One Health Symposium for South Asia Progress So Far Roger Morris

April 2009 → pandemic H1N1 –Precipitated formal involvement in ‘one health training’ Regional training program in animal and human health epidemiology –Two-phase project in South Asia, –Funded by the European Commission, administered by the World Bank through a grant to Massey University –Implemented in seven countries in South Asia –Similar activities in China and Mongolia One Health training

Phase 1: Master’s degree joint training of 68 human and animal health professionals across South Asia to build cross-sectoral collaboration Predominantly web-based learning plus face-to-face blocks in a blended-learning program Now extended to China and Mongolia (extra 19 students) Phase 2: Applied training through: 11 in-country disease investigations Involved 200+ participants and 1,000+ implementers, integrating human and animal health sectors Further advanced training in epidemiology and economics Supported by web-based platform, ‘Hubnet’ One Health training

Phase 1: Masters training program 68 Masters students

Brucellosis Rabies One Health evaluation CCHF (brucellosis) Leptospirosis Rabies Brucellosis review Brucellosis (Q fever, CCHF) Anthrax Rabies Leptospirosis Phase 2: Much wider participation Core - Phase 1 graduates Expanded involvement, 200+ contributors plus implementers

Afghanistan

Anthrax case Anthrax surveillance training Dog bites Bangladesh

One Health Hubs –Developed as an organisational framework to facilitate cross-sectoral collaboration in each country –Foster leadership development and coordination of activities at both national and regional levels –Country Hubs are connected to form a ‘One Health Network’ in the South Asia Region Hubnet –Hubs are underpinned by an online collaboration and resource-sharing platform called ‘Hubnet’ Sustainability

Hubnet

One Health Hubs: Part of the ‘SAR Regional Network’ 7 SAR countries with active Hubs

Hubnet for registered users IRIS – national information system HandiResponse – managing disease risks + detection HandiManager – managing disease control action Public information site (firewalled) Health information strategy Smart phone 40 satellite layers National data Disease data Health slate Policy analysis

IRIS is a very flexible system to support human and animal health. It can: Manage any disease outbreak in people or animals, running in any world language Manage disease surveillance and control programs in people and animals Support assessments of risk and response Could also manage crop disease, fire, flood... Incident Response Information System

Mapping disease outbreaks Brucellosis in Afghanistan on satellite image

Mapping avian influenza in Vietnam

Data analysis

Swasthya (health) slate does 33+ tests and collects health data on village people (+ animals??)

Example health slate applications Demographic dataHeart assessmentDiagnostic tests

Human and ANimal Disease Incident Response management software Tool for evaluating the likely effects of a new zoonosis establishing in a country Procedures to choose an appropriate surveillance strategy to detect the disease promptly should it arrive or arise “Surveillance portfolio” for the disease is chosen based on economic analysis HandiResponse

Risk landscape – environment plus cattle density

Human population density for India

Apply risk levels from map to each area of the country for the disease of concern Computer model tests how rapidly the disease would be detected with different surveillance strategies – traditional, risk- based, etc. Evaluate economic benefits and costs of each surveillance activity Select surveillance portfolio

Future plans – Massey University Encourage sustained action within region Provide resources and expertise to assist European Union four country one health project Million Euros Twinning with academic institutions Funding for innovative information management Regional health risk management hub

Symposium activities Presentation of results of collaborative investigation projects and group discussions – summary results next Meeting of One Health Hub coordinators, reporting of outcomes of national symposia, preparation of regional and national resolutions and recommendations Technical part of Mysteria outbreak exercise

Maintaining existing momentum Maintaining and extending relationships Carrying projects on from current successes to a broader platform of action Resourcing the continuing development of innovative tools to support effective action against health risks We all need to work together on this!!!! The challenges