Steps towards one health
Climate change, rapid population growth and globalisation increase the risk of infectious disease, particularly those fuelled by human being interaction with animals and the environmental interface.
The recognition that many risk factors of infectious disease fall outside the typical domain of the health sector creates the challenge of identifying and pursuing priorities for cross-sectoral action aimed at strengthening global health security.
Most emerging infectious disease risks originate from the human-animal-environment interface.
We need to embrace the one health approach, which requires a holistic view of humans’ interaction with animal and ecosystem health domains.
One health promotes an international, interdisciplinary, inter-sectoral perspective to disease emergence and control.
The strategy is cost-effective because it leads to early detection in animals, thus reducing the impact on human lives.
Preparedness is about the knowledge and capacities developed by governments, response and recovery organisations, communities and individuals to effectively anticipate, respond to, and recover from the impacts of likely, imminent or current disasters.
How prepared is Malawi to implement the one health approach? What are the likely challenges? These are some of the burning questions.
Moreover, the reporting of outbreaks is often culturally and politically charged due to factors such as the lack of clear compensation schemes or stigma.
Communication mechanisms and frameworks should, therefore, be established before the emergency period and always with a focus on all aspects of one health.
Surveillance and early warning systems across sectors and coordinated response plans should be improved.
There is an urgent need for a mechanism for joint situational awareness as well as a platform to share early signals with a low threshold of interaction.
Mechanisms are needed to harmonise diagnostic laboratory tests and clarify roles during outbreaks.
Joint public outreach and education should also be enhanced.
However, the sharing of data and samples between sectors and agencies are problematic. To improve the situation, we must establish a joint database. Since outbreaks must be fought where they occur, we should invest in local human resources who cover risk assessment, diagnostics, awareness and vaccine production.
Risk perception also slows one health. The level of acceptable risk differs between public health (precautionary) and animal health (less stringent). There is a need for agreement on the level of acceptable risk.
There must be collaboration in the area of prediction modelling for risk assessment across different sectors. Additionally, more funding for sample testing, timely exchange of samples and a focus on preparedness could solve some of the barriers.
If Malawi was hit by Ebola or Zika outbreak today (God forbid!), how long will it take as a country to diagnose it? Are our citizens properly aware of it? How ready are our laboratories and hospitals for such diseases?
How many people are trained to handle such cases? How ready are we to work with other sectors or governments? What are we doing with regards to early detection in animals? Do we know the pathogens (viruses) our immediate neighbours (mosquitoes, bats and rats) carry? What about monkeys which live in proximity to us due to habitat destruction?
Responses to these questions will determine how prepared we are to confront diseases resulting from animals in our environment.
The successful preparedness and implementation of one health in fighting zoonotic diseases require coordination and collaboration across the entire human-animal–environmental interface.
This requires better research, networks, increased awareness, availability of funds, overcoming silo mentality, clear roles, collaborative actions, and clearly defined preparedness methodologies within coordinated frameworks.
