Conservation medicine and One Health in zoos: Scope, obstacles, and unrecognized potential.

Zoo veterinarians and allied professionals have been contributing to conservation medicine (CM) and One Health (OH) activities for more than two decades. Although the Association of Zoos and Aquariums (AZA) considers conservation a key part of its mission, little published material exists about the extent of AZA work in CM/OH or the challenges and opportunities associated with these endeavors. To better understand the current scope of CM/OH in zoos, we surveyed 53 AZA-accredited institutions from April through October of 2016. We obtained information on CM/OH infrastructure, support for expansion in this area, and strategies to overcome perceived obstacles hindering CM/OH from becoming a core AZA activity. Survey results revealed that while most zoos favor greater investment in CM/OH programs, awareness, and understanding of CM/OH across the broader zoo community and public is lacking. The majority of respondents stated that overcoming this challenge is paramount to attaining support for CM/OH initiatives. In spite of these obstacles, survey respondents highlighted many positive developments in CM/OH. We found that 84% of zoos surveyed are actively engaged in CM/OH activities, and 12% house formal CM/OH programs. Another 8% of respondents said their institutions were developing CM/OH programs. Perhaps most noteworthy, we found that zoo size did not have a significant bearing on the financial amount allocated toward an institution's CM/OH activities. This suggests that all zoos, regardless of size, can make meaningful contributions to the growing movement of CM/OH and help redefine the role of zoos within this movement.

Integrating epidemiological and economic models to identify the cost of foodborne diseases.

Despite food technology advancements, food safety policies and alert systems, foodborne diseases are still a relevant concern for consumers and public health authorities, with great impacts on the economy and the society. Evaluating the cost of foodborne diseases may support the design and the implementation of policy interventions. This paper proposes a simple method for cost identification of foodborne diseases, accessible to researchers and practitioners who are not specialist in economics. The method is based on the assumption that epidemiological and economic models can be integrated to understand how the burden of disease determines costs in a wider socio-economic perspective. Systems thinking and interdisciplinary approach are the pivotal conceptual tools of the method. Systems thinking allows for the understanding of the complex relationships working among the elementary units of a system (e.g. wildlife, bred animals, consumers, environment, agro-food industry) in the occurrence of a health problem such foodborne diseases. Complex systemic relationships usually cross the traditional boundaries of scientific knowledge (human medicine, veterinary science, economics) and sectoral institutional responsibilities (e.g. ministry of health, ministry of agriculture). For these reasons more scientific disciplines, institutional competences and social bodies need to work together to face complex health problems, in an interdisciplinary framework. The first step of the proposed method is the identification of the potential cost of the disease. To this aim, the authors first focus on the links between epidemiological and economic models, based on the fact that foodborne diseases, likewise other diseases, hit people's and animals' aptitude to produce utility and goods for the society (e.g. wellbeing, revenue, safe food). These utility losses are real economic costs. Then they show how simple economic models, such as the food supply chain, can help understand the way costs spread across the economic sectors and the society. It should be underlined that the authors adopt already existing and well rooted scientific tools, focusing in particular that their integration in an interdisciplinary framework can effectively contribute to increase the understanding of complex health problems in a viable way.

Economics of One Health: Costs and benefits of integrated West Nile virus surveillance in Emilia-Romagna.

Since 2013 in Emilia-Romagna, Italy, surveillance information generated in the public health and in the animal health sectors has been shared and used to guide public health interventions to mitigate the risk of West Nile virus (WNV) transmission via blood transfusion. The objective of the current study was to identify and estimate the costs and benefits associated with this One Health surveillance approach, and to compare it to an approach that does not integrate animal health information in blood donations safety policy (uni-sectoral scenario). Costs of human, animal, and entomological surveillance, sharing of information, and triggered interventions were estimated. Benefits were quantified as the averted costs of potential human cases of WNV neuroinvasive disease associated to infected blood transfusion. In the 2009-2015 period, the One Health approach was estimated to represent a cost saving of €160,921 compared to the uni-sectoral scenario. Blood donation screening was the main cost for both scenarios. The One Health approach further allowed savings of €1.21 million in terms of avoided tests on blood units. Benefits of the One Health approach due to short-term costs of hospitalization and compensation for transfusion-associated disease potentially avoided, were estimated to range from €0 to €2.98 million according to the probability of developing WNV neuroinvasive disease after receiving an infected blood transfusion.

One Health Economics to confront disease threats.

Global economic impacts of epidemics suggest high return on investment in prevention and One Health capacity. However, such investments remain limited, contributing to persistent endemic diseases and vulnerability to emerging ones. An interdisciplinary workshop explored methods for country-level analysis of added value of One Health approaches to disease control. Key recommendations include: 1. systems thinking to identify risks and mitigation options for decision-making under uncertainty; 2. multisectoral economic impact assessment to identify wider relevance and possible resource-sharing, and 3. consistent integration of environmental considerations. Economic analysis offers a congruent measure of value complementing diverse impact metrics among sectors and contexts.

Should we be treating animal schistosomiasis in Africa? The need for a One Health economic evaluation of schistosomiasis control in people and their livestock.

A One Health economic perspective allows informed decisions to be made regarding control priorities and/or implementation strategies for infectious diseases. Schistosomiasis is a major and highly resilient disease of both humans and livestock. The zoonotic component of transmission in sub-Saharan Africa appears to be more significant than previously assumed, and may thereby affect the recently revised WHO vision to eliminate schistosomiasis as a public health problem by 2025. Moreover, animal schistosomiasis is likely to be a significant cost to affected communities due to its direct and indirect impact on livelihoods. We argue here for a comprehensive evaluation of the economic burden of livestock and zoonotic schistosomiasis in sub-Saharan Africa in order to determine if extending treatment to include animal hosts in a One Health approach is economically, as well as epidemiologically, desirable.

Dog-bites, rabies and One Health: Towards improved coordination in research, policy and practice.

Dog-bites and rabies are neglected problems worldwide, notwithstanding recent efforts to raise awareness and to consolidate preventive action. As problems, dog-bites and rabies are entangled with one another, and both align with the concept of One Health. This concept emphasizes interdependence between humans and non-human species in complex socio-ecological systems. Despite intuitive appeal, One Health applications and critiques remain under-developed with respect to social science and social justice. In this article, we report on an ethnographic case-study of policies on dog bites and rabies, with a focus on Calgary, Alberta, Canada, which is widely recognized as a leader in animal-control policies. The fieldwork took place between 2013 and 2016. Our analysis suggests that current policies on rabies prevention may come at the expense of a 'bigger picture' for One Health. In that 'bigger picture,' support is needed to enhance coordination between animal-control and public-health policies. Such coordination has direct relevance for the well-being of children, not least Indigenous children.