The CoVID-19 pandemic is amongst the biggest pandemic in history. While there is no clarity on the emergence of the SARS-CoV-2 virus, scientists have found the presence of a SARS-like virus in bats. The WHO, in its report on the emergence of the SARS-CoV-2 virus, has listed four pathways that could have contributed to its emergence, three of which involve the role of animals, directly or indirectly: (i) direct transmission through animals (ii) transmission by animals as an intermediary from a host to human; and (iii) introduction through cold/food chain. The emergence of the CoVID-19 pandemic has reminded us that well-sound public health policy and administration are incomplete without considering animal health.
This is not an exclusive case of an epidemic possibly caused by animal health. As per World Organization for Animal Health (OIE), 60% of human infectious diseases are zoonotic and at least 75% of emerging infectious diseases have an animal origin. While the further rise in zoonotic infections is being foreseen, let us not forget the occurrence of reverse zoonotic diseases(transmission from humans to animals). Infections and diseases such as Swine flu, bird/avian flu, HIV, smallpox, plague, rabies, etc. are in fact believed to be evolved from the animals and are caused by direct zoonotic transmission.
This co-relation of animal and human health is dealt with through the “One Health” approach. Center for Disease Control and Prevention(CDC) mentions that One Health is “an approach that recognizes that the health of people is closely connected to the health of animals and our shared environment”. The One Health approach is based on designing and implementing programs, policies, legislation, and research in which multiple sectors communicate and work together to achieve better public health outcomes, as per WHO.
The global efforts towards a greater, inclusive One Health of the modern time date back to 2008, when a global initiative was adopted for the overarching goal of contributing to “One World, One Health” under a strategic framework signed by the leading organizations of the world viz. Food and Agriculture Organization(FAO), the World Organization for Animal Health(OIE), World Health Organization(WHO) and the United National Environment Program(UNEP), supported by United Nations Children’s Fund (UNICEF) and World Bank. Since the early 2000s, palpable efforts for One Health have been made by the United States administration, such as the constitution of One-Health Initiative Task Force in 2007, official recognition of One Health Commission as a non-profit organization u/s 501(c) (3) dedicated for the purpose, creation of a One Health Office in Centre for Disease Control, etc. Other countries and organizations have also contributed towards greater higher education on One Health: for example, in Belgium, Sciensano Institute has been established based on the One Health concept. Today, a large number of dedicated online courses and online degrees are also available for One Health. In the latest effort towards One Health, a bipartisan Bill to develop an interagency One Health Program has introduced in United States Congress in 2019.
CDC notes that the relevance of One Health has increased in recent years due to increased interactions between people, animals, plants, and our environment. I agree with this. There are myriad ways in which animals and humans interact today. The lands inhabited by wildlife are being unsustainably encroached on by humans for construction activities. A lot of farming, poultry, and other such activities are dependent on animals in the rural areas. In an article titled “A One Health approach can benefit humans, animals, and the environment”. Thierry van den Berg mentions that our society has witnessed a “livestock revolution”, whereby the stock of food animals, their productivity, and their trade has increased rapidly to feed the fast-expanding and urbanized human population.
Limiting the animal-human interaction is a challenge that needs to be worked upon, but looks impossible at the moment. Below, I offer some views for achieving a greater One Health inclusivity.
Collaborations, galore -
Berg mentions that for a One Health approach, researchers and practitioners from animal, human and environmental health need to cohort to mitigate and analyze the associated risks of emerging infections and re-infections. Greater collaboration between scientists, stakeholders, policy experts, and people with local area knowledge is required to analyze the strategies for mitigation of infection, as per Berg.
Inter-sector collaborations are not only necessary but also mandatory, as, without specialized knowledge from these fields, the aim for overall positive health for the entire Earth will fail. This will call for addressing the legal/ economic and social challenges and removing the bureaucratic bottlenecks.
Additionally, regular tracking and tracing of cases of human infections in areas of animal-human interaction, such as cropland, abattoirs, poultry, seafood market, etc., in greater assistance with disease diagnostic laboratories for testing of samples, can help to curb the number of cases at an early stage.
Veterinary Public Health as a Key area:-
Berg states that the “Veterinary Public Health” (VPH) is an important area, as their activities address the human-animal interface and most veterinarians contribute, directly or indirectly, to public health goals and outcomes. I believe that as a moral obligation to these “frontline” workers, the vaccination of veterinary doctors against pathogens must be a priority.
Certain educational reforms in the Veterinary Public Health sector shall reap benefits to the overall public health. Berg suggests introducing inter/transdisciplinary education on these collaborations, inter-disciplinary schools, and VPH educational programs for this purpose. A “One Health” study in the curriculum of veterinary workers will equip them with the knowledge to contain the spread of infections and other zoonotic diseases amongst the masses at an early stage.
Special attention to marginalized groups:-
In his article titled “The Coming Pandemic: Preparing for the Future”, Bob Kirsch throws light on recommendations made in a report by the National Academy of Medicine (NAM) on addressing infectious disease threats by improving the public health infrastructure. Kirsch states that attention to marginalized groups and systemic racism is one of the two dominant themes in the recommendations by NAM. Kirsch suggests launching government campaigns and communications to bust the “conspiracy theories promulgated on social media” and to spread awareness to reach all segments of the population, including children, adolescents, and minority communities, to address the vaccine hesitancy.
Other awareness campaigns for the marginalized communities on infection prevention measures, such as regular washing of hands, wearing face masks in a pandemic, maintaining hygiene, etc., through greater collaboration with NGOs, can curb infections at the grassroots level and prevent the spread of infections to the greater parts of the country. The specialized measures for the marginalized community ought to range from campaigns and research of the local environment to the distribution of vaccines.
Global R&D collaboration:-
Kirsch cites this article published in The Lancet which states the need for an international “standing, coordinated system and sustainable financing” for an “effective end-to-end R&D [research and development] preparedness and response ecosystem” targeting pandemic infectious diseases.
The scope and importance of global R&D collaborations in analyzing the origin of diseases to the development of vaccines cannot be downplayed. The initial sharing of the genetic sequence of CoVID-19 by China, which ultimately helped in greater diagnostics of the COVID-19 virus and its origin may be recalled in this context.
Greater work on the “One Health” approach is the need of the hour to prevent future zoonotic and anthropozoonotic outbreaks. In a post-CoVID world, taking immediate actions for implementing a One Health Policy can help in regaining the people’s lost confidence in public health. Let us not forget to take away the key message from the occurrence of three consequent Coronavirus infections (SARS, MERS and CoVID-19) in less than two decades: the risk of similar outbreaks in the future remains high and the coronavirus may still linger around the corner in a post-CoVID world.