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One World, One Health

The new concept, "One World, One Health", has recently appeared, indicating that the world has suddenly woken up to the link between animal diseases and public health. And about time too!

It has long been known that 60% of known human infectious diseases have their source in animals (whether domestic or wild), as do 75% of emerging human diseases and 80% of the pathogens that could potentially be used in bioterrorism. We also know that human populations need a regular diet of protein from milk, eggs or meat, and that a deficiency can also be a public health problem.

Some estimates suggest that world production of food animals is reduced by more than 20% due to disease, which means that even animal diseases not transmissible to humans may lead to serious public health problems due to the shortages and deficiencies that can follow.

We also know that the unprecedented flow of commodities and people gives pathogens of all kinds the opportunity to spread and multiply around the world, and that climate change can enable them to extend their range, notably through vectors such as insects colonising new areas that up until a few years ago were too cold for them to survive the winter.

The only way to prevent all these new hazards is to adapt the existing systems of health governance at world, regional and national levels in a harmonised and coordinated manner.

At the global level, the OIE has modernised its worldwide information system on animal diseases (including zoonoses) with the creation of WAHIS, a mechanism whereby all countries are linked on-line to a central server that collects all the compulsory notifications sent to the OIE, covering 100 priority terrestrial and aquatic animal diseases.

WHO has adopted the International Health Regulations, placing new obligations on its Members. The OIE, WHO and FAO have created GLEWS, the Global Early Warning System, a platform shared by the three organisations to improve early warning on animal diseases and zoonoses worldwide.

The OIE, WHO and FAO (with the support of UNICEF, the UN System Influenza Coordinator [UNSIC] and the World Bank) have prepared a consensus document on global measures needed to coordinate medical and veterinary health policies more effectively, taking into account new requirements to prevent and control zoonoses. This document was presented and adopted by the Ministers of more than 100 countries at a Conference in Sharm el-Sheikh, Egypt , in October 2008.

At the national level, the OIE has created a mechanism whereby countries can volunteer to have an OIE independent evaluation of their animal health system, including their Veterinary Services' compliance with international standards of quality adopted and published by the OIE and serving as the basis for good governance. More than 120 countries have already taken this step as part of the worldwide application of the OIE PVS (Performance of Veterinary Services) tool.

A PVS evaluation provides a preliminary diagnosis of governance, which can then be followed up by support in the form of a gap analysis mission to establish what "treatment" will be needed, according to the country's own priorities, to remedy weaknesses detected during the diagnosis.

Although there is not yet an equivalent system for public health systems, application of the PVS can, among its many benefits, enable recommendations to be made on ways of improving cooperation between the Veterinary Services and the Public Health Services. Recent events have shown just how important this cooperation can be in dealing with zonootic diseases such as rabies and highly pathogenic avian influenza, and indeed with certain types of foodborne diseases. In all these cases, controlling the pathogen at its source in animals could help to avoid subsequent public health problems, which explains the importance of suitable budgetary allocations for disease prevention and the usefulness of national joint committees with the participation of the Veterinary Services and the Medical Services, aimed at establishing permanent consultation and cooperation, a situation that unfortunately does not exist in all too many countries.

We can only hope that the discussions currently taking place on the concept "One World, One Health" will eventually lead all countries to give a firm commitment to making their animal health situation transparent and setting up mechanisms for the early detection of disease outbreaks. This will require a sound legal basis and national investments, enabling countries to achieve compliance with standards of quality, especially as regards their Veterinary Services, with the support of the OIE and their government and, where necessary, interested international donors agencies.

It is also to be hoped that the Member Countries and Territories will continue to demonstrate their commitment to further strengthening the international legal framework of the WHO and the OIE in order to comply with all the rules that avoid other Members to be put at risk because diseases have not been rapidly detected and correctly notified.

Nevertheless, the concept "One World, One Health" should not serve as a pretext for dangerous initiatives like trying to achieve economies of scale based on purely theoretical notions worthy of a sorcerer's apprentice, such as trying to merge the Veterinary Services and the Public Health Services.

Bernard Vallat

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