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"Hands-on care for One Health" EC-OIE One Health concept: OIE approach and collaboration with WHO and FAO including on rabies and avian influenza control and new disease naming Preparation of the IHR/PVS national seminars Dr S. de La Rocque, OIE, seconded to WHO
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Key principles of Manhattan New York, September 29, 2004 one world. one health "It is clear that no one discipline or sector of society has enough knowledge and resources to prevent the emergence or resurgence of diseases in today’s globalized world." "Only by breaking down the barriers among agencies, individuals, specialties and sectors can we unleash the innovation and expertise needed to meet the many serious challenges to the health of people, domestic animals, and wildlife and to the integrity of ecosystems. " "We are in an era of “One World, One Health” and we must devise adaptive, forward-looking and multidisciplinary solutions to the challenges that undoubtedly lie ahead."
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OIE/FAO programme on Good Governance of Veterinary Services Ensuring Good Governance to Address Emerging and Re-emerging Animal Disease Threats November 2005; August 2006 and last updated in September 2007
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Contributing to One World, One Health A Strategic Framework for Reducing Risks of Infectious Diseases at the Animal-Human-Ecosystems interface International Ministerial Conference on Avian and Pandemic Influenza in Sharm el-Sheikh (Egypt) 25 -26 October 2008
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Contributing to One World, One Health A Strategic Framework for Reducing Risks of Infectious Diseases at the Animal-Human-Ecosystems interface International Ministerial Conference on Avian and Pandemic Influenza in Sharm el-Sheikh (Egypt) 25 -26 October 2008 Five strategic elements: Building robust and well-governed public and animal health systems compliant with the WHO IHR (2005) and OIE international standards Improved national and international emergency response capabilities shift the focus from developed to developing economies, from potential to actual disease problems Collaboration across sectors and disciplines Developing rational and targeted disease control programmes through strategic research.
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One World, One Health: from ideas to Action Expert Consultation : 16-19 March 2009, Winnipeg (Canada) Operationalizing ‘One Health’ Taking Stock & Shaping an Implementation Roadmap 4 – 6 May 2010, Stone Mountain (USA) + Culture change + Increased visibility + Political will and financial support + Improved coordination One Health Governance and Global network Expert meeting: 31-Oct-1 Nov 2011, Atlanta (USA)
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Prevention and control of emerging infectious diseases are public goods; Support for national services and building on existing structures; Reference to internationally adopted standards and references; Shifting the focus - towards good governance and national health systems strengthening instead of short-to- medium-term ad hoc interventions "… A framework for collaboration is necessary at national and international levels, with clear roles and responsibilities " …. based on shared principles
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Ministerial Declaration Meeting of G20 Paris, 22 -23 June 2011 Action Plan on Food Price Volatility and Agriculture (25.) …, we stress the importance of strengthening …, good governance and official services, since they ensure an early detection and a rapid response to biological threats, facilitate trade flows and contribute to global food security. … we encourage international organizations, especially FAO, WHO, OIE, the Codex Alimentarius Commission (Codex), the IPPC and WTO to continue their efforts towards enhancing interagency cooperation. Views strongly supported in the political area
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Toward implementation of the Tripartite Concept Note : Good governance at the human-animal interface …"a need to strengthen animal and human health institutions" remains and "protocols and standards…should be jointly developed to achieve coherence of any related global standard-setting activities, and to address gaps in the capacities of countries". 2 main guiding lines :
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IHR MF
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In 2005, the 58 th World Health Assembly adopted the revised International Health Regulations (IHR)
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" to prevent, protect against, control and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade" IHR (2005), article 2 A legal commitment of 194 States Parties that have agreed to play by the same rules to secure international health. Purpose of the IHR (2005)
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“Each State Party shall develop, strengthen and maintain, as soon as possible but no later than five years from the entry into force of these Regulations (…), the capacity to detect, assess, notify and report events in accordance with these Regulations… and... the capacity to respond promptly and effectively…" IHR (2005), articles 5 and 13 Purpose of the IHR (2005)
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Legislation and Policy Coordination Surveillance Response Preparedness Risk Comm. Human Resources Laboratory Zoonotic pathogens Food safety Human infectious pathogens Radio nuclear hazards IHR (2005): Capacity to detect, assess, report and response to all Emergency Event of International Concern Chemical hazards IHR (2005): a multi-hazards overarching scope
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Through the IHR, WHO has a dual mandate: 1 - maintain an effective global system that helps countries to be informed in a timely manner on unusual events, assess public health risks and respond appropriately;
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Through the IHR, WHO has a dual mandate: 2 - provide support to countries to strengthen capacities for detection, reporting, assessment and response to health events and to prevent international spread, as specified in the IHR IHR - Core Capacity Assessment Protocol IHR – Indicators and checklist
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IHR – indicators of Core Capacities PVS - indicators of Critcal capacities
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Mapping of overlapping CRITICAL COMPETENCIES IN THE OIE PVS PATHWAY
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Mapping of overlapping Mechanisms for effective risk communication during a public health emergency are established and functioning III – 1. Communication
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Joint Communication: Madagascar, Apr. 2008
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FAO/HPA simulation exercise in Croatia, 2011
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Operational Framework on Good Governance of human and animal heath services www.who.int/ihr/publications/WHO- OIE_Operational_Framework/en / www.oie.int/for-the-media/onehealth/
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Presentation of the results of the last IHR monitoring and recent PVS/GAP missions
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III-1 Communications The capability of the VS to keep stakeholders informed, in a transparent, effective and timely manner, of VS activities and programs, and of developments in animal health and food safety. Levels of advancement 1. The VS have no mechanism in place to inform stakeholders of VS activities and programs. 2. The VS have informal communication mechanisms. 3. The VS maintain an official contact point for communications but it is not always up-to-date in providing information. 4. The VS contact point for communications provides up-to-date information, accessible via the Internet and other appropriate channels, on activities and programs. 5. The VS have a well-developed communication plan, and actively and regularly circulate information to stakeholders. One of the 46 critical competency carts False example Presentation of the results of the last IHR monitoring and recent PVS/GAP missions
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III-1 Communications The capability of the VS to keep stakeholders informed, in a transparent, effective and timely manner, of VS activities and programs, and of developments in animal health and food safety. Levels of advancement 1. The VS have no mechanism in place to inform stakeholders of VS activities and programs. 2. The VS have informal communication mechanisms. 3. The VS maintain an official contact point for communications but it is not always up-to-date in providing information. 4. The VS contact point for communications provides up-to-date information, accessible via the Internet and other appropriate channels, on activities and programs. 5. The VS have a well-developed communication plan, and actively and regularly circulate information to stakeholders. One of the 46 critical competency carts False example 1 - Presentation of the results of the last IHR monitoring and recent PVS/GAP missions
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2 - Working group sessions on cases scenario used to identify gaps at the interface between sectors
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A case of rabies, which has been confirmed in a dairy cow recently inseminated and regularly milked, generates panic in the population
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2 - Working group sessions on cases scenario used to identify gaps at the interface between sectors A case of rabies, which has been confirmed in a dairy cow recently inseminated and regularly milked, generates panic in the population H7N9 was confirmed in a vet who returns from a conference in China and lives in the northern part of Thailand A case of rabies, which has been confirmed in a dairy cow recently inseminated and regularly milked, generates panic in the population Nine people showed identical anthrax-like lesions reported in a district hospital close to a border post. One is working in village slaughterhouse
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2 - Working group sessions on cases scenario used to identify gaps at the interface between sectors X X Y Y Z Z [Type a quote from the document or the summary of an interesting point. You can position the text box anywhere in the document. Use the Drawing Tools tab to change the formatting of the pull quote text box.]
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3 - Positioning the identified gap on the matrix helps to highlight areas of priority
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4 - Main gaps are discussed and corrective actions proposed
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AreaRisk communicationJoint investigationRisk assessmentJoint surveillance Gaps Lack of SOPs for efficient crisis communication Lack of operational joint SOPs Lack of joint framework for risk assessment, limited knowledge on RA Need to strengthen surveillance Activities - Create an ad hoc working group - Define policy, guidelines, draft of SOPs - … - Definition of contingency plan, joint exercise, use and coordination of alert system - … - Conception of the framework: event database, data information, pilot model - … - Meeting to develop a guidelines for relevant surveillance plan and strengthen knowledge of local officers - … Expected outcomes - A finalized SOP on risk communication - Trained staff to apply this SOP - A Guidance for joint investigation - Integrated contingency plan - Well-designed reporting system - A clear and effective framework for RA - Relevant human resources - Effective team and good guidelines to define and organize relevant surveillance
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ONE HEALTH IN A BOXONE HEALTH IN A BOX The new most popular board game in Ministries
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Gaps identified GF-Tad Capacity building Technical support Disease-specific Control Program
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RABIES, THE 100% PREVENTABLE DISEASE
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KEY RATIONALE FOR INVESTMENT Rationale 1: Rabies disproportionately burdens poor rural communities Rationale 2: Dog-mediated human rabies can be eliminated by vaccinating dogs Rationale 3: Rabies is preventable yet continues to kill
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+ + A mechanism is established for the coordination of the relevant sectors III.2 – Consultation with interested parties The tool helps to open discussion on critical synergetic areas and identify way forward
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"Rabies vaccines for animals should … comply with national requirements for vaccines. When there are no adequate national regulations, reference should be made to the relevant international standards." "The success of vaccination campaigns in Latin America was due to the central coordinating role of the public health sector and the involvement of communities in rabies control." WHO expert consultation, 2013
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+ + Public health emergency response mechanisms are established II.9 – Veterinary medicines and biologicals
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OIE Rabies Vaccine Bank Deliveries as of 1 August 2015 CountryNumberYear Afghanistan200.0002014 Bangladesh200.0002013 Bhutan100.0002013; 2014 Indonesia200,0002013 Lao PDR290,4002012; 2013; 2014 Myanmar200,0002013 Nepal200,0002013 Philippines1 120,0002013; 2014; 2015 Sri Lanka300,4002013 Vietnam872,0002012; 2013; 2014 TOTAL3.682.800 Significant additional amounts are currently being scheduled through WHO projects
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+ + Mechanisms for effective communication during a public health emergency are established and functioning III.1 – Communication
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Communication Handbook WHO International Health Regulation OIE Intergovernmental science based standards OIE/WHO Risk Communication common tools November 2015
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Capacity Building collaboration REMESA Communication Seminar on Rabies OIE Communication Focal Points Regional Trainings -Europe: Estonia, July 2014 -South East Asia: Cambodia, November 2015 -Planned in 2016: Americas and Africa WHO Capacity building trainings -Risk Communication training, Serbia October 2014 -Emergency Communication Network trainings: -Switzerland, March 2015 -Jordania, November 2015 -Tunisia, November 2015 -Dedicated to Rabies awareness -Gathered all the stakeholders: (Health, Agriculture, Interior, Education, Laboratories) -Five Maghreb countries For more information: communication@oie.int
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+ + Indicator-base surveillance incudes an early-warning function for the early detection of a public health event II. 5– Epid. surveillance and early detection
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4 ways linking
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+ + Priority public health risks and resources are mapped and utilized II.3 – Risk analysis
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Twice a year Early sharing of genetic and antigenic data and their analysis from Reference labs and parent organizations Initially H5N1 HPAI, expanded to all H5 and H7 HPAI, H9N2 LPAI, and other LPAI viruses Contribution to WHO Pandemic Vaccine Candidate Meeting
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+ + Public health emergency response mechanisms are established II.9 – Veterinary medicines and biologicals
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In kind donations Multi-donor approach* involving: EU Africa (2006-2007)18 M doses CanadaWorldwide (2007-2011)40 M doses Canada (donation)1,9 M doses UK (donation) (2007)2,1 M doses Deliveries to 8 countries including Egypt (45%) and Vietnam (43%) Total : 62 million doses of Avian Influenza vaccines Avian Influenza Vaccine Bank Multi Donor
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+ + Mechanisms for effective communication during a public health emergency are established and functioning III.1 – Communication
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Diseases naming
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To span the gap between identification of a new disease and the formal assignation of a name by the ICD (International Classification of Diseases) WHO strongly encourage scientists, national authorities, medias and other stakeholders to follow the best practices
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www.who.int/ihr www.oie.int/en/support-to-oie-members/pvs-pathway Thank you for your interest and support
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