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Vets are good for people, too
  1. Kathryn Clark

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Next Friday – November 3 – will mark One Health Day. Launched in 2016, the day aims to raise global awareness of the need for One Health interactions across human, animal and environmental health.

There are many diseases that affect both people and animals – influenza is a good example. There are also significant issues that threaten future human and animal health – antimicrobial resistance is possibly the most serious global one. Dealing with all of these problems effectively requires a sustained One Health approach.

Recently, there has been something of a flurry of One Health-related announcements with particular relevance to animal health. If they come to fruition, they could potentially bring significant benefits to people as well.

Underway are three drives to tackle rabies, peste des petits ruminants (PPR) and bovine/zoonotic TB.

A global goal of eliminating dog-mediated cases of rabies in people by 2030 was first called for in 2015, although efforts to tackle transmission of the virus from dogs to people have been going on for much longer. A significant step forward was taken last month with the announcement on September 28 – World Rabies Day – of an ambitious strategic plan for achieving that goal.

The plan, ‘Zero by 30: The Strategic Plan’,1 has been drawn up by the World Health Organization (WHO), the World Organisation for Animal Health (OIE), the Food and Agriculture Organization of the United Nations (FAO) and the Global Alliance for Rabies Control. That both human and animal health agencies are involved reflects the toll of this zoonotic disease. Rabies occurs in more than 150 countries, and, in livestock, it causes annual losses of more than US $500 million.

Dog-mediated transmission accounts for about 99 per cent of human rabies cases. Some 59,000 people, many of them children, die from the disease each year, mainly in Africa and Asia. Vaccination of dogs is acknowledged as key to preventing cases in people.

The strategic plan brings together the differing expertise of the four organisations behind it and aims to provide a coherent foundation for rabies control, giving affected countries support and a framework for action. It focuses on the societal changes that will be needed to achieve the target of zero human deaths from dog-mediated rabies by 2030, considering the prevention of and response to rabies, surveillance, and the need for sustained commitment and resources.

2030 could turn out to be a momentous year for animal health as it has also been set as the target date for the eradication of PPR. (2030 ties in with the UN’s Sustainable Development Goals.) Unlike rabies, PPR is not zoonotic, but it undoubtedly still has a serious impact on human wellbeing as well as on sheep and goats, in which it kills up to 90 per cent of infected animals. Like rabies, PPR disproportionately affects the world’s poorest communities. It was first detected in Côte d’Ivoire in 1942 and cases have since been reported in more than 70 countries in the Middle East, Africa and Asia, where 80 per cent of the world’s sheep and goats are found. It is also still spreading, with Mongolia reporting its first case in September 2016.

The FAO estimates that, globally, approximately 300 million small-scale farming families depend on sheep and goats for their food and livelihoods. Losses due to PPR are estimated at between US $1.4 and $2.1 billion each year. Eradicating the disease would contribute to food security and nutrition, help alleviate poverty and strengthen the resilience of communities.

A year after launching their ‘initial battle plan’ for eradicating PPR,2 the OIE and FAO announced earlier this month that the European Union had pledged its support for their global campaign. A ‘PPR pledging conference’ is to be held in Brussels early in 2018 with the aim of encouraging countries to support the eradication programme, the first phase of which will cost an estimated US $996 million.

Rabies and PPR have something else in common – the vaccines and know-how needed to deal with them already exist. Therefore, recent emphasis has been on developing coordinated, holistic approaches for building capacity in animal health services, surveillance, vaccine delivery, etc, which are needed to tackle both diseases in a sustained, strategic manner. Success with the PPR campaign would make the disease the second infectious animal disease to be eradicated through human effort, following rinderpest in 2011 – an achievement hailed at the time as ‘a success for veterinary services and the entire veterinary profession’.

Although neither rabies nor PPR affect the UK directly, that’s not to say that vets and scientists in this country are not contributing towards tackling them. The APHA laboratory at Weybridge is an OIE Reference Laboratory for rabies, while The Pirbright Institute is an OIE Reference Laboratory for PPR. Numerous UK vets and vet nurses have volunteered to help with mass dog vaccination drives in rabies-endemic countries led by charities such as Mission Rabies.

One disease that most definitely does affect the UK is bovine TB, with only Scotland holding Officially TB-Free status. However, thanks to the public health safeguards in place, zoonotic TB is a remote possibility in the UK – fewer than 1 per cent of human TB cases confirmed in the UK each year are due to Mycobacterium bovis. The same cannot be said for many countries, with some 12,000 people a year estimated to die from zoonotic TB, mainly in Africa and South East Asia.

In another recent development, human and animal health organisations have joined forces to create a roadmap for tackling the transmission of bovine and zoonotic TB. Launched earlier this month, the roadmap has been developed jointly by the WHO, the OIE, the FAO and the International Union Against Tuberculosis and Lung Disease.3

It sets out 10 priority actions for tackling zoonotic TB in people and bovine TB in animals. It recognises the interdependence of human and animal health and the importance of a One Health approach that draws on expertise from across different sectors and disciplines.

These recent announcements demonstrate willingness to collaborate at the highest levels to make a One Health approach happen. With its essential role in tackling animal disease, and therefore in One Health, the veterinary profession can be a global force for good – not just for animals, but for people, too.

1 www.oie.int/fileadmin/Home/eng/Media_Center/docs/pdf/Rabies_portal/UnitedAgainstRabies/Executive%20summary_Unitedagainstrabies_sept2017.pdf

2 www.oie.int/fileadmin/home/eng/Media_Center/docs/pdf/PortailPPR/EN_GEP_PPR_Finalweb.pdf

3 www.fao.org/3/a-i7807e.pdf

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