Factors that enable effective One Health collaborations - A scoping review of the literature.

Advocates for a One Health approach recognize that global health challenges require multidisciplinary collaborative efforts. While past publications have looked at interdisciplinary competency training for collaboration, few have identified the factors and conditions that enable operational One Health. Through a scoping review of the literature, a multidisciplinary team of researchers analyzed peer-reviewed publications describing multisectoral collaborations around infectious disease-related health events. The review identified 12 factors that support successful One Health collaborations and a coordinated response to health events across three levels: two individual factors (education & training and prior experience & existing relationships), four organizational factors (organizational structures, culture, human resources and, communication), and six network factors (network structures, relationships, leadership, management, available & accessible resources, political environment). The researchers also identified the stage of collaboration during which these factors were most critical, further organizing into starting condition or process-based factors. The research found that publications on multisectoral collaboration for health events do not uniformly report on successes or challenges of collaboration and rarely identify outputs or outcomes of the collaborative process. This paper proposes a common language and framework to enable more uniform reporting, implementation, and evaluation of future One Health collaborations.

One Health operations: a critical component in the International Health Regulations Monitoring and Evaluation Framework.

Under the International Health Regulations (IHR, 2005), a legally binding document adopted by 196 States Parties, countries are required to develop their capacity to rapidly detect, assess, notify and respond to unusual health events of potential international concern. To support countries in monitoring and enhancing their capacities and complying with the IHR (2005), the World Health Organization (WHO) developed the IHR Monitoring and Evaluation Framework (IHR MEF). This framework comprises four complementary components: the State Party Annual Report, the Joint External Evaluation, after-action reviews and simulation exercises. The first two are used to review capacities and the second two to help to explore their functionality. The contribution of different disciplines, sectors, and areas of work, joining forces through a One Health approach, is essential for the implementation of the IHR (2005). Therefore, WHO, in partnership with the Food and Agriculture Organization of the United Nations (FAO), the World Organisation for Animal Health (OIE), and other international and national partners, has actively worked on facilitating the inclusion of the relevant sectors, in particular the animal health sector, in each of the four components of the IHR MEF. Other tools complement the IHR MEF, such as the WHO/OIE IHR-PVS [Performance of Veterinary Services] National Bridging Workshops, which facilitate the optimal use of the results of the IHR MEF and the OIE Performance of Veterinary Services Pathway and create an opportunity for stakeholders from animal health and human health services to work on the coordination of their efforts. The results of these various tools are used in countries' planning processes and are incorporated in their National Action Plan for Health Security to accelerate the implementation of IHR core capacities. The present article describes how One Health is incorporated in all components of the IHR MEF.

En vertu du Règlement sanitaire international (RSI, 2005), instrument juridique ayant force obligatoire pour les 196 États Parties dans le monde, les pays s'engagent à renforcer leurs capacités de détection, d'évaluation, de notification et de réaction en cas d'événements sanitaires inhabituels ou présentant une dimension internationale inquiétante. Le Cadre de suivi et d'évaluation du RSI (2005) a été élaboré par l'Organisation mondiale de la santé (OMS) afin de soutenir les pays souhaitant évaluer et améliorer leurs capacités et leur niveau de conformité avec le RSI (2005). Ce cadre comprend quatre composantes complémentaires : le rapport annuel de l'État Partie, l'Évaluation extérieure conjointe, les examens « après action¼ et les exercices de simulation. Les deux premières composantes permettent de faire le point sur les capacités tandis que les deux dernières visent une connaissance détaillée de leur fonctionnement. La mise en oeuvre du RSI (2005) demande aux différentes disciplines, secteurs et domaines d'activités de fédérer leurs forces dans une approche Une seule santé. Par conséquent, en partenariat avec l'Organisation des Nations Unies pour l'alimentation et l'agriculture (FAO), avec l'Organisation mondiale de la santé animale (OIE) et avec d'autres partenaires internationaux et nationaux, l'OMS a fait en sorte de faciliter l'intégration de tous les secteurs concernés, en particulier celui de la santé animale, dans les diverses composantes du Cadre d'évaluation du RSI. D'autres outils complètent celui-ci, en particulier les ateliers de liaison nationaux OMS/OIE sur le RSI et le Processus d'évaluation des performances des Services vétérinaires (PVS), dont le but est de faciliter l'utilisation optimale des résultats du Cadre d'évaluation du RSI et du Processus PVS de l'OIE et de fournir aux acteurs des services de santé animale et de santé publique la possibilité de se concerter sur les modalités d'une synergie de leur action. Les résultats de ces outils sont ensuite pris en compte par les pays lors des procédures de planification et intégrés dans les Plans d'action nationaux pour la sécurité sanitaire afin d'accélérer la mise en oeuvre des capacités fondamentales décrites dans le RSI. Les auteurs décrivent l'intégration du concept Une seule santé dans chacune des composantes du Cadre d'évaluation du RSI.

Según lo dispuesto en el Reglamento Sanitario Internacional (RSI, 2005), documento jurídicamente vinculante suscrito por 196 Estados Partes, los países están obligados a dotarse de la capacidad necesaria para detectar, evaluar, notificar y afrontar con rapidez todo evento sanitario inusual que pueda revestir importancia internacional. Para ayudar a los países a dotarse de mejores capacidades, a seguir de cerca su evolución al respecto y a dar cumplimiento al RSI (2005), la Organización Mundial de la Salud (OMS) elaboró el marco de seguimiento y evaluación del RSI, que consta de cuatro elementos complementarios: el informe anual que debe presentar cada Estado Parte; la evaluación externa conjunta; exámenes posteriores a las intervenciones; y ejercicios de simulación. Los dos primeros sirven para examinar las capacidades, y los dos segundos para ayudar a estudiar su funcionalidad. Para la aplicación del RSI (2005) es fundamental la contribución de diferentes disciplinas, sectores y ámbitos de trabajo, que aúnen esfuerzos actuando desde los postulados de Una sola salud. Por ello la OMS, en colaboración con la Organización de las Naciones Unidas para la Alimentación y la Agricultura (FAO), la Organización Mundial de Sanidad Animal (OIE) y otros asociados internacionales y nacionales, ha trabajado activamente para facilitar la integración de los sectores pertinentes, en particular el de la sanidad animal, en cada uno de los cuatro componentes del marco de seguimiento y evaluación del RSI. Hay otros dispositivos que vienen a complementar este marco, por ejemplo los talleres nacionales dedicados a la creación de nexos entre el RSI y el proceso PVS (Prestaciones de los Servicios Veterinarios) de la OIE, organizados conjuntamente por la OMS y la OIE, que facilitan un uso idóneo de los resultados del marco de seguimiento y evaluación del RSI y del proceso PVS y brindan a las partes interesadas de los servicios sanitarios y zoosanitarios la oportunidad de trabajar sobre la coordinación de sus respectivas actividades. Los resultados de estas diversas herramientas alimentan después los procesos de planificación de los países y son incorporados a su Plan de acción nacional de seguridad sanitaria para acelerar la implantación de las capacidades básicas prescritas en el RSI. Los autores explican cómo se incorpora la filosofía de Una sola salud a todos los componentes del marco de seguimiento y evaluación del RSI.

Evaluating One Health: the role of team science in multisectoral collaboration.

In a review of the literature surrounding One Health, cross-boundary collaboration, the science of teams, and interdisciplinary health competencies, many individual disciplines, and in some cases multidisciplinary research teams, have looked at the scholarship of collaboration and arrived at remarkably similar conclusions as to which factors and competencies support effective collaboration. However, conclusions on how to effectively evaluate collaboration are consistently lacking across the literature reviewed. Although important advances have been made recently in the area of evaluating One Health operations and outcomes, there is an opportunity to develop process-based performance measures for One Health collaboration and teamwork. Synthesising work on collaborative performance evaluation across multiple disciplinary and sectoral lanes and levels of collaborative analysis, the authors argue that, in addition to outcome-based One Health evaluation, the evaluation of One Health processes needs to be further refined and 'team' effectiveness needs to be evaluated at all levels of the health system: individual, organisational and network.

À l'occasion d'une revue de la littérature scientifique consacrée à Une seule santé, à la collaboration transversale, à la science des équipes et aux compétences interdisciplinaires en matière de santé, plusieurs équipes de chercheurs, pour la plupart spécialisées dans une seule discipline mais aussi, pour certaines, multidisciplinaires, ont étudié la science du travail en collaboration et sont parvenues à des conclusions étonnamment similaires quant aux facteurs et aux compétences qui soutiennent une collaboration efficace. En revanche, il ressort de cet examen de la littérature qu'aucune conclusion n'y apparaît sur la manière d'évaluer efficacement une telle collaboration. Si des avancées importantes ont été enregistrées dans le domaine de l'évaluation des interventions et des résultats Une seule santé, il y a encore matière à développer des méthodes de mesure des performances basées sur les procédures. Cette synthèse des travaux sur l'évaluation collaborative des performances, qui recouvre de multiples voies disciplinaires et sectorielles et différents niveaux d'analyse collaborative permet aux auteurs de soutenir que les évaluations des processus Une seule santé doivent être élaborées plus finement afin de compléter les évaluations basées sur les résultats, et que l'efficacité des « équipe ¼ doit être évaluée à tous les niveaux du système de santé : individus, organisations et réseaux.

Los autores exponen un estudio recapitulativo de la bibliografía relativa a temas como la noción de Una sola salud, la colaboración transfronteriza, la ciencia del trabajo en equipo o las competencias interdisciplinares en temas de salud, señalando a partir de ahí que buen número de disciplinas y, en ciertos casos, equipos pluridisciplinares de investigación, tras examinar cuanto saben los estudiosos en cuestiones de colaboración, llegaron a conclusiones notablemente similares acerca de la suma de factores y competencias que propician una colaboración eficaz. En la bibliografía examinada, sin embargo, brillan por su ausencia las pistas sobre el modo de evaluar eficazmente la colaboración. Aunque últimamente ha habido avances importantes en cuanto a la evaluación de las actividades emprendidas en clave de Una sola salud y sus resultados, existe la posibilidad de establecer parámetros que midan la eficacia de los procesos de colaboración y de trabajo en equipo encuadrados en la filosofía de Una sola salud. Sintetizando los estudios de evaluación de la eficacia de la colaboración que se han realizado desde múltiples ángulos disciplinares y sectoriales y niveles de análisis colectivo, los autores postulan que, además de la evaluación de los resultados, es preciso perfeccionar aún más la evaluación de los procesos de Una sola salud y evaluar asimismo la eficacia de los «equipos¼ en todos los niveles que configuran un sistema de salud: el individual, el institucional y el de las redes de trabajo.

Promoting the One Health concept: Thai Coordinating Unit for One Health.

Within the last decade, One Health has gained momentum in government agencies, academic institutions, intergovernmental organisations and civil society organisations within Thailand. One Health is an approach of multisectoral and multidisciplinary collaboration that connects human, animal and environmental health sectors to improve the health of all. In 2014, the Coordinating Unit for One Health (CUOH), based within the Thai Ministry of Public Health, was officially established to serve as a focal point within Thailand for One Health collaboration both domestically and internationally. The unit's main functions are to share data, information and resources, and to support One Health activities within the country. The CUOH Steering Committee meets regularly to provide technical and administrative guidance on the functions and directions of the CUOH. A memorandum of understanding on One Health, signed in 2016 by seven Ministries and the Thai Red Cross Society, has strengthened One Health collaboration and provides a formalised channel through which the CUOH can facilitate activities across Ministries and with non-governmental agencies in Thailand.

En l'espace d'une décennie, le recours aux méthodes Une seule santé en Thaïlande s'est intensifié au sein des agences gouvernementales, des institutions académiques, des organisations intergouvernementales et des organisations de la société civile. La collaboration multisectorielle et pluridisciplinaire mise en place selon les principes Une seule santé vise à connecter les secteurs de la santé publique, la santé animale et la santé environnementale afin d'améliorer la santé pour tous. En 2014, l'Unité de coordination Une seule santé (CUOH) a été officiellement créée au sein du ministère thaïlandais de la santé publique dans le but de servir de point focal national pour la collaboration Une seule santé aussi bien dans le pays qu'au niveau international. L'Unité a pour principales fonctions le partage de données, d'informations et de ressources et le soutien aux activités Une seule santé dans le pays. Le comité directeur de la CUOH se réunit régulièrement pour fixer les orientations techniques et administratives des tâches et des objectifs de l'Unité. Un protocole d'accord sur le thème Une seule santé signé en 2016 par sept ministères et la Société thaïlandaise de la Croix rouge renforce cette collaboration Une seule santé et fournit un canal officiel grâce auquel la CUOH peut déployer des activités transversales faisant intervenir plusieurs ministères et organisations non gouvernementales en Thaïlande.

En el curso del último decenio, la noción de Una sola salud ha ido ganando presencia y peso en el seno de organismos públicos, instituciones universitarias, organizaciones intergubernamentales y entidades de la sociedad civil de Tailandia. La filosofía de Una sola salud se traduce en un trabajo de colaboración multisectorial y pluridisciplinar que conecta entre sí los sectores de la salud humana, animal y ambiental con el objetivo último de hacer realidad un mejor estado de salud para todos. En 2014 se estableció oficialmente dentro del Ministerio de Salud Pública de Tailandia la Unidad de Coordinación en pro de Una sola salud, que tiene por cometido ejercer de enlace dentro del país de todas las actividades de colaboración en clave de Una sola salud, ya sean nacionales o internacionales. Sus principales funciones son el intercambio de datos, información y recursos y la prestación de apoyo a dichas actividades dentro del país. Su Comité de Dirección se reúne periódicamente para marcar pautas técnicas y administrativas sobre las funciones y las líneas de trabajo de la Unidad. En 2016, siete ministerios y la Sociedad Tailandesa de la Cruz Roja suscribieron un memorando de entendimiento en torno a la noción de Una sola salud que, además de reforzar la colaboración encuadrada en esta filosofía, abre un cauce oficial a través del cual la Unidad puede facilitar el trabajo interministerial o la colaboración con entidades no gubernamentales en Tailandia.

The importance of a One Health approach for prioritising zoonotic diseases to focus on capacity-building efforts in Uganda.

Zoonotic diseases constitute a significant threat to the health of humans, livestock and wildlife, as well as to livestock production, and can also have a negative impact on our shared environment and on livelihoods. Uganda is a hotspot for emerging and re-emerging zoonotic disease threats, with the main drivers of this phenomenon being identified as agricultural intensification, proximity to wildlife reservoirs and climate change. The threat of zoonotic disease outbreaks affects not only human healthcare systems but also livestock production, food security, human capital development, wildlife health, environmental health and privatesector growth. Firstly, to prevent, control and mitigate the threat from zoonotic diseases, in March 2017, Uganda prioritised zoonotic diseases using a One Health approach that focuses the limited resources available on those diseases that have the greatest impact at the national level. The prioritised zoonotic diseases in question are anthrax, zoonotic influenza viruses, viral haemorrhagic fevers, brucellosis, trypanosomiosis (African sleeping sickness), plague and rabies. Secondly, in January 2018, Uganda published a National One Health Strategic Plan, which was developed after these zoonotic diseases had been prioritised. In addition, the Ugandan Government and its partners are currently collaboratively addressing several of these previously neglected, endemic zoonotic diseases, such as anthrax, brucellosis and rabies. As a result of these One Health efforts, capacity has increased for early detection of, reporting on and response to zoonotic diseases at all levels. To consolidate the achievements of the One Health approach, the Ugandan Government and its partners should continue to support capacity building for the prevention and control of zoonotic diseases.

Les maladies zoonotiques représentent une menace importante pour la santé publique, pour la santé du bétail et de la faune sauvage et pour la productivité du secteur de l'élevage ; en outre, elles ont un impact négatif sur notre environnement commun et sur les moyens de subsistance des populations. L'Ouganda est particulièrement exposé au risque d'émergence et de réémergence des menaces zoonotiques, les principaux facteurs de ce phénomène étant l'intensification agricole, la proximité des espèces sauvages faisant office de réservoirs et le changement climatique. Les menaces de foyers de maladie zoonotique n'affectent pas seulement les systèmes de santé publique mais aussi la production animale, la sécurité alimentaire, le développement du capital humain, la santé de la faune sauvage, la santé environnementale et la croissance du secteur privé. Afin de maîtriser et d'atténuer les menaces liées aux zoonoses, l'Ouganda a d'abord entrepris en mars 2017 de prioriser ces maladies au moyen d'une méthode Une seule santé destinée à recentrer les ressources disponibles, qui sont limitées, sur les zoonoses présentant le plus fort impact au niveau national. Les maladies ainsi définies comme prioritaires sont la fièvre charbonneuse, les virus influenza zoonotiques, les fièvres hémorragiques virales, la brucellose, la trypanosomose humaine africaine (maladie du sommeil), la peste et la rage. Dans un deuxième temps, l'Ouganda a publié en janvier 2018 son Plan stratégique national Une seule santé, en tenant compte des maladies zoonotiques définies comme prioritaires. En outre, le gouvernement ougandais et ses partenaires ont mis en place un cadre de collaboration en vue de traiter un certain nombre de maladies zoonotiques endémiques précédemment négligées telles que la fièvre charbonneuse, la brucellose et la rage. Grâce à ces efforts Une seule santé, l'Ouganda à pu renforcer ses capacités en matière de détection précoce des maladies zoonotiques, de notification et de réponse, et ce à tous les niveaux. Afin de consolider les résultats obtenus par l'approche Une seule santé, le gouvernement ougandais et ses partenaires devraient continuer à soutenir les efforts de renforcement des capacités destinées à la prévention et au contrôle des zoonoses.

Las enfermedades zoonóticas constituyen una importante amenaza no solo para la salud de personas, animales domésticos y fauna silvestre, sino también para la producción pecuaria, sin olvidar que pueden repercutir negativamente en el entorno natural que todos compartimos y en nuestros medios de sustento. Por lo que respecta al peligro que representan las enfermedades zoonóticas emergentes y reemergentes, cabe decir que Uganda es un «avispero¼, en el que convergen varios de los principales factores que alimentan el fenómeno: la intensificación de la agricultura, la cercanía de animales salvajes que ejercen de reservorio y el cambio climático. La amenaza de brotes de enfermedades zoonóticas afecta no solo a los sistemas de atención sanitaria sino también a la producción pecuaria, la seguridad alimentaria, el desarrollo del capital humano, la sanidad de los animales silvestres, la salud ambiental y el crecimiento del sector privado. En primer lugar, con el fin de prevenir, controlar y reducir la amenaza derivada de enfermedades zoonóticas, en marzo de 2017 Uganda definió un orden de prioridades entre esta clase de enfermedades, aplicando para ello la lógica de Una sola salud para concentrar los escasos recursos en aquellas enfermedades que tienen la mayor repercusión a escala nacional. Las enfermedades zoonóticas consideradas así prioritarias son: el carbunco bacteridiano, los virus gripales zoonóticos, las fiebres hemorrágicas víricas, la brucelosis, la tripanosomosis (enfermedad del sueño africana), la peste y la rabia. En segundo lugar, en enero de 2018 Uganda hizo público un Plan Estratégico Nacional de Una sola salud, que se elaboró tras haber definido como prioritarias las mencionadas enfermedades zoonóticas. Además, el Gobierno ugandés y sus asociados colaboran ahora en la lucha contra varias de estas enfermedades zoonóticas endémicas, hasta ahora desatendidas, como el carbunco, la brucelosis o la rabia. Gracias a estas actividades en clave de Una sola salud, el país se ha dotado de mayor capacidad para detectar rápidamente enfermedades zoonóticas, notificarlas y afrontarlas a todos los niveles. Ahora, para afianzar los resultados obtenidos, es preciso que el Gobierno del país y sus asociados sigan respaldando la labor de creación de capacidad para la prevención y el control de enfermedades zoonóticas.

Importance of a One Health approach in advancing global health security and the Sustainable Development Goals.

The One Health approach supports global health security by improving coordination, collaboration and communication at the human-animal-environment interface to address shared health threats such as zoonotic diseases, antimicrobial resistance, food safety and others. Over the past decade, country after country has implemented the One Health approach and demonstrated recognised benefits. However, in order to build sustainability of One Health in these efforts, One Health champions and implementers need to collect and provide government decision-makers with country-level data on One Health's impact to help justify policy decisions and resource allocations. Due to the broad, often seemingly all encompassing, nature of One Health in promoting synergies of multiple disciplines and sectors, the One Health community has faced difficulties in determining specific One Health impact indicators for formally evaluating One Health successes. In this paper, the author a) briefly reviews the ongoing commentary on the recognised benefits of the implementation of a One Health approach in the global health security context, b) discusses challenges in measuring the impact of One Health, and c) proposes possible solutions for evaluating the impact of One Health on global health security.

L'approche Une seule santé soutient la sécurité sanitaire mondiale en améliorant la coordination, la collaboration et la communication à l'interface entre les humains, les animaux et l'environnement afin de répondre aux menaces qui leur sont communes, qu'il s'agisse des maladies zoonotiques, de la résistance aux agents antimicrobiens, de la sécurité sanitaire des aliments ou d'autres encore. Au cours de la dernière décennie, les pays ont peu à peu adopté l'approche. Une seule santé et perçu les bénéfices qu'elle apporte. Toutefois, pour asseoir la durabilité des efforts déployés selon l'approche Une seule santé, les principaux pionniers et acteurs de sa mise en œuvre doivent recueillir des données sur l'impact de cette approche au niveau national et les communiquer aux décideurs politiques afin de les aider à justifier les politiques menées et les allocations de ressources. En raison de l'ampleur de l'approche Une seule santé et du caractère souvent globalisant qu'elle peut présenter dans la promotion des synergies pluridisciplinaires et intersectorielles, la communauté Une seule santé rencontre quelques difficultés à déterminer des indicateurs d'impact spécifiques permettant d'évaluer formellement les résultats positifs d'Une seule santé. Dans cet article, l'auteur a) fait le point sur la perception actuelle des bénéfices reconnus de la mise en œuvre de l'approche Une seule santé dans le contexte de la sécurité sanitaire mondiale ; b) examine les défis liés à l'estimation de l'impact d'Une seule santé ; c) propose quelques solutions envisageables pour évaluer cet impact sur la sécurité sanitaire mondiale.

La filosofía de Una sola salud favorece la seguridad sanitaria mundial porque mejora la labor de coordinación, colaboración y comunicación en la confluencia de personas, animales y medio ambiente para afrontar amenazas sanitarias comunes, como puedan ser enfermedades zoonóticas, resistencias a los antimicrobianos o peligros para la inocuidad de los alimentos. De un decenio a esta parte, en un país tras otro, la noción de Una sola salud ha sido aplicada en la práctica y deparado indudables beneficios. Sin embargo, para inscribirla duraderamente en este quehacer, quienes la promueven y pugnan por aplicarla deben reunir datos que demuestren su incidencia real en cada país y hacer llegar esos datos a las instancias decisorias de los gobiernos para que estos puedan fundamentar en ellos sus decisiones sobre políticas y sobre distribución de los recursos. Por la propia amplitud de la noción de Una sola salud, percibida a menudo como una filosofía global para promover sinergias entre múltiples disciplinas y sectores, quienes trabajan en el tema han tenido dificultades para dar con indicadores referidos específicamente al impacto de Una sola salud que ayuden a evaluar oficialmente los éxitos que haya podido deparar. El autor procede: a) repasar brevemente las observaciones actuales sobre las reconocidas ventajas de abordar las cuestiones de seguridad sanitaria mundial desde la óptica de Una sola salud; b) examinar los problemas que se plantean para cuantificar el impacto de esta filosofía; y c) proponer posibles soluciones para determinar el impacto de Una sola salud en la seguridad sanitaria mundia.

Defining and combating antibiotic resistance from One Health and Global Health perspectives.

Several interconnected human, animal and environmental habitats can contribute to the emergence, evolution and spread of antibiotic resistance, and the health of these contiguous habitats (the focus of the One Health approach) may represent a risk to human health. Additionally, the expansion of resistant clones and antibiotic resistance determinants among human-associated, animal-associated and environmental microbiomes have the potential to alter bacterial population genetics at local and global levels, thereby modifying the structure, and eventually the productivity, of microbiomes where antibiotic-resistant bacteria can expand. Conversely, any change in these habitats (including pollution by antibiotics or by antibiotic-resistant organisms) may influence the structures of their associated bacterial populations, which might affect the spread of antibiotic resistance to, and among, the above-mentioned microbiomes. Besides local transmission among connected habitats-the focus of studies under the One Health concept-the transmission of resistant microorganisms might occur on a broader (even worldwide) scale, requiring coordinated Global Health actions. This Review provides updated information on the elements involved in the evolution and spread of antibiotic resistance at local and global levels, and proposes studies to be performed and strategies to be followed that may help reduce the burden of antibiotic resistance as well as its impact on human and planetary health.

A rapid diagnostic multiplex PCR approach for xenomonitoring of human and animal schistosomiasis in a 'One Health' context.

Studying the epidemiology of schistosomiasis-the most prevalent gastropod-borne human disease and an economic burden for the livestock industry-relies on adequate monitoring tools. Here we describe a molecular assay for detecting human and animal African schistosome species in their planorbid gastropod host (xenomonitoring) using a two-step approach. First, schistosome infections are detected and discriminated from other trematode infections using a multiplex polymerase chain reaction (PCR) that includes a trematode-specific marker (in 18S rDNA), a Schistosoma genus-specific marker (in internal transcribed spacer 2 [ITS2]) and a general gastropod marker (in 18S rDNA) as an internal control. Upon Schistosoma sp. detection, a second multiplex PCR is performed to discriminate among Schistosoma haematobium, Schistosoma mansoni, Schistosoma mattheei and Schistosoma bovis/Schistosoma curassoni/Schistosoma guineensis using markers of differential lengths in the cytochrome c oxidase subunit 1 (COX1) gene. The specificity of these assays was validated with adult worms, naturally infected gastropods and human urine and stool samples. Sensitivity was tested on experimentally infected snail specimens that were sacrificed 10 and 40 days post-infection in order to mimic a natural prepatent and mature infection, respectively. The assay provides a diagnostic tool to support the xenomonitoring of planorbid gastropods for trematode infections in a One Health context, with a focus on the transmission monitoring of schistosomiasis.

Strengthening multi-sectoral collaboration on critical health issues: One Health Systems Mapping and Analysis Resource Toolkit (OH-SMART) for operationalizing One Health.

Addressing critical global health issues, such as antimicrobial resistance, infectious disease outbreaks, and natural disasters, requires strong coordination and management across sectors. The One Health approach is the integrative effort of multiple sectors working to attain optimal health for people, animals, and the environment, and is increasingly recognized by experts as a means to address complex challenges. However, practical application of the One Health approach has been challenging. The One Health Systems Mapping and Analysis Resource Toolkit (OH-SMART) introduced in this paper was designed using a multistage prototyping process to support systematic improvement in multi-sectoral coordination and collaboration to better address complex health concerns through an operational, stepwise, and practical One Health approach. To date, OH-SMART has been used to strengthen One Health systems in 17 countries and has been deployed to revise emergency response frameworks, improve antimicrobial resistance national action plans and create multi agency infectious disease collaboration protocols. OH-SMART has proven to be user friendly, robust, and capable of fostering multi-sectoral collaboration and complex system-wide problem solving.

Public preferences for One Health approaches to emerging infectious diseases: A discrete choice experiment.

There is increasing scientific consensus that a One Health approach (acknowledging links between human, animal and environmental health) is the most effective way of responding to emerging infectious disease (EID) threats. However, reviews of past EID events show that successful implementation of control strategies hinge on alignment with public values. Given the limited evidence about public values in this area, we sought to understand public preferences for attributes associated with One Health strategies for EID prevention and control, using a discrete choice experiment (DCE). The DCE was conducted in 2016 using an online panel of Australian respondents aged over 18. Participants were presented with 18 pairs of scenarios describing One Health strategies and outcomes, and asked to select their preferred one. Scenarios were described by nine attributes with varying levels: personal autonomy, economic development, environmental health, community cohesion, free trade and travel, zoonotic risk, mortality, animal welfare and food security. Respondents were broadly representative of the Australian population (n = 1999, mean age 45.3 years (range 18-89); 50.7% male). The public preferred scenarios in which individual freedoms are not restricted for the greater good; unemployment is low; the environment is healthy; there is good community cohesion; travel, imports and exports are tightly controlled; there is lower mortality and incidence of disease; and where animal welfare and food security are protected. Although lower morbidity and mortality were preferable, respondents were willing to accept extra cases of severe disease and deaths to avoid reductions in some attributes. However, a mixed logit model indicated significant heterogeneity. A latent class analysis suggested wide variability across respondent classes in the valuation of attributes, and the trade-offs respondents were willing to accept. Therefore, a single approach to managing EID using One Health is unlikely to be acceptable to all community members.

Institutionalizing One Health: From Assessment to Action.

A One Health approach is critical to strengthening health security at country, regional, and global levels. However, operationally its uptake remains limited. Recent momentum in assessing capacity to effectively prevent, detect, and respond to disease threats has resulted in identification of gaps that require dedicated action. This article highlights relevant tools, standards, and guidance to assist countries and institutions in meeting the collective vision articulated at the 2018 Prince Mahidol Award Conference on "Making the World Safe from the Threats of Emerging Infectious Diseases." Taking stock of assessment findings, resources, priorities, and implementation initiatives across human and animal health, environment and disaster risk reduction sectors can help expand participation in global health security, target risk drivers, and form synergies for collective action and shared gains for both emerging and endemic disease challenges. In addition to health security gains, a multisectoral, One Health approach can drive benefits for wider health sector and global development goals.

Antimicrobial Resistance: a One Health Perspective.

One Health is the collaborative effort of multiple health science professions to attain optimal health for people, domestic animals, wildlife, plants, and our environment. The drivers of antimicrobial resistance include antimicrobial use and abuse in human, animal, and environmental sectors and the spread of resistant bacteria and resistance determinants within and between these sectors and around the globe. Most of the classes of antimicrobials used to treat bacterial infections in humans are also used in animals. Given the important and interdependent human, animal, and environmental dimensions of antimicrobial resistance, it is logical to take a One Health approach when addressing this problem. This includes taking steps to preserve the continued effectiveness of existing antimicrobials by eliminating their inappropriate use and by limiting the spread of infection. Major concerns in the animal health and agriculture sectors are mass medication of animals with antimicrobials that are critically important for humans, such as third-generation cephalosporins and fluoroquinolones, and the long-term, in-feed use of medically important antimicrobials, such as colistin, tetracyclines, and macrolides, for growth promotion. In the human sector it is essential to prevent infections, reduce over-prescribing of antimicrobials, improve sanitation, and improve hygiene and infection control. Pollution from inadequate treatment of industrial, residential, and farm waste is expanding the resistome in the environment. Numerous countries and several international agencies have included a One Health approach within their action plans to address antimicrobial resistance. Necessary actions include improvements in antimicrobial use regulation and policy, surveillance, stewardship, infection control, sanitation, animal husbandry, and alternatives to antimicrobials. WHO recently has launched new guidelines on the use of medically important antimicrobials in food-producing animals, recommending that farmers and the food industry stop using antimicrobials routinely to promote growth and prevent disease in healthy animals. These guidelines aim to help preserve the effectiveness of antimicrobials that are important for human medicine by reducing their use in animals.

Strengthening One Health Through Investments in Agricultural Preparedness.

There are links among agriculture and zoonotic diseases, transboundary diseases in domesticated and wild animals, climate patterns, and human population migrations. A natural or intentionally occurring high-consequence infectious disease ("biothreat") often has no geographic boundaries and has the potential to result in disease epidemics in humans, animals, or both. Although significant strides have been made globally in preparing for a natural or intentional introduction of an emerging and/or zoonotic disease, much remains to be accomplished. Enhancing animal health and well-being is a vital component to enable a sustainable, safe, and nutritious food supply for global food economies. This article explores the biothreat environment, its One Health interrelationship, and the significance and role of US agriculture in One Health. We provide an overview of the US Emergency Medical Countermeasure Enterprise (EMCE) and current state of veterinary and zoonotic medical countermeasures portfolio management in the US government, veterinary biologic industry, not-for-profit groups, and public-private partnerships. The highest zoonotic and epizootic threats to the US livestock industry are briefly reviewed, and currently available veterinary medical countermeasures are presented. Lastly, important gaps and priorities are identified, followed by specific recommendations to address these gaps.

One Health/EcoHealth capacity building programs in South and South East Asia: a mixed method rapid systematic review.

BACKGROUND: Although One Health (OH) or EcoHealth (EH) have been acknowledged to provide comprehensive and holistic approaches to study complex problems, like zoonoses and emerging infectious diseases, there remains multiple challenges in implementing them in a problem-solving paradigm. One of the most commonly encountered barriers, especially in low- and middle-income countries, is limited capacity to undertake OH/EH inquiries. A rapid review was undertaken to conduct a situation analysis of the existing OH/EH capacity building programs, with a focused analysis of those programs with extensive OH engagement, to help map the current efforts in this area. METHODS: A listing of the OH/EH projects/initiatives implemented in South Asia (SA) and South East Asia (SEA) was done, followed by analysis of documents related to the projects, available from peer-reviewed or grey literature sources. Quantitative data was extracted using a data extraction format, and a free listing of qualitative themes was undertaken. RESULTS: In SEA, 13 unique OH/EH projects, with 37 capacity building programs, were identified. In contrast, in SA, the numbers were 8 and 11 respectively. In SA, programs were oriented to develop careers in program management, whereas, in SEA, the emphasis was on research. Two thirds of the programs in SEA had extensive OH engagement, whereas only one third of those in SA did. The target for the SEA programs was wider, including a population more representative of OH stakes. SEA program themes reveal utilization of multiple approaches, usually in shorter terms, and are growing towards integration with the traditional curricula. Such convergence of themes was lacking in SA programs. In both regions, the programs were driven by external donor agencies, with minimal local buy-in. CONCLUSIONS: There is limited investment in research capacity building in both SA and SEA. The situation appears to be more stark in SA, whilst SEA has been able to use the systematic investment and support to develop the OH/EH agenda and strategize capacity building in the core competencies. In order to effectively address the disease emergence hotspots in these regions, there needs to be strategic funding decisions targeting capacity building in the core OH/EH competencies especially related to transdisciplinarity, systems thinking, and adaptive management.

Biological threats from a 'One Health' perspective.

Biological threats are a prime example of an issue that needs the 'One Health' approach. Such an approach would facilitate the prevention and mitigation of these threats. 'One Health' is defined as any added value in terms of the health of humans and animals, financial savings or environmental services achievable through the cooperation of human and veterinary medicines when compared to the two disciplines working separately. This principle also applies to the involvement of other disciplines from the natural sciences and humanities. This paper is not an exhaustive survey of integrated approaches but discusses concepts and methods and provides key examples of the benefits of a 'One Health' approach when applied to biological threats. Zoonoses and vector-borne diseases (i.e. diseases transmitted between animals and humans and by insect or acarian vectors) remain central biological threats in highly dynamic social and environmental conditions. Such diseases are not always directly transmitted. Contaminated food, water, air and soil represent important sources of transmission for foodborne and environmentally related diseases. Therefore, this paper treats environmental sanitation separately because of the importance of the excreta management of humans and animals. Integrated syndromic surveillance and antimicrobial resistance surveillance link the above aspects and are showcases for a 'One Health' approach to biological threat reduction. Biological threats are not only related to natural conditions but may also be exacerbated by large development projects such as dams, mining and infrastructure. Consequently, it is recommended that the health impact assessment (HIA) approach be implemented as early as the planning stage of any large infrastructure project located in a complex socioecological system. This paper extends the HIA approach to an integrated 'One Health' impact assessment approach.

Les menaces biologiques sont un parfait exemple de problématique nécessitant une approche « Une seule santé ¼ en matière de prévention et d'atténuation des risques. « Une seule santé ¼ désigne toute valeur ajoutée en termes de santé humaine et animale, d'économies d'échelle ou de services écologiques obtenue grâce à la collaboration de la médecine humaine et de la médecine vétérinaire (comparativement à ce qu'elles auraient obtenu en travaillant chacune de son côté). Ce principe s'applique également à l'apport d'autres disciplines relevant des sciences naturelles ou sociales. Cet article ne passe pas en revue l'ensemble de ces approches intégrées mais examine les concepts et les méthodes qui les sous-tendent et donne quelques exemples forts des bénéfices apportés par l'approche « Une seule santé ¼ dans le traitement des menaces biologiques. Les maladies zoonotiques (transmissibles entre l'homme et les animaux) et à transmission vectorielle (par un insecte ou un acarien vecteur) représentent une menace biologique particulièrement importante dans les situations fortement dynamiques au plan social et environnemental. La transmission de ces maladies est parfois indirecte. Ainsi les aliments, l'eau, l'air et le sol sont-ils d'importantes sources de transmission pour les maladies d'origine alimentaire ou environnementale. L'hygiène environnementale fait l'objet d'un examen particulier en raison de l'importance de la gestion des déjections humaines et animales. La surveillance intégrée syndromique et la surveillance de la résistance aux agents antimicrobiens relient ces différents aspects et illustrent le recours à une approche « Une seule santé ¼ en matière de réduction des risques biologiques. Les menaces biologiques ne sont pas seulement dues à des évènements naturels ; certains projets de développement peuvent aussi y contribuer, par exemple les barrages, l'exploitation minière et les travaux d'infrastructures. Par conséquent, il est recommandé de procéder à une « évaluation de l'impact sanitaire ¼ dès la phase de planification de tout projet d'infrastructure de grande ampleur situé dans un système socio-écologique complexe. Les auteurs préconisent d'élargir la portée des évaluations de l'impact sanitaire dans une perspective intégrée « Une seule santé ¼.

Las amenazas biológicas son un perfecto ejemplo del tipo de problemas cuya prevención y atenuación exige abordarlos desde los planteamientos de «Una sola salud¼. Se entiende por «Una sola salud¼ todo valor añadido, en términos de salud humana o animal, ahorro económico o servicios ambientales, que pueda deparar la cooperación entre la medicina humana y la veterinaria en comparación con el trabajo de ambas por separado. Este principio se aplica igualmente a la intervención de otras ramas de las ciencias naturales y las humanidades. Los autores no proponen un repaso exhaustivo de las distintas fórmulas de trabajo integrado, sino que examinan conceptos y métodos y ofrecen importantes ejemplos de los beneficios que se obtienen al aplicar la lógica de «Una sola salud¼ a la cuestión de las amenazas biológicas. Las zoonosis y las enfermedades de transmisión vectorial (es decir, respectivamente, las patologías que se transmiten entre animales y personas y las que se transmiten por intervención de un insecto o ácaro como vector) siguen constituyendo amenazas biológicas de primer orden en las condiciones de gran dinamismo social y ambiental que imperan hoy en día. Estas enfermedades no siempre se transmiten directamente. Los alimentos, el agua, el aire y los suelos contaminados son un importante vehículo de enfermedades de transmisión alimentaria o ligadas a factores ambientales. De ahí que los autores examinen por separado el saneamiento ambiental, subrayando la importancia que reviste la gestión de las excreciones humanas y animales. La integración de la vigilancia sindrómica y la vigilancia de las resistencias a antimicrobianos articula entre sí todos estos aspectos y permite abordar la reducción de las amenazas biológicas desde la óptica de «Una sola salud¼. Las amenazas biológicas no solo guardan relación con las condiciones naturales, sino que además pueden verse favorecidas por grandes proyectos de desarrollo como la construcción de represas o infraestructuras o la excavación de minas. Por ello se recomienda aplicar fórmulas de evaluación del impacto sanitario desde la fase misma de planificación de todo gran proyecto de infraestructura que se ubique dentro de un sistema socioecológico complejo. Los autores hacen extensivo el método de evaluación del impacto sanitario a la idea de una evaluación integrada del impacto desde la perspectiva de «Una sola salud¼.