Actualization of an interdisciplinary curriculum for “One-Health” in West Africa - (Lessons from the PENAPH, ProMED and

1. Actualization of an interdisciplinary curriculum for “One-Health” in West Africa- (Lessons from the PENAPH, ProMED and NFELTP examples) An invited plenary session Lead Speaker presentation at the 2nd Centre for Control and Prevention of ZoonosesCCPZ Annual Conference and One-Health exposition “Improving Zoonoses Surveillance in West Africa: The One-Health Approach”. 30th June to 4th July 2013

2. 2ndCCPZ Conference Actualization of an interdisciplinary curriculum for “One-Health” in West Africa (Lessons from the PENAPH, ProMED and NFELTP examples) An invited plenary session Lead Speaker presentation at the 2nd Centre for Control and Prevention of ZoonosesCCPZ Annual Conference and One-Health exposition “Improving Zoonoses Surveillance in West Africa: The One-Health Approach”. 30th June to 4th July 2013

3. 2nd CCPZ Conference Presenter Dr Olutayo O. Babalobi(DVM, MPVM, PhD; FCVSN). Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, University of Ibadan, Ibadan, Nigeria GSM Nos. : +234-816-753-8536; +234-805-530-1991. E-mail: tayobabalobi@gmail.com; oo.babalobi@mail.ui.edu.ng

4. Key Terms: • Actualization: making real or giving the appearance of reality. Actualizing: To describe or portray realistically.

5. Definition of termsHealth • Interdisciplinary: Of, relating to, or involving two or more academic disciplines that are usually considered distinct

6. Definition of terms • Health:"A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity." (WHO 1946) • “…Health does not just mean the physical well-being of the individual but refers to the social, emotional, spiritual and cultural well-being of the whole community.

7. Existing terms in Health • Global health: Global Health is the health of populations in a global context and transcends the perspectives and concerns of individual nations • It is the area of study, research and practice that places a priority on improving health and achieving equity in health for all people worldwide' • Global health is typified by the international activities of the World Health Organization

8. International Health • International Health: International health is defined as a well-established branch of public health, with origins in the health situation of developing nations and the efforts of industrialized countries to assist them • US-CDC started as International Health

9. Public Health: • Public Health: Interdisciplinary an d multidisciplinary preventive education, research and extension ion measures against health problems and threats at local and foreign communities to improve human well-being involving professionals mainly  epidemiologists, biostatisticians, community health and environmental health officers but also physicians public health nurses, medical microbiologists, Ecologists, environmental health officers / public health inspectors, pharmacists, dental hygienists, dietitians and nutritionists, veterinarians, public health engineers, public health lawyers, sociologists, community development workers, communications experts, and others

10. Veterinary Public Health (VPH) • Veterinary Public Health (VPH) is defined as “The contributions to the physical, mental and social well-being of humans through an understanding and application of veterinary science” [WHO/FAO/OIE definition 1999]. • Human health, animal husbandry and animal health are closely connected and VPH is a fundamental part of public health whereby human health and well-being are the main objectives.

11. Veterinary Public Health (VPH) • VPH is multidisciplinary and contributes to many areas of public health that are not always related to animals. • In order to integrate veterinary public health into the goals of public health, it is essential to improve collaboration between human and veterinary medical science, environmental science and other related fields – • in accordance with ‘one health’ principles.

13. ONE HEALTH

14. ONE HEALTH • It is a multidisciplinary strategy to prevent, control and eliminate the challenge of diseases, where possible, within a larger ecological context that includes humans, animals and plants interacting in a complex ever-changing natural environment recognizing that 60% of all human pathogens are zoonotic (http://nigeria-feltp.net/prog_desc.php)

15. Definition of terms • One Health:"the collaborative effort of multiple disciplines — working locally, nationally, and globally — to attain optimal health for people, animals and the environment"

16. Definition of terms My comprehensive definition: • All collaborating efforts of various human activities, occupations and professions; labouring as companions, working together, united to achieve a common mandate, purpose and responsibility of making man to be at ease with other biological and non-biological components of the earth and its environment.

17. Disciplines • A discipline (or specialism) is knowledge or wisdom associated with one academic field of study or profession. A discipline incorporates types of knowledge, expertise, skills, people, projects, communities, problems, challenges, studies, inquiry, approaches, and research areas that are strongly associated with academic areas of study or areas of professional practice.

18. Multidisciplinary • Multidisciplinary: of, relating to using several disciples at the same time mul·ti·dis·ci·pli·nar·y (m l t -d s -pl -n r , -t -). adj. Of, relating to, or making use of several disciplines at once: a multidisciplinary approach to teaching. • A multidisciplinary community or project is made up of people from different disciplines and professions who are engaged in working together as equal stakeholders in addressing a common challenge.

19. Interdisciplinary: • Interdisciplinary knowledge is the knowledge extensions that exist between or beyond existing academic disciplines or professions. The new knowledge may be claimed by members of none, one, both, or an emerging new academic discipline or profession. • An interdisciplinary community or project is made up of people from multiple disciplines and professions who are engaged in creating and applying new knowledge as they work together as equal stakeholders in addressing a common challenge.

20. Interdisciplinary • The key question is what new knowledge (of an academic discipline nature), which is outside the existing disciplines, is required to address the challenge. • Aspects of the challenge cannot be addressed easily with existing distributed knowledge, and new knowledge becomes a primary sub goal of addressing the common challenge.

21. Difference between multidisciplinary and interdisciplinary • Multidisciplinarity is a non-integrative mixture of disciplines in that each discipline retains its methodologies and assumptions without change or development from other disciplines within the multidisciplinary relationship. An interdisciplinary field is a field of study that crosses traditional boundaries between academic disciplines or schools of thought, as new needs and professions have emerged.

22. One Health: Inter or Multi • Is One Health • multidisciplinary or • interdisciplinary • or both?

23. Disciplines involved in OH • Disciplines involved in OH include: • Professions : Agricultural, Biomedical health, Ecological/Environmental, Laboratory, Medical and Veterinary Health • Academic and Research Institutions: University Faculties/Schools/Colleges of Agriculture, Animal health and Production; Environmental Sciences; Biomedical, Medical, Nursing, Public Health, Community and Social Medicine; Veterinary Biomedical, Clinical and Pathological Medicine, Public Health and Preventive Medicine; Biomedical, Environmental and Veterinary Research Institutes) • Relevant professional students/trainees: (agricultural, biomedical, environmental health, laboratory, medical, nursing, public health, veterinary etc. • Other non-professional/ occupational trainees

24. Conservation medicine is an emerging, interdisciplinary field that studies the relationship between human and animalhealth, and environmental conditions. • Also known as  • ecological medicine,  • environmental medicine, or  • medical geology.

25. CURRICULUM : WHAT IS CURRICULUM? • A curriculum is a planned guided learning experience of a student. • From Latin, literally “running, course,” it is the subjects taught at an educational institution, or the elements taught in a particular subject. • The curriculum is really the entire program of the schools' work. It is the essential means of education. It is everything that the students and their teachers do.

26. Curriculum Components • Essentially, the curriculum should contain four main components or elements: • the objectives or purpose, • the content or subject-matter, • the method or ways of passing on knowledge, and • evaluation or assessment (i.e. the procedure for testing whether or not the pupils or students have benefited from the instructions given).

27. Curriculum • The knowledge of the environments in which the trainees will work and the task they will face as well as getting the appropriate training strategies including the field exposure are factors highly influential in designing a curriculum.

28. ONE HEALTH CURRICULUM COURSES • A typical One Health Curriculum (OHC) should involve the following courses: • Basic One Health Concept: Definition, Concepts, History , General Introduction to the One Health /Collaborative/Comparative Medicine concept • Basic Epidemiology: - Host-Agent-Environment interactions and Disease Transmission. Outbreak Investigation and Disease Reporting. Ecology/Environment Health. Wildlife / Zoo Medicine • Disease Surveillance, Monitoring, Prevention and Control. Disease Emergency Preparedness Response

29. ONE HEALTH CURRICULUM COURSES Epidemiology of Zoonotic diseases. Emerging, Infectious, Neglected and Re-occurring Zoonoses Diseases. Animal: Human Interface in a Pathogenic Environment • Non-Zoonotic/Non-communicable Animal and Human Public Health Issues e.g. Food Hygiene and Food Safety; Transboundary/Exotic/Foreign/Tropical Diseases. Livestock Livelihood and Socio-Cultural/ Traditional and Socio-Economic factors • Laboratory Clinical Diagnostic issues in One Health- biochemical, immunological, microbiological and molecular medicine.

30. Examples of One Health Curriculum • NFELTP-OHCCC In 2011, African Field Epidemiology Network (AFENET), Kampala, Uganda engaged the presenter as a Veterinary Academics Consultant during his sabbatical leave. Working in conjunction with Dr Lora Davis, the Chief Veterinary Medical Officer of the Animal-Human Interface Project, AHIP Nigeria, Centers for Disease Prevention and Control CDC- Atlanta One Health Office

31. NFELTP-OHCCC • The presenter assumed the lead role in organizing a collaborative working group to review existing NFELTP curricula and course content and recommend a One Health curriculum and standardized course content OHCCC template that may be used by AFENET for establishing additional One Health training programs in Africa.

32. NFELTP-OHCCC • The report of has since being submitted in 2012 as a 55 page Technical Report and Recommendation for a One Health standardized curriculum and course content in Field Epidemiology Training Programs July 2012. 55pp.

33. ProMED-mail • A more efficient and effective disease reporting/ surveillance systems for diseases is one of the envisage benefit of One Health. A One Health activity needed to be promoted to permit a rapid response to disease outbreak, control and surveillance is operating a joint collaborative outbreak reporting list along the lines of Program for Monitoring Emerging Diseases (ProMED-mail) • ProMED-mail since its inception, has espoused the “One Health” concept. (See PROMED AND ONE HEALTH http://www.onehealthinitiative.com/publications/ProMED%20article2.pdf)

34. EPIDEMIOLOGY • Epidemiology/Epizootiology, the branch of medicine that deals with the incidence, distribution, and control of diseases (in human populations), is a major vehicle for One Health. • Though used for animal populations, Epizootiology or veterinary epidemiology, is the study of disease patterns within animal populations.

35. EPIDEMIOLOGY/PARTICIPATORY EPIDEMIOLOGY • Participatory epidemiology is the application of participatory methods to epidemiological research and disease surveillance. It is a proven technique which overcomes many of the limitations of conventional epidemiological methods, and has been used to solve a number of animal health surveillance and research problems (Jost CC, Mariner JC, Roeder PL, Sawitri E, Macgregor-Skinner GJ (2007): Participatory epidemiology in disease surveillance and research. Rev Sci Tech. 2007 Dec; 26(3):537-549).

36. Participatory Epidemiology • Participatory Epidemiology (PE) integrates human and veterinary medicine into a common approach and is a powerful tool in international public health

37. PARTICIPATORY EPIDEMIOLOGY • Initiated in 2007, the Participatory Epidemiology Network for Animal and Public Health (PENAPH) connects groups and individuals who apply PE methods in controlling emerging and existing diseases. The concept arose as a result of applying participatory epidemiology to some of ILRI’s projects which bridge human and livestock health.

38. CONCLUSION • What are some challenges to creating One Health partnerships and collaborations? • Coordination • Leadership • Individuality • Professional suspicion/ Mutual mistrust • Professional arrogance • Professional ignorance

39. WHAT IS THE ROLE OF UNIVERSITIES IN INSTUTIONALIZING ONE HEALTH IN NIGERIA • University roles from pre-degree to preclinical to postgraduate levels: Training, Research and community and social extension services • One Health general studies courses for 100L undergraduate agricultural, biomedical, environmental health, medical, science and veterinary students • Joint pre-clinical -200L One Health course for biomedical, medical and veterinary students • Joint teaching of zoonosis courses by medical and veterinary lecturers • Recognition and adequate respect of the role of technologists and biomedical professionals in public health training

40. One Health postgraduate degrees for students of diverse professional background • Admission of qualified students of various professional backgrounds to courses such as MPH, MSc Epidemiology/Epizootiology, MSc Immunology, MSc Virology and other clinical and field- based postgraduate degrees • One Health extension and community services to clients, patients and livestock farmers’ level at rural, suburban and urban levels • Creation of University One Health Continuous Education, Distant Learning, E-Learning and Research Centres or Units • One Health extension and community services to clients, patients and livestock farmers’ level at rural, suburban and urban levels

41. Joint comparative research (e.g. on Avian/ Swine Influenzas, Brucellosis, Lassa fever, Rabies, Rift valley fever, Tuberculosis and other zoonosis and environmental diseases) • at undergraduate and postgraduate levels involving agricultural, biomedical, environmental health, medical and veterinary students and lecturers; and across universities at local, national and international links levels

42. Conclusion • The issue of One Health is more and beyond just Zoonosis, even though zoonosis is a major item • The history of One Health in Nigeria shows it beganfrom the University of Ibadan, the first University in Nigeria • Efforts to have a National OH Coordinating Center at the Dr Nasidi headed Nigeria CDC have been frustrating • Still the first and the best, there is need for One Health National Coordinating Center which UI should be readyto host

43. THANK YOU FOR GIVING ME AUDIENCE