People, Pathogens and Oru Planet

People, Pathogens and our Planet: Review of Report by World Bank Report on One Health Approach for Controlling Zoonotic Diseases

Developmental economists from the World Bank have outlined a strategic framework to operationalise the One Health approach for controlling zoonotic infections in the recently published report: “People, Pathogens and Our Planet; Volume 1: Towards a One Health Approach for Controlling Zoonotic Diseases”. The report is the joint effort of the Agricultural & Rural Development and Health,
Nutrition & Population divisions of the World Bank.

It carries forward earlier discussions regarding the conceptual framework of One Health approach to the next level. Describing major limitations of the present institutional structure in implementing One Health principles, it outlines key action points needed to overcome these limitations and proposes funding mechanisms to finance operationalisation of One Health strategies based on estimated financial needs.

It begins with a description of the threat of emerging zoonoses and outlines key advances in establishing national and global networks in the wake of recent pandemic threats. The main drivers of emerging zoonotic diseases are then identified and categorised as drivers in human living environments, in food and agriculture systems and at the earth and ecosystems level.

Drivers in Human Living Environments

  • Changing Consumer Demand and Dietary Habits
  • Urbanization and Human and Animal Population Density
  • Changing Demographics
  • Mobility
  • Poverty including health system issues

Drivers in Food and Agriculture Systems

  • Livestock numbers
  • The Spatial Concentration of Livestock Production
  • Mixed Biosecurity Regimes

Drivers at the Earth and Ecosystems Level

  • Major Changes in Land Use and Agricultural Intensification
  • Land Use Change, Deforestation, Habitat Fragmentation, and Biodiversity Loss
  • Increased Hunting, Poachng, and Bushmeat Trade
  • Trade in Live Animals
  • Climate Change

Adapted from People, Pathogens and our Planet. The World Bank. Washington DC (2010)

The report highlights the lack of intersectoral coordination mechanisms as a key constraint in the early identification and prevention of emerging pathogens. It makes a valid point by stating, “Discrete, purely disciplinary approaches have led to delayed diagnoses and sometimes misdiagnoses of diseases and disease risks and to the formulation of incomplete and ineffective control strategies by public institutions that do not effectively communicate with each other until the disease has spread widely.”

The report stresses the fact that in the absence of epidemiologic information, risk analysis studies are strongly advocated as an essential prerequisite to priority setting of zoonoses. Other mechanisms are also proposed, promoting coordination and communication between veterinary and public health sectors such as establishment of joint preparedness planning mechanisms, exchanging staff and sharing facilities and providing an overall institutional framework for systematic coordination.

An emphatic point that is relevant to countries like India, is to see funding disease surveillance networks as a global public good and costs to be accordingly shared among all countries that have the resources to do so. It also suggests that the conventional project-based financing mechanisms might not be the best suited for establishing and maintaining a sustained level of surveillance. It accordingly proposes several novel ways of financing One Health related activities

For a theme that is as cross cutting as One Health, economic studies are most useful way to compare findings across sectors and appeal to policy makers and donors. One of the annexures contains a summary of global literature regarding economic impact of emerging zoonotic diseases that should be useful for economists interested in the area.

The report is a timely contribution to the global debate on operational issues of One Health approach. It marshals evidence from across sectors to inform the framework. The document extensively cites case studies from newer examples of One Health initiatives globally.

It manages to succinctly explain the many operational ramifications of an abstract approach while providing a useful primer to policy makers and researchers to plan for practical strategies based upon the One Health approach.

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