One Health Leadership: Heeding Society’s Call; Addressing the Global Need August 25, 2012

© 2007 Her Majesty the Queen in right of Canada (Canadian Food Inspection Agency), all rights reserved. Use without permission is prohibited.

Overview

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One Health is Not New

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So What has Changed? The Convergence Dilemma

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Scoping the Definition of One Health

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One Health Call to Action

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Animals as Sentinels

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Disease Control Has Consequences

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Changing International Standards

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The Leadership Path

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D.V.M.’s Are……..

2

One Health Is Not New

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From time immemorial……

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From hunting to herding to domestication…..

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First nations culture…….

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International bragging rights ….

3

Bourgelat

Bourgelat

Claude Bourgelat 1712-1779

Rudolph Virchow

(1821 –1902

Between animal and human medicine there is no dividing line –nor should there be.”

19th century and the early 20th century there was continued interest in linking human and veterinary medicine based on the discoveries that there were similar disease processes in both animals and humans.

History of “One Health”

Sir William Osler

(1849 - 1919) • • • Father of modern medicine Taught at the Montreal Veterinary College and had responsibilities at McGill University Medical School Pioneered the concepts of comparative medicine and comparative pathology and made important contributions to the standards of veterinary education

The term "one medicine" (forerunner of the more current term, One Health) was used by Dr. Schwabe in his 1984 book,

Veterinary Medicine and Human Health

, to bring a renewed interest to the synergy that can emerge when health practitioners and scientists collaborate. His insightful words, "The critical needs of man include the combating of diseases, ensuring enough food, adequate environmental quality, and a society in which humane values prevail," are even more compelling today.

Convergence Model : The Perfect Biological Storm

Genetic and Biological Factors Physical and Environmental Factors Animals E I D Humans Wildlife Social, Political, and Economic Factors Ecological Factors

Dilemma Drivers

Genetic and biological factors • • • Microbial adaptation and change Susceptibility to infection Loss of biodiversity Physical environmental factors • • Climate and weather Economic development and land use Ecological factors • • • Changing ecosystems Human demographics and behavior Animal production systems Social, political, and economic factors • • • • Globalization of people, commerce and pathogens Poverty and social inequity Food security Intent to harm

Convergence Model : The Perfect Biological Storm

Genetic and Biological Factors Physical and Environmental Factors Animals Food Security Wildlife Humans Social, Political, and Economic Factors Ecological Factors

What is One Health?

• One Health is about managing health threats at the interface between eco-system health, animal health and human health Ecosystems • It recognizes that the health of people, animals and the ecosystem of which we are a part, are interconnected.

Animals Humans

Scoping the Definition of One Health

Health is more than the absence of disease • A dynamic state of complete physical, mental, spiritual and social well being and not merely the absence of disease or infirmity The health impacts resulting from an animal disease outbreak can be physical, emotional and psychological Social, cultural, economic, political and environmental consequences can arise from animal disease occurrences • Loss of identity or social status, community disruption, family breakdown, loss of species of religious and cultural significance, loss of primary source of nutrition, loss of biodiversity, loss of livelihood, loss of public confidence

Scoping the Definition of One Health

• One health is problem solving with an emphasis on determining the cause of the cause (of the cause).

• One health is being more cost effective by moving from paying for consequences to investing in prevention and mitigation.

• One health is preventive medicine for multiple species in parallel.

• One health is much more than the control of zoonoses. It includes food security and food safety, sustainable production systems, protection of biodiversity and genetics and the well being derived from the human:animal bond.

• One Health is the “Nature of Things” for real

One Health 101 As An Acronym

• • •

O

ur

N

ecessity

E

ntails • • • • • •

H

umans

E

co-systems and

A

nimals

L

iving

T

ogether

H

armoniously • Brian Evans, Global One Health Conference, Melbourne, Australia, January 2010

Challenges: Economic Impact of Emerging Infectious Disease

hunger is the world’s No. 1 public health threat — killing more people than AIDS, malaria and tuberculosis combined.”

—James T. Morris, Executive Director, U.N. World Food Programme March 15, 2007

Photos by Astronaut Sunita Williams

Two families

Germany: The Melander family of Bargteheide

Food expenditure for one week: 375.39 Euros or $500.07

Chad: The Aboubakar family of Breidjing Camp

Food expenditure for one week: 685 CFA Francs or $1.23 http://www.humanespot.org/node/2885

Clockwise from top left: Algeria, Egypt, Tunisia and Yemen - FAO, IMF anticipate more civil unrest and protests because of soaring food prices

One Health Call To Action

• One Health is why we should be paying attention to white nose syndrome in bats • • • Estimated death of 7 million bats in 20 states and four provinces Capable of consuming 21 metric tons of insects per night Many of the insects are known vectors of transmissible diseases • One Health is why we should be paying attention to sick oceans • • • • • 80 per cent of earths species reside in the oceans Fastest growing source of animal protein to address global food security challenge is derived from aquaculture Carbon sequestration increasing acidity Warming of the planet Disruption of the food chain

Animals as Sentinels

• The full potential of linking animal and human health information to provide early warning of shared disease risks from environmental hazards has not been realised • The One Health concept holds promise for improved sentinel event coordination in order to detect and reduce environmental health threats shared between humans and animals

Animals as Sentinels (toxic and infectious disease)

• Mercury poisoning in cats (dancing cat disease) • • Cats eating fish from river containing mercury lead to testing of humans eating same fish High levels of mercury exposure revealed • Lead poisoning diagnosed in pets exposed to paint chips leading to positive findings in children • Caged canaries in coal mines for early warning of toxic gas exposure • Chickens serving as sentinels for West Nile Virus exposure risk for humans

Zoonoses are a two way street

Stamping out policy

photo: Tom Brownlie RVC (Final year) 2001 Professor Joe Brownlie RVC

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© A. Michaud, 2003

World organisation for animal health

12 rue de prony 75017 paris, france Tel: 33 (0)1 44 15 18 88 – Fax: 33 (0)1 42 67 09 87 Email: [email protected]

http://www.oie.int

The Evolution of International Standards

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Changes in disease reporting obligations Elimination of historic list A and list B Move to report:

• • • • • • First occurrence of a listed disease Reoccurrence of a listed disease following declaration of eradication First occurrence of a new strain of a pathogen Sudden or unexpected increase in the distribution, incidence, morbidity or mortality of an indigenous disease An emerging disease with significant morbidity, mortality or zoonotic potential Evidence of change in the epidemiology of a listed disease such as host species or pathogenicity

The Evolution of International Standards

• Move from emphasis on country freedom status to regionalization and compartmentalization • Increased focus on commodity risk rather than disease free status • Emphasis on reward for investment in surveillance, reporting and biosecurity measures • All serve to increase the timeliness and transparency of disease reporting • Complimented by IHR and INFOSAN

The Leadership Path

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Congratulations are in order

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Believe that leadership potential has been recognized in each of you

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Leadership means influencing behaviours

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Leadership means facilitating change in response to new imperatives

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Leadership means empowering and engaging others

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The Leadership Path

Leadership means asking the right questions

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Leadership means acting with integrity

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Leadership recognizes evidence and values as important elements in decision making

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Leadership comes in different styles

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Support next generation of students as they are the primary drivers behind innovation and change

No generation understands interconnectivity better

D.V.M.’s Are………

Doctors of Veterinary Medicine (DVMs) and as a result… Doctors of Very Many Species (DVMs) and as a result...

Doctors of Very Many Situations (DVMs) and as a result… Determiners of Very Many Scenarios (DVMs)

© 2007 Her Majesty the Queen in right of Canada (Canadian Food Inspection Agency), all rights reserved. Use without permission is prohibited. 38