1. ONE HEALTH LEADERSHIP EXPERIENCE
Dr. Mark Raizenne
Centre for Food-Borne, Environmental and Zoonotic Infectious Diseases
Public Health Agency of Canada

2. Breaking Down Barriers, Creating Connections
ONE HEALTH LEADERSHIP EXPERIENCE
Breaking Down Barriers, Creating Connections
Public health has had a long history of recognizing that animal health and human health are linked – veterinary public health
Some initiatives such as EcoHealth programs have explored the importance of human and ecosystem health
Traditional silos exist between
public health professionals,
doctors, vets, ecologists,
social scientists

3. Drivers of Public Health Threats Today
ONE HEALTH LEADERSHIP EXPERIENCE
Drivers of Public Health Threats Today
Food and water consumption
Catastrophic
natural events
Habitat disruption or modification (agricultural practices)
Ecosystems
Casual exposures
Human population growth
Animals
Humans
Estimates suggest that approximately 70% of emerging and re-emerging diseases are zoonotic in origin and global trends such as human population growth, increase in livestock production, climate change, the movement of animals, people and goods, rapid urbanization, changing farming systems and forest encroachment, are creating favourable conditions for the emergence and re-emergence of infectious diseases.
Occupational
exposures
Economics
Climate change
Movement of people, animals, goods

4. Public Health Agency of Canada | Agence de la santé publique du Canada
What is One Health?
Transcending Borders: One Health recognizes the linkages among human, animal and ecosystem health domains.
A Whole-of-Society Approach: It proposes an international, interdisciplinary, cross-sectoral approach to surveillance, monitoring, prevention, control and mitigation of emerging diseases, as well as to environmental conservation.
PHAC is exploring the One Health approach as a means to prevent and respond to complex public health threats at the animal-human-ecosystem interface
The collaborative efforts of multiple disciplines working locally, nationally, and globally, to attain optimal health for people, animals, and our environment (AVMA 2008)
Source: “Contributing to One World, One Health”
Strategic Framework, Oct. 14, 2008

5. The Environment/Ecosystem Connection
ONE HEALTH LEADERSHIP EXPERIENCE
The Environment/Ecosystem Connection
Environmental health is often forgotten
Challenge to engage environmental health researchers and scientists
Climate change creates favourable conditions for the emergence and establishment of disease vectors
Examples of environmental issues
Antimicrobial resistance
Prions
Shale gas and oil sands
Arboviruses
Other pathogens which may emerge in Canada because of climate change: Arboviruses - Eastern Equine Encephalitis Virus (EEEV) and California serogroup viruses (Jamestown Canyon and Snowshoe Hare)
Changing weather patterns can create favourable conditions for the spread of vector-borne diseases. In Canada, we have observed the spread of Lyme disease and the West Nile virus – in both cases warmer temperature may well have facilitated the spread of these vectors into parts of our country where they did not exist previously.
Lyme disease is emerging in Canada because the tick vector is expanding its range. Studies show that the ticks are establishing in the warmest regions of Canada. Risk maps will help to meet the public health challenge of Lyme disease by allowing targeting of surveillance and intervention activities

6. One Health Helps us Focus on the Margins
ONE HEALTH LEADERSHIP EXPERIENCE
One Health Helps us Focus on the Margins
Big problems cross disciplines…and solutions are not specific to any one of us
We need to focus on the margins – the spaces between human, animal and ecosystem health
Risk of missing “causes of the causes” – what expertise don’t we need?

7. One Health Advantages Multiple perspectives are better than one
ONE HEALTH LEADERSHIP EXPERIENCE
One Health Advantages
Multiple perspectives are better than one
Looking at human disease without including
the context in which human illness occurs will
not inform our decision-making ability
One Health is a useful paradigm to frame complex public health issues
A way to foster information sharing and integrative surveillance
Improved professional competencies and education
One Health is an integrated approach to risk management and decision making

8. How Can One Health Improve What We Do?
ONE HEALTH LEADERSHIP EXPERIENCE
How Can One Health Improve What We Do?
Current Situation
With One Health
Focus on outbreak response
Focus is generally on health and scientific aspects of disease
Approach tends to be siloed and fragmented
Focus is primarily national
Education tends to be discipline-specific
Communities engaged and mobilized only after outbreak event
Focus on preventing outbreaks
Focus includes social and cultural determinants of health
Approach is holistic, integrative and interdisciplinary
Focus includes international cooperation and prevention
Education is cross-sectoral, including other disciplines and perspectives
Early education and information sharing with communities to prevent zoonotic outbreaks 8

9. One Health Activities PHAC’s One Health activities
ONE HEALTH LEADERSHIP EXPERIENCE
One Health Activities
PHAC’s One Health activities
PHAC is highly engaged in promoting One Health; collaborating with other departments (CFIA)
PHAC is applying a One Health approach to AMR policy development, CIPARS, C-EnterNet, West Nile and Lyme disease surveillance, Science-Policy Integration
One Health Operational Model
Provinces and Territories
Manitoba, Ontario, Alberta, Saskatchewan, Quebec
Manitoba:
One Health Committee with a food safety and surveillance focus – pilot on Salmonella
Medical Officer of Health working with National Collaborating Centre for Infectious Diseases
Quebec:
“One Health, Health for All”: animal health and welfare strategy with a strong focus on animal-human interaction
Alberta:
applying One Health to Salmonella surveillance and AMR
Ontario:
Public Health Ontario and Ontario Ministry of Agriculture, Food and Rural Affairs looking into One Health

10. Infectious Disease Prevention and Control Branch (IDPC)
ONE HEALTH AND THE PUBLIC HEALTH AGENCY OF CANADA
Infectious Disease Prevention and Control Branch (IDPC)
One Health Operational Model
One Health provides a means to look at the complete picture, so that all emerging health issues are tackled in a balanced and effective way
Stage 1 of the framework involves identifying the One Health issue to be investigated or supported.
Stage 2 involves a more detailed description of how the 3 relevant sectors (human health, animal health and environmental health) are associated with the issue/project/program being investigated.
Stage 3 of the framework examines the data needs of the project, activity or program.
Stage 4 involves a description of the human resource needs and contacts that need to be made for successful completion of the project activity or program.
Stage 5 of the framework includes the identification of options or solutions for the original One Health issue presented.
Stage 6 of the framework involves describing the final outcome(s) of the project or program, what is needed for this outcome to take place (funding, materials, and human resources) and what will be necessary for further research, the communication plan, the education plan and the surveillance plan, if they apply.

11. International One Health Activities
ONE HEALTH LEADERSHIP EXPERIENCE
International One Health Activities
United States:
CDC – One Health Office
USDA-APHIS – OH Coord’n Office
Multiple Universities
European Union:
Animal Health Strategy (2007 – 2013)
Australia
World Health Organization (WHO), World Organization for Animal Health (OIE), Food and Agriculture Organization (FAO), the World Bank

12. Upcoming International Events
POWERPOINT TITLE GOES HERE USING: VIEW > HEADERS AND FOOTERS
Upcoming International Events
2nd GRF One Health Summit 2013
One Health - One Planet –
One Future: Risks and Opportunities
Davos, Switzerland November 17 – 20, 2013
3rd International One Health Congress
Amsterdam, Netherlands March 15-18, 2015
Would be an excellent meeting to showcase
the One Health activities at the University
of Saskatchewan
GRF = Global Risk Forum

13. ONE HEALTH LEADERSHIP EXPERIENCE
One Health Education
One Health curriculum needs to address the effects of climate on ecosystem health, wildlife, and the movement of plant, animal, and human diseases
There is an opportunity for veterinary medicine to leverage its expertise in One Health and lead advances in food-animal husbandry and welfare, water safety and security, and the health of wildlife and ecosystems
Need to integrate the key disciplines of human medicine, veterinary medicine, conservation biology, public health, basic sciences, agriculture, economics, social sciences and environmental sciences
AVMA 2008
The convergence of people, animals, and our environment has created a new dynamic in which the health of each group is inextricably interconnected
The veterinary medical profession must implement solutions to the critical workforce challenges in collaboration with multiple professions, including public health, human medicine, bio-engineering, animal science, environmental science, and wildlife

14. Education Recommendations
ONE HEALTH LEADERSHIP EXPERIENCE
Education Recommendations
One Health is an “… opportunity to connect and educate health professionals at an early stage, when they are naturally learning together. As undergraduates, these students are excited about integrating new ideas, and their academic schedule may be more accommodating to a variety of classes. Presenting One Health concepts to students at this stage of their education could have a positive impact on their awareness of and attitudes toward public health.”
Farone TS. Incorporating the one-health concept into undergraduate education.J Am Vet Med Assoc Dec 1;239(11):
“Introducing this concept to students early in their academic careers is important to ensure that they are still open to broad-based, interdisciplinary ways of thinking.
Kahn LH. Educating undergraduates on one health. J Am Vet Med Assoc Jan 15;240(2):144.
“Schools of medicine and veterinary medicine should provide their students the opportunities to learn about how animal and human health can impact on each other.”
Kahn LH, Kaplan B, Monath, TP, Steele JH. Teaching “One Medicine, One Health”. The American Journal of Medicine, Vol 121, No 3, March 2008

15. Challenges for One Health Leaders
ONE HEALTH LEADERSHIP EXPERIENCE
Challenges for One Health Leaders
Labelled as a non-expert
Issues with common language when mixing disciplines
Lack of funding – public, private and industry, competing priorities
Small number of One Health mentors and senior faculty
No unifying vision for One Health in Canada and abroad - poor coordination among Canadian health actors, “siloes”
Career paths in One Health are often unclear and few well-paying job opportunities are advertised for graduates
Limited opportunities to mobilize interest in One Health outside of academia in Canada
Will require changing behaviours and mindsets
One Health generally accepted by veterinary medicine, not so in other sectors
Need to substantially expand the traditional roles of health and medicine and redefine competencies
The veterinary profession needs to expand recognition of its immense responsibilities in addressing global food security and resilience
Too few positions that pay appropriately – incongruences in pay for DVMs, MDs, environmental sciences
There is often limited application of our understanding of the impacts of animal and environmental health on human health, policies and actions
There are limited avenues or opportunities to mobilize interest in One Health.
Need opportunities in curriculum to expose students to public (govt), corporate and academia employment opportunities

16. ONE HEALTH LEADERSHIP EXPERIENCE
An Uphill Battle
“…a shortage of collaborative student programs, insufficient environmental training for health professionals, and a lack of institutional support impede progress”
Meredith A Barrett, Timothy A Bouley, Aaron H Stoertz, and Rosemary W Stoertz Integrating a One Health approach in education to address global health and sustainability challenges. Frontiers in Ecology and the Environment (e-View)

17. ONE HEALTH LEADERSHIP EXPERIENCE
“If you always do what you've always done, you'll always get what you've always got.”

18. The Benefits of One Health (AVMA 2008)
ONE HEALTH LEADERSHIP EXPERIENCE
The Benefits of One Health (AVMA 2008)
Improving animal and human health globally through collaboration among all the health sciences, especially between the veterinary and human medical professions to address critical needs
Meeting new global challenges head-on through collaboration among multiple professions—veterinary medicine, human medicine, environmental, wildlife and public health
Developing centers of excellence for education and training in specific areas through enhanced collaboration among colleges and schools of veterinary medicine, human medicine, and public health
Increasing professional opportunities for veterinarians
Adding to our scientific knowledge to create innovative programs to improve health

19. Advantages for One Health Leaders
ONE HEALTH LEADERSHIP EXPERIENCE
Advantages for One Health Leaders
Marketable
Nimble, adaptable
Responsive to disease outbreaks, challenges
Broader perspective, see the commonalities
Chance to show leadership nationally and globally
Canada has recognized leaders in One Health – available for mentoring and support
Help to bridge the educational and research gap between the human, veterinary and environmental science fields
Potential employers – government, educational institutions, NGOs

20. Physical Environments
ONE HEALTH LEADERSHIP EXPERIENCE
The Next Generation of One Health Practitioners
Governance
Psychological
Public and Population Health
Sociological
Physical Environments
Veterinary Medical
Historical
Public Population Health
Anthropological
Humans
Animals
Animal Science
Economic
Evolutionary and Comparative
Political
Social Environments
Environmental and Ecological
Public Policy
Medical
Communication Studies
Biomedical
Source: Rock et al., 2009

21. “Gentlemen, we can rebuild him, we have the technology”
ONE HEALTH LEADERSHIP EXPERIENCE
“Gentlemen, we can rebuild him, we have the technology”