Published on February 20, 2014
Global Veterinary and Medical Perspectives on One Health
Increased population; Urbanization Intensified livestock production; Ecosystem encroachment M an A nimal P lants Crisis in use of natural resources (Zinsstag et al., 2011)
66 217 287 307 538 Non-infectious Bacteria & Rickettsia Fungi Helminth Virus & Prion Protozoan Pie diagram showing rate of death due to causes (Chugh T.D., 2008) ( • • C 60.3 % of infectious diseases are zoonotic : 71.8 % originate in wild life. h u (Jones et al., 2008) g h 75 % (132/175) of the emerging diseases are zoonotic. (Asokan et al., 2011) , T • Direct loss of $20 billion with over $200 billion indirect losses in zoonosis. . (World Bank, 2010) D .
HOST-PARASITE-ECOLOGICAL RELATIONSHIP Translocation Encroachment; Introduction; Spill over and spill back Wild life EID Domestic animal EID Human encroachment; Ex situ contact; Ecological manipulation Human EID Agricultural Intensification Global travel; Urbanization; Biomedical manipulation Technology & industry (Daszak et al., 2000)
HISTORY • Ancient healers - priests : Slaughter sacrificial animals (Schwabe, 1984) • Kahun Papyrus (1900 B.C.) : Chimeric animals & human in myths; Vector borne diseases (Driesch and Peters, 2003) • King Adadapla- iddina (1068-1047 B.C.) : Constructed temple for Goddess Gula - healer of Rabies (Day, 2011)
HISTORY (contd)… Chinese Zhou dynasty (11- 13th Century) : – Integrated public health system – Principles of yin-yang : Acupuncture in animals & man “ The foundations of veterinary medicine are as comprehensive and subtle as those of human medicine and it is not possible to place one above the other.” (On the origin and development of Medicine: Xu Dachun) (Driesch and Peters, 2003)
HISTORY (contd)… • Arab : Kitab al Baytara ( ) • Greek scholars: Aristotle (384-322 B.C.) & Hippocrates (460-367 B.C.) – Public health on clean environment – Promoted comparative medicine • Galen (130-200 A.D.) : extended idea of Hippocrates • Leonardo da Vinci (1452-1519 A.D.) : Comparative anatomy
HISTORY (contd)… • Giovani Maria Lancisi (1654-1720) : Veterinarian Use of mosquito nets for malaria control Pioneer in RinderPest control • John Hunter (1728-1793) : Comparative medicine • Edward Jenner FRS (1749-1823) : Small pox vaccination
HISTORY (contd)… INCEPTION OF VETERINARY SCIENCES…… 1761 January (1712-1779) 2011 January “Either medicine will mutually enlighten and perfect the other when we discard a derisory, harmful prejudice.” (Claude Bourgelat)
HISTORY (contd)… • Rudolf Virchow (1821-1902) : Father of comparative medicine & cellular pathology Coined “Zoonoses” Regular meat inspection “Between animal and human medicine there is no dividing line, nor should there be. The object is different, but the experience obtained constitutes the basis of all medicine.” (Virchow)
HISTORY (contd)… • William Osler (1849-1919) : Father of Veterinary pathology in North America “Veterinary medicine and human medicine complement each other and should be considered as one medicine” (Osler) • Louis Pasteur (1822-1895); • Robert Koch (1843-1910); • John McFadyean (1853-1941) : Lab confirmation of Anthrax; Zoonotic potential of bovine T.B.
HISTORY (contd)… • Calvin W Schwabe (1927-2006): One Health “ …there is no difference of paradigm between human and veterinary medicine , and is extension of notions of comparative medicine. Both sciences share, as a general medicine, a common body of knowledge in anatomy, physiology, pathology and the origin of diseases in all species.” (Schwabe, 1984) (Veterinary Medicine and Human Health, Schwabe, 1984)
HISTORY (contd)… • James H Steele (1913- 2013): International doyen of VPH Founder of CDC VPH One World, One Medicine, One Health (Monath et al., 2010) • Frederick A. Murphy & Karl M. Johnson (Kahn et al., 2009)
HISTORY (contd)… • Stephen S Morse (1993) : ProMED - Programme for Monitoring Emerging Diseases “Global electronic reporting system for outbreaks of Emerging Infectious Diseases and toxins” (Dell, 2010)
Being admitted to the profession of veterinary medicine, I solemnly swear to use my scientific knowledge and skills for the benefit of society through the protection of animal health and welfare, the prevention and relief of animal suffering, the conservation of animal resources, the promotion of public health, and the advancement of medical knowledge........ (AVMA Veterinarian’s Oath , 2010)
MANHATTAN PRINCIPLES • Wildlife Conservation Society (2004) at Rockefeller University • Building interdisciplinary bridges to health in Globalised world • ONE WORLD - ONE HEALTH • Promote the impact of land use & wildlife health on human • Holistic approach to prevent epidemic/epizootic disease and ecosystem integrity.
ONE HEALTH INITIATIVE • AMA (June 25, 2007) House of Delegates approved resolution • AVMA (July, 2007) implemented One Health Concept • To revive integration of human, animal or environmental health (Klement et al., 2009) • Inter-professional collaboration • To extend research on EIDs; surveillance • Improve scientific knowledge & clinical care (Hristovski et al., 2010) (Atlas et al., 2010)
Science (Vol. 316: June 15, 2007)
“One Health is the collaborative efforts of multiple disciplines working locally, nationally, and globally to attain optimal health for people, animals, plants and our environment” (One Health Initiative Task Force, AVMA, 2008)
“You can’t tell the story of human health separate from animal health or environmental health.” (William Foege) CDC President to declare small pox eradication programme
BENEFITS OF ONE HEALTH • Improve animal & human health by interdisciplinary collaboration • Meet new global challenges • Develop new centres of excellence for education and training in specific areas • Increase professional opportunities • Gain scientific knowledge to create innovative programmes to improve health (One Health Initiative Task Force, AVMA, 2008)
SCOPE OF ONE HEALTH Food safety; security Antimicrobial resistance Global water/ food system Climate change Bioterrorism Training Land use pattern Biomedical Research Creation of scientific Occupational health Comparitive Medicine knowledge Public health Conservation Medicine Regulatory enforcement Biodiversity Zoonoses Wildlife promotion Emerging Infectious Global trade & Disease; ecology commerce (One Health Initiative Task Force, AVMA, 2008)
ADDRESSING PROBLEMS OF 21st CENTURY Population Explosion Infectious Diseases Pollution Poverty & Starvation Food Security Climate Change
Population (billions) POPULATION EXPLOSION Human population increases by: 2.5 people/sec; 150people/min; 9000/hr; 2,14,000/day; 78 million/year (Courtesy: United Nations Population Division, World Population Prospects: 2006 Revision)
CLIMATE CHANGE “Climate change is perhaps the most challenging collective action problem the world has faced” (Tony Blair) Indian subcontinent: • Increase trends in annual mean temperature; • 0.68oC increase in the temperature per century • 8.7% increase of Carbon-di-oxide • Increase in extreme rains in NE & SW monsoons Temperature rise 2099 • Low number of rainy days in East coast • Increased coastal water temperature in South Asia • Water availability: 1820 cu.m/year (2001) 1140 cu.m/year (2050) (Courtesy: IPCC Website)
EMERGING INFECTIOUS DISEASES • Modern jet travel allows passengers to move less than the incubation period of diseases: Notion of exotic diseases are meaningless. (Sherman, 2010) • Rapid dissemination of disease occurrence: ProMED; OIE • Initiate quickly the surveillance pattern • Should be proper, responsible, effective risk communication (Decker et al., 2010) Consider 50,000 known vertebrates; each with 20 endemic viruses: Total of 1 million vertebrate viruses. Only 2000 viruses discovered 99.8% vertebrate viruses remain to be discovered (Atlas et al., 2010)
FOOD SAFETY • Global demand for foods of animal origin is steadily growing and is apparent that livestock sector will continue to grow (FAO, 2009) • Demand for food expected to increase by 50% before 2020 (Scott,2008) • Reduction of tariff associated with market reforms • Advances in shipping – growth of animal products trade • Regulations for international trade (Speedy, 2003)
POVERTY • Around 3 billion people live on less than $2 per day (World Bank, 2008) • Professionals are unwilling to offer services • Little or no access to prevent and cure veterinary medical services • Serve as source of transmissible disease & spread (WHO, 2006) • Food/ agri products faced average inflation rate of 9.9% over last half decade in India (Moorthy et al., 2011)
ANTIMICROBIAL RESISTANCE Soil Water Effluents Sewage Wild Life Vegetation Animal Feed Companion Animals Food Animals Meat Humans Direct Contact Irwin (2005) adapted from Linton (1977)
ONE HEALTH IN INDIAN PERSPECTIVE Wild life Drug resistant agents Non- wild life Vectors To be kept in mind while propagating One Health programme (Jones et al., 2008)
One health in Indian perspective (Contd)… • 37 Veterinary Colleges V/s 251+ Medical colleges • Lack of inter-sectorial collaboration • Limited field epidemiology capacity • Awareness of zoonoses is poor Knowledge among Medical Graduates (Sekar et al., 2011) (Kakkar et al., 2011)
One health in Indian perspective (Contd)… • Lack of national programme on Zoonoses managed by Dept of Animal Husbandry, Ministry of Agriculture except for Rabies in few states • Lack of authentic data on occurrence of the diseases • No Public Health implementing agency (Asokan et al., 2011) TO KNOW why 1,000 Indian children die of diarrhoeal sickness every day, take a wary stroll along the Ganges in Varanasi. As it enters the city, Hinduism’s sacred river contains 60,000 faecal coliform bacteria per 100 millilitres, 120 times more than is considered safe for bathing. Four miles downstream, with inputs from 24 gushing sewers and 60,000 pilgrim-bathers, the concentration is 3,000 times over the safety limit. In places, the Ganges becomes black and septic. Corpses, of semicremated adults or enshrouded babies, drift slowly by. (The Economist; 2008 Dec. 11)
How to reach One Health??.. • Consensus among stakeholders • Collaboration among professionals, • Cooperation among interdisciplinary groups, • Coordination among partner agencies and • Commitment (Political and financial) by donors, partners, regional organizations and national governments For low/ middle income nations : US$ 1.3 billion spend for One Health per year till 2020 (Contributing to One World, One Health: A Strategic Framework for Reducing Risks of Infectious Diseases at the Animal-Human-Ecosystem Interface, 2008)
Opportunities for One Health partnerships
Solving today’s threats and tomorrow’s problems cannot be accomplished with yesterday’s approaches…..
“It is not the strongest of the species who survive, nor the most intelligent; rather it is those most responsive to change” (Charles Darwin)
THANK YOU…….. Your attitude determines your altitude..
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