between human and veterinary medicine can be improved.

The document presents a vision of ‘A world capable of preventing, detecting, containing, eliminating, and responding to animal and public health risks attributable to zoonoses and animal diseases with an impact on food security through multi-sectoral cooperation and strong partnerships’. It makes the point that pathogens circulating in animal populations can threaten both animal and human health, and thus both the animal and human health sectors have a stake in, and responsibility for, their control. However, it also points out that, while the integration of control systems across animal, food and human sectors has been attempted in some countries and regions, ‘most country control systems are generally non-integrated with limited collaborative work’. It says that efforts to control highly pathogenic avian influenza and contributions towards pandemic preparedness have re-emphasised the need for increased focus on reducing the risks associated with zoonotic pathogens and diseases of animal origin through multidisciplinary collaboration; they have also underlined the fact that successful and sustained results are possible when functional collaborations are established at country level and internationally.

Describing the prevention of the emergence and cross border spread of human and animal infectious diseases as ‘a global public good with benefits which extend to all countries, people and generations’, the document sets out a joint strategic direction for the FAO, OIE and WHO and proposes a long-term basis for international collaboration. Recognising that addressing health risks at the human-animal interface requires ‘strong partnerships among players who may have different perspectives and different levels of resources’, it notes that efforts must be coordinated to minimise the burden on member countries of multiple monitoring, reporting and delivery systems, and to avoid duplication of effort. Among other things, it says that there is a need to strengthen animal and human health institutions, as well as partnerships, and to manage existing and novel diseases that will be of public health, agricultural, social and economic importance. When appropriate, protocols and standards for managing emerging zoonotic diseases should be jointly developed and, in the case of high-impact zoonotic diseases, improvements in governance, infrastructure and capacity building will be necessary.

It calls for a joint framework to address gaps and strengthen collaboration in the activities of human and animal health laboratories, and to promote cooperation between human and animal surveillance systems. It says that models for forecasting animal disease outbreaks should be developed in close collaboration so that animal disease outbreaks which precede human outbreaks can provide an early warning, and ensure preparedness and a targeted response. It also calls for joint efforts to be made to obtain ‘deeper and sustainable political support’ for the integrated prevention of diseases of medical and veterinary importance.

In addition to the FAO/OIE/WHO document, this year’s EU Veterinary Week, which starts with a conference in Brussels on June 14, will again have as its theme Animals + humans = one health, and will focus on the importance of the identification and traceability of animals for disease control and public health purposes (VR, May 8, 2010, vol 166, p 574). It is five years since Veterinary Record and the BMJ produced a joint issue highlighting the importance of the interface between human and animal health (VR, November 26, 2005, vol 157, pp 669-716; BMJ, November 26, 2005, vol 331, pp 1213-1280), and it is good to see the cause being taken up at such high levels.

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