10 May 2019
Leading experts from around the world will converge in Oslo this week for the inaugural meeting of the One Health Lancet Commission.
The initiative, supported by the prestigious medical journal The Lancet, will bring together 22 experts from the field of One Health to ‘promote original thinking and generate solutions to the complex Global Health threats of modern times; the majority of which, when analysed properly, requires a One Health approach.’
One Health is a holistic approach recognising the connection between humans, animals and the environment to better understand and manage global issues like food safety, antibiotic resistance and zoonotic disease control. The concept has been highlighted and promoted by the United Nations, the G20 and the World Organization for Animal Health.
The commission will run over three years and will aim to produce an evidence-based report demonstrating the benefit of taking a One Health approach to developing public health policy to be presented at a conference in 2021.
Dr Anna Okello, Livestock Research Program Manager at the Australian Centre for International Agricultural Research (ACIAR), has been invited to join the commission as the only Australian representative and is taking part in the first meeting, being hosted at the Centre of Global Health at the University of Oslo, Norway.
‘Dealing with issues at the interface of human, animal and environmental health is the essence of One Health,’ says Dr Okello.
‘The concept is not new, but the increased recognition of the concept over the past 20 years was really born out of the spread of zoonotic diseases like bird flu and severe acute respiratory syndrome (SARS), with Ebola being the most recent of major outbreaks.
‘If we are going to talk about zoonotic disease control, we can’t just do it as the veterinary community, we need to work with human health experts…it’s all about cross-sectoral working and a collective approach. Human health and animal health are inextricably linked to our environment’ she says.
‘If we can get that recognition at a global level and put together the evidence base to justify a cross-sectoral and transdisciplinary approach to human and animal health, that would be a fantastic outcome,’ says Dr Okello. ‘The other area that needs work is to present a business case and identify the necessary policy approaches to operationalise it.’
Zoonotic diseases—infections that can pass between humans and animals—is arguably the main catalyst for the upswing in support of One Health, with recent outbreaks of Ebola and highly pathogenic avian influenza refreshing fears of a global pandemic. The 1918 Spanish flu infected 500 million people and is estimated to have killed 3-5% of the world’s population at the time.
It’s this devastating potential that Dr Okello believes will support the business case and other incentives for taking a One Health approach to global public health policy.
‘The social and economic cost associated with these outbreaks is huge,’ says Dr Okello. ‘We saw how quickly Ebola and avian influenza spread. If a big pandemic happens in our region, the costs to the economy, our trade partners, our health system would be extensive. It’s in everyone’s interest to produce food and interact with our environment in a safe and sustainable way.’
Dr Okello hopes that ACIAR’s long-running involvement in One Health and proven track record in delivering outcomes will assist the commission with examples of how to turn good intentions into results on the ground.
‘There are some really good case studies in One Health that have come out of ACIAR-funded research over the years,’ says Dr Okello, referring specifically to a project in Laos which helped local villages address one of the highest rates of pork tapeworm infection ever detected.
Beginning in 2010, the project initially set out to increase smallholder incomes through improved pig production, but quickly uncovered a deeper human health issue of widespread Taenia solium infection; a tapeworm that can cause a condition known as ‘neurocysticercosis’; the leading cause of epilepsy in the developing world.
‘We proved the concept of interventions that could be rolled-out throughout Asia that could be used to control the disease,’ says Dr Okello. ‘This aligned with similar efforts in Africa, and the Gates Foundation has recently funded a massive elimination program in Peru.’
In addition to the long history ACIAR has in the One Health space, Dr Okello hopes to highlight the development of the Indo-Pacific Centre for Health Security funded by the Department of Foreign Affairs and Trade.
‘The Australian Government is putting a lot of money into this space; $300 million in health security with much of that work recognising the importance of a One Health approach, simply because pandemics are more than 75% likely to stem from animal disease.’
The World Health Organization estimates that almost half of the world’s rural poor—around 411 million people—are livestock keepers with half again residing in Asia.
With rapid urbanisation and an increasing population living in close proximity to animals, the likelihood of endemics, epidemics and pandemics are also increased.
‘There are no borders when it comes to this space,’ says Dr Okello. ‘Someone can hop on plane and travel across the world quicker than the incubation period of a virus. Health security is everyone’s problem.’
You can learn more about the One Health Lancet Commission via the University of Oslo’s website.