Projects

The RCZI initiative has engaged itself in multiple areas of work that cover the entire gamut of zoonoses control and prevention through research, capacity building and advocacy. Below are listed some of its major activities that it has undertaken since the year 2006, when it came into existence:


Collaborative Research

RCZI’s research work is spread over two broad categories, namely Systems and Policy based research and epidemiological research.

Systems & Policy Research

Strategic Research Agenda for Zoonoses Prevention and Control in India
To promote multisectoral research, RCZI has identified priority research options for zoonoses prevention and control in India to be researched in the next five years. Developed through a rigorous methodology that involved consultations with leading national and international experts and research institutions, a guiding framework for multisectoral collaborative research has been developed to generate evidence and guide policies on zoonoses prevention and control. Click here to access the document

Disease Surveillance
RCZI is currently undertaking a retrospective policy analysis of communicable disease surveillance policies in India of the last two decades. This work is supported under a Fellowship from the Wellcome Trust - PHFI joint capacity building grant. This study aims to critically analyse the genesis of disease surveillance policies in India using a historical lens. It aims to document the global and national context that were crucial to the design and implementation of pilot programs on integrate disease surveillance and outbreak response. It seeks to examine the interactions between and the roles played by major actors and institutions in influencing the national strategy. The study uses the case study method to study the successive surveillance models active in the country within the last 25 years and document the policy formulation and implementation processes.

Rabies Initiative in Tamil Nadu
Guided by the CDC Programme Evaluation Framework, RCZI conducted an assessment in 2010 to review rabies prevention and control initiatives in Tamil Nadu, focusing on mechanisms that helped achieve intersectoral coordination. The study found that rabies control activities in Tamil Nadu were conducted by separate departments linked by similar objectives. In addition to public health surveillance, animal census and implementation of dog licensing rules, other targeted interventions included waste management, animal birth control and anti-rabies vaccination, awareness campaigns, and widespread availability of anti-rabies vaccine at all public health facilities. A comprehensive set of human as well as animal-side interventions were being implemented through a joint intersectoral coordination mechanism involving state departments responsible for public health, municipal administration, town administrations, village panchayats and veterinary public health. A district-level monitoring committee with similar composition oversaw implementation of rabies control efforts.

Developing a cost-analysis framework for rabies control
RCZI helped develop a framework for estimating costs of the rabies control initiative in Tamil Nadu. The study aimed to determine costs to the state government of implementing different interventions for controlling rabies among the entire human and animal populations of Tamil Nadu. Costs for scaling up this programme (as well as additional interventions) were estimated using programme data. Initial cost estimations were refined based on feedback from stakeholders by including additional scenarios and revising cost and operational estimates. Costs were estimated for five different combinations of animal and human interventions using an activity-based costing approach from the provider perspective. Disease and population data were sourced from state surveillance data, human census and livestock census.

Priority Vs. Conducted Research: The Disconnect
A comparison of identified research options with research conducted on rabies in the last decade in India highlighted contrasts between the two. The study proved the need for an RCZI-like approach to original research in zoonoses. The study examined the disconnect that prevents translation of scientific research outputs into effective policies. RCZI contrasted the type of research papers published on rabies from India in the last eleven years with a previously identified set of priority research options. As per the findings, most published research articles related to biomedical research focusing on development of new interventions.

Knowledge & Practice among Medical Students
One of the initial activities that informed the development of a capacity development strategy of RCZI, was an assessment of knowledge and practices of recent medical graduates relating to management of common zoonoses. Findings of the study demonstrated for the first time the extent to which the domain was ignored in the medical curriculum. It also described the effects of an unbalanced curriculum on the quality of trained graduates with respect to awareness on zoonoses management and control. Following the findings of the study, experts in the three sectors have expressed urgency to bring about a revision in the medical curriculum to address knowledge gaps amongst medical students.

Public Health Legislations on Pandemic Preparedness
RCZI along with the legal arm of PHFI undertook a study that was done as a narrative review on the influenza pandemics and linkages to legal frameworks. Findings from the mapping of key national and sub-national legislations in India related to public health response in the face of an influenza pandemic. It highlighted key gaps and suggested recommendations to strengthen the legal framework of the country, so that response to public health emergencies could be more effective, consistent and standardised.

Institutional Mapping
The study mapped the institutions in India working on zoonoses through its research output on 20 priority zoonoses. It challenged previously held notions about lack of capacity in the area, making a case for promoting sophisticated models of institutional networking, over merely setting up additional standalone Centres of Excellence. RCZI addressed the issue of limited understanding of institutional capacity relating to zoonoses in India through this unique assessment. Research articles from India related to a list of 20 priority zoonotic diseases that were identified to the capture research output over the last decade for all institutions working on these diseases. The assessment of current status of nation-wide preparedness and response systems to deal with zoonoses indicated that these efforts were clearly inadequate, resulting in the need for greater institutional capacity.

Epidemiologic Research

Japanese Encephalitis Micro-ecosystems
To address gaps between transmission patterns and risk drivers as areas of research, an EcoHealth Research Core Group was formed, comprising of a multisectoral team of experts from public health, veterinary, virology and entomology. These experts worked closely with the local NGO in three blocks of Kushinagar district in Uttar Pradesh using an EcoHealth approach to study the association of ecological, physical, biological and social factors on transmission of JE virus among different host populations. Following an interdisciplinary methodology and study protocol, the study emphasised a unique, intersectoral approach to understand JE transmission and looking at socio-cultural dynamics which strongly influence disease transmission and outcomes. Despite repeated outbreaks of JE, limited information exists on these risk drivers. Key results of the study pointed towards the health system’s efforts for JE prevention/control being rarely corroborated by community perceptions of such activities. Further, limited knowledge among communities on JE’s route of transmission was seen across settings.

Surveillance Capacity of Acute Encephalitis Syndrome in Kushinagar District
A study conducted by RCZI examined usefulness of AES surveillance for informing policy, by reviewing Acute Encephalitis Syndrome (AES) surveillance data for January 2011–June 2012 from Kushinagar District. The study team examined the completeness and quality of AES surveillance data from the district where Japanese Encephalitis Virus (JEV) is highly endemic. The inferences about AES epidemiology and etiology would be useful for policy planners and programmem implementers. Accordingly, the data was cleaned, incidence determined, and demographic characteristics of cases and data quality analysed. The study concluded that there is urgent need for a good quality surveillance system with adequate laboratory support.

Use of Antibiotics in Veterinary Sector
In order to establish better understanding of the effect of antibiotic use in food animals in India, RCZI in collaboration with Karnataka Veterinary Animal and Fisheries Sciences University (KVAFSU), Bangalore and Guru Angad Dev University (GADVASU), Ludhiana undertook a pilot study to determine antibiotic use in chicken and dairy cattle, including types of antibiotics, purpose of their use, and degree to which they are present in food products. The study pointed out that India had been late in recognising the critical role of antibiotic use in agricultural animals in promoting antibiotic resistance and was limited by current regulations which were confined mostly to rules about antibiotic residues in seafood. There has been barely any regulation in the country on the use of antibiotics in food animals such as poultry, dairy cows and buffaloes raised for domestic consumption, making the study even more relevant and topical.

Promoting Health, Livelihood and Sustainable Livestock Systems
The RCZI/PHFI and the International Livestock Research Institute (ILRI) are jointly working on a four-year India Research Initiative on Peri-Urban Human-Animal-Environment Interface for research and coordination for local healthy food production, healthy livestock and enhanced public health. The research forms the initial basis of the Initiative’s activities to focus on the zoonotic potential of bovine tuberculosis and brucellosis in peri-urban small holder dairy farms and the use of antibiotic as risky and unsustainable means of increasing food output. An on-going study, the long-term objective of the India Research Initiative on Peri-Urban Human-Animal-Environment Interface is to create and maintain sustainable multidisciplinary and multi-actor partnerships for policy-relevant research aiming at decreasing health and environmental problems from livestock agriculture and overcrowded conditions in peri-urban ecosystems.

Capacity Building

Short-term Strategy: Training in Integrated Prevention and Control of Zoonoses
As a short-term strategy for building multisectoral response, RCZI developed a three-day training module for district level medical, veterinary and wild life health officers in early detection and response to episodes of zoonotic infections. This is a unique one-of-its-kind training package that steps back from a disease-based approach and imparts skills for better coordination and planning against both endemic and epidemic zoonoses situations. Trainees work in multisectoral teams and through a case study approach investigate and control a zoonotic disease outbreak before jointly developing a district level action plan for prevention and control of endemic zoonoses.

Long-term Strategy: Framework for Targeted Advocacy' for Revision of Medical Curriculum'
Inadequate recognition of zoonoses as a problem and lack of understanding of the role of intersectoral collaboration for its effective prevention and control has been one of the major flaws in medical and veterinary graduate education. Several innovations have been attempted in the past in other parts of the world to improve education of zoonoses, including conceptualising and offering a joint degree programme in (MPH/DVM) in American universities.

In India, the concept of offering a Masters in Public Health (MPH) programme is yet to gain a stronghold. Medical and veterinary graduates continue to be the custodians of public health. Therefore, as a long-term strategy to strengthen zoonoses prevention and control, RCZI along with partner organisations has developed of a 'framework for targeted advocacy' for revision of medical curriculum to make zoonoses related education more effective.

This has been done through a seminal exercise of developing a structured data collection methodology for generation of primary evidence on gaps in knowledge and practice level of medical students and graduates, gap analysis of current medical curriculum followed by intense consultation with leading national experts and academicians to make recommendations for suitable revisions. The process will now be extended to graduate veterinary curriculum followed by dissemination to central and state level medical councils. Click here to access the document

Research Capacity Initiative
RCZI has been training graduate-level researchers in projects involving priority setting, institutional mapping, legislative review, community based qualitative research, research administration and risk assessment. Trainees have come from both national as well as international universities, including University of North Carolina at Chapel Hill, Princeton University, University of Edinburgh, University of Delhi, McMaster University and SRM University, Tamil Nadu, amongst others.

In addition to various strategies aimed at building collaborative research capacity domestically, RCZI has also contributed to regional level capacity building efforts. The prioritisation exercise conducted by RCZI has been much appreciated within the South Asian subcontinent. RCZI experts have been invited by the One Health Alliance of Nepal and the country office of World Health Organization in January 2013 to conduct a training workshop for junior researchers in priority setting methods. Similar plans have been underway to replicate the study in different countries in the region.

Recognising the work done by RCZI, the team was invited to conceptualise a training module and to use it to conduct a two-day workshop for country investigators from India, Sri Lanka, Nepal, Indonesia, South Africa, Ghana, Ethiopia and Belgium at South Africa in August 2015. The workshop was supported by the Institute of Tropical Medicine, Belgium. While these are trainings for international audience, trainings have also happened for local level NGO staff and researchers under different projects done by RCZI.

Communication& Advocacy

Advocacy and communications are a critical component of RCZI’s strategic mandates. Using a multipronged approach, on the one hand it looks at risk and crisis communication for a general audience, while on the other, creates advocacy on specific issues for policymakers and public health professionals through multiple tools and communication products.

Communication Strategy on Zoonoses
Through a consultative process with stakeholders in multiple sectors and seeking field level inputs from communities and stakeholders, RCZI developed a framework for medium- to long-term zoonoses communication-health promotion strategy. It assessed the communication need and environment, identified communication gaps and opportunities and mapped available communication channels for zoonoses prevention and control in India across sectors. It suggested pathways for providing information and triggering motivation to enable communities and stakeholders to take action. It also explored advocacy opportunities for zoonoses prevention and control, including health communication and advocacy training in zoonoses sensitisation and capacity-building. The document came up with a set of suggestions and ideas for risk and outbreak communication for zoonoses of public health importance in India.

Newsletter: Zoonoses Watch
A key strategy of the RCZI Initiative is to raise awareness on zoonoses amongst various stakeholders and sections of society and to advocate for greater intersectoral collaboration for prevention and control of zoonoses and emerging infectious diseases. As a short-term communication and health promotion strategy, RCZI launched a quarterly e-newsletter. 'Zoonoses Watch' in January, 2009. Broadly, its content covers strategic aspect of zoonoses prevention and control. Divided into sections that included, Researchers’ Update, Practitioners’ Forum, Policy Focus and Info Corner, it provides readers a comprehensive update while strengthening their understanding of the subject. The thematic E-newsletters have a strong South Asia focus, highlighting best practices from India and abroad. Some of the themes it has covered include Conservation Medicine, Food-borne Zoonoses, Intersectoral Coordination, Peri Urban settings and Novel Influenza, H1N1. Click here for more details

RCZI Website
Creating an interactive platform that allows free access to information, updates on national and international events/happenings and analysis of issues that are topical and relevant to zoonoses, the website reaches out to health professionals, researchers and policy makers who are interested in zoonoses and its interconnectedness to other aspects of medical, veterinary and public health. Serving as a credible repository of information, it can be accessed by both the specialist and non specialist, providing depth through interactive platforms, allowing feedback, sharing of resources and cross linking, with the aim of evolving into a rich and dynamic medium that has credible information and updates on zoonoses.

JE Microsite
A dedicated JE microsite has been launched as a comprehensive and strategic communication with the objective of creating an interactive and sustainable platform. It aims to regularly publish stories on latest developments, summarising findings of research studies, sharing community perspectives and pushing for greater awareness and understanding while advocating for necessary policy change. The decision to launch and manage a microsite on JE was taken based on insights that emerged from the findings of the EcoHealth study (Identifying Sources, Pathways and Risk Drivers in Ecosystems of JE in an Epidemic-Prone North Indian District) conducted by RCZI in the state of Uttar Pradesh in 2011-13. The study, while demonstrating the interconnectedness of drivers of JE transmission and disease outcomes, highlighted acute lack of awareness on JE, prompting RCZI’s communication team to develop specific materials, such as a photo documentation of field experiences, series of comic strips, a dedicated microsite on JE and a short documentary film on JE.

A microsite on H1N1
This microsite on H1N1 or swine flu was developed in 2010-11as a response to the outbreak in an effort to strengthen the government’s own response to creating an authentic and credible public platform that could provide information and stall a panic situation. The website answered all questions which a common person needed answers to, providing valuable insights and linkages to relevant government departments and emergency control rooms that had been set up at the time.

Coordination Mechanism for Multisectoral Collaboration
A multisectoral Joint Working Group has been formed with membership and active technical support of 13 national and international, government and non-government organisations which have research as well programme implementation mandates. The group meets every six months to advise on the activities of RCZI in addition to fostering national and international collaborations for the initiative. Click here for more details

Roadmap for Strengthening Public Health Laboratory Services for Diagnosis of Infectious Disease including Emerging Infections
Major challenges exist in making health laboratories less than effective. These include weak nationwide systems, disjointed procurement and supply systems, disparity between urban and rural areas, lack of infrastructure and human resources, variable quality of laboratory performance and equipment/supplies/diagnostics that is either inappropriate or ill-maintained. The strategic framework for strengthening public health laboratories services outlines a roadmap for the systematic implementation of current and future efforts especially in the context of infectious diseases. Click here for more details

Developing Policy Briefs
These are produced regularly drawing attention of policymakers on issues of concern. Findings of important studies, especially those which have topical relevance, suggesting recommendations of consultations on themes like rabies control and prevention efforts; need to step up safety standards of national laboratories etc have been presented to central and state governments. The aim being to take these up at relevant platforms that can push for institutionalisation of task forces; building a case for additional, more in-depth studies that can generate evidence; conducting impact assessments; and signing of joint projects. Some of the policy briefs that were developed include seeking revision of medical curriculum, developing risk-based approach to the complex issue of zoonoses and adopting best practices on intersectoral coordination mechanisms, amongst others.