ONE HEALTH

Prof. drh. Wiku Adisasmito, MSc., Ph.D.

 Source : Emerging & Re-Emerging Infectious Disease Challenges. Nature 430: 242-49 (Morenz. DM et al, 2004)

EMERGING INFECTIOUS DISEASES

EID Challenges
Anthrax and
Rabies Avian Influenza Brucellosis
Hog Cholera

Dengue Chikungunya Malaria Filariasis

Schistosomiasis Leptospirosis Tuberculosis Plague

Brucellosis Salmonellosis Cysticercosis Toxoplasmosis

Human-Animal-Environment Interface

Human
Key risk
factors for
important
EIDs Environment Animal
WHAT IS ONE HEALTH..?
One Health Vision..........
........a multidisciplinary collaborative approach to improving the
health of humans, animals and the environment, endorsed by
FAO, OIE and WHO.......

One Health approach.......

.......encourages the collaborative efforts of multiple disciplines
working locally, nationally, and globally, applying their
expertise to attain optimal health for people, animals, and the
environment

In particular when addressing prevention, surveillance, and

response to zoonotic disease outbreaks (e.g. HPAI, Rabies,
Anthrax)
 What is One Health?
One Health is the collaborative effort of
multiple disciplines – working locally,
nationally, and globally – to attain
optimal health for people, animals and
our environment. (American Veterinary
Medical Association)
Advocacy to unite human and
veterinary medicine with ecosystem
health. Recognizing that human
health, animal health, and ecosystem
health are inextricably linked, One
Health seeks to promote, improve, and
defend the health and well-being of all
species by enhancing cooperation and
collaboration between physicians,
veterinarians, other scientific health
and environmental professionals and
by promoting strengths in leadership
and management to achieve these
goals. (One Health Commission)
What would be characteristics of a One Health approach?
• Recognizes the interdependence of, and seeks to improve human, animal and
1 environmental health

• Recognizes that communication, collaboration and trust between human and animal health
2 practitioners is at the heart of the One Health concept

• Has a broad vision and includes other disciplines such as economics and social behavior
3 that are essential to success

• Needs to promote the ‘doable’ such as improving surveillance and response for emerging
4 infectious diseases whilst developing the broader approach

• Emphasizes community participation and development of community capacity, and

5 especially, an open transparent dialogue

• Requires both ‘ground up ‘and ‘top down’ action

6

• Recognizes that understanding ecosystems, including molecular ecobiology, are an

7 essential part of One Health.

• Recognizes that One Health is a major component of food security and safety
8
One Health Approach
Recognizes the interdependence of, and seeks to improve human,
animal and environmental health

Recognizes that communication, collaboration and trust between

human and animal health practitioners is at the heart of the One
Health concept
Has a broad vision and includes other disciplines such as economics
and social behavior that are essential to success

Needs to promote the ‘doable’ such as improving surveillance and

response for emerging infectious diseases whilst developing the
broader approach
Emphasizes community participation and development of community
capacity, and especially, an open transparent dialogue
One Health Approach
• Requires both ‘ground up ‘and ‘top down’ action
• Recognizes that understanding ecosystems, including
molecular ecobiology, are an essential part of One Health.
• Recognizes that One Health is a major component of food
security and safety
One Health Emerging Zoonotic Diseases (EZD) Science:
Integrating Disciplinary and Sectoral Knowledge

Bruce Wilcox, 2011, Integrative Health Research & Education EID

SECTORS CONTRIBUTING TO ONE HEALTH
• physicians
• public health professionals
Human health • government and
sector nongovernmental
organizations focused on
health education

Health related • environmental scientists

disciplines in the • biology, ecology, zoology,
environmental • medical entomology, wildlife
sector
biology

• private and public-sector

Agricultural, veterinarians
Animal
production,
• village and community
Veterinary animal health workers
medicine sector • animal producers, food
systems
 Some disciplines who might work together in
response to an outbreak of a new zoonotic disease

Human Sociologists
Physicians Health

Veterinarians Economists

Nurses Anthropologists
Global Pathologists
Ecologists Health
Zoologists Environment Animal
Microbiologists
al Health Health
Entomologists Epidemiologists
Politicians!

Many other “ologists”!!

ONE HEALTH CONCEPTS

IN PUBLIC
HEALTH
Wilcox, B. A., & Colwell, R. R. (2005). Emerging and Reemerging Infectious Diseases:
Biocomplexity as an Interdisciplinary Paradigm. EcoHealth, 2(4), 244-257.
 Public Health Problems
Infectious Diseases Non Infectious Disease

Malnutrition
AI

Degenerative
Dengue Diseases

Malaria Disorders

others Obesity

others
 Source : Preparing for Highly Pathogenic Avian Influenza - V. Martin, A. Forman, J. Lubroth
Animal Production and Health Division FAO, Rome, Italy

Consultative
committee
Suitable
command
structure Management
of disease
control
National and
local animal
disease
control
centre

Arrangement of
outbreak (human
health and
veterinary
services)
 PUBLIC HEALTH

Environmental Health

ONE HEALTH Epidemiology

Human Health Policy INTER-

CONNECTED
Behavior

Animal Environment Biostatistics

Occupational Health

EIDs
(or other
disease)
One Health can be applied at all levels

International
and Regional

National
Provincial
District
Community

Academic and
Professional
Institutions
Whose responsibility?

Paederus riparius
INTERNATIONAL BODIES
COMMITTED TO ONE HEALTH
Organizations working on One Health

Food and World

World Health
Agriculture Organization
Organization
Organization for Animal
(WHO)
(FAO) Health (OIE)

US Centers for
One Health EcoHealth
Disease
Initiative Alliance
Control
 The World Health Organization (WHO) is the
directing and coordinating authority on
WHO international health within the United
Nations’ system. WHO experts produce
health guidelines and standards, and help
countries to address public health issues.
WHO also supports and promotes health
research. Through WHO, governments can
jointly tackle global health problems and
http://www.who.int/about/en/ improve people’s well-being.

In the 21st century, health is a shared

responsibility, involving equitable access to
essential care and collective defence against
transnational threats.
 Goal
Advance global solidarity
on surveillance by
illuminating challenges,
solutions and promoting
policies that lead to actions
and a way forward to build
a world united against
infectious disease.
Objectives
• Introduce the overarching theme of
infectious disease surveillance
from a national, regional and
global perspective
• Build global solidarity around
effective actions to promote cross
sectoral and cross border
surveillance
• Present concrete examples of
knowledge, policies and innovation
and action that can be taken based
upon successes at the national,
regional and global level
• Identify and define policies that
promote cross sectoral and cross
 FAO FAO's mandate

Achieving food security for all is at the

heart of FAO's efforts - to make sure
people have regular access to enough
high-quality food to lead active, healthy
lives.

FAO's mandate is to raise levels of

nutrition, improve agricultural
productivity, better the lives of rural
populations and contribute to the
http://www.fao.org/asiapacific/en/
growth of the world economy.
Objectives
• Provide a better understanding to biologists,

1 ecologists, and natural resource mangers on how

they can contribute to One Health efforts focused
on infectious diseases

• Provide a better understanding to medics and

2 veterinarians on how biodiversity conservation and

ecosystem services ensure human health &
contribute to One Health

• Develop a statement that can be included in the

3 definition of One Health, reflecting the interests

and perspectives of biologists, ecologists, and
natural resource managers.
 OIE
The World Organisation
for Animal Health
http://www.oie.int/about-us/
The need to fight animal diseases at global level
led to the creation of the Office International des
Epizooties through the international Agreement
signed on January 25th 1924. In May 2003 the
Office became the World Organisation for Animal
Health but kept its historical acronym OIE.
The OIE is the intergovernmental organisation
responsible for improving animal health
worldwide.
It is recognised as a reference organisation by the
World Trade Organization (WTO) and in 2013 had a
total of 178 Member Countries. The OIE maintains
permanent relations with 45 other international
and regional organisations and has Regional and
sub-regional Offices on every continent.
How does the organization function?

The day-to-day operation of the OIE is managed at the Headquarters situated

in Paris and placed under the responsibility of a Director General elected by
the World Assembly of Delegates. The Headquarters implements the
resolutions passed by the International Committee and developed with the
support of Commissions elected by the Delegates:
• Council
• Regional Commissions
• Specialist Technical Commissions

The OIE's financial resources are derived principally from compulsory annual
contributions backed up by voluntary contributions from Member Countries.
Objectives
Ensure transparency in the global animal disease
Transparency situation

Collect, analyse and disseminate veterinary

Scientific information scientific information

International Encourage international solidarity in the control

solidarity of animal diseases

Safeguard world trade by publishing health

Sanitary safety standards for international trade in animals and
animal products

Promotion of Improve the legal framework and resources of

veterinary services national Veterinary Services

Food safety and To provide a better guarantee of food of animal

origin and to promote animal welfare through a
animal welfare science-based approach
ONE HEALTH: GOVERNMENT
NETWORKS
Connecting
Organizations
for Regional
Disease
Surveillance
(CORDS)

http://www.cordsnetwork.org/
 CORDS
Members
MBDS –
Mekong Basin
Disease
EAIDS – East MECIDS – Surveillance
African Middle east Network
Integrated Consortium on
Disease Infectious
Surveillance SACIDS – Disease
Network Southern Africa Surveillance
Center for
Infectious
Disease APEIR- Asia
SEEHN – Surveillance Partnership on
Southeastern Emerging
Europe Health Infectious
Network Disease
Research
Strategic Objectives
• Improving capacity: CORDS facilitates the sharing between networks of case
studies, technical expertise, data, best practices and resources to help networks
1 develop new skills and to build operational partnerships between regions.

• Advancing the “One Health” initiative: CORDS seeks to modernize disease

surveillance by improving the coordination between the sectors of animal, human,
2 and environmental health at the national, regional, and international levels.

• Promoting innovation: CORDS serves as a venue for networks to share their

innovative ideas and approaches in disease surveillance. It also offers an
organized platform for the co-development of new technologies and innovations
3 within and between regions.

• Creation of sustainable networks: CORDS works to strengthen international

disease surveillance networks and to facilitate the creation of new networks in
4 high-risk areas (epidemiological).
The Partner Organizations
ONE HEALTH: UNIVERSITY
NETWORKS
Organizations working on One Health

Indonesia One Health University Malaysia One Health University

Network (INDOHUN) Network (MYOHUN)

Southeast Asia One Health

University Network
(SEAOHUN)

Thailand One Health University Vietnam One Health University

Network (THOHUN) Network (VOHUN)
 SEAOHUN Core Universities

Hanoi School of Public Health

Hanoi Medical University
Hanoi University of Agriculture

Chiang Mai University

Mahidol University

Universiti Kebangsaan Malaysia

Universiti Putra Malaysia

Institut Pertanian Bogor

Universitas Indonesia
Universitas Gadjah Mada

4 countries/10 universities/14 faculties

 SEAOHUN Vision and Mission

Vision
A South East Asia One Health University Network
fostering sustainable trans-disciplinary capacity building
to respond to emerging and re-emerging infectious and
zoonotic diseases

Mission
To leverage the training, education, and research
capacities of the university network to build the skills,
knowledge and attitude base for One Health leaders
 SEAOHUN Objectives

1. To promote and advance the One Health approach

for control of emerging and re-emerging infectious
and zoonotic diseases (EZDs)
2. To improve the competencies of One Health
professionals
3. To build a One Health evidence base through
research activity
4. To build cadres of trained professionals to be One
Health current and future leaders
Possible members of a one health team
Veterinarian
Economist
Physician
Communications Specialist
Nurse

Emergency Responder
Public Health Workers

Epidemiologist Diagnostician

Wildlife Scientists
Pharmacist

Local Leader/Politician
Logistician
Environmental Health Worker

Public Affairs/Marketing
Ecologist

Social Scientist Information Technologist

THE ACTIONS
Who might be on a One Health team?
DEFORESTATION AND MALARIA:
Massive clearing of forests has enormous
impacts on local ecosystems and human
disease pattern. It alters microclimates by
reducing shade, altering rainfall patterns,
augmenting air movement, and
changing the humidity regime (Reiter 2001)

Vector-borne diseases such a malaria wreak

havoc on the lives of many millions of people
in poor, tropical countries, partly because
these regions are exposed to environmental
conditions such deforestation, livestock
Source: climatetasmania.com.au
rearing, irrigated farming, road construction,
and dam-building that encourage vector
abundance and disease transmission.
Preventing and Controlling Zoonotic Disease
Improving farm and market health management through Bio-security and
Bio-sanitation

Vaccination of humans and animals

Regulation of importation and movement of exotic animals

Control of feral/stray populations

Regulation of bush meat trade

Testing and culling infected wildlife

Educating people on wildlife and possible disease transmission

Public Actions
• Start with experience of both rural and urban communities:
listen, absorb, respond

• Bring livestock, food security and nutrition into all policies related to
poverty and equity, climate change, value chains and risk management

• Focus on resilience in face of risks to health and livelihoods at Interfaces

between species, cultures, livelihood groups, ethnicities, geographical areas,
sectors of government, professional groups and nations

• Engage the Whole of Society in work on risk management

• Nurture practitioner networks that span interfaces