One Health Cure For Multiple Ills

While the world is focused on fighting the ongoing Covid-19 pandemic with vaccination, concerns are also building up about how to fight future pandemics better. Since zoonoses, which jump from animals to humans, comprise 60% of infectious diseases and 75% of emerging infectious diseases worldwide, attention is falling on pursuing the One Health approach. SARS-CoV-2, which causes Covid-19, too, has a zoonotic source as per the available evidence, while its laboratory construct theories abound too.

One Health is an integrated and unifying approach that aims to sustainably balance and tackle health-related threats emerging at the intersection of animals, humans, plants and the environment. This approach seeks to address the collective need for clean water, energy, air, safe and nutritious food, taking action on climate change and contributing to sustainable development, as per the just released official definition by United Nations agencies.

The economics of pursuing the One Health approach are also compelling. The death toll and the financial losses due to Covid-19 are still mounting. Setting up and running One Health systems for effective disease management in developing countries would cost $ 3 billion and enable saving of $37billion or net saving of $34 billion annually from fewer epidemics and pandemics. It is all the more important because antimicrobial resistance (AMR), a causative agent for zoonoses, can bring down the global GDP by more than 3.5% annually by 2050, according to an pre-Covid-1 report by the World Bank titled Operational Framework for Strengthening Human, Animal, and Environmental Public Health Systems at their Interface.

The world community is seized of the issue like never before. The One Health approach was taken up for discussion at the last G20 summit. The World Health Assembly deliberated the approach. United Nations organisations set up an expert panel. Private foundations like Bill & Melinda Gates Foundation, too, have marked their presence. National governments, including India, are taking their first steps.

Corporate sector, too, has started weighing in. Vani Manja, managing director, Boehringer Ingelheim India, says: “With the past several months putting to test healthcare infrastructure across the world, the broader topic of One Health is gaining significance, as it recognises that the health and well-being of human beings, animals and the environment are deeply interlinked, thus requiring a collaborative and multidisciplinary approach involving multiple stakeholders to drive desired health outcomes.”

Since the health and well-being of animals, humans and plants are intrinsically linked, the health of one can impact the health of all. Microbes affect both animals and humans because of their common habitat and the contact between the two—directly or through contaminated food—can lead to transmission of drug resistant microbes between them. Changes in climatic conditions and encroachment of wildlife areas by humans have only increased health risks by creating more opportunities for pathogens to not only spread, but also develop new types.

The risk is as much for animals as for humans. Though the focus is more on animal to human transmission of pathogens, animal health is also at risk from humans. The health of animals can be affected by diseases like coronavirus and tuberculosis. They can even succumb to these diseases. The genetic similarity of gorillas and chimpanzees to humans increases their risk from human diseases.

A common and coordinated approach to tackle human and animal health issues can show better results. Rabies in humans can be better prevented by vaccinating dogs, which are the source of the virus. Making vaccines for human influenza can be aided by learnings from influenza viruses in animals.

Ravi Bhatnagar, director of external affairs and partnerships, Reckitt Benckiser, emphasises: “We all need to focus on creating a healthier planet and it is possible with healthy people, healthy environment and healthy plants and animals.”

The One Health initiatives set up or in the pipeline in India indicate the seriousness of the government in promoting interdisciplinary collaborations for research and knowledge sharing related to the health of humans, animals, plants and the environment.

One Health got an allocation in the Union budget last year. The Department of Animal Husbandry and Dairying is implementing the One Health framework in the country to address health threats from zoonotic diseases and antimicrobial resistance. Even a One Health Support Unit has been set up. The department is reaching out to experts ranging from veterinary science, epidemiology, wildlife and human health sectors, as well as disease diagnosis and data science.

Key stakeholders like the Indian Federation of Animal Health Companies (INFAH), which has more than 50 member companies from different genres of animal healthcare like nutrition, pharmaceuticals, biologicals, diagnostics and Ayurveda, are also involved in active consultations with the department on how to tackle future pandemics, overcome AMR issues and ensure good health for both animals and people. “One of the areas where INFAH has been working closely with government bodies is to provide expertise on emerging diseases and fulfill its role as part of the solution to control these diseases in animals,” says Vijay Makhija, president, INFAH.

Other initiatives are also taking shape. A national expert group on One Health, a multi-disciplinary group, has prepared its report on the inclusion of subject specific health action plans on identified climate sensitive diseases and One Health. The National Institute of One Health in Nagpur is mandated to conduct research in One Health. India’s first One Health consortium is being anchored by the Department of Biotechnology and the National Institute of Animal Biotechnology, Hyderabad.

Partnerships between international agencies and government agencies, too, are becoming order of the day. “The World Bank is supporting the Government of India in its efforts to strengthen pandemic preparedness and One Health, both at the Centre and in states,” says Junaid Ahmad, World Bank India country director. This covers the Ministry of Health and Family Welfare, and the Minister of Fisheries, Animal Husbandry and Dairying. It has approved a $125 million to support the Resilient Kerala Programme, which includes setting up an IT-enabled One Health platform to strengthen preparedness to counter future disease outbreaks.

Overall India’s national response is in keeping with what the country has been saying on global platforms. Talking about fighting the global pandemic at the 16th G-20 Summit late last year, Prime Minister Narendra Modi said, “We have put forward the vision of ‘One Earth-One Health’ to the world. This vision can become a great strength for the world to deal with any such crisis in future.”

The world leaders at the G-20 summit also called for “working towards monitoring and implementation of multi-sectoral, evidence-based One Health approach in a bid to address risks emerging due to interface between human, animal and environment”.

Earlier the declaration by G20 health ministers, who were also addressed by Indian health minister Mansukh Mandaviya in Rome, noted: “[The] linkages between human and animal health, the effects across One Health related to AMR, food systems and environmental health, including climate change, ecosystem degradation, increased encroachment into natural systems and loss of biodiversity should be addressed through the One Health approach.”

Last year’s Global Health Summit in Rome, too, committed to work towards “enhanced implementation of the multi-sectoral, evidence based One Health approach to address risks emerging from the human-animal-environment interface [and] the threat of antimicrobial resistance” and “invest in further developing, enhancing and improving interoperable early warning information, surveillance, and trigger systems in line with the One Health approach.” India was represented by Suresh Prabhu, the-then Sherpa for G20.

At the intergovernmental level, The Food and Agriculture Organization of the United Nations, the World Organisation for Animal Health, the United Nations Environment Programme and the World Health Organization (WHO) have already set up One Health High Level Expert Panel for developing a strategy and an action plan. Abhishek Chaudhary of the Indian Institute of Technology, Kanpur, is the only Indian on the 26-member panel. He says, “After coming out with the definition of One Health, we are working on the global plan of action.” The International Fund for Agricultural Development, United Nations Children’s Fund, World Bank and World Food Programme, too, are seized of the challenge.

Companies are also working across countries on the subject. Boehringer Ingelheim is collaborating with Zoonoses Anticipation and Preparedness Initiative, a European consortium, to focus on research around measures and processes used in animal health that could potentially be applicable to Covid-19 and similar emerging diseases.

At the same time, companies like Reckitt Benckiser are already working at the ground level with their product categories that enable them to support last mile access in the areas of hygiene, health and nutrition. The company has commitments to cover more than 50% (60/117) of the most disadvantageous districts by supporting the NITI Aayog to achieve development goals, including in health. Bhatnagar adds: “Our focus on One Health is paramount. With our programmes we are working with a clear focus towards ‘One Health, One Planet, One Future and in the process ensuring that we are aligned to the SDG vision 2030 of ‘Leaving No One Behind’.”

While keeping an eye on globally emerging outbreaks is a given, there is a need to accelerate setting up of the end-to-end digital platform being set up by the government to tackle information gaps related to livestock, including disease and active surveillance. Farmers and livestock managers, too, need to be better informed.

Apart from joining the dots of what is happening at the present, it would enable better coordination at the national, regional and local levels and synergise their effort. It would increase chances of effective and efficient response, including avoiding duplication. “There is also a need for collaborative participation of public-private people. Institutional mechanisms are also required to enable experts from public health, animal health, plant health and the environment need to work together and conduct cross-sectoral research and share data,’’ says Rahul Srivastava, programme manager, One Health Support Unit, Department of Animal Husbandry.

In due course, it would be enabling to lay down policies and create a legal framework. One Health holds the potential to not only secure public health, food and nutrition and sustainable ecosystems, but also help accelerate achievement of Sustainable Development Goals.