Through the years, our lives and societies have been impacted by several diseases, such as Ebola, influenza and COVID-19, that can spread between animals and humans, also known as zoonoses. These diseases have challenged our global health systems, food supply chains, and economies.

While the scope of the impacts of zoonoses might vary to different extents, many countries showed to have inadequate mechanisms in place to ensure a longstanding and sustainable One Health collaboration. To support countries in filling these gaps, the Food and Agriculture Organization of the United Nations (FAO), the World Health Organization (WHO) and the World Organisation for Animal Health (WOAH) developed new operational tools to facilitate the establishment of multisectoral coordination mechanisms, as well as of surveillance and information sharing systems.

Leadership and technical functions to address zoonoses need to be coordinated across all sectors involved. In Qatar, for instance, the MERS-CoV outbreak provided an occasion to strengthen multisectoral coordination at national level, later expanding its areas of work in managing other zoonotic diseases. The Operational Tool on Multisectoral Coordination Mechanisms (MCM OT) provides a standard stepwise approach for countries to establish or strengthen a mechanism for One Health coordination to manage zoonotic diseases, with references to principles and best practices described in the Tripartite Zoonoses Guide.

As zoonotic diseases can be transmitted between people and animals, including vectors, or via the environment, coordinated surveillance must address all pathways. The Operational Tool on Surveillance and Information Sharing (SIS OT) supports national authorities in their efforts to establish or strengthen a One Health multisectoral coordinated SIS system for zoonotic diseases. Such a system is essential for early detection of disease events. By sharing timely information, the risk of transmission from animals to humans can be decreased.

These operational tools complement the already existing Joint Risk Assessment Operational Tool.

The impact of emerging diseases goes far beyond the public and animal health sectors: nearly all sectors are adversely affected. Therefore, multiple sectors and disciplines must work together in response to these sanitary challenges. This applies to coordination mechanisms, surveillance as well as to other aspects of national health systems.

As the world starts to recover from the impacts of the COVID-19 pandemic, the operational tools will help improve collaborative response to zoonotic diseases, as well as to other health risks at the human-animal-environment interface in countries.

The Quadripartite organisations – the Food and Agriculture Organization of the United Nations (FAO), the United Nations Environment Programme (UNEP), the World Health Organization (WHO), and the World Organisation for Animal Health (WOAH, founded as OIE) are pleased to announce the theme of World Antimicrobial Awareness Week (WAAW) 2022: ‘Preventing antimicrobial resistance together’.  

Antimicrobial resistance (AMR) is a threat to humans, animals, plants and the environment. It affects us all. This is why this year’s theme calls for collaboration across sectors to preserve the efficacy of these critical medicines. Fighting AMR is a truly global endeavour and must be addressed through a One Health approach.  

To curb it effectively, all sectors must join forces and encourage the prudent use of antimicrobials, as well as preventive measures. Strengthening infection prevention and control in health care facilities, farms and food industry premises, ensuring access to vaccines, clean water, sanitation and hygiene, implementing best practices in food and agriculture production, and guaranteeing the sound management of waste and wastewater from key sectors are critical to reducing the need for antimicrobials and minimizing the emergence and transmission of AMR.  

The slogan of World Antimicrobial Awareness Week remains ‘Antimicrobials: Handle with Care‘. WAAW is celebrated from 18 to 24 November every year. 

Preventing antimicrobial resistance together 

Joint FAO/OIE/WHO/UNEP Press release

Strengthened partnership aims to accelerate coordinated strategy on human, animal and ecosystem health

Rome/Paris/Geneva/Nairobi – Work to tackle the challenges of human, animal and ecosystem health using a more integrated approach has seen significant progress in the past year, leaders of three international organizations cooperating across these sectors said, as they expanded their group to include a fourth body, the UN Environment Programme (UNEP).

At its annual executive meeting this week, the Tripartite partnership for One Health, bringing together the Food and Agriculture Organization of the United Nations (FAO), the World Health Organization (WHO) and the World Organisation for Animal Health (OIE), formally became the Quadripartite as it signed a Memorandum of Understanding with UNEP.

The One Health approach aims to sustainably balance and optimize the health of people, animals,  ecosystems and the wider environment. It mobilizes multiple sectors, disciplines and communities to work together to foster well-being and tackle threats to health and ecosystems. And it addresses the collective need for clean water, energy and air, safe and nutritious food, action on climate change, and contributing to sustainable development.

“We are stronger with UNEP joining the Tripartite, FAO Director-General QU Dongyu said, adding: “UNEP is already active in relevant areas of Tripartite work.” The Memorandum of Understanding notes that UNEP “sets the environmental agenda and promotes the coherent implementation of the environmental dimension of sustainable development within the UN system, and serves as an authoritative advocate for the global environment.”

The work of the newly expanded alliance will be focused on a One Health Joint Plan of Action, which includes six main action tracks: enhancing countries’ capacity to strengthen health systems under a One Health approach; reducing the risks from emerging or resurfacing zoonotic epidemics and pandemics; controlling and eliminating endemic zoonotic, neglected tropical or vector-borne diseases; strengthening the assessment, management and communication of food safety risks; curbing the silent pandemic of antimicrobial resistance (AMR) and better integrating the environment into the One Health approach.

Plan implementation: the key challenge 

As FAO handed over the rotating chair of the secretariat to WHO, Director-General Qu noted the past year’s substantial progress in efforts to collectively develop the action plan and added: “Now the challenge is implementation: how do we translate our work on the ground to support our Members? And how do we mobilize funding and financing mechanisms to support the Joint Plan for Action?”

In his opening remarks, WHO Director-General Tedros Adhanom Ghebreyesus, said: “We need to build a more comprehensive and coordinated One Health governance structure at global level. We need a strong workforce, committed political will, and sustained financial investment. We need to develop a more proactive way of communicating and engaging across sectors, disciplines and communities to elicit the change we need.” 

Monique Eloit, OIE Director General acknowledged the key milestone of the MoU with UNEP, saying: “Today, I am particularly pleased that our Tripartite collaboration is expanded to include UNEP as an equal partner. Its mandate, expertise and networks will provide an important contribution to advance One Health. This new chapter in our partnership will make us stronger and more prepared to serve our members and address global health challenges.”  

UNEP’s Executive Director Inger Andersen said: “What is apparent to everyone involved in One Health is that no one sector can solve the many problems we face alone. To secure human, animal and environment health – to secure the very future of this planet – we need more collaboration and partnerships. We need to stand together and work together if we are to thrive together. UNEP, as the newest full member of the Alliance, is ready to do its part as an equal partner.”

Increased awareness of One Health 

As the world enters the third year of the COVID-19 pandemic, with an estimated cost of $8 to 16 trillion, there is increased awareness and broad recognition of the importance of One Health as a long-term, viable and sustainable approach. And it is also now firmly anchored on the global agenda, from the G7 and G20 to the UN Food Systems Summit.  To support a global One Health Coalition, a One Health Commitment was registered at the UN Food Systems Summit, aimed at building engagement across sectors, disciplines, and all levels of society. This commitment will help shape national agrifood systems transformation pathways as part of the Summit follow-up.

Last year saw the Tripartite also implement a number of other initiatives on One Health and AMR. The One Health High-Level Expert Panel had an important scientific advisory role. One Health Regional Platforms were strengthened and new ones initiated to share information and best practices. Important progress was also made in establishing a Joint Framework on AMR, a Global Leaders’ Group on AMR, and in work towards an AMR Multi-stakeholder Partnership Platform, mobilizing resources and action to fight antimicrobial resistance that threatens the lives of millions. These achievements reflect the successful cooperation between the Tripartite and UNEP which has now reached an important new milestone with the signature of a formal collaboration agreement.

Photo credit: (c) FAO

Specialists:  

  • Sean Shadomy, DVM, MPH, DACVPM, Veterinary Epidemiologist, Food and Agriculture Organization of the United Nations (FAO)
  • Tianna Brand, Foresight Advisor, International Standards and Science Directorate, World Organisation for Animal Health (OIE)
  • Dr Mariana Marrana, DVM, Programme Manager, Preparedness and Resilience Department, World Organisation for Animal Health (OIE)
  • Dr Stephane de La Rocque, DMV, MSc PhS, Team lead for the Animal-Human Interface Health Security Preparedness Department, World Health Organization (WHO) Emergency Program
1. What factors can increase the emergence and spread of zoonoses?

Tianna Brand, OIE: The literature and scientific studies reveal numerous factors – environmental, pathogen, host or vector adaptation, to name a few. The central and recurring theme in emergence and spread are the interactions between humans and animals.

The opportunities for zoonotic pathogens to emerge are increasing. The growth of the human population and its consumption habits are the underlying factors – or root causes – for the emergence and spread of diseases. Ultimately a larger human population drives higher levels of intensive animal production, and furthermore drives the expansion of crop lands, human settlements and cities. All these factors contribute to the disruption of natural ecosystems and increased encroachment of humans into previously wild areas. Historically, the emergence of new human diseases from animal sources, such as the plague or Ebola, has been associated with major societal change.

Mariana Marrana, OIE: New pathogenic agents appear all the time at the human-animal-environment interface. While, most often, the newly emerged diseases often only result in local transmission before fading away, human activities provide the pathway for local disease events to become regional or global. Therefore, a disease outbreak that could be inconsequential from a global perspective can take pandemic proportions in a matter of weeks, as we saw at the start of the COVID-19 pandemic.

2. Why is preventing zoonotic diseases important for food security?

Sean Shadomy, FAO: It is critical to control and prevent zoonotic diseases, and to protect livestock in order to ensure food security and safeguard the livelihoods of families and communities. Food production and distribution systems are highly complex and multisectoral, and the full impact of zoonotic diseases on food production and food security, as well as the human health and societal costs and economic impact on producers, is difficult to determine.

The direct impact of some zoonotic diseases can include high rates of illness and death among food-producing animals, causing mass die-offs among livestock and poultry herds and flocks. They can also cause decreased production, such as by causing poultry to lay fewer eggs, or by causing stillbirths and abortions in meat producing or dairy animals, which mean both less meat and less milk production. In those countries where livestock are used as draught animals, the illness or death in these animals from zoonotic diseases can mean a loss of power and transport for agricultural production.

Some zoonotic diseases such as brucellosis can be spread in abattoirs and meat-packing facilities, causing debilitating illness and preventing their work, thereby impacting production. However, as witnessed with the COVID-19 pandemic, some zoonotic diseases are even more highly transmissible in these settings. The introduction of zoonotic pathogens into the food production and transport system, either through infected workers or on contaminated products, has led to widespread production and processing facility shutdowns, severely impacting market chains and distribution networks, leading to food shortages. The disruptive effects can be seen up and down the production chain, even causing some livestock producers to cull their animals as they cannot go to market. In addition, the economic impact and complete cessation of use of certain food commodities due to pandemic control measures has negatively affected or even forced closure of producers and processors throughout the production and distribution pathways.
The responses required to control certain zoonotic diseases can exacerbate the direct losses in animal production. Control measures including culling affected flocks and herds can cause the elimination of whole farms. In addition, national campaigns can cull hundreds of thousands of animals or more. When countries restrict or ban exports from other countries affected by zoonotic diseases of concern for animal trade, this can have tremendous negative economic impact on the producers in the affected countries, potentially driving them out of business. In turn, other exporting countries may move to fill the export trade gap, and this disruption in food trade to countries importing meat (often higher income countries) means that prices for meat will go up in the exporting countries; this in turn can put meat protein out of the reach of less affluent consumers, and impact the food security in those exporting countries.

3. What lessons have we learned from the COVID-19 outbreak and how will that change the approach to zoonotic disease preparedness?

Stephane de La Rocque, WHO: COVID-19 demonstrated the impacts that zoonotic diseases can have on all aspects of society. We all know that pathogens are shared between animals and humans, but this is often a neglected aspect of public health, especially in advanced countries where biosecurity, prevention and curative options keep us safe from many of these diseases. It appeared that some of the capacities we thought were robust in fact still needed to be further consolidated. This includes capacities for coordination between sectors, through a One Health approach.

The Tripartite has worked through expert consultations to develop tools and guidance for countries. But with COVID-19, we realized now more than ever, that countries needed to be able to access and implement key principles and best practices for the management of zoonotic diseases in the midst of active outbreak response. The Tripartite accelerated the deployment of its tools, and developed online trainings and methods for virtual facilitation to adapt and iteratively improve existing tools and approaches for diseases arising at the human-animal-interface.

4. How can capacity building needs be identified at the human-animal interface?

Stephane de La Rocque, WHO: The IHR-PVS National Bridging workshops (NBWs) create an opportunity for the human health and veterinary sectors to jointly discuss their respective capacities for health security and to agree on concrete activities to improve their multi-sectoral coordination, through a One Health approach.
The jointly developed operational roadmaps resulting from this exercise helps countries to prioritize their investments in building capacities, whether technical, institutional or workforce related. The NBWs provide a first step in One Health operational planning in countries and the implementation of these roadmaps is ensured through operational tools developed by WHO and its partners.

5. Why did FAO, OIE and WHO come together to write the Tripartite Zoonoses Guide (TZG)?

Mariana Marrana, OIE: For many decades the Tripartite Organisations have been collaborating on programmes to support their respective memberships in addressing zoonotic diseases, such as rabies or zoonotic influenzas, and health risks such as antimicrobial resistance. As part of this collaboration, the organizations advocate for an approach which is inclusive of a variety of disciplines in an effort to bridge knowledge and practices to respond or address zoonotic diseases and other health risks at the human-animal-environment interface. In the simplest of terms, we refer to this as the One Health approach.
The Tripartite Zoonoses Guide is a reflection of this approach and ways to make it operational at national level. It brings together principles for One Health, along with best practices in play in countries and information on how to set up efficient coordination mechanisms across sectors to address health threats, notably in regard to strategic planning and emergency preparedness or surveillance and information sharing to name a few.

6. What makes the Tripartite Zoonoses Guide unique?

Sean Shadomy, FAO: The TZG was developed under the leadership of FAO, OIE and WHO with the technical contributions of hundreds of experts representing UN and other international organizations, national ministries and agencies, and organizations representing civil society. This global team of experts developed detailed guidance to support countries in taking a multisectoral, One Health approach to address zoonotic diseases, and included recommendations for best practices for implementation as well as country examples.

The TZG was developed to be applicable to all countries and regions, and to address zoonotic disease threats, be they endemic or newly identified in a country or region. To go further, operational tools are now being developed and pilot tested to provide step-by-step guidance on implementing specific technical sections of the TZG – this detailed advice has been requested by countries. The Tripartite Zoonoses Guide and the operational tools are broadly applicable and not disease-specific. The entire toolkit is also flexible enough to support multisectoral collaborations to address other health threats at the human-animal-environment interface, such as food safety and antimicrobial resistance.

7. How can the Tripartite Zoonoses Guide and operational tools support country preparedness for their national context?

Stephane de La Rocque, WHO: The Tripartite Zoonoses Guide highlights over 80 country examples, ranging from the development of effective government One Health mechanisms or platforms, to zoonotic disease prioritization, joint risk assessment, planning and preparedness, investigation and response, coordinated surveillance and workforce development. Designed for decision makers and technical staff in countries, we recognized the need to create operational tools to support implementation of key principles. Three operational tools have been developed so far to support a step-by-step One Health approach in countries for joint risk assessment, multisectoral government mechanisms, and coordinated surveillance and information sharing. These tools are facilitative and adaptive to country context and allow for sustainable and iterative use as needed.

8. What will the Tripartite do to further promote the use of the Tripartite Zoonoses Guide?

Sean Shadomy, FAO: As part of a coordinated communication and dissemination strategy for the TZG, the Tripartite organizations have promoted its use through their respective communication channels, including websites, publications, social media, and throughout their respective networks. In addition, they have introduced the TZG and the operational tools through international conferences and virtual events such as the 2021 World One Health Congress.

The Tripartite provide training on the use of the TZG and the operational tools to the Tripartite regional and subregional offices as part of the pilot process for the operational tools. The goal is to increase the use of the TZG and to arrive at the point where countries and regions can use the TZG and the operational tools without Tripartite facilitation. Training on the TZG in six languages is freely available online.

9. How can we further improve our response to zoonotic diseases?

Tianna Brand, OIE: Pragmatically, working in isolation to address complex and constantly evolving parameters, really only provides one or a limited view of a much larger, dynamic and interconnected problem(s) – potentially worsening the issue.

Improving the operationalization of the One Health approach requires identifying the linkages between disciplines, organizations, data, resources and stakeholders, to bridge knowledge and actions and thereby prevent, mitigate or adapt to health risks.