GRF One Health Summit 2012, Davos: Presentation by Prof. Maged Younes - Director - Department of Food Safety - World Health Organization WHO

1. Working at the human-animal-
ecosystem interfaces within the
framework of One Health:
The Importance for Health Security
Maged Younes
Director
Department of Food Safety and Zoonoses
| One Health: The Importance for Health Security | 21 February 2012

2. One Health
 Grown to become a movement with appreciable
momentum
 Recognizes interconnections between the health of
humans, animals and ecosystems
 Involves applying coordinated, collaborative,
multidisciplinary and cross-sectoral approaches at the
human-animal-ecosystems interfaces (HAEI)
| One Health: The Importance for Health Security | 21 February 2012

3. One Health (2)
 "One Health" concept is necessarily broad and flexible
– Encompasses many varied facets of the relationships between
humans, animals, and their environments
– Inclusively and holistically embraces a very broad scope including:
• Technical and policy issues, including rural development, food security, ecosystem
sustainability, biodiversity, endangered species and wildlife diseases
• Sectors and partners; everyone involved in "One Health" work can identify their
specific role within it.
 Recent emergence, recognition, increasing importance and
global relevance of issues at the HAEI
| One Health: The Importance for Health Security | 21 February 2012

4. Why we need to work together?
 An estimated 60% of known infectious human diseases
have their source in animals
 The same seems to apply to 75% of emerging human
diseases and 80% of pathogens that are a potential threat
to biosecurity
| One Health: The Importance for Health Security | 21 February 2012

5. Why we need to work together? (2)
 Many possibilities of inter-specific transmission:
– Food-borne (Mad cow disease, salmonellosis)
– Vector-borne (West Nile fever, Rift valley fever, tick-borne
encephalitis)
– Direct contact (rabies)
 Prevention and control require a collaborative approach of
the human health and animal health sectors
| One Health: The Importance for Health Security | 21 February 2012

6. Why we need to work together? (3)
 Economic impact:
– Can be disastrous, even if the risk is only perceived
 Impact on food security:
– Food security, nutrition, and income of rural communities
may be threatened in low-income countries
 Environmental relevance
 Societal aspects:
– Rumours, loss of trust
| One Health: The Importance for Health Security | 21 February 2012

7. WHO's Constitution
"The objective of the World Health Organization shall be the
attainment by all peoples of the highest possible level of health"
 WHO‟s mandate
– Covers provision of public health leadership, and the development
of standards, and norms to help governments protect and improve
health
– Collaboration and promoting cooperation (among relevant
agencies, scientific and professional groups contributing to health)
are constitutionally mandated
| One Health: The Importance for Health Security | 21 February 2012

8. WHO's Core Areas of Work
 Health development
 Health security
 Health systems and institutions
 Health trends and determinants
 Convening for better health
| One Health: The Importance for Health Security | 21 February 2012

9. What is Health Security?
Health Security is the reduction of vulnerability and
protection of populations against high impact public health
risks that endanger their health and wellbeing.
 A modern way to think
about an old problem
 Preventing and mitigating
health shocks that have an
immediate impact on the
whole of society
| One Health: The Importance for Health Security | 21 February 2012

10. What is Health Security? (2)
 Global due to increased
inter-connectedness
 Four essential elements of
health security:
– Awareness
– Readiness (or
Preparedness)
– Response
– Resilience
 Working at the human-
animal-ecosystems
interfaces is vital
| One Health: The Importance for Health Security | 21 February 2012

11. Working together: The Tripartite
 FAO, OIE and WHO: working together to address issues at
the human-animal-ecosystem interfaces
 Recognizes that the interaction between
animals, humans, and ecosystems impacts, inter
alia, public health and global health security
 Collaborative and complementary efforts
| One Health: The Importance for Health Security | 21 February 2012

12. Tripartite and "One Health"
 Promoting and facilitating the cross-sectoral relationships
and collaborations to support animal and human health
internationally and with Member States
 Supporting governance, and systems required for national
(or regional) disease prevention, detection and control
| One Health: The Importance for Health Security | 21 February 2012

13. The Tripartite Concept Note
 Co-signed by the three
Executive Heads of FAO,
OIE and WHO in 2010
 Complementary agenda
and new synergies in:
– Normative work
– Public communication
– Pathogen detection
– Risk assessment and
management
– Technical capacity building
– Research development
| One Health: The Importance for Health Security | 21 February 2012

14. The Tripartite Concept Note (2)
 Vision:
"A world capable of preventing, detecting, containing,
eliminating, and responding to animal and public
health risks attributable to zoonoses and animal
diseases with an impact on food security through
multi-sectoral cooperation and strong partnerships"
| One Health: The Importance for Health Security | 21 February 2012

15. The Tripartite Concept Note
Strategic Alignment
 Promoting strong  Promote collaboration to
manage existing and novel
partnerships diseases
 Coordination to avoid  Joint framework to address
duplication of efforts gaps and strengthen
collaboration in laboratory
activities
 Strengthening animal and
human health institutions  Alignment and coherence of
global standard setting
activities
 Improvement of
governance, infrastructure  Effective strategies for
and capacity building improving national, regional
and community level
pandemic preparedness and
| response
One Health: The Importance for Health Security | 21 February 2012

16. Operationalizing the Concept Note
 "Action Plan" is being developed
 Key areas:
– Disease surveillance
– Capacity building
– Governance
– Overall strengthening of public health systems
 Specific topics as models for addressing broader issues:
– Antimicrobial resistance
– Zoonotic influenza
– Rabies
| One Health: The Importance for Health Security | 21 February 2012

17. Building on existing collaboration
 Understanding and reducing health risks from
– Zoonotic, emerging, re-emerging, and neglected infectious diseases
– antimicrobial resistance in pathogens
 Ensuring food security and safety along the food production chain
– Codex Alimentarius
– International Food Safety Authorities Network (INFOSAN)
 Early warning and communication
– Global Early Warning System for Major Animal Diseases, including Zoonoses
(GLEWS)
 Integrated risk assessment
 Capacity building
– Global Foodborne Infections Network (GFN)
| One Health: The Importance for Health Security | 21 February 2012

18. Antimicrobial Resistance (AMR)
 Antimicrobials are essential
medicines in human and
animal clinical practice that
ensure effective control of
infectious diseases
 AMR is a global threat to
health
 Preserving antimicrobial
efficacy is essential to human
and animal health and
protecting livelihoods
 AMR containment requires
elimination of inappropriate
use of antimicrobials
| One Health: The Importance for Health Security | 21 February 2012

19. AMR: Benefits of intersectoral collaboration
 Control of AMR requires
effective containment
strategies in both, animal and
human health sectors
 Management across
ecosystems and geographic
locations
 Need for harmonization of
legal requirements if
veterinary and human
medicines are managed by
different entities
| One Health: The Importance for Health Security | 21 February 2012

20. AMR:
Some challenges
 Lack of research
 No commitment
 Weak surveillance
 Poor Drug Quality
 Irrational drug use
 No infection control
| One Health: The Importance for Health Security | 21 February 2012

21. AMR: Examples of ongoing tripartite
collaboration
 Tripartite consultative process on non-human use of
antimicrobials and AMR initiated in 2003
 Ad-hoc Inter-governmental Task Force on Antimicrobial
Resistance under the auspices of the Codex Alimentarius
Commission
 Country projects (e.g. in Kenya) to strengthen national
policies, capacities and systems for detection, monitoring,
regulation and management of AMR (WHO/FAO)
 Pilot studies by the WHO Advisory Group on Integrated
Surveillance of AMR (AGISAR)
| One Health: The Importance for Health Security | 21 February 2012

22. High Level Technical Meeting to Address Health Risks
at the Human-Animal-Ecosystems Interface (HLTM)
 Convened by the Government of Mexico, FAO, OIE and
WHO (15-17 November 2011)
 100 participants from the human and animal
health, agriculture and environmental sectors, international
technical experts, and regional and donor organisations
and partners
 AMR, zoonotic influenza, and rabies used as „entry points‟
for discussions
 http://www.hltm.org/
| One Health: The Importance for Health Security | 21 February 2012

23. HLTM: Outcomes
 Outlined:
– Cross-cutting “key elements” (including political will, trust and
financial support)
– High priority technical actions
– Practical next steps for moving forward on intersectoral
collaboration, coordination and communication
 Broad consensus and commitment on intersectoral
approaches
 Major next steps:
– Translating technical outcomes into messages and actions for
policy makers and political leaders
– Alignment of technical outcomes with the broader political
processes
| One Health: The Importance for Health Security | 21 February 2012

24. HLTM: Key Messages
 High-level political will, trust among stakeholders, cultural
and behavioural changes, and financial support are needed
to establish cross-sectoral approaches
 Strong governance structures and aligned legal frameworks,
building on existing mechanisms, are essential to achieving
effective disease surveillance and response
 Communication is crucial to ensuring cross-sectoral
coordination
 Actions and activities must address institutions and
infrastructure at local, national, regional and international
levels
| One Health: The Importance for Health Security | 21 February 2012

25. Outlook
 Health security is key to public health, global security and
economic development
 Working cross-/inter-sectorally to address risks at the
human-animal-ecosystems interface within the framework
of "One Health" is crucial to attaining health security
 WHO is committed to play an active and constructive role
with all partners
| One Health: The Importance for Health Security | 21 February 2012