One Health evaluation of brucellosis control in Kazakhstan

Brucellosis is one of the main livestock disease risks in Kazakhstan. It’s been endemic there since 1930, accounting for over 1300 human cases per annum. The economic loss was 45 million USD in 2015 alone. Since 1952, Kazakhstan has implemented various control strategies with little success. One Health approaches have been suggested to tackle brucellosis, however, there is a lack of evidence for best practices to operationalise One Health in the literature, and methods for implementation are not established. The intention of this study was to introduce the One Health approach during the evaluation phase of the policy cycle. A two-day workshop was organized by the authors to familiarize participants with the evaluation methodology. Twenty-one specialists representing veterinary and public health sector, together with researchers, took part in this study. For two weeks following the workshop, first author conducted individual interviews with workshop participants to obtain individual scorings to assess knowledge integration capacity (One Health-ness). The evaluation results show that there is a lack of knowledge about the perceived damage caused by brucellosis to animal owners and other stakeholders. There is insufficient data available about farmers’ practices, interests and motivations, and also data is missing for important transmission processes such as the amount of unsafe dairy consumption. The absence of such data illustrates the extent of the uncertainty to which decision-makers are exposed despite well-elaborated transmission models and supports the importance of co-producing solutions with participatory methods. The results suggest the need for broader involvement of stakeholders. Outputs of this study could help navigate the initial stages of One Health operationalization

No clear trends in expatriation of non-human primate research from ­Switzerland between 2004 and 2017

Animal experimentation is commonly practiced in scientific research worldwide. However, there are no globally accepted standards for regulating the ethical boundaries and accepted practices for animal experimentation. Large differences exist between countries. A report suggested that some researchers, especially from countries with more stringent animal experimentation regulations, may be relocating experimental research to countries with less stringent regulations. We followed a systematic literature review approach to identity publications and determine whether there is an increasing trend in expatriation of non-human primate experimentation by researchers based in Switzerland. We used the Projects People Publications database, which contains projects funded by the Swiss National Science Foundation, to identify researchers conducting experiments using non-human primates. This list of names, together with terms referring to non-human primates were used to search the Web of Science. Publications without an author affiliated to a Swiss institution, no living or only with free non-human primates, and non-original research were excluded. For each publication, we recorded the place of experimentation, funding source, number of animals, species and the statement of ethical approval. We retained 120 publications, involving more than 2,429 non-human primates. Macaca mulatta and Macaca fascicularis were the most common species. We could not confirm an increasing trend in expatriation of non-human primate experimentation outside of Switzerland. Over time, publications appeared to report the ethical approval number more consistently. These results should be interpreted with caution because the sample included only studies that were: 1) published and 2) reported in the Web of Science. Consequently, studies with insignificant results may have been excluded because these studies are rarely published, and studies of poor quality may have been excluded because they are often published in lower quality journals, not indexed by the Web of Science

One Health continues to evolve for better health of people, animals and ecosystems

This article provides insights gained during a four-year project funded by the European Cooperation in Science and Technology (COST) named «Network for Evaluation of One Health», which brought together over 250 scientists, decision-makers and practitioners with expertise and/or interest in One Health to investigate the added value of One Health and elaborate and evaluation protocol for One Health. Here, we present our reflections on the significance of these findings for our common practice as health professionals. Two initial findings lie at the core of this analysis, namely the observation that 1) One Health integrates knowledge from various sources in a transdisciplinary way and that there are as many concepts of health as participants in a specific initiative; and 2) the nature of complex One Health problems necessitates systems thinking and consideration of emergences as a One Health initiative is implemented. An analysis of eight case studies, i.e., evaluations of different One Health initiatives, found that the capacity of an initiative to facilitate knowledge integration improves with the age of the initiative, political boundaries of any nature hinder knowledge integration, and the prevailing competitive mentality in academia may be a serious obstacle to trusted collaboration required for interdisciplinary progress. The COST project also revealed a number of important knowledge gaps, namely the need for: a scalable definition of health, balancing expert advice and citizen participation to tackle health challenges, bridging the scission between the benefits and risks arising from nature, discussing whether egoism will define the boundary to sustainable health, a biocentric social justice framework, and comparative values associated with health of people, animals, plants and ecosystems. Furthermore, methodological challenges were identified such as participatory methods that are scalable to large populations, a specific skill set to facilitate transdisciplinary research, and governing mechanisms alternative to legislation and markets. Finally, as a rather unexpected outcome, the project has revealed the tension between the academic and societal demands for infallibility and predictability versus the need for honesty, authenticity, humbleness and emotion to permit the full unfolding of human creativity

COVID-19 exposes weaknesses in public health in the Peruvian Amazon and highlights opportunities for a One Health approach

The Amazon is home to important wildlife and a biodiversity hotspot of global importance. The ancestral knowledge kept by Indigenous communities about its fauna and flora contributes further to its irreplaceable value. The Peruvian Amazon was heavily struck by the COVID-19 epidemic with a cumulative incidence of 725, a mortality rate of 34 per 100,000 inhabitants, and a case fatality rate of 4.6% by the end of July 2020. In this work, we review scientific literature and media to trace the events that happened at the beginning of the COVID-19 epidemic in the Peruvian Amazon. Results are synthesized in three observations: (1) the evolution of the COVID-19 epidemic within the Peruvian Amazon and the response of the Peruvian health care system, (2) Confusing information about Ivermectin use for COVID-19 treatment and prevalent self-medication (3) The response of the traditional Indigenous health care system to the COVID-19 epidemic. These three observations are interdependent. There is an unexploited potential for integrative approaches linking traditional medical practices (TMP) and biomedical approaches and they may benefit from the interactions that occur between them. Synergies can also be explored between the human and animal health care sector, especially in terms of the use and stewardship of medicines. We conclude that there is a benefit of the One Health approach in the region, which can go through the common ambition to improve the integrated health of people, animals and ecosystems, facilitate the enhancement of equity and inclusion while improving access to health services and conserving biodiversity. One Health Impact Statement The Amazon region is home to wildlife flora and fauna and indigenous Amazon communities. The case presented in this work shows that an existing grassroots initiative has been reducing case fatality rates tenfold during the COVID-19 epidemic, while acting in respect towards nature and the environment, and using its resources. This is in stark contrast to the uncontrolled, ineffective self-medication with ivermectin in that same period, which may endanger the biodiversity hotspot through metabolic residues. While the current example seems to illustrate community resilience due to government negligence, it also shows the vastly unexplored potential of integrating biomedical and traditional indigenous knowledge in a solidaric and co-creative framework such as One Health

The dual burden of animal and human zoonoses: A systematic review

Background Zoonoses can cause a substantial burden on both human and animal health. Globally, estimates of the dual (human and animal) burden of zoonoses are scarce. Therefore, this study aims to quantify the dual burden of zoonoses using a comparable metric, “zoonosis Disability Adjusted Life Years” (zDALY). Methodology We systematically reviewed studies that quantify in the same article zoonoses in animals, through monetary losses, and in humans in terms of Disability Adjusted Life Years (DALYs). We searched EMBASE, Web of Science, Scopus, PubMed, and Google Scholar. We excluded articles that did not provide the data to estimate the zDALY or those for which full text was not available. This study was registered at PROSPERO, CRD42022313081. Principal findings/Significance We identified 512 potentially eligible records. After deduplication and screening of the title and abstract, 23 records were assessed for full-text review. Fourteen studies were included in this systematic review. The data contains estimates from 10 countries, a study at continental level (Asia and Africa), and 2 studies on a global scale. Rabies was the most frequently reported zoonosis where zDALYs were calculated, based on the following included studies: for Kazakhstan 457 (95% CI 342–597), Viet Nam 5316 (95% CI 4382–6244), Asia 1,145,287 (90% CI 388,592–1,902,310), Africa 837,158 (90% CI 283,087–1,388,963), and worldwide rabies 5,920,014 (95% CI 1,547,860–10,290,815). This was followed by echinococcosis, the zDALYs in Peru were 2238 (95% CI 1931–2546), in China 1490 (95% CI 1442–1537), and worldwide cystic echinococcosis 5,935,463 (95% CI 4,497,316–7,377,636). Then, the zDALYs on cysticercosis for Mozambique were 2075 (95% CI 1476–2809), Cameroon 59,540 (95% CR 16,896–101,803), and Tanzania 34,455 (95% CI 12,993–76,193). Brucellosis in Kazakhstan were 2443 zDALYs (95% CI 2391–2496), and brucellosis and anthrax in Turkey 3538 zDALYs (95% CI 2567–6706). Finally, zDALYs on leptospirosis in New Zealand were 196, and Q fever in Netherlands 2843 (95% CI 1071–4603). The animal burden was superior to the human burden in the following studies: worldwide cystic echinococcosis (83%), brucellosis in Kazakhstan (71%), leptospirosis in New Zealand (91%), and brucellosis, and anthrax in Turkey (52%). Countries priorities on zoonoses can change if animal populations are taken into consideration

Protocol of the Dual Burden of Animal and Human Zoonoses: A Systematic Review

Background: When we talk about zoonoses, it is undeniable that we have a human and animal population that has been isolated in studies over time. Besides human and animal health, zoonoses also impact the economy and society. Therefore, the integration of the analysis in this area is essential to optimize resources in public health decisions. We have new challenges in public health that we need to overcome in a more comprehensive method such as One Health. For better measures in public health, the dual burden of zoonoses seems a logical way to determine the integral impact of such diseases in society and thus take better measures to prevent and reduce the impact of these diseases. Methods: We follow the guidelines for “Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). We search human and animal zoonoses on Embase, Ovid Medline, Scopus, Web of Science, and Google Scholar, from an unrestricted period until November 2021. For the search, we consider the Disability Adjusted Life Years (DALYs) for the human zoonotic burden and the animal zoonotic burden in monetary terms. A librarian collaborates to optimize the search string for the databases, and two reviewers screen eligible articles (first by title, then by abstracts, and finally, by full-text assessment.) For the analysis, we aim to convert the burden of zoonoses of all selected studies into the zoonotic Disability Adjusted Life Years (zDALYs) – including the human and animal components. Discussion: The study results will provide information on published studies that have accounted for the dual burden of zoonoses (both human and animal health aspects.) In addition, the synthesis of the available literature will address the knowledge gap in this area in order to know to what extent it is possible to convert the burden of human zoonoses to the animal burden of zoonoses and integrate them into a more comprehensive approach (dual burden of zoonoses.

A Blueprint to Evaluate One Health

One Health (OH) positions health professionals as agents for change and provides a platform to manage determinants of health that are often not comprehensively captured in medicine or public health alone. However, due to the organization of societies and disciplines, and the sectoral allocation of resources, the development of transdisciplinary approaches requires effort and perseverance. Therefore, there is a need to provide evidence on the added value of OH for governments, researchers, funding bodies, and stakeholders. This paper outlines a conceptual framework of what OH approaches can encompass and the added values they can provide. The framework was developed during a workshop conducted by the “Network for Evaluation of One Health,” an Action funded by the European Cooperation in Science and Technology. By systematically describing the various aspects of OH, we provide the basis for measuring and monitoring the integration of disciplines, sectors, and stakeholders in health initiatives. The framework identifies the social, economic, and environmental drivers leading to integrated approaches to health and illustrates how these evoke characteristic OH operations, i.e., thinking, planning, and working, and require supporting infrastructures to allow learning, sharing, and systemic organization. It also describes the OH outcomes (i.e., sustainability, health and welfare, interspecies equity and stewardship, effectiveness, and efficiency), which are not possible to obtain through sectoral approaches alone, and their alignment with aspects of sustainable development based on society, environment, and economy

Reflecting on One Health in Action During the COVID-19 Response

The COVID-19 pandemic, a singular disruptive event in recent human history, has required rapid, innovative, coordinated and collaborative approaches to manage and ameliorate its worst impacts. However, the threat remains, and learning from initial efforts may benefit the response management in the future. One Health approaches to managing health challenges through multi-stakeholder engagement are underscored by an enabling environment. Here we describe three case studies from state (New South Wales, Australia), national (Ireland), and international (sub-Saharan Africa) scales which illustrate different aspects of One Health in action in response to the COVID-19 pandemic. In Ireland, a One Health team was assembled to help parameterise complex mathematical and resource models. In New South Wales, state authorities engaged collaboratively with animal health veterinarians and epidemiologists to leverage disease outbreak knowledge, expertise and technical and support structures for application to the COVID-19 emergency. The African One Health University Network linked members from health institutions and universities from eight countries to provide a virtual platform knowledge exchange on COVID-19 to support the response. Themes common to successful experiences included a shared resource base, interdisciplinary engagement, communication network strategies, and looking global to address local need. The One Health approaches used, particularly shared responsibility and knowledge integration, are benefiting the management of this pandemic and future One Health global challenges

Mathematical modelling of Echinococcus multilocularis abundance in foxes in Zurich, Switzerland

Background In Europe, the red fox (Vulpes vulpes) is the main definitive host of Echinococcus multilocularis, the aetiological agent of a severe disease in humans called alveolar echinococcosis. The distribution of this zoonotic parasite among the fox population is remarkably aggregated with few heavily infected animals harbouring much of the parasite burdens and being responsible for most of the environmental parasitic egg contamination. Important research questions explored were: (i) spatial differences in parasite infection pressure related to the level of urbanization; (ii) temporal differences in parasite infection pressure in relation to time of the year; (iii) is herd immunity or an age-dependent infection pressure responsible for the observed parasite abundance; (iv) assuming E. multilocularis infection is a clumped process, how many parasites results from a regular infection insult. Methods By developing and comparing different transmission models we characterised the spatio-temporal variation of the infection pressure, in terms of numbers of parasites that foxes acquired after exposure per unit time, in foxes in Zurich (Switzerland). These included the variations in infection pressure with age of fox and season and the possible regulating effect of herd immunity on parasite abundance. Results The model fitting best to the observed data supported the existence of spatial and seasonal differences in infection pressure and the absence of parasite-induced host immunity. The periodic infection pressure had different amplitudes across urbanization zones with higher peaks during autumn and winter. In addition, the model indicated the existence of variations in infection pressure among age groups in foxes from the periurban zone. Conclusions These heterogeneities in infection exposure have strong implications for the implementation of targeted control interventions to lower the intensity of environmental contamination with parasite eggs and, ultimately, the infection risk to humans