Global Veterinary and Medical Perspectives on One Health
Increased population;
UrbanizationIntensified livestock production;
Ecosystem encroachment
Crisis in use of natural resources (Zinsstag et al., 2011)
M anA nimalP lants
Non-infectious
Bacteria & Rickettsia
Fungi
Helminth
Virus & Prion
Protozoan
538
307
287217
66
(Chugh,
T.D.
2008)
• 60.3 % of infectious diseases are zoonotic : 71.8 % originate in wild life.
(Jones et al., 2008)
• 75 % (132/175) of the emerging diseases are zoonotic. (Asokan et al., 2011)
• Direct loss of $20 billion with over $200 billion indirect losses in zoonosis.
(World Bank, 2010)
Pie diagram showing rate of death due to causes (Chugh T.D., 2008)
Wild life EID
Domestic
animal EIDHuman EID
Translocation
Agricultural
IntensificationGlobal travel;
Urbanization;
Biomedical
manipulationTechnology &
industry
Encroachment;
Introduction;
Spill over and
spill back
Human
encroachment;
Ex situ contact;
Ecological
manipulation
(Daszak et al., 2000)
HOST-PARASITE-ECOLOGICAL RELATIONSHIP
HISTORY • Ancient healers - priests : Slaughter sacrificial animals (Schwabe, 1984)
• Kahun Papyrus (1900 B.C.) : Chimeric animals & human in myths;
Vector borne diseases
(Driesch and Peters, 2003)
• King Adadapla- iddina (1068-1047 B.C.) : Constructed temple for
Goddess Gula - healer of Rabies (Day, 2011)
Chinese Zhou dynasty (11- 13th Century) :
– Integrated public health system
– Principles of yin-yang : Acupuncture in animals & man
“ The foundations of veterinary medicine are as comprehensive and subtle
as those of human medicine and it is not possible to place one above the
other.” (On the origin and development of Medicine: Xu Dachun)
(Driesch and Peters, 2003)
HISTORY (contd)…
• Arab : Kitab al Baytara ( )
• Greek scholars: Aristotle (384-322 B.C.) & Hippocrates (460-367 B.C.)
– Public health on clean environment
– Promoted comparative medicine
• Galen (130-200 A.D.) : extended idea of Hippocrates
• Leonardo da Vinci (1452-1519 A.D.) : Comparative anatomy
HISTORY (contd)…
• Giovani Maria Lancisi (1654-1720) :
Veterinarian
Use of mosquito nets for malaria control
Pioneer in RinderPest control
• John Hunter (1728-1793) : Comparative medicine
• Edward Jenner FRS (1749-1823) :
Small pox vaccination
HISTORY (contd)…
1761 January 2011 January
INCEPTION OF VETERINARY SCIENCES……
“Either medicine will mutually enlighten and perfect the other when we
discard a derisory, harmful prejudice.” (Claude Bourgelat)
(1712-1779)
HISTORY (contd)…
• Rudolf Virchow (1821-1902) :
Father of comparative medicine & cellular pathology
Coined “Zoonoses”
Regular meat inspection
“Between animal and human medicine there is
no dividing line, nor should there be. The object
is different, but the experience obtained
constitutes the basis of all medicine.” (Virchow)
HISTORY (contd)…
• William Osler (1849-1919) :
Father of Veterinary pathology in North America
• Louis Pasteur (1822-1895);
• Robert Koch (1843-1910);
• John McFadyean (1853-1941) :
Lab confirmation of Anthrax;
Zoonotic potential of bovine T.B.
“Veterinary medicine and human medicine
complement each other and should be considered as
one medicine” (Osler)
HISTORY (contd)…
• Calvin W Schwabe (1927-2006): One Health
“ …there is no difference of paradigm between human
and veterinary medicine , and is extension of notions
of comparative medicine. Both sciences share, as a
general medicine, a common body of knowledge in
anatomy, physiology, pathology and the origin of
diseases in all species.” (Schwabe, 1984)
(Veterinary Medicine and Human Health, Schwabe, 1984)
HISTORY (contd)…
• James H Steele (1913- 2013):
International doyen of VPH
Founder of CDC VPH
One World, One Medicine, One Health
(Monath et al., 2010)
• Frederick A. Murphy & Karl M. Johnson
(Kahn et al., 2009)
HISTORY (contd)…
• Stephen S Morse (1993) :
ProMED - Programme for Monitoring Emerging Diseases
“Global electronic reporting system for outbreaks of Emerging Infectious
Diseases and toxins” (Dell, 2010)
HISTORY (contd)…
Being admitted to the profession of veterinary medicine, I
solemnly swear to use my scientific knowledge and skills for
the benefit of society through the protection of animal
health and welfare, the prevention and relief of animal
suffering, the conservation of animal resources, the
promotion of public health, and the advancement of medical
knowledge........ (AVMA Veterinarian’s Oath , 2010)
• Wildlife Conservation Society (2004) at Rockefeller University
• Building interdisciplinary bridges to health in Globalised world
• ONE WORLD - ONE HEALTH
• Promote the impact of land use & wildlife health on human
• Holistic approach to prevent epidemic/epizootic disease and ecosystem
integrity.
MANHATTAN PRINCIPLES
• AMA (June 25, 2007) House of Delegates approved resolution
• AVMA (July, 2007) implemented One Health Concept
• To revive integration of human, animal or environmental health
(Klement et al., 2009)
• Inter-professional collaboration (Hristovski et al., 2010)
• To extend research on EIDs; surveillance (Atlas et al., 2010)
• Improve scientific knowledge & clinical care
ONE HEALTH INITIATIVE
Science (Vol. 316: June 15, 2007)
“One Health is the collaborative efforts of multiple disciplines working
locally, nationally, and globally to attain optimal health for people, animals,
plants and our environment”
(One Health Initiative Task Force, AVMA, 2008)
“You can’t tell the story of human health separate from animal health
or environmental health.” (William Foege)
CDC President to declare small pox eradication programme
• Improve animal & human health by interdisciplinary collaboration
• Meet new global challenges
• Develop new centres of excellence for education and training in specific
areas
• Increase professional opportunities
• Gain scientific knowledge to create innovative programmes to improve
health (One Health Initiative Task Force, AVMA, 2008)
BENEFITS OF ONE HEALTH
SCOPE OF ONE HEALTH
Antimicrobial resistance
Bioterrorism
Biomedical Research
Comparitive Medicine
Conservation Medicine
Zoonoses
Emerging Infectious
Disease; ecology
Food safety; security
Global water/ food system
Training
Creation of scientific
knowledge
Regulatory enforcement
Climate change
Land use pattern
Occupational health
Public health
Biodiversity
Wildlife promotion
Global trade &
commerce
(One Health Initiative Task Force, AVMA, 2008)
ADDRESSING PROBLEMS OF 21st CENTURY
Population Explosion
Food Security
Infectious Diseases Pollution
Climate Change
Poverty & Starvation
Human population increases by: 2.5 people/sec; 150people/min; 9000/hr; 2,14,000/day;
78 million/year
POPULATION EXPLOSION
(Courtesy: United Nations Population Division, World Population Prospects: 2006 Revision)
Pop
ula
tio
n (
bill
ion
s)
CLIMATE CHANGE
“Climate change is perhaps the most challenging collective action problem
the world has faced” (Tony Blair)
Temperature rise 2099
Indian subcontinent:
• Increase trends in annual mean temperature;
• 0.68oC increase in the temperature per century
• 8.7% increase of Carbon-di-oxide
• Increase in extreme rains in NE & SW monsoons
• Low number of rainy days in East coast
• Increased coastal water temperature in South Asia
• Water availability: 1820 cu.m/year (2001)
1140 cu.m/year (2050)
(Courtesy: IPCC Website)
EMERGING INFECTIOUS DISEASES
• Modern jet travel allows passengers to move less than the incubation period
of diseases: Notion of exotic diseases are meaningless. (Sherman, 2010)
• Rapid dissemination of disease occurrence: ProMED; OIE
• Initiate quickly the surveillance pattern
• Should be proper, responsible, effective risk communication
(Decker et al., 2010)
Consider 50,000 known vertebrates; each with 20 endemic viruses:
Total of 1 million vertebrate viruses.
Only 2000 viruses discovered
99.8% vertebrate viruses remain to be discovered
(Atlas et al., 2010)
• Global demand for foods of animal origin is steadily growing and is
apparent that livestock sector will continue to grow (FAO, 2009)
• Demand for food expected to increase by 50% before 2020 (Scott,2008)
• Reduction of tariff associated with market reforms
• Advances in shipping – growth of animal products trade (Speedy, 2003)
• Regulations for international trade
FOOD SAFETY
• Around 3 billion people live on less than $2 per day (World Bank, 2008)
• Professionals are unwilling to offer services
• Little or no access to prevent and cure veterinary medical services
• Serve as source of transmissible disease & spread (WHO, 2006)
• Food/ agri products faced average inflation rate of 9.9% over last half
decade in India (Moorthy et al., 2011)
POVERTY
Water
HumansFood
Animals
Soil
Wild Life
Meat
Effluents
Companion
Animals
Animal
Feed
Vegetation
Direct Contact
Sewage
ANTIMICROBIAL RESISTANCE
Irwin (2005) adapted from Linton (1977)
ONE HEALTH IN INDIAN PERSPECTIVE
Wild life Non- wild life
VectorsDrug resistant agents
(Jones et al., 2008)
To be kept in mind while propagating One Health programme
• 37 Veterinary Colleges V/s 251+ Medical colleges
• Lack of inter-sectorial collaboration
• Limited field epidemiology capacity
• Awareness of zoonoses is poor (Sekar et al., 2011)
One health in Indian perspective (Contd)…
Knowledge among Medical Graduates (Kakkar et al., 2011)
• Lack of national programme on Zoonoses managed by Dept of Animal
Husbandry, Ministry of Agriculture except for Rabies in few states
• Lack of authentic data on occurrence of the diseases
• No Public Health implementing agency (Asokan et al., 2011)
TO KNOW why 1,000 Indian children die of diarrhoeal sickness every day, take a
wary stroll along the Ganges in Varanasi. As it enters the city, Hinduism’s sacred
river contains 60,000 faecal coliform bacteria per 100 millilitres, 120 times more
than is considered safe for bathing. Four miles downstream, with inputs from 24
gushing sewers and 60,000 pilgrim-bathers, the concentration is 3,000 times over
the safety limit. In places, the Ganges becomes black and septic. Corpses, of semi-
cremated adults or enshrouded babies, drift slowly by.
(The Economist; 2008 Dec. 11)
One health in Indian perspective (Contd)…
• Consensus among stakeholders
• Collaboration among professionals,
• Cooperation among interdisciplinary groups,
• Coordination among partner agencies and
• Commitment (Political and financial) by donors, partners, regional
organizations and national governments
How to reach One Health??..
For low/ middle income nations : US$ 1.3 billion spend forOne Health per year till 2020
(Contributing to One World, One Health: A Strategic Framework for Reducing Risks of Infectious Diseases at the Animal-Human-Ecosystem Interface, 2008)
Opportunities for One Health partnerships
Solving today’s threats and tomorrow’s problems cannot be accomplished
with yesterday’s approaches…..
“It is not the strongest of the species who survive, nor the most intelligent;
rather it is those most responsive to change” (Charles Darwin)
THANK YOU……..
Your attitude determines your altitude..