Plenary Session I: Development of a Global One Health Network - Creating Added Value
Chaired by Marco Ferrari
This session tackled the question of what the One Health approach involves and what added value can be created through its development. There is a need to identify common ground and establish a common global network.
Alain Vandersmissen considered where we the field has progressed to after the Atlanta meeting of 2011. He noted that there are some success stories in research and implementation. The Stone Mountain meeting of May 2010 gave three to five years to demonstrate the impact of One Health. Seven working groups were established, two of which subsequently merged. They will report their deliberations in the near future. A "network of networks" is ready to be activated, but it needs to be structured and co-ordinated. There should be no boss and no owner; instead, co-ordinators and facilitators are needed, in order to create a global community of like-minded individuals around the One Health concept. This initiative should not duplicate existing efforts but should lead to a network distinguished by shared ownership. A web portal is ready to be populated and then opened to the public.
Governance of the One Health movement is a vital issue, but also a complex one. One Health is a public good and should be treated as such. It should draw its strength from a global pool of initiative. A roadmap for this process began to be developed in Atlanta. The initiative will 'go global' from 2013. Meanwhile, the One Health Global Guidance Group should be considered as a "work in progress". It comprises an association of 20-25 people, with rotating membership, a group that is dedicated to the global pooling of knowledge and resources.
Martyn Jeggo presented an example of One Health in action, drawn from the Australian experience. Hendra virus originates in bats (which are merely carriers), but affects horses and has led to human fatalities. It is a disease that crosses barriers and one that, ominously, has a 60-70 per cent morality rate in humans. In 2011 there were 19 incidences of the disease in Australia. However, bats are not the problem and any attempt to eradicate them would be counterproductive, as well as ecologically unjustifiable. However, it would take 10-12 years to produce a vaccine for humans. A subunit vaccine will be produced more quickly. A vaccine for horses will be available by 2013 and a post-exposure human treatment is being developed. By ensuring that different groups, professions and disciplines work together, more has been achieved in less time than would have happened if the groups had worked separately. The control of Hendra virus in Australia is thus an exemplary One Health success story.
Laura Kahn noted that One Health is a straightforward concept, but one that is not easy to implement. The systematic challenges reside in institutions, funding, education and attitudes. There are many different organisations with different missions and priorities. Globally, the main nucleus is composed of UN organisations (principally WHO and FAO), but the World Organisation for Animal Health is not part of the UN umbrella. There is also a major series of imbalances. Very much more is spent on researching and ensuring human health than animal health. There is a paucity of funding for animal disease surveillance, control and research, which makes it difficult to implement One Health. Worldwide, four human health medical schools exist for every one veterinary medical school. Most veterinarians work in companion animal health management, as this is the most economically buoyant source of employment: they are nonetheless few relative to physicians, and are even more sparsely distributed in livestock and wildlife veterinary medicine. In the USA, where surveys have been conducted, physicians are not very interested in bridging the species gap. Veterinarians are not treated with quite the same respect as medical doctors.
Dr Kahn advocates the formation of a One Health Organisation in place of the WHO-FAO-OIE triumvirate. There is a need to share learning experiences, literature and professional language, and to be very open to new collaborative experiences. To enable this to happen, first and foremost political leaders need to be convinced of the need. One Health is critical to the future sustainability of our planet. It goes far beyond zoonotic disease control.
Helmut Brand described ASPHER, the Association of Public Health Schools in the European Region. The cycle followed by participating schools involves assessment, policy development and assurance, and is a proven concept. ASPHER advocates that, in the name of capacity building, One Health be mainstreamed across policy sectors. The regional strategy involved is to provide a European review and action plan for strengthening public health in Europe. In the capacity assessment of European public health, One Health is not yet mentioned, but there is a window of opportunity to incorporate it. Surveillance is at the heart of public health, and it involves concepts that can be integrated into the One Health concept. In synthesis, One Health and public health are quite easy to bring together providing we can find the will.
Qian Ye discussed disaster risk reduction and noted that foreseeable events can lead to unforeseeable consequences. The One Health concept helps to improve the understanding of disaster chains.
Chadia Wannous described how the Safer World initiative has synergy with the One Health concept. Lessons learned from epidemics and zoonoses should be translated and applied to new contexts.
One participant from the floor noted that plants have not been explicitly mentioned in the discussion, but plant disease is an important part of human security. Another participant noted that disaster risk reduction needs to be incorporated better into the One Health concept. Value would be added to the latter, especially in the weather-water-climate-health linkage. It was noted that it is always easier to get people to work together in a crisis than under normal conditions.