Building subnational capacities in animal health to deliver frontline cross-sectoral health services in Kenya.

Introduction: Operationalizing effective subnational veterinary services as major contributor to disease surveillance, reporting, diagnoses and One Health requires resources and mindset change. Here we describe workforce capacity building in animal health in Kenya and an approach that can be used to skill-up this workforce to respond beyond animal health challenges to emergent One Health realities and public health emergencies. Furthermore, triggering a paradigm shift has been identified for impactful delivery of health services, thus mindset change are important for learning new skills, but they also affect the way that we think about everything, for instance training in field epidemiology. Emphasis was therefore placed on skills, beliefs, and mindset shift. Methods: Contextualized within the Kenyan environment, this description identifies problems likely to be found elsewhere: They are (a) The limited programs that offer structured and routine on-the-job training for animal health workers; (b) Unequal distribution and inadequate quantity and quality of highly skilled workforce with appropriate technical training and scientific skills to combat public (and animal) health challenges at the frontline; (c) Health challenges occasioned by climate change and drought, including feed, and water scarcity; and (d) Inadequate contingency, preparedness, and response planning for effective deployment of ready-to-trigger workforce capacity. In-Service Applied Veterinary Epidemiology Training (ISAVET) is a four-month long training program targeted at capacity building of frontline animal health professionals. The training, which is currently implemented in 17 African countries, is innovative and a customized field epidemiology program, which responds to specific needs in animal health and contribute to approaches utilizing One Health. Results: Several trainees have marked mindset change as shown in the outputs and outcomes. Positive attitudes towards improving animal health surveillance were noted during the evaluation process. Discussion and Conclusion: Most existing workforce capacities in the animal and public health systems were built for specific fields, and hardly respond optimally for cross-sectoral purposes. We proposed customised in-service applied veterinary epidemiology training that bypasses narrow-scoped workforce development but meets multifunctional, multidisciplinary and multisectoral needs before and during emergencies.

Development of core competencies for field veterinary epidemiology training programs.

A workforce with the adequate field epidemiology knowledge, skills and abilities is the foundation of a strong and effective animal health system. Field epidemiology training is conducted in several countries to meet the increased global demand for such a workforce. However, core competencies for field veterinary epidemiology have not been identified and agreed upon globally, leading to the development of different training curricula. Having a set of agreed core competencies can harmonize field veterinary epidemiology training. The Food and Agriculture Organization of the United Nations (FAO) initiated a collective, iterative, and participative process to achieve this and organized two expert consultative workshops in 2018 to develop core competencies for field veterinary epidemiology at the frontline and intermediate levels. Based on these expert discussions, 13 competencies were identified for the frontline and intermediate levels. These competencies were organized into three domains: epidemiological surveillance and studies; field investigation, preparedness and response; and One Health, communication, ethics and professionalism. These competencies can be used to facilitate the development of field epidemiology training curricula for veterinarians, adapted to country training needs, or customized for training other close disciplines. The competencies can also be useful for mentors and employers to monitor and evaluate the progress of their mentees, or to guide the selection process during the recruitment of new staff.

Drivers for emerging issues in animal and plant health.

The history of agriculture includes many animal and plant disease events that have had major consequences for the sector, as well as for humans. At the same time, human activities beyond agriculture have often driven the emergence of diseases. The more that humans expand the footprint of the global population, encroach into natural habitats, alter these habitats to extract resources and intensify food production, as well as move animals, people and commodities along with the pathogens they carry, the greater the potential for pathogens and pests to spread and for infection to emerge or re-emerge. While essential to human well-being, producing food also plays a major role in disease dynamics. The risk of emergence of pests and pathogens has increased as a consequence of global changes in the way food is produced, moved and consumed. Climate change is likely to increase pressure on the availability of food and provide newly suitable conditions for invasive pests and pathogens. Human population displacements due to economic, political and humanitarian crises represent another set of potential drivers for emerging issues. The overlapping drivers of plant, animal and human disease emergence and environmental changes point towards the concept of 'One Health'. This paradigm underlines the urgent need to understand the influence of human behaviour and incorporate this understanding into our approach to emerging risks. For this, we face two major challenges. One is cultural; the second is methodological. We have to look at systems not under the narrow view of specific hazards but with a wider approach to system dynamics, and consider a broad spectrum of potential outcomes in terms of risk. In addition, we have to make sense of the vast amounts of data that are available in the modern age. This paper aims to help in preparing for the cultural and methodological shifts needed in our approach to emerging risks.

Metapopulation dynamics and determinants of H5N1 highly pathogenic avian influenza outbreaks in Indonesian poultry.

In 2008, the Indonesian Government implemented a revised village-level Participatory Disease Surveillance and Response (PDSR) program to gain a better understanding of both the magnitude and spatial distribution of H5N1 highly pathogenic avian influenza (HPAI) outbreaks in backyard poultry. To date, there has been considerable collection of data, but limited publically available analysis. This study utilizes data collected by the PDSR program between April 2008 and September 2010 for Java, Bali and the Lampung Province of Sumatra. The analysis employs hierarchical Bayesian occurrence models to quantify spatial and temporal dynamics in backyard HPAI infection reports at the District level in 90 day time periods, and relates the probability of HPAI occurrence to PDSR-reported village HPAI infection status and human and poultry density. The probability of infection in a District was assumed to be dependent on the status of the District in the previous 90 day time period, and described by either a colonization probability (the probability of HPAI infection in a District given there had not been infection in the previous 90 day time period) or a persistence probability (the probability of HPAI infection being maintained in the District from the previous to current 90 day period). Results suggest that the number of surveillance activities in a district had little relationship to outbreak occurrence probabilities, but human and poultry densities were found to have non-linear relationships to outbreak occurrence probabilities. We found significant spatial dependency among neighboring districts, indicating that there are latent spatial processes that are not captured by the covariates available for this study, but which nonetheless impact outbreak dynamics. The results of this work may help improve understanding of the seasonal nature of H5N1 in poultry and the potential role of poultry density in enabling endemicity to occur, as well as to assist the Government of Indonesia target scarce resources to regions and time periods when outbreaks of HPAI in poultry are most likely to occur.