Presented by Jeff Gilbert at the second scientific Asia and the Pacific symposium on "Sustainable diets: Human nutrition and livestock", Ulaanbaatar, Mongolia, 21 August 2013.

1. EcoHealth approach to control of zoonotic emerging
infectious diseases in SE Asia: Sharing the experiences
Jeffrey Gilbert MD DVM
EcoZD* coordinator
2nd Scientific Asia and the Pacific Symposium on Sustainable Diets: Human
Nutrition and Livestock, Ulaanbaatar, Mongolia, 21 August 2013
*Ecosystem Approaches to the
Better Management of Zoonotic
Emerging Infectious Diseases in
SE Asia

2. Outline of talk
•
•
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Introduction to ILRI (ILRAD/ILCA); CGIAR; CGIAR Research
Programmes (CRPs)
EcoHealth, OneHealth and ‘OneHealth versus EcoHealth’
ILRI project : Ecosystem Approaches to the Better
Management of Zoonotic Emerging Infectious Diseases in SE
Asia (EcoZD) - focus on learning and uptake of the approach
(all teams focussed on zoonoses

3. ILRI

4. ILRI

5. CRP4
http://www.ifpri.org/sites/default/files/crp4proposal_final_oct06_2011.pdf

6. What is health
•
•
•
•
absence of illness / disease
“complete physical, mental and social well being and not merely the absence of
disease or infirmity””(WHO Constitution, 1967)
Alma Ata Declaration: “ he extent to which an individual or group is able, on the
T
one hand, to realize aspirations and satisfy needs; and, on the other hand, to
change or cope with the environment”(WHO, 1978)
Prerequisites for Health – “The fundamental conditions and resources for health
are: peace, shelter, education, food, income, a stable eco-system, sustainable
resources, social justice, and equity.” (International Conference on Health
Promotion, Ottawa, 1986)

7. Health – who is responsible
Animal
Health
DVMs
Human
Health
MDs

8. Interaction (1)
Animal
Health
Human
Health
Zoonoses; food safety; VPH

9. Interaction (2)
Emerging Disease Threats: SARS.. INFLUENZA …
Animal Human
Health Health
Zoonoses; food safety; VPH

10. Interaction (3)
Emerging Disease Threats
Neglected Tropical Diseases (rabies,
leptospirosis, brucellosis … )
Animal Human
Health Health
Zoonoses; food safety; VPH

11. Interaction (4)
Animal Human
Health Health
Ecosystem

12. Broader thinking needed
substantial challenge ahead - 9 billion by 2050
innovative approaches
We need to appreciate that we are in a inter-connected world –
ecology / social sciences
Vets & Medics only part of OneHealth
One Health & Ecosystem Health (EcoHealth): neither have ‘strict’
standardised definitions; various interpretations & language
issues

13. Broader thinking - OneHealth
Eco Health – One Health
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One Health is the collaborative effort of multiple disciplines
working locally, nationally, and globally, to address critical
challenges and attain optimal health for people, domestic
animals, wildlife, and our environment
One Health Commission (http://www.onehealthcommission.org/ )
• The One Health concept is a worldwide strategy for expanding
interdisciplinary collaborations and communications in all
aspects of health care for humans and animals. One Health
Initiative (http://onehealthinitiative.com/)

14. Broader thinking EcoHealth
Eco Health – -One Health
• Ecosystem approaches to public health issues acknowledge the complex,
systemic nature of public health and environmental issues, and the
inadequacy of conventional methodologies for dealing with them. David
Walter-Toews, University of Guelph
• The Ecohealth approach focuses above all on the place of human beings
within their environment. It recognizes that there are inextricable links
between humans and their biophysical, social, and economic environments,
and that these links are reflected in a population's state of health.
International Development Research Centre (IDRC)
• EcoHealth is an emerging field of study researching how changes in the
earth’s ecoszstems affect human health. It has many prospects. EcoHealth
examines changes in the biological, physical, social and economic
environments and relates these changes to human health. Wikipedia.

15. Compare / Contrast
v OneHealth
• Definitions open to debate: range from quite rigid to
very flexible; issues of branding
• One-Health – biomedical focus: human + animal +
wildlife;
• One-Health: focus on communicable diseases
• One-Health: operational / strategy
• EcoHealth: environment & socio-economic aspects –
pioneered outside ‘traditional’ health
• EcoHealth: communicable & non-communicable
diseases (dioxin; heavy metal toxicity)
• Eco-Health: academic / research / complexity

16. Inter-connectivity of EcoHealth
Eco Health – One Health

17. Inter-connectivity of EcoHealth
Eco Health – One Health
From Wilcox & Colwell, EcoHealth journal 2005

18. Compare / Contrast
Eco Health – One Health
One Health
Eco Health
Complexity focus
System thinking
Pioneered by IDRC
One Health
Schwabe‘s One Medicine
One world/One Medicine
More quantitative
Integrated approach
‘Bottom Up’
Vets, Medics,
Eco health
epidemiologists,
ecologists, social scientists,
Adapted from indigenous
philosophers,Karen Morison, University of Guelph
Veterinarians, medics, some
ecologists
Currently institutionalized
Rather ‘Top down’

19. Important OneHealth Case-study in Mongolia

20. EcoZD: Location of Project Activities
Increased risk of brucellosis and
toxoplasmosis
EcoHealth Resource Centre at Chiang Mai
University
Prevalence of priority pig zoonoses
Hygiene in small-scale poultry
slaughterhouses (2 countries)
Leptospirosis in community and abattoirs
Zoonotic causes of acute diarrhoea
Rabies control and prevention
EcoHealth Resource Centre at Gadjah Mada
University

21. Challenges & Solutions
Challenges
• Accepting novel ‘EcoHealth’
paradigm and fostering transdisciplinary collaboration (some
countries rigid mechanism
including financial mechanisms)
Solutions
5 year project cycle assisted, learning by
doing approach gives first-hand experience
using country priorities not donor ones
Plans for all countries to disseminate
approach and findings to research
community, policy makers and communities
• Limited capacity within disciplines
eg proposal writing, epidemiology,
dissemination (journal articles,
policy, IEC)
Mentoring by ILRI researchers & technical
experts provided real-time suppport
according to needs;EcoHealth(One Health)
Resource Centres for regional training and
advocacy
• Competition with other
projects/initiatives/’paradigm (One
Health)
Teams/members were encouraged to be
part of other initiatives; some team members
drafted & submitted multi-country proposal
to APEIR
• Sustainability of EcoHealth (One
Health) approach
Ownership by teams: they chose the priority
and conducted the research
Further funding cycle(s) essential: 10+ years
to institutionalise

22. Yunnan - China
Brucellosis
• Emerging disease in
southern China
• Coordination by YAGAS
• Use of participatory
tools
• Combined
dissemination at
national level

23. Cambodia
Zoonotic diarrhoea
• Coordination by NGO
(CelAgrid)
• Use of participatory
tools (MoH)
• Combined fieldwork

24. Indonesia
Rabies in Bali
• Ecological focus:
• Behaviour
• Demography
• Fecundity
• Socio-cultural

25. Lao PDR
Priority Pig zoonoses
• 5 zoonoses & 3 nonzoonoses
• Development of
existing MoH/MAF
partnership

26. Joint Thai-Vietnamese team
Poulty slaughterhouse hygiene
• Engage community
• Discuss cost-benefits
• Policy engagement at
central level (DLD)

27. Viet Nam
Leptospirosis
• First joint MoH/DAH
activity with joint
fieldwork
• Participatory tools
applied
• Behaviour change in the
researchers!

28. EcoHealth Resource Centres
Chiang Mai & Gadja Mada Universities
• Academic environment
• Multi-faculty training
• Multi-faculty research
• Future OH/EH resource
for the SE Asia region

29. Personal Reflections : Högertrafikomläggningen

30. Personal Reflections : Oil tankers

31. EcoZD Project
For more information about the EcoZD project, please
visit:www.ilri.org/ecozdhttp://ecozd.wikispaces.com/
www.ilriasia.wordpress.com/tag/ecozd
Email: J.Gilbert@cgiar.org for OH-EH
resources