Taking A Multisectoral One Health Approach A Tripartite Guide To Addressing Zoonotic Diseases In Countries

The 2018 FAO-OIE-WHO (Tripartite) zoonoses guide, “Taking A Multisectoral, One Health Approach: A Tripartite Guide to Addressing Zoonotic Diseases in Countries” (2018 TZG) is being jointly developed to provide member countries with practical guidance on OH approaches to build national mechanisms for multisectoral coordination, communication, and collaboration to address zoonotic disease threats at the animal-human-environment interface. The 2018 TZG updates and expands on the guidance in the one previous jointly-developed, zoonoses-specific guidance document: the 2008 Tripartite “Zoonotic Diseases: A Guide to Establishing Collaboration between Animal and Human Health Sectors at the Country Level”, developed in WHO South-East Asia Region and Western Pacific Region. The 2018 TZG supports building by countries of the resilience and capacity to address emerging and endemic zoonotic diseases such as avian influenza, rabies, Ebola, and Rift Valley fever, as well as food-borne diseases and antimicrobial resistance, and to minimize their impacts on health, livelihoods, and economies. It additionally supports country efforts to implement WHO International Health Regulations (2005) and OIE international standards, to address gaps identified through external and internal health system evaluations, and to achieve targets of the Sustainable Development Goals. The 2018 TZG provides relevant country ministries and agencies with lessons learned and good practices identified from country-level experiences in taking OH approaches for preparedness, prevention, detection and response to zoonotic disease threats, and provides guidance on multisectoral communication, coordination, and collaboration. It informs on regional and country-level OH activities and relevant unisectoral and multisectoral tools available for countries to use.

Zoonotic diseases, i.e. those affecting animals and humans, need a different, holistic approach to risk assessment engaging all sectors involved in their management and control. Joint Risk Assessment (JRA) brings these sectors together to assess risks from zoonotic disease threats at the animal-human-environmental interface jointly. The JRA operational tool is part of the Tripartite Zoonoses Guide and is intended for use by staff from national ministries responsible for human health, animal health, and the environment, or other government agencies that are responsible for the control and management of zoonotic diseases, in particular epidemiologists, with the close involvement of laboratory staff, risk managers and communication officers. The operational tool presents the principles of JRA and its role in informing policy development. It provides guidance on how to set up a joint qualitative risk assessment process and describes step-by-step how to conduct each component of the process. The Annexes include model documents and templates to support implementation. A JRA provides decision-makers with scientifically sound advice that can be used to inform risk management and communication policies for an effective response to a zoonotic disease threat. Routine JRA supports international regulations, such as International Health Regulations and the OIE standards, by providing a mechanism to effectively address management decisions and communications based on a JRA. When done jointly and across the spectrum of different sectors they are more likely to be relevant and acceptable to all stakeholders, and therefore also more likely to be effective.

Zoonotic diseases are transmitted between animals and people and impact health, livelihood and national and global health security. A multisectoral, One Health approach is necessary to address such complex heath threats at the human-animal-environment interface. Establishment of a multisectoral, One Health coordination mechanism allows countries to coordinate addressing zoonotic diseases and other shared health concerns at the human-animal-environment interface, including both leadership and technical functions, to strengthen and develop collaboration, communication, and coordination across the sectors and achieve better health outcomes. The Multisectoral Coordination Mechanism Operational Tool (MCM OT) provides a standard stepwise approach for countries to establish or strengthen a mechanism for multisectoral, One Health coordination to manage zoonotic diseases, with references to principles and best practices described in the Tripartite Zoonosis Guide.

A framework to implement the One Health approach at the national level may facilitate its implementation and assist national authorities in addressing the agenda of (i) enhancing national capacity for zoonotic diseases and AMR for prevention, detection and response; and (ii) improving joint coordination and collaboration between major stakeholders for control of zoonoses and AMR. With this objective, FAO has developed a National Framework for One Health to assist national authorities in initiating steps to strengthen efforts towards the control of AMR anddisease in a comprehensive manner through collaborative activities among various sectors. The framework has been developed through extensive consultations with leading scientists from human health, animal health, fisheries, environment sectors representing research and academic institutions and international agencies.

One Health addresses health challenges arising from the intertwined spheres of humans, animals and ecosystems. This handbook is the product of an interdisciplinary effort to provide science-based guidance for the evaluation of One Health and other integrated approaches to health. It guides the reader through a systems approach and framework to evaluate such approaches in a standardised way. It provides an overview of concepts and metrics from health and life sciences, social sciences, economics, and ecology that are relevant for the evaluation of the processes involved, as well as the characterisation of expected and unexpected outcomes of One Health initiatives. Finally, the handbook provides guidance and practical protocols to help plan and implement evaluations in order to generate new insights and provide meaningful information about the value of One Health. The handbook is intended for practitioners, researchers, evaluators as well as funders of integrated approaches to health and beyond.

Global health is a rapidly emerging discipline with a transformative potential for public policy and international development. Emphasizing transnational health issues, global health aims to improve health and achieve health equity for all people worldwide. Its multidisciplinary scope includes contributions from many disciplines within and beyond the health sciences, including clinical medicine, public health, social and behavioral sciences, environmental sciences, economics, public policy, law and ethics. This large reference offers up-to-date information and expertise across all aspects of global health and helps readers to achieve a truly multidisciplinary understanding of the topics, trends as well as the clinical, socioeconomic and environmental drivers impacting global health. As a fully comprehensive, state-of-the-art and continuously updated, living reference, the Handbook of Global Health is an important, dynamic resource to provide context for global health clinical care, organizational decision-making, and overall public policy on many levels. Health workers, physicians, economists, environmental and social scientists, trainees and medical students as well as professionals and practitioners will find this handbook of great value.

Modern transportation allows people, animals, and plants-and the pathogens they carry-to travel more easily than ever before. The ease and speed of travel, tourism, and international trade connect once-remote areas with one another, eliminating many of the geographic and cultural barriers that once limited the spread of disease. Because of our global interconnectedness through transportation, tourism and trade, infectious diseases emerge more frequently; spread greater distances; pass more easily between humans and animals; and evolve into new and more virulent strains. The IOM's Forum on Microbial Threats hosted the workshop "Globalization, Movement of Pathogens (and Their Hosts) and the Revised International Health Regulations" December 16-17, 2008 in order to explore issues related to infectious disease spread in a "borderless" world. Participants discussed the global emergence, establishment, and surveillance of infectious diseases; the complex relationship between travel, trade, tourism, and the spread of infectious diseases; national and international policies for mitigating disease movement locally and globally; and obstacles and opportunities for detecting and containing these potentially wide-reaching and devastating diseases. This document summarizes the workshop.