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‘ONE Health’ has become a bit of a buzzword over the past 12 months and Veterinary Record may have to take some of the blame for that. The upside is that it looks as if progress may be beginning to be made. That things are indeed happening was clear at the 3rd International One Health Congress held in Amsterdam this week. The congress – by no means the only conference on the subject taking place this year – was notable in bringing together scientists and policymakers with an interest in One Health, with a view to seeing how the concept might be more widely applied. Lessons from the ongoing outbreak of Ebola in West Africa, and frustration about the world's lack of preparedness for that outbreak, provided an extra edge to the proceedings.
The significance of One Health to policymakers was highlighted during a programme on the first day of the congress considering the ‘science-policy interface’. With discussion of the impact of diseases ranging from BSE to SARS to avian influenza, this illustrated the value of a collaborative, preventive approach not just in terms of safeguarding public health but economically as well. Antimicrobial resistance was another area where a combined approach was clearly necessary. There was, it was argued, a need for more effective global leadership in relation to One Health, and for professional and disciplinary ‘silos’ to be broken down. Changing mindsets and persuading people to relinquish professional ownership of certain areas is notoriously difficult but, it was argued, progress could be made by training the next generation to think more broadly.
Frustration about preparedness for the Ebola outbreak was apparent in the title of a talk in the policy programme by Ab Osterhaus, of the Center for Infection Medicines and Zoonoses Research at Hannover university in Germany, called ‘How we addressed the Ebola crisis: “too little, too late”’. Also, in a satellite programme organised by the animal health company Zoetis, Professor Adrian Hill, head of the Jenner Institute for vaccine development in Oxford, discussed how, as a result of an unprecedented effort involving scientists, drug companies, regulatory bodies and international agencies, a vaccine for Ebola was now in phase 3 trials and might yet prove useful in helping to deal with the epidemic. All this had been achieved in six months but vaccine development usually took much longer than that and, said Professor Hill, ‘We shouldn't be in a position where we have to achieve in six months what should have been done five years ago.’ There was a difference between disease preparedness and attempting to mount a rapid response and, he pointed out, it was far better to be prepared.
Professor Hill showed a list including several other infectious pathogens for which vaccines could and should be produced for use in the event of future disease outbreaks. Along with other speakers, including industry representatives, he argued that a new public/private sector funding model was needed to facilitate the production of new vaccines and provide new platforms for vaccine development. This required collaboration across the human and animal health sectors, and scientists, industry, regulators and international agencies all needed to be involved.
The idea that it is better to be prepared for a disease emergency rather than belatedly trying to mount a response is by no means new, but it does seem to be a lesson that needs to be repeatedly relearned. Indeed, this point was highlighted by US President Barack Obama in his call to arms in the fight against Ebola in September last year (VR, October 4, 2014, vol 175, p 310). Noting that Ebola was not the first disease to cross borders and pose an international threat, he remarked, ‘Each time, the world scrambles to coordinate a response. Each time, it's been harder than it should be to share information and contain the outbreak. As a result, diseases have spread faster and further than they should have – which means that lives are lost that could have been saved.’ Equally pertinent were comments President Obama made about disease prevention and early detection of emerging threats: ‘We have to prevent outbreaks by reducing risks. We need to detect threats immediately whenever they arise. And we need to respond rapidly and effectively when we see something happening so that we can save lives and avert even larger outbreaks.’
With most emerging diseases being zoonotic in origin, early detection requires strengthening disease surveillance at the animal-human interface, which in turn requires that appropriate veterinary and wildlife surveillance infrastructures are in place. Responding to an outbreak may require safe and effective vaccines to be quickly made available for use if needed. The arguments for a One Health approach to emerging diseases are compelling, but they do keep having to be made.
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