Nov 26, 2008 (CIDRAP News) – At last month's avian flu conference in Sharm el-Sheikh, Egypt, participants endorsed a new strategy for fighting avian influenza and other infectious diseases, one that focuses on points where animal, human, and ecosystems meet, according to a recent statement by the United Nations Food and Agriculture Organization (FAO).
The groups' support for the "One World, One Health" (OWOH) approach, detailed in a 68-page strategy report, was overshadowed by news from the donor session of the meeting of a $350 million infusion of funds, led by the United States, toward the international fight against avian influenza, the FAO said. The meeting took place Oct 24 through Oct 26 and was attended by 530 participants from more than 120 countries and 26 regional and international organizations.
The FAO said the strategy paper was released on Oct 14 under the banner of the FAO, the World Organization for Animal Health (OIE), the World Health Organization (WHO), UNICEF, the United Nations Influenza Coordination System, and the World Bank.
The main goal of the OWOH approach is to shrink the risk and global impact of disease outbreaks by improving livestock and wildlife intelligence, surveillance, and emergency response through stronger public and animal health systems, according to the FAO. The approach calls on broad cooperation among disciplines and sectors and puts a high priority on "hot spots" for emerging infectious diseases.
"Delegates to the Sharm el-Sheikh meeting welcomed the approach as a starting point for future action and called for further elaboration of the concept and clear indications of the roles of all stakeholders in the process," the FAO said.
An emerging One World, One Health view
The Wildlife Conservation Society, a nonprofit group based in the Bronx, N.Y., that is active in 53 countries and manages wildlife parks and zoos, first introduced the OWOH concept at an international symposium in 2004. The ideas were presented as 12 recommendations that served as "Manhattan principles" for a more holistic approach for preventing disease epidemics and maintaining the global ecosystem to promote human and animal health, according to the report by the FAO and its colleagues.
Since then, the concept has picked up momentum through European and US initiatives, according to the strategy report. For example, the American Veterinary Medical Association (AVMA) established a task force in 2004 to address OWOH issues and frequently includes sessions on the theme at its regional and national conferences, according to background materials posted on the AVMA Web site.
At a December 2007 international avian flu conference in New Delhi, participants agreed that they needed a better understanding of the drivers surrounding emerging infectious diseases and singled out the OWOH perspectives as helpful for developing medium-term strategies to address emerging infectious diseases, according to the report.
New proposals take shape
According to the new report by the FAO and its collaborators, the OWOH approach includes five main strategies:
- Build robust public and animal health systems that comply with the WHO's International Health Regulations and OIE standards
- Prevent and control disease outbreaks by improving national and international response capacities
- Address the needs of poor populations by shifting focuses to developing economies and locally important diseases such as Rift Valley fever, tuberculosis, and foot-and-mouth disease
- Promote collaborations across sectors and disciplines
- Conduct research that guides the development of targeted disease control programs.
A benefit of focusing on problems that affect developing world areas is not only controlling the often-neglected diseases, but also promoting infectious disease surveillance at the local level, the report said. "Surveillance systems at the grassroots level that are based on engaging poor communities by addressing their immediate disease problems are likely to generate better cooperation and will be more robust and sustainable in the long term," it said.
Enhanced global collaboration among national and regional groups to improve disease surveillance and prevention will also help fight bioterrorism and agroterrorism, the report notes.
The global fight against avian influenza has already improved collaboration among the world's public health and veterinary groups, but a greater focus on pooling resources and forming effective synergies as part of an OWOH strategy can lead to a better understanding of the epidemiology of emerging diseases, faster identification of reservoirs, and more efficient control and prevention, particularly in poorer countries, according to the report.
To fund OWOH goals, the report suggests expanding the financial model that has been used since the January 2006 Beijing international avian influenza conference to include contributions from nonconventional donors such as groups that fight specific diseases, industry groups, and foundations.
"The introduction of a special system of levies at the international level to fund public health infrastructure in several developing countries, particularly fragile states, would need to be seriously considered," the report said.
Canada's government has offered to host a technical meeting in Winnipeg in early 2009 to further discuss the OWOH strategy, the FAO said in its press release.
Participants, including the groups that helped author the OWOH report, will likely discuss what the next steps would be toward implementing the strategy, how the measures could be financed, and how to encourage stakeholder buy-in, according to the FAO.
"Timely implementation will contribute significantly to the overall goal of improving public health, food safety and security, and the livelihoods of poor farming communities, as well as protecting the health of ecosystems," the FAO said.
Nov 24 FAO news release
Oct 14 "One World, One Health" consultation document
AVMA Web site