Presentation by Delia Grace, Bernard Bett, Christine Atherstone, Fred Unger, Hung Nguyen-Viet and Sinh Dang-Xuan at the Australian Veterinary Association Annual Conference, Perth, Australia, 5–10 May 2019.
1. International perspectives on One Health
Delia Grace, Bernard Bett, Christine Atherstone, Fred Unger, Hung Nguyen-Viet, Sinh Dang-
Xuan
Australian Veterinary Association annual conference
Perth, Australia
5–10 May 2019
2. I have the following disclosures related to my
presentation:
•Funding Sources: Donors including ACIAR, BMGF, BMZ,
DFID, IDRC, SIDA, USAID
•Financial Interests: None
•Other Interests: None
3. REDUCED
POVERTY
IMPROVED FOOD AND
NUTRITION SECURITY
FOR HEALTH
IMPROVED NATURAL
RESOURCE SYSTEMS AND
ECOSYSTEM SERVICES
EQUITY, CAPACITY
AND ENABLING
ENVIRONMENT
CGIAR on the ground:
15 research centres | more than 70 countries
4. Improved food and nutrition
security for health
Improved natural
resource systems and
ecosystem services
Reduced
poverty
ILRI and CGIAR contributions to the SDGs
ILRI’s mission is
to improve food and nutritional security
and to reduce poverty in developing countries through
research for
efficient, safe and sustainable
use of livestock —
ensuring better lives through livestock.
5. ILRI Resources
• Staff: 630+
• $ 80-90 million annual budget
• 130 scientists from over 30 countries
• One third of ILRI staff are women
• Large campuses in Kenya and Ethiopia
• Regional or country office in 14 countries
8. Source: (Steinfeld et al. 2006)
Some developing country
regions have gaps of up
to 430% in milk
The production gap
9. 9
The death gap
Animal disease can be the bottleneck
ND Africa and Asia
ECF east Africa
Young Adult
Cattle 22% 6%
Shoat 28% 11%
Poultry 70% 30%
Source: Otte & Chilonda; IAEA
Annual mortality of African livestock
( Around half due to preventable or curable disease )
12. The reporting gap
Reporting
system
Zoonoses Scope
WAHID 33 Animal
TAD Info 2 Animal
Pro Med All All
GLEWS 19 All
Health Map All All
Africa
•253 million SLU
•25 million lost annually
Source: HealthMap
• 12-13 million from notifiable disease
• 80,000 reported == 99.8% un-reported
13. The costly gap
Period
Costs (conservative
estimates)
Annual
average
6 outbreaks other than SARS
-Nipah virus (Malaysia),
-West Nile fever (USA),
-HPAI (Asia, Europe),
-BSE (US),
-Rift Valley Fever (Tanzania, Kenya, Somalia)
- BSE (UK) costs in 1997-09 only
1998-2009 38.7
SARS 2002-2004 41.5
Total in 12 year
period (1998-2009)
80.2
6.7 b
13
Source World Bank 2012
14. One Health diseases ILRI is working on
African swine fever
Rift valley fever
Peste des petits ruminants
Highly pathogenic avian influenza
Middle eastern respiratory syndrome
Ebola
Contagious bovine and caprine pleuropneumonia
15. You are called out and find a dying pig with unfamiliar
symptoms. What do you do?
1. Call the police / vet authorities
2. Advise the farmer to sell it fast so he can recoup some loss
3. Take photos, notes and samples
4. Give mouth-to-mouth resuscitation
5. Kill it and eat it
16. African swine fever –bloody blackberry
Many sudden deaths
Bloody skin, eye
Bloody guts
Blackberry jam spleen
Not definitive
17. ILRI is building a comparative blue-print of viral
genome sequences
Lay the genomic foundations to help understand the complex molecular epidemiology and disease
18. Potential points of disease
interventions by mapping key
drivers of disease spread
19. We have a challenge model for ASF that few groups have access to and allows
laboratory testing of new vaccines
Identification of candidate vaccine antigens
o Test via live attenuated viral vaccines
made using genome editing tools, e.g., CRISPR/cas
made via synthetic genomics
o Test via subunit vaccine
viral vectored vaccine
recombinant protein
There are no commercial vaccines
Sanjay Vashee, J. Craig Venter Institute
20. Hypothesis: Domestic pigs are naturally infected with Ebola virus;
they play a role in the epidemiology of the virus as an amplification host
they are a possible zoonotic source for human infection.
21. ILRI foresight ‘risk assessment for Ebola in pig
value chain in Uganda’
Hayman and Olival
2014
26. 26
Rift Valley fever- valley origins
Water associated- mosquitoes spread
Depression
Abortions at any age in sheep cattle
Young animals (lambs calves) die
Humans susceptible – 2%
27. RVF -- Background
• Rift Valley fever – mosquito-borne viral
zoonosis mainly affecting cattle, sheep,
goats and camels
• Epidemics -- associated with above-
normal, persistent rainfall and flooding
• Motivation:
o Overlap select pathogen -- severe threat
to human and animal health
o Epidemics – severe socioeconomic
impacts
28. Drivers
• 2000, following heavy rainfall
• About 2000 humans infected,
245 deaths
• Thousands of sheep and
goats affected
• RVF virus introduction linked
to livestock trade
• Evidence of new
transmissions 2004
• 1987, 93, 98, 2003
• Heavy rainfall,
following a short
rainless period
• Ae. aegypti, C.
nebulosus, A.
gambiae, C.
quinquefasciatus
• Mar 1990 and Jan
2008
• Livestock movement
from Comoros
• Climate variables not
clear
• 1977 outbreak
• Suspected to be due
to livestock
movement or wind-
assisted migration of
mosquitoes
• Heavy, persistent
rainfall
29. Mapping RVF in East Africa
Mapping using outbreak data
Predictors:
o Cumulative rainfall
o Soil types – clayey soils
About 50 million people live in
the high risk areas
32. You give a talk at a conference on epidemiology of a
major disease.
The govt. press mis-reports and mis-genders you. What
do you do?
1. Insist you are a man and offer to prove it
2. Apologize profusely and resign from your high paid job
3. Keep your head down and hope it all blows over
4. Engage with relevant authorities to make a correction to the record
39. Strategic L&F CRP Cross-cutting Platforms
• Technology Generation
• Market Innovation
• Targeting & Impact
Consumers
ILRI and partners are working to transform selected value chains in targeted
commodities and countries.
Value chain development team + research partners
GLOBAL RESEARCH
PUBLIC GOODS
INTERVENTIONS TO
SCALE OUT REGIONALLY
Major intervention with development partners
Leverage the livestock revolution for the poor
What
is ILRI
doing?
40. Key messages
Large gaps in livestock productivity keep people poor,
hungry and at risk
Livestock disease is a key barrier to using livestock as a
ladder out of poverty
Participatory, Demand-led, One Health research can
leverage livestock for poor countries and safe-guard
middle and high income countries
ECF and Newcastle Disease are examples where the disease is the biggest constraint in the system. Several studies have shown that where these are controlled populations and/or offtake can double.
The table summarises a number of studies in a systematic review of mortality in African traditional systems, by age group
Last year ILRI conducted a systematic review of zoonoses, livestock-keeping and poverty. This found that the heaviest burden of zoonoses falls on poor people in close contact with animals
PeriodDisease (Country)StartEstimate
1986-2009Bovine Spongiform Encephalopathy (UK)198615,500,000,0006.1 billion in 1997-2009
1994Plague (India)19942,000,000,000
Sept. 1998-April 1999Nipah virus (Malaysia)1998671,000,000
January 1999-Dec. 2008West Nile fever (USA)1999400,000,000
Nov. 2002-July 2003Severe Acute Respiratory Syndrome (CD, China, ROW)200241,500,000,000
January 2004-January 2009Highly Pathogenic Avian Influenza (Asia)200420,000,000,000
2003-2007Bovine Spongiform Encephalopathy (USA) 200411,000,000,000
Oct. 2005-Jan. 2009Highly Pathogenic Avian Influenza (Europe)2005500,000,000
Nov. 2005-January 2009Highly Pathogenic Avian Influenza (Africa)2005
Nov. 2006-May 2007Rift Valley Fever (Tanzania, Kenya, Somalia)200630,000,000
per year
without SARS48,329,000,000 2,301,380,952
SARS41,500,000,000 1,976,190,476
Total in 1986-200689,829,000,000 4,277,571,429
Total in 1998-2009 only80,201,000,000 6,683,416,667
without SARS38,701,000,000 3,225,083,333
SARS41,500,000,000 3,458,333,333
Annual avg (12 yrs) for 7 outbreaks is $3.2 b
If SARS is once in 12-yrs event, the annual cost is $3.5 b
Moreover, there are other zoonotic diseases that are not included in this calculation. For instance HIV/AIDs which imposes heavy human, social and economic costs. At present, programs to control the disease are spending on the order of $10 billion per year – if we had included this, the total costs would be even more staggering.
Costs of a flu pandemic would range from about 5x the impact of these 8 outbreaks in a mild flu scenario (455 billion) to about 40 x in a severe flu scenario ($3.1 trillion). Most of these costs would be indirect.
Edward Okoth at ILRI – DTRA funds
Lucilla Steinaa at ILRI leads vaccine work
Reston Ebola: Accidental discovery during an outbreak of PRRS, human antibodies, experimental transmission studies with Zaire strain (pig-pig and pig-NHP).
Pig production: Over last 30 years pig population increase (0.19 million to 3.2 million), Uganda has the highest per capita pork consumption in East Africa @ 3.4kg/person/year.
Epidemiology: Bats main suspect for reservoir host/primates zoonotic source surveillance for other host involvement is in its infancy. Other possibles include rats, duikers, dogs which have shown serological evidence.
Pigs are a suspect spillover host but to date there is no serological evidence for Ebola in endemic Africa (or any other livestock species). Although, sampling efforts are limited: 12 samples from two outbreaks in DRC 1976 and 1995 and 31 samples from the 2012 Kibaale outbreak in Uganda.
Temporal correlations:
Overlaying outbreaks of Ebolavirus in Uganda with seasonal pork consumption patterns shows outbreaks near peak pork consumption periods, where increased handling, butchering and transporting of pigs would happen.
The sale of sick pigs in outbreaks is a common practice in Uganda. This and the practice of eating diseased pigs that have died of unknown causes could spread and extend an outbreak of Ebolavirus in pigs and increase the risk of spillover into humans.
Temporal correlations:
Overlaying outbreaks of Ebolavirus in Uganda with seasonal pork consumption patterns shows outbreaks near peak pork consumption periods, where increased handling, butchering and transporting of pigs would happen.
The sale of sick pigs in outbreaks is a common practice in Uganda. This and the practice of eating diseased pigs that have died of unknown causes could spread and extend an outbreak of Ebolavirus in pigs and increase the risk of spillover into humans.
Input data used:
Assembled location data on all recorded zoonotic transmission to humans
AND Ebola virusinfection in bats and primates (1976-2014).
These occurrence data were then paired with environmental covariates to predict a zoonotic transmission niche covering 22
countries across Central and West Africa.
Vegetation, elevation, temperature, evapotranspiration and suspected reservoir bat distributions define this relationship
Our method: We converted the continuous probability of risk to a binary map classifying pixels as either high or low risk. A pixel was deemed high risk if its predicted mean environmental suitability for zoonotic transmission value was greater than 0.25. This corresponds to the lowest mean suitability value predicted at most locations of known Ebola zoonotic transmission to Uganda based on polygons of 195 km2 (with a circular buffer zone radius of 7.87 km), the average subcounty size in the country. The proposed Gulu zoonotic transmission polygon was a definite outlier with a mean suitability value of 0.05. As such it was omitted when establishing a threshold value for ‘high risk’.
Red areas represent hypothetical risk areas for a spillover event to humans; do not reflect in any way the likelihood of a spillover event occurring.
High risk areas are found predominantly in the central and western parts of the country, with a few isolated areas in the North and East of the country.
All outbreak sites except for Gulu lie within clear risk areas. Not surprising as outlier for zoonotic niche and virtually no pig production in this district
All ILRI value chain sites except Lira are within clear risk areas. Mukono having the highest area of high risk of any district (km squared)
Interesting to note that the protected areas (main national parks and central forest reserves) very often associated with risk areas, particularly in the Western region.
Potential methodology flaws:
Gulu an outlier (0.05 risk level) so not used
Pig denisty data from 2008.
Zoonotic niche data only used 3 species suspected as reservoir of Zaire not recorded in Uganda, could be more reservoir bat species BUT most comprehensive data we have and perhaps there are other ways to account for this in our sampling design.
ILRI is leveraging the livestock revolution in a new approach to research for development which addresses the whole value chain and works directly towards impact at scale with development partners. This is also an opportunity to grow demand for animal health services and products to support the health of animals and people at risk of zoonoses or food-borne disease.