iniciativa mundial “una salud” worldwide initiative...

Iniciativa mundial “Una Salud”Worldwide initiative “One Health”

07/11/19 1

Scientific veterinary institute “Novi Sad”Novi Sad

SerbiaEurope

Special thanks to: Dra Diana Elisa Zamora AvilaDr Gustavo Moreno DegolladoDr Sergio Fernandez DelgadilloDr Santos Guzman LopezDr Gustavo Hernanez VidalDr Juan Joze Zarate Ramos

Who am I J

07/11/19 Научни институт за ветеринарство „Нови Сад“ Интернет: http://niv.ns.ac.rs 2

Sara Savic, PhD, DVMScientific Veterinary Institute “Novi Sad”, SerbiaHead of Department for serology, immunology and biochemistryHead of National reference laboratory for Q-fever, Maedi-Visna (CAEV) and LeptospirosisQuality manager of the InstituteSecretary member of EcoHealth InternationalOne of 3 Founders of Serbian Association for One Health Organizor of “One Health Day” in SerbiaExpertize: One Health, Public Health and Vector borne zoonozes, animal infectious diseases

Novi Sad, Serbia


Serbia


Serbia is a country in the middle of Europe

(Balkan Peninsula)

Serbia


It is famous for best sports

man,happy people,

good food, dramatic

history and international

music festivals

One Health


One Health defined by the One Health Initiative Task Force is "the collaborative efforts of multiple disciplines working locally, nationally, and globally, to attain optimal health for people, animals and our environment"

American Veterinary Medical Association has established in 2007One Health Initiative Task Force - to study the feasibility of a campaign to facilitate collaboration and cooperation among health science professions, academic institutions, governmental agencies, and industries to help with the assessment, treatment, and prevention of cross-species disease transmission and mutually prevalent, but non-transmitted, human and animal diseases, and medical conditions.

One Health by


The One Health concept recognizes that the health of people is connected to the health of animals and the environment. Centre for Disease Control and Prevention uses a One Health approach by working with physicians, veterinarians, ecologists, and many others to monitor and control public health threats and to learn about how diseases spread among people, animals, and the environment.One Health is defined as a - collaborative, multisectoral, and transdisciplinary approach - working at the local, regional, national, and global levels - with the goal of achieving optimal health outcomes recognizing the interconnection between people, animals, plants, and their shared environment.

One Health Initiative


The One Health Initiative is a movement to include collaborations between physicians, osteopathic physicians, veterinarians, dentists, nurses and other scientific-health and environmentally related disciplines- American Medical Association, -American Veterinary Medical Association, - American Academy of Pediatrics, - American Nurses Association, - American Association of Public Health Physicians, - American Society of Tropical Medicine and Hygiene, - Centers for Disease Control and Prevention (CDC), - United States Department of Agriculture (USDA), - U.S. National Environmental Health Association (NEHA). More than 950 prominent scientists, physicians and veterinarians worldwide have endorsed the initiative.

One Health Commission


One Health is a collaborative, multisectoral, and trans-disciplinary approach - working at local, regional, national, and global levels - to achieve optimal health and well-being outcomes recognizing the interconnections between people, animals, plants and their shared environment.

The task of the One Health Commission is to ‘Educate’ and ‘Create’ networks to improve health outcomes and well-being of humans, animals and plants and to promote environmental resilience through a collaborative, global One Health approach.

One Health by WHO


For World Health Organisation, One Health is an approach to designing and implementing programmes, policies, legislation and research in which multiple sectors communicate and work together to achieve better public health outcomes.The areas of work in which a One Health approach is particularly relevant include - food safety, - the control of zoonoses (diseases that can spread between animals and humans, such as flu, rabies and Rift Valley Fever), - fighting antibiotic resistance (when bacteria change after being exposed to antibiotics and become more difficult to treat).

One Health by OiE


The concept of One Health is implemented by the World organisation for Animal Health (OiE) as a collaborative globalapproach to understanding risks for human and animal health (including both domestic animals and wildlife) and ecosystem health as a whole. The OIE builds upon the intergovernmental standards which it publishes worldwide information on animal health that it collects as well as its network of international experts and programmes for strengthening national Veterinary Services. OiE collaborates synergistically with more than 70 other international organisations, particularly those which play a key role in the human–animal–ecosystems interface.

World Organisation for Animal Health

One Health Platform

07/11/19 12

The One Health Platform is a scientific reference center and a network of One Health stakeholders. Independent, international not-for-profit organization that fosters science for the greater good. The One Health Platform aims to enhance understanding and preparedness for current and future outbreaks of zoonoses, emerging and re-emerging infectious diseases in humans and animals and antimicrobial resistance. This includes the ecological and environmental factors which drive and impact on these diseases.“We stand for collaborative, multisectoral and transboundary approaches that tear down silos and enable interdisciplinary and multisectoral solutions to tackle major global health security challenges”

One Heath Day

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One Health DayInitiated in 2016 by the

- One Health Commission, - One Health Platform- One Health Initiative Team.

International One Health Day is officially celebrated around the world

every year on November 3. One Health Day brings global attention to the need for One Health interactions and allow

the world to ‘see them in action’.

One Health

07/11/19 14

Why One Health ?


Many of the same microbes infect animals and humans, as they share the eco-systems they live in. Efforts by just one sector cannot prevent or eliminate the problem.

1. Rabies in humans is effectively prevented only by targeting the animal source of the virus - by vaccinating dogs

2. Brucellosis in humans is only resolved by eradication in animals3. Drug-resistant microbes can be transmitted between animals and

humans through direct contact between animals and humans or through contaminated food, so to effectively contain it, a well-coordinated approach in humans and in animals is required.

Why One Health ?


Why One Health ?


Professionals with a range of expertise active in different sectors -public health, animal health, plant health and the environment, should join forces to support One Health approaches.

To detect, respond, and prevent outbreaks of zoonoses and food safety problems - epidemiological data and laboratory information should be shared across sectors, level and countries. Local, national, regional and global levels should implement joint responses to health threats.

WHO + FAO + OIE = multi-sectoral responses to food safety hazards, risks from zoonoses, and other public health threats at the human-animal-ecosystem interface.

Expected outcomes of One Health


Sustainability

SocietyStewardship & Equity

EcologyHealth & Well-being

EconomyEfficiency & Effectiveness

Beyond One Health

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European Ecohealth International ChapterNetwork for Ecohealth and One Health

One Health in Public Health

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Medics + Vets + BiologistsAn open mind!!!

One Health in Public Health

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Emerging diseases depend on several factors

• Microbial adaptation and ability to change• Susceptibility of the hosts to infection• Climate and weather changes• Changes in ecosystems• Economic development and land exploatation• Behaviour and demoraphy of the inhabitants• Technology and industry

One Health in Europe

07/11/19 222014-2018, involving 38 Europen countries

International survey with European experts in Pubic Health on the most important topics where an OH approach should

be applied

07/11/19 24

07/11/19 25

Evaluation in NEOH• The NEOH framework was applied to 12 case studies in NEOH• Simplified tools were applied to the initiatives from the literature

to collect more data • Meta-study including case studies and information from the

literature• Handbook published “Integrated approaches to health - A

handbook for the evaluation of One Health” • Publication of manuscripts in “Frontiers the SpecialIssue”

https://www.wageningenacademic.com/neoh

One Health characteristics

Rüegg SR, McMahon BJ, Häsler B, Esposito R, Rosenbaum Nielsen L, et al (2017). A blueprint to evaluate One Health. Frontiers in Public Health, section Public Health Policy. February 2017, doi.org/10.3389/fpubh.2017.00020

NEOH - http://neoh.onehealthglobal.net/

http://neoh.onehealthglobal.net/

29

OneHealthIndexandRatio

- values

OH

oper

atio

ns ThinkingPlanningWorking

Supp

ortin

g in

fras

truc

ture Sharing

Learning

Systemic organisation

One Health Index

One Health Ratio

OneHealthIndexandRatioSpiderDiagram

Values from0 (=no OH approach) to1 (=perfect OH approach)

Example of eradication of brucellosis in Serbia and Malta

• Systems thinking – is there an understanding of the context?• Acknowledge and use hierarchies in socio-ecological systems.• Consider beliefs about evidence, values about health, cultural

grounding.• Reflect on how and where the initiative is placed in relation to the

system.• Match / balance dimensions and scales in system and initiative.

à Integrated approach to health.• Target underlying structures of the system to affect patterns and

events.• Consider development over time, delayed effects and feedback

loops.• Consider the three pillars of sustainability

à Ecosystem/environment(ecology), economy and society

Systems Thinking in One Health

IT TAKES TIME TO

DEVELOP SYSTEMS

THINKING!

One Health thinking in Brucellosis Case StudySerbia 0,60 Malta 0,70

Overall score:From 0-1

0.00.20.40.60.81.0

Dimensionscoverage +

balanceInitiative-

to-environmen

t match

Integratedhealth

approach

Systemfeatures

and targets

Sustainability and socio-ecologicalconsiderat…

Perspectives and TOC-

factors 0.00.20.40.60.81.0

Dimensionscoverage +

balance

Initiative-to-environmen

t match

Integratedhealth

approach

Systemfeatures and

targets

Sustainability and socio-ecologicalconsiderat…

Perspectivesand TOC-

factors

• Do tasks, resources and competencies match?• Are methods appropriate to engage essential actors and

stakeholders?• Is structure, location and timing of the initiative to support

each objective and the expected outcomes planned?

• Are there mechanisms in the initiative to do self-assessment, to learn, to reflect and adapt to new knowledge and changing conditions.

32

One Health Planning

ALLOCATE TIME & RESOURCES



0.00.20.40.60.81.0

Common aimsStakeholder and

actorengagement

Self-assessmentand planrevisions

Human healthdiagnostics,

hospitalization…Health

education/promotion. Food…

Identification /registration ofanimals/farms

Blood samplingfrom animals(cattle, sheep,…

Annualsurveillance

0.00.20.40.60.8

Commonaims Stakeholder

and actorengagementSelf-

assessmentand plan…

Objective 1

Objective 2

Objective 3

Objective 4

Objective 5

One Health workingIs about formulation of the, goals, focus and criteria of successBroadness: to integrate disciplines and sectors

Collaboration: Stakeholder participation including non-scientific community, power imbalances (gender, social, cultural….)Flexibility and adaption: Reflection and learning

Transdisciplinary BalanceCultural and social ballance

NEOH Workshop 2018

0.00.20.40.60.81.0

Broadnessof initiative

Collaboration

Transdisciplinary

balance

Cultural andsocial

balance

Flexibilityand

adaptation0.00.20.40.60.81.0

Broadnessof initiative

Collaboration

Transdisciplinary

balance

Cultural andsocial

balance

Flexibilityand

adaptation



One Health characteristics

Rüegg SR, McMahon BJ, Häsler B, Esposito R, Rosenbaum Nielsen L, et al (2017). A blueprint to evaluate One Health. Frontiers in Public Health, section Public Health Policy. February 2017, doi.org/10.3389/fpubh.2017.00020

NEOH - http://neoh.onehealthglobal.net/

http://neoh.onehealthglobal.net/

One Health sharing

General information sharingSharing of data, knowledge, information, resources, staff, facilities …..Internal and external sharing mechanisms and agreements

Sharing of methods and resultsThere have to Resources allocated for sharing

Data (quality, storage, accessibility to all actors)Institutional Resilience of sharing to change (e.g. in change of staff)

One Health sharing in Brucellosis Case Study

Serbia 0,60 Malta 0,60


0.00.20.40.60.81.0

Generalinformation/awareness sharing

Data andinformation sharing

Methodsand results

sharing

Institutional

memory/resilience

0.00.20.40.60.81.0

Generalinformation/awaren

esssharing

Data andinformation sharing

Methodsand

resultssharing

Institutional

memory/resilience

One Health learning

Knowledge gathering, storage and distribution

Working environment, technology, reward system….

Learning levelIndividualTeamOrganisation

EnvironmentDirect environmentGeneral context

http://lounge.obviousmag.org/augere/2015/04/informacao-e-conhecimento.html

BasicAdaptiveGenerative learning

0.00.20.40.60.81.0

Focus onadaptive

andgenerativeindividual…

Focus onadaptive

andgenerative

team…Focus onadaptive

andgenerativeorganisati…

Directlearning

environment supportive

of…

Generallearning

environment supportive

of…

One Health learning in Brucellosis Case StudySerbia 0,60 Malta 0,65

0.00.20.40.60.81.0

Focus onadaptive and

generativeindividuallearning


generativeteam learning


generativeorganisationa

l learning

Directlearning

environmentsupportive of

adaptive…

Generallearning

environmentsupportive of

adaptive…


One Health systemic organisation

One Health systemic organisation: Adaptive and shared leadership

q Management, social and leadership skills

q Team structure

q Actors and competenceq Focus and inovation

0.0

0.2

0.4

0.6

0.8

1.0

Teamstructures

Social andleadershi

pstructures

+ skills

Competence

Focus andinnovatio

n

One Health systemic organisation in Brucellosis CS

Serbia 0,80 Malta 0,80


0.0

0.2

0.4

0.6

0.8

1.0

Teamstructures

Socialand

leadership

structures+ skills

Competence

Focus andinnovatio

n

0.00

0.20

0.40

0.60

0.80

1.00Planning

Learning

Sharing

SystemicOrganisation

Working

Thinking

One Health Index

oper

atio

nin

frastr

uctu

re

NEOH One Health evaluation of Brucellosis CS

Serbia Malta Together

0.000.200.400.600.801.00

Planning

Learning

Sharing

SystemicOrganisation

Working

Thinking

oper

atio

nin

frastr

uctu

reop

erat

ion

infra

struc

tur

e

One Health Index 0.54

One Health Ratio 1.37238

The purpose of OH Evaluation

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• Evaluation oh OH initiatives – numerical calculation of One Healthness

• Forming a criteria for OH initiatives for a minimum OH index

• Improvement of existing initiatives

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