The Rabies Free Burkina Faso initiative: an example of how one health-oriented civil society organizations can contribute towards the achievement of the rabies zero by 30 goal.

While technologies, tools and expertise have proven that countries can be made safe from dog-mediated human rabies, the disease remains a major public health threat in Burkina Faso. The paper reports the experience and success stories of Rabies Free Burkina Faso, an initiative established in 2020 as an example of civil society organization that promotes One Health for integrated rabies control in Africa. As recommended in the Global strategic plan, rabies elimination requires a systematic One Health approach, enhancing pre-exposure and postexposure prophylaxis, dog population management, dog vaccination, awareness raising, diagnosis, surveillance, funding as well as policies and regulations. Rabies Free Burkina Faso was established on 28 September 2020 as not-for-profit organization and aims to strengthen the use of a One Health approach as a non-governmental, multidisciplinary initiative dedicated to promoting rabies elimination. Categories of interventions developed by Rabies Free Burkina Faso cover awareness raising, training and One Health capacity building, dog rabies vaccination, seeking vaccines and providing support, including financial resource to communities to ensure that bite victims are appropriately provided with post-exposure prophylaxis, research, community engagement and joint outbreak investigation in collaboration with competent authorities. Reported success stories confirm the relevance of roles that can be played by Rabies Free Burkina Faso supporting animal health and human health authorities in the fields of rabies control and One Health development in the country.

One Health early warning and response system for zoonotic diseases outbreaks: Emphasis on the involvement of grassroots actors.

BACKGROUND: Emerging and reemerging zoonotic diseases have become a global concern due to their frequent occurrence. Large delays between onset of emerging zoonotic disease outbreaks and their reporting and control are indicative of weak animal and human health systems. OBJECTIVES: The objective of this paper is to tackle the time delay by suggesting a One Health Early Warning and Response System (OH-EWRS) aiming at improving the surveillance and notification of zoonotic diseases by strengthening 'bottom-up' approaches and systems for early detection, especially in hot spot areas where they emerge. METHODS: In this conceptual paper, we searched online database including PubMed, Google and Google Scholar to explore the scientific landscape for zoonotic diseases and One Health Early Warning and Response Systems published in English up to December, 2020. In addition, the authors made use of their own expertise and critically reviewed the retrieved papers that were found to be of relevance as the three authors are experts in their own fields, coming from different backgrounds, but are all working to improve the prevention and control of zoonotic disease outbreak. RESULTS: The OH-EWRS advocates for collaboration between relevant stakeholders including nongovernmental organisations, country offices of international and intergovernmental technical organisations, governmental bodies, research institutes, the private sector and local communities with the aim of an integrated One Health prevention and control system. The OH-EWRS considers various priorities and objectives of the different stakeholders, taking into account possible conflict of interests and considering the need for trust, transparency and mutual benefits. CONCLUSIONS: Although the operationalisation, governance and institutionalisation of the OH-EWRS should be the responsibility of government bodies, inputs from and feedback to relevant stakeholders through a bottom-up and top-down approach are essential elements for the application of the successful operationalisation of a OH-EWRS.

United Against Rabies Forum: The first 2 years.

Rabies continues to kill an estimated 59,000 people annually, with up to 99% of human cases transmitted by domestic dogs. The elimination of human deaths from dog-mediated rabies is achievable by applying a One Health approach, and the framework to do this is outlined in Zero by 30: the Global Strategic Plan to end human deaths from dog-mediated rabies by 2030. To build on this global goal, and implement the approaches set out in Zero by 30, the United Against Rabies Forum was launched in 2020. This paper gives a review of the objectives, governance, activities and achievements of the United Against Rabies Forum to date. It also outlines ongoing work, and next steps as the United Against Rabies Forum reviews its first 2 years of activities and identifies priority areas for the coming 12 months.

Coordinated surveillance system under the One Health approach for cross-border pathogens that threaten the Union - options for sustainable surveillance strategies for priority pathogens.

This report provides guidance for Member states who plan to submit applications under the work programme 'CP-g-22-04.01 Direct grants to Member States' authorities'. The priority pathogens on which the coordinated surveillance under the grant initiative shall focus have been identified in a prioritisation exercise with Member States and ECDC. These are Crimean Congo haemorrhagic fever, echinococcosis, hepatitis E, highly pathogenic avian influenza (HPAI), influenza in swine, Lyme disease, Q-fever, Rift Valley fever, tick-borne encephalitis, West Nile fever and Disease X (Disease Y of animals). Surveillance activities (surveillance cards) have been proposed for these agents in this report. Member States should select one or more diseases from the list of priority diseases and then choose surveillance activities from the surveillance cards and modify them where needed, to reflect their national needs and situation. Member States can also design alternative surveillance activities for the priority infectious agents that may better fit the epidemiological situation in their country. Further, this report provides a section on surveillance perspectives that links infectious agents to different hosts, allowing Member States to consider the testing for multiple infectious agents in samples from a single host population, as well as sections providing guidance on surveillance in vectors and wildlife and for Disease X (Disease Y in animals). Member States are encouraged to develop cross-sectoral collaborations and the report provides guidance on cross-sectoral collaboration to help them. Finally, there is a roadmap providing an overall description of the steps in the process of developing a surveillance system in order to apply for the grant.

Prioritisation of zoonotic diseases for coordinated surveillance systems under the One Health approach for cross-border pathogens that threaten the Union.

In the context of the initiative 'CP-g-22-04.01 Direct grants to Member States' authorities', EFSA was requested to develop and conduct a prioritisation of zoonotic diseases, in collaboration with Member States, to identify priorities for the establishment of a coordinated surveillance system under the One Health approach. The methodology developed by EFSA's Working Group on One Health surveillance was based on a combination of multi-criteria decision analysis and the Delphi method. It comprised the establishment of a list of zoonotic diseases, definition of pathogen- and surveillance-related criteria, weighing of those criteria, scoring of zoonotic diseases by Member States, calculation of summary scores, and ranking of the list of zoonotic diseases according to those scores. Results were presented at EU and country level. A prioritisation workshop was organised with the One Health subgroup of EFSA's Scientific Network for Risk Assessment in Animal Health and Welfare in November 2022 to discuss and agree on a final list of priorities for which specific surveillance strategies would be developed. Those 10 priorities were Crimean-Congo haemorrhagic fever, echinococcosis (both E. granulosus and E. multilocularis), hepatitis E, influenza (avian), influenza (swine), Lyme borreliosis, Q-fever, Rift Valley fever, tick-borne encephalitis and West Nile fever. 'Disease X' was not assessed in the same way as other zoonotic diseases on the list, but it was added to the final list of priorities due to its relevance and importance in the One Health context.

United Against Rabies Forum: The One Health Concept at Work.

Human deaths from rabies are preventable and can be eliminated by applying a systematic One Health approach. However, this ancient disease still threatens the lives of millions of people in up to 150 countries and kills an estimated 59, 000 people every year. Rabies today is largely a disease of poverty, almost always linked to dog bites, with most deaths occurring in neglected communities in Africa and Asia. The disease places an immense economic burden on its victims, a cost that far outweighs the investment needed to control it. A global framework for rabies elimination in humans is set out in Zero by 30: The Global Strategic Plan to end human deaths from dog-mediated rabies by 2030. Despite the existence of proven control strategies and agreement on the path to eliminating human rabies deaths, mortality numbers from rabies remain high, and COVID-19 has set back efforts even further. But COVID-19 has also highlighted the value of a One Health approach to zoonotic disease and pandemic prevention. Rabies control programs offer a practical route to building One Health capacities that can also address other zoonotic threats, including those with pandemic potential. The United Against Rabies Forum aims to accelerate progress on rabies elimination while applying a One Health approach. The Forum promotes cross-sector collaboration among stakeholders and supports countries in their rabies elimination efforts. Increased political engagement and resource mobilization, both internationally and nationally, will be needed to achieve global rabies goals and can also make One Health implementation a reality.

Antimicrobials Used in Backyard and Commercial Poultry and Swine Farms in the Philippines: A Qualitative Pilot Study.

Chicken and pork are the most frequently consumed meat products in the Philippines. Swine and poultry are reared in either commercial farms (CMf) or backyard farms (BYf); the latter production system is relatively common and essential to food security in low- and middle-income countries (LMICs) such as the Philippines. Similar to resource-limited LMICs, antimicrobial use (AMU) surveillance has not yet been established; thus, AMU in food animals is a knowledge gap in understanding the emergence of antimicrobial resistance (AMR) in zoonotic foodborne bacteria in the country. This qualitative AMU pilot study aims to describe the antimicrobial active ingredients (AAIs) used and associated AMU practices (e.g., source of AAIs and informed AMU decisions) by poultry and swine CMf and BYf in the Philippines. Ninety-three farms across four regions in the Philippines voluntarily provided AMU information as part of a larger biosecurity and good practices study. The percentage of farms using AAI over the total number of farms was the metric used to describe AMU. In total, there were 30 AAIs used (CMf: n =27 and BYf: n = 13); per farm, the number of AAIs used ranged from 1 to 7. The spectrum of AAIs was more diverse in swine (n = 24) compared to poultry (n = 18). Enrofloxacin was the most frequently reported AAI in poultry (33%) and swine (36%) farms. Respiratory diseases were the most frequently reported reason for AMU in both species. Between production systems, significant differences were observed in the percentage of farms using amoxicillin (27% CMf vs. 3% BYf), colistin (17% CMf vs. 3% BYf), and oxytetracycline (12% CMf vs. 39% BYf). In terms of AMU practices, of important concern was the over-the-counter access of AAIs at retail outlets and the limited veterinary oversight in BYf. Our data indicated that antimicrobials critically important for human medicine are frequently used in poultry and swine farms in the Philippines. This study can inform the development of guidelines for curbing AMR through prudent AMU and serves as a reference point for AMU surveillance capacity development in the Philippines.

Operationalization of One Health and tripartite collaboration in the Asia-Pacific region.

One Health refers to the collaborative efforts of multiple disciplines working locally, nationally and globally to attain optimal health for people, animals and our environment. The One Health approach is increasingly popular in the context of growing threats from emerging zoonoses, antimicrobial resistance and climate change. The Food and Agriculture Organization of the United Nations, World Organisation for Animal Health and World Health Organization have been working together in the wake of the avian influenza crisis in the Asia-Pacific region to provide strong leadership to endorse the One Health concept and promote interagency and intersectoral collaboration. The programme on highly pathogenic emerging diseases in Asia (2009-2014) led to the establishment of a regional tripartite coordination mechanism in the Asia-Pacific region to support collaboration between the animal and human health sectors. The remit of this mechanism has expanded to include other priority One Health challenges, such as antimicrobial resistance and food safety. The mechanism has helped to organize eight Asia-Pacific workshops on multisectoral collaboration for the prevention and control of zoonoses since 2010, facilitating advocacy and operationalization of One Health at regional and country levels. The tripartite group and international partners have developed several One Health tools, which are useful for operationalization of One Health at the country level. Member States are encouraged to develop a One Health strategic framework taking into account the country's context and priorities.

Towards rabies elimination in the Asia-Pacific region: From theory to practice.

Rabies is a major neglected zoonotic disease and causes a substantial burden in the Asian region. Currently, Pacific Oceania is free of rabies but enzootic areas throughout southeast Asia represent a major risk of disease introduction to this region. On September 25-26, 2019, researchers, government officials and related stakeholders met at an IABS conference in Bangkok, Thailand to engage on the topic of human rabies mediated by dogs. The objective of the meeting was focused upon snowballing efforts towards achieving substantial progress in rabies prevention, control and elimination within Asia by 2030, and thereby to safeguard the Pacific region. Individual sessions focused upon domestic animal, wildlife and human vaccination; the production and evaluation of quality, safety and efficacy of existing rabies biologics; and the future development of new products. Participants reviewed the progress to date in eliminating canine rabies by mass vaccination, described supportive methods to parenteral administration by oral vaccine application, considered updated global and local approaches at human prophylaxis and discussed the considerable challenges ahead. Such opportunities provide continuous engagement on disease management among professionals at a trans-disciplinary level and promote new applied research collaborations in a modern One Health context.

Engaging research with policy and action: what are the challenges of responding to zoonotic disease in Africa?

Zoonotic diseases will maintain a high level of public policy attention in the coming decades. From the spectre of a global pandemic to anxieties over agricultural change, urbanization, social inequality and threats to natural ecosystems, effectively preparing and responding to endemic and emerging diseases will require technological, institutional and social innovation. Much current discussion emphasizes the need for a 'One Health' approach: bridging disciplines and sectors to tackle these complex dynamics. However, as attention has increased, so too has an appreciation of the practical challenges in linking multi-disciplinary, multi-sectoral research with policy, action and impact. In this commentary paper, we reflect on these issues with particular reference to the African sub-continent. We structure the themes of our analysis on the existing literature, expert opinion and 11 interviews with leading One Health scholars and practitioners, conducted at an international symposium in 2016. We highlight a variety of challenges in research and knowledge production, in the difficult terrain of implementation and outreach, and in the politicized nature of decision-making and priority setting. We then turn our attention to a number of strategies that might help reconfigure current pathways and accepted norms of practice. These include: (i) challenging scientific expertise; (ii) strengthening national multi-sectoral coordination; (iii) building on what works; and (iv) re-framing policy narratives. We argue that bridging the research-policy-action interface in Africa, and better connecting zoonoses, ecosystems and well-being in the twenty-first century, will ultimately require greater attention to the democratization of science and public policy.This article is part of the themed issue 'One Health for a changing world: zoonoses, ecosystems and human well-being'.

The Road to Dog Rabies Control and Elimination-What Keeps Us from Moving Faster?

Rabies, a vaccine preventable neglected tropical disease, still claims an estimated 35,000-60,000 human lives annually. The international community, with more than 100 endemic countries, has set a global target of 0 human deaths from dog-transmitted rabies by 2030. While it has been proven in several countries and regions that elimination of rabies as a public health problem is feasible and tools are available, rabies deaths globally have not yet been prevented effectively. While there has been extensive rabies research, specific areas of implementation for control and elimination have not been sufficiently addressed. This article highlights some of the commonest perceived barriers for countries to implementing rabies control and elimination programs and discusses possible solutions for sociopolitical, organizational, technical, and resource-linked requirements, following the pillars of the global framework for the elimination of dog-mediated human rabies adopted at the global rabies meeting in December 2015.

Review of Participatory Epidemiology Practices in Animal Health (1980-2015) and Future Practice Directions.

In this study we combined an inventory of the major applications, geographic regions and diseases covered by participatory epidemiology (PE) activities in the field of animal health since 1980, together with an email discussion forum with PE practitioners from different regions of the world. The inventory included the search of peer-reviewed papers, master and technical reports, conference proceedings, manuals, training materials and projects. The search resulted in a low number of PE activity results until the year 2000, followed by a considerable increase (especially from 2012). Most of the identified activities were implemented in Africa and Asia, and focused on surveillance, disease survey and prioritization, and disease control. Seventy-nine PE practitioners working predominantly in Africa, Asia and Europe (29, 22 and 18 respectively) contributed to the email discussion forum. They proposed various modifications to the existing PE definition and discussed different issues related to the applicatoin of PE, its institutionalization for use in policy development, as well as the priorities for future development. The need to increase the number of PE trained people together with some methodological developments and the application of this methodology in developed countries, were some of the points highlighted during the forum. These factors stress the importance of further developing PE as a useful approach for engaging communities in addressing animal and related public health risks.

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.

Renewed global partnerships and redesigned roadmaps for rabies prevention and control.

Canine rabies, responsible for most human rabies deaths, is a serious global public health concern. This zoonosis is entirely preventable, but by focusing solely upon rabies prevention in humans, this "incurable wound" persists at high costs. Although preventing human deaths through canine rabies elimination is feasible, dog rabies control is often neglected, because dogs are not considered typical economic commodities by the animal health sector. Here, we demonstrate that the responsibility of managing rabies falls upon multiple sectors, that a truly integrated approach is the key to rabies elimination, and that considerable progress has been made to this effect. Achievements include the construction of global rabies networks and organizational partnerships; development of road maps, operational toolkits, and a blueprint for rabies prevention and control; and opportunities for scaling up and replication of successful programs. Progress must continue towards overcoming the remaining challenges preventing the ultimate goal of rabies elimination.

New approaches for education and training in veterinary public health: the SAPUVET projects.

Continued contact between humans and animals, in combination with the ever-increasing movement of human and animal populations that is one effect of globalization, contributes to the spread of diseases, often with detrimental effects on public health. This has led professionals involved in both animal health and public health to recognize veterinary public health (VPH) as a key area for their activities to address the human-animal interface. Veterinarians, a profession with major involvement in this field, are in need of specific knowledge and skills to prevent and control public-health problems. As a result, VPH must be directly integrated into veterinary educational programs. At present, only few veterinary schools have specific VPH programs; in most institutions, VPH does not feature as a specific subject in either undergraduate or post-graduate curricula. SAPUVET and SAPUVETNET II are network projects supported by the ALFA program of the European Union (EU). Their main objectives are to reach a common understanding between European and Latin American universities in the definition of the areas in which VPH is important in their respective countries, and to design a harmonized training program for veterinarians in VPH, by making use of new technological applications and innovative teaching methodologies. The elaboration of educational material in combination with case studies presenting real-life problems provides a basis to apply the knowledge acquired on VPH. It is envisaged that the material and modules developed during the two projects will be integrated into the veterinary curricula of the participating universities, as well as in other partner organizations.

Experiences and difficulties encountered during a course on veterinary public health with students of different nationalities.

Veterinary public health (VPH) issues have received increased attention over the last few years as a result of the rising threat of emerging zoonoses (i.e., those due to globalized trade in animal and animal products and to changes in livestock production systems and the environment). The international dimension of VPH is gradually becoming recognized, and there is a growing need for veterinarians with experience in this field. In order to familiarize (future) veterinarians with the international dimension of VPH, the Department of Public Health and Food Safety of the Faculty of Veterinary Medicine, Utrecht University, has been organizing a course in Veterinary Public Health and Animal Production for over the last 10 years. This course has been intended for Dutch as well as foreign final-year veterinary students and recent veterinary graduates. By bringing together participants from different countries, the course reinforces the international dimension of the issues addressed through the exchange of experiences by the participants themselves. The present article provides information about this course on Veterinary Public Health (VPH): it discusses logistics, didactical approaches, the course program, and the use of information and communication technology (ICT). Special attention is given to the intercultural aspects of higher education, all of which play an important role in the efficient exchange of knowledge between lecturers and students. International courses are an important tool to enable participants to interact in a multicultural environment and address issues that demand international cooperation and a global public health focus.