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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 Subhash.

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Presentation on theme: "Contributing to One World, One Health A strategic framework for Reducing Risks of Infectious Diseases at the Animal–Human–Ecosystems Interface Subhash."— Presentation transcript:

1 Contributing to One World, One Health A strategic framework for Reducing Risks of Infectious Diseases at the Animal–Human–Ecosystems Interface Subhash Morzaria Contributing to One World, One Health A strategic framework for Reducing Risks of Infectious Diseases at the Animal–Human–Ecosystems Interface Subhash Morzaria Joint FAO-OIE-WHO-UNICEF-UNSIC-WB presentation Sharm El Sheikh Ministerial Conference on HPAI Egypt 25-26 October 2008 UNSIC Regional Workshop for UN Country Teams, 30-31 March 2009

2 Overview of the presentation Origin and the development of the Strategy Components of the Strategy 1.Introduction 2.HPAI Achievements and Lessons Learned 3.EIDs and Existing IDs and their Impacts 4.The Strategic Framework 5.Specific Objectives and Outputs 6.Cross Cutting Issues 7.Institutional Issues 8.Financing the Framework Conclusions and Way Forward Origin and the development of the Strategy Components of the Strategy 1.Introduction 2.HPAI Achievements and Lessons Learned 3.EIDs and Existing IDs and their Impacts 4.The Strategic Framework 5.Specific Objectives and Outputs 6.Cross Cutting Issues 7.Institutional Issues 8.Financing the Framework Conclusions and Way Forward

3 Introduction New Delhi recommendation, Dec 2007 Disease entrenched in several countries Continued risk of re-emergence and pandemic flu HPAI still a priority Also recognition HPAI is one of many other E/rEIDs Address the larger issue of EIDs at animal-human- ecosystem interface using OWOH approach New Delhi recommendation, Dec 2007 Disease entrenched in several countries Continued risk of re-emergence and pandemic flu HPAI still a priority Also recognition HPAI is one of many other E/rEIDs Address the larger issue of EIDs at animal-human- ecosystem interface using OWOH approach

4 Genesis Planning meeting in Geneva (FAO, WHO, OIE, UNICEF with UNSIC and WB) between 3-4 June 2008 to discuss strategy development Based on the broad discussions in Geneva, outline for the Strategy agreed upon by mid June 2008 LATEST joint document (FAO-WHO-OIE-UNICEF-WB) finalized in mid October 2008 This is still a STRATEGIC FRAMEWORK with key concepts for WIDER CONSULTATION Planning meeting in Geneva (FAO, WHO, OIE, UNICEF with UNSIC and WB) between 3-4 June 2008 to discuss strategy development Based on the broad discussions in Geneva, outline for the Strategy agreed upon by mid June 2008 LATEST joint document (FAO-WHO-OIE-UNICEF-WB) finalized in mid October 2008 This is still a STRATEGIC FRAMEWORK with key concepts for WIDER CONSULTATION

5 Lessons learned… Economic development and disease Disease control and livelihoods Role of wildlife and transmission Understanding epidemiology Effective communication strategies Cross-sectoral collaboration Political commitment Economic development and disease Disease control and livelihoods Role of wildlife and transmission Understanding epidemiology Effective communication strategies Cross-sectoral collaboration Political commitment

6 EIDs: main characteristics Studies show over the last 50 years: One new disease every year >70% are zoonotic, % increasing Many are of transboundary in nature Wide and significant impacts (SARS/HPAI) Global significance, international public good Studies show over the last 50 years: One new disease every year >70% are zoonotic, % increasing Many are of transboundary in nature Wide and significant impacts (SARS/HPAI) Global significance, international public good

7 Economic Impact of EID Figures are estimates and are presented as relative size. 1996199719981999200020012002 2003 1994 1995 2004 2005 2006 $50bn $40bn $30bn $20bn $10bn Estimated Cost BSE UK, $10-13bn Foot & Mouth Taiwan, $5-8bn Foot & Mouth UK $25–30bn Avian Flu Asia, $5–10bn BSE U.S., $3.5bn BSE Canada $1.5bn Avian Flu, NL $500m SARS China, Hong Kong, Singapore, Canada $30-50bn Nipah, Malaysia $350-400m Classical Swine Fever, Netherlands $2.3bn BSE Japan $1.5bn HPAI, Italy $400m

8 Impact of pandemic influenza Loss to the global economy US$2 trillion Prevention is cost- beneficial Loss to the global economy US$2 trillion Prevention is cost- beneficial

9 Drivers for emergence and spread (Human factors) Less developed nations More developed nations 7070 6565 60605 19 50 7575 8080 8585 9090 9595 20 00 0505 1010 1515 0 1 2 3 4 5 6 7 8 Billions Total Global Population: 1950-2015 Source: US Bureau of the Census >90% population growth in Africa, Asia and L. America Poverty on the rise Rapid economic development Huge demand for livestock Rapid evolution of farming systems >90% population growth in Africa, Asia and L. America Poverty on the rise Rapid economic development Huge demand for livestock Rapid evolution of farming systems

10 Increasing food demand

11 Farming systems: Numbers and density In 2007, over 21 billion food animals were produced for over 6 billion people By 2020 the demand for animal protein up by 50% mainly in developing countries requiring over 30 billion animals

12 Wildlife factor Forest encroachment Nipah, Hendra and Ebola Bush meat (HIV and chimpanzee) Exotic animal farming SARS Trade in exotic animals Monkey pox, psittacosis 37.8 million counted animals imported in USA from 163 countries in 2000-2004

13 Vector ecology and distribution (flies, ticks, mosquitoes) Invading pathogen adaptation with new vectors Migratory patterns Climate change - diseases

14 Spread of pathogens (globalized travel and trade) Increase in international air travel (5%/yr) Large shipments of livestock Animals can be any part of the world in time shorter than the IPs of many diseases Increase in international air travel (5%/yr) Large shipments of livestock Animals can be any part of the world in time shorter than the IPs of many diseases

15 Pathogen risk factors All pathogens EIDs OIE list HumanDomestic animals Domestic carnivores

16 16 Viruses Both DNA and RNA viruses represented RNA highly likely as EID High mutation rate, no repair mechanisms Small, Ubiquitous, Intrusive Ebola, Marburg, Nipah, Hendra, Lassa, Hanta, Influenza, Polio, Hepatitis, FMD, West Nile, Rabies, Yellow fever, SARS Cleaveland, S., Laurenson, M.K. &Taylor, L.H (2001). Phil. Trans. R. Soc. Lond. 356, 991-999

17 Goal Diminish the threat and minimize the global impact of epidemics and pandemics due to highly infectious and pathogenic diseases of humans and animals Broader vision Public health and food safety Food security Livelihoods of poor and vulnerable people

18 Focus Emerging and re-emerging infectious diseases at the animal-human-ecosystems interface with epidemic and pandemic potential causing wide ranging impacts

19 OWOH Manhattan Principles Developed by WCS in 2004 in New York Increasingly being adopted to address pathogen jumps between animals and humans Holistic approach encompassing interfaces among the human, animal and ecosystem health domains Proposes an international, interdisciplinary, cross- sectoral approach to disease emergence and control

20 Major thrusts/objectives 1.Preventive action and root causes and drivers 2.Building more robust public and animal health systems (IHR 2005, OIE Standards) 3.Strengthening the national and international emergency response capabilities 4.Better addressing the concerns of the poor: developed to developing economies potential to actual disease problems focusing on locally important diseases 5.Promoting cross sectoral and multi- disciplinary approach 6.Conducting strategic research

21 Priorities Country Level Long term, improve disease control capacity, including the public and animal health and food safety services based on good governance compliant with WHO IHR and OIE standards Country and Regional Levels Short to medium term establish risk-based disease surveillance in humans and animals to identify diseases at source (hotspots, human-animal interface) International Level Medium to long term strengthen capacity to improve horizon scanning to support countries to respond early and control infectious disease events (GLEWS).

22 Risk-based surveillance for sources of infection Hotspots (Range of researchable issues) Entrenchment animal/human/ecosystems population density

23 A- Zoonotic/wild B -Zoonotic/domestic D- Vector-borne C -Drug resistant

24 Cross cutting issues Surveillance at three health domains Biosecurity Bioterrorism Socio-economics Development issues Communications strategies at different levels Private-public partnership Monitoring and evaluation Cross cutting issues Surveillance at three health domains Biosecurity Bioterrorism Socio-economics Development issues Communications strategies at different levels Private-public partnership Monitoring and evaluation Strategy Components cont…

25 Institutional Issues Guiding Principles Country level initiation and implementing stronger intersectoral collaboration and political commitment Country, regional and international levels coordinated action that brings together those working on human, animal and ecosystems health International level engaging international institutions drawing on their unique mandates and complementary expert base Permitting rapid engagement of a broader range of stakeholders, including regional organizations in order to respond effectively to a variety of disease threats

26 Financing Framework FUNDING FOR THE FOLLOWING KEY AREAS: Responding to the ongoing avian influenza crisis Strengthening public and animal health services Improving surveillance: special attention for hotspots and strengthening wildlife surveillance Providing funds for emergency response 1.Supporting communication and social mobilization 2.Conducting strategic research 3.Supporting international organizations for regional and global initiatives

27 Preliminary cost estimates HPAI support Annual funding needs over next 3 years: US$542–735 million Estimated cost of funding the OWOH Strategic Framework to 2020 Average per year: Scenario 1: US$852 million (43 low income countries) Scenario 2: US$1,343 million (139 eligible countries) Total Scenario 1: US$ 10,228 million Scenario 2: US$ 16,116 million

28 Funding sources Existing donors Non-conventional donors and foundations Emergency funds Country level fund for emergencies and compensation UN Central Emergency Response Fund FAO Special Fund for Emergency and Rehabilitation OIEs World Animal Health and Welfare Fund The World Bank and the Regional IFIs Industry and other private sector Meat exporting countries

29 Conclusions HPAI and EIDs are a complex problem Multidisciplinary, multisectoral and multi- partnerships Global challenge, requiring global solutions Builds on HPAI successes and lessons learned FAO, OIE, WHO, UNICEF, UNSIC and WB support Stakeholders buy in and ownership important

30 Sharm El Sheikh response All the respondent countries strongly supported the OWOH Framework All the donors see this as synergistic with their future objectives EC Canada USDA Australia, Germany, Japan, Sweden Canada to support Winnipeg Meeting (16-19 March 09) Globally advance the framework Priority actions for implementation

31 Winnipeg Response Wide range of interest groups ( 16-19 March 09) Academic community Research Institutes Donors Countries Regional Organizations

32 USAID Initiative EPT Programme, Components Detect Identify Respond Prepare

33 Next steps Conducting wider consultation with countries, regions and other key partners Political commitment at country level Importance of cross-border collaboration Developing implementation strategies and plans Mobilizing resources for implementation Establishing timeframes for the above actions

34 CMC Collaboration enhanced due HPAI


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