OH- Egypt D.Safaa EL Fadaly GOVS-MOALR
Overview of thepresentation • OH concept • OH approach • Background • Drivers for OH approaches • Benefit from OH approaches • Examples of OH approaches • OH – Where we are ? • What we want to achieve ?
OHconcept One Health is collaborating across sectors that have a direct or indirect impact on health of Humans and animals, it involves:‐ • Applying a coordinated, collaborative, multidisciplinary and cross‐sectoral approach to address potential or existing risks that originate at the animal‐ human‐ecosystems interface. • optimizing resources and efforts while respecting the autonomy of the various sectors.
OHApproach OH concept OHapproach • OH approach has been formally endorsed by the European Commission, the US Department of State, US Department of Agriculture, US Center for Disease Control and Prevention (CDC), World Bank, World Health Organization (WHO), Food and Agriculture Organization of the United Nations (FAO), World Organization for Animal Health (OIE), United Nations System Influenza Coordination (UNSIC), various Universities, NGOs and many others. • Successful public health interventions require the cooperation of human, animal, and environmental health as well as social scientists and development actors to achieve optimal health outcomes for both people and animals
Background • Sharm El‐Sheikh meeting, high‐level inter‐ministerial conferences on avian and pandemic influenza (24 ‐ 26 October 2008). • Under the banner of One World, One Health, FAO, OIE, WHO and UNICEF (together with the World Bank and the UN System Influenza Coordinator (UNSIC), have agreed that a better understanding of the global emergence, spread and impact of EIDs is both urgent and important, and that because of the complexities of novel disease flare‐ups, broad multidisciplinary and multisectoral cooperation across the animal‐human‐ecosystems interface should be put in place. • Winnipeg, Canada Meeting (16‐19 March 09) • Globally advance the OH framework
Cont… 3) Stone Mountain (Georgia, US, May 2010), • participants agreed that One Health should not be “possessed” or “mastered” by any one organization or institution; that One Health should remain flexible and comprehensive. • Also One Health Global Network should be developed to improve coordination and collaboration.
Background • 4) The first international One Health scientific congress, which took place in Melbourne, Australia, in February of 2011. • demonstrated that One Health was becoming an international movement, with One Health research and projects being conducted in many places of the world. 5) Expert Meeting on One Health Governance and Global Network was held in Atlanta, Georgia, US, on October 31 to November 1, 2011. • package of deliverables and a roadmap for the way forward.
Cont… 6) stated key elements for One Health actions. A High‐Level Technical meeting to Address Health Risks at the Human‐Animal‐Ecosystem Interface in Mexico City (Mexico), with the support of UNSIC and the Government of Mexico, November 2011, • One ‐ The need for political will and high‐level commitment between ministries involved in One Health (Agriculture, Health, and Environment/ Natural Resources) and trust between the different stakeholders involved, as well as underscoring a common vision with priorities and shared benefits. • Two ‐ The importance of strong and appropriate governance structures, aligned legal frameworks, and recognition of existing international standards such as the WHO International Health Regulations and the OIE International Standards on quality of animal health systems and for animal diseases including zoonoses. • Three –A joint cross‐sectoral collaboration and coordination with an active data sharing, joint risk assessments, and a timely and transparent communication
Cont… • 7) Prince Mahidol Award Conference 2013 (PMAC) Thailand , A world united against infectious diseases, cross‐ sectoral solutions o The message of PMAC 2013: “The success of One Health requires primarily trust, with appropriate doses of political commitment, transparency, leadership delivery, collaboration, economic impact, global management and quality of life improvement”.
Cont… • 8) In November 2010, a review mission was conducted by FAO and WHO experts in Egypt. • Each stakeholder was asked to describe their sources of epidemiological and virological information on influenza H5N1 in animals and/or people, the types of information received and its form.
Cont…. • Major outcomes of the review mission • Opportunities were identified for: • Strengthening some aspects of national diagnostic capacity, • implementing mechanisms for cross-sectoraldata sharing, and for combining and linking information from the sectors, • Strengthening surveillance and, • Implementation of joint investigations at governorate and local levels • Also key strengths were identified such as good communication within sectors generally, and among sectors.
Cont… • The Four-Way Linking project was launched in Egypt in November 2010, • FAO and WHO have initiated a Four-Way Linking (4WL) initiative and established a national-level joint framework aiming to: • Address gaps in surveillance and control, • Improve cross-sectoralworking and communications within and among governmental public health and animal health influenza laboratories, epidemiology offices.
Four-way linking taskforce partners : • MOHP, • Epidemiology and surveillance Unit(ESU), • Central Public Health Laboratories (CPHL) • MOALR • General Organization for Veterinary Services (GOVS) • National Laboratory for Quality Control of Poultry Production (NLQP). Other partners were also invited to attend the meeting (WHO, CDC and NAMRU-3) and international expert
Cont… • During 2012, despite political instability • The Four-Way Linking Task Force established and met five times and once in 2013 (April) to share information and technical expertise, and conduct joint risk assessment. • Over thirteen meetings had been organized targeting two aspects concerning understanding of health threats at the human-animal interface which are: • Informationsharing and linking among governmental public health and animal health • Joint risk assessment
Drivers for oh approach 1- Human Factors 2- Farming systems: Numbers and density 3- Wildlife factor. 4- Climate change ‐ diseases. 5- Spread of pathogens (globalized travel and trade)
Benefits from OHapproaches • Collaboration between veterinarians and physicians and other related sciences should produce benefits that are much more than merely additive • Direct positive outcomes in reduced risks; • Improved health and well‐being of animals and humans; • Financial savings; • Reduced time to detection of disease outbreaks and implemented public health actions; • Improved environmental services. • If the risk of EIDs is not well analyzed in terms of common source detection and common transmission pathway recognition, pandemics could develop unchecked.
Examples of OHcollaboration • At country level • In Thailand, One Health Epidemiology Training including the public, livestock and wildlife health professionals was established using a multidisciplinary approach for preparedness and response to EIDs. • In Egypt , 4 Way linking inter‐sectoral platform for information sharing • At international Level • The OIE, WHO and FAO created the Global Early Warning System (GLEWS) • OIE/FAO Network of Expertise on Animal Influenza (OFFLU)
OH - Where we are? • 4 Way linking task force as success story since 2011 • Maintain the success and sustain the OH group, expansion to include other relevant parties. • Regular meeting with variable intervals (2-4 months). • TORs for OH-TAG group developed and approved by all parties • Draft proposal developed by GOVS and MOH to be presented to the ministers. • Last 2 meetings was 9thof July & 18th of Sept.2018.
Steps for implementation • Approved ToRS for OH-TAG • The MoHP and MoALR have to assign a focal person for OH his role is to take the lead in OH platform establishment process. • Proposal to be sent to each minister of the relevant ministries to approve OH concept and the idea of the platform. • Support from UN organizations (FAO, WHO) a letter to the ministers and a workshop. • One of the ministers take the lead to reach the prime minister to endorse the following:- • Endorse the establishment and TORs of the OH technical advisory group. • Update the ToRs for ministerial supreme committee for influenza to be in charge of all zoonotic diseases
What we want to atchieve • Institutionalization of the OH group • Establish a OH platform (the group to be part of a wider approach) associated to: • Decision makers • All relevant ministries