Con el correr de los años, nuestras vidas y sociedades se han visto afectadas por enfermedades como el ébola, la influenza y la COVID-19. Se trata de enfermedades denominadas “zoonosis” que pueden propagarse entre animales y seres humanos, y que han puesto en peligro nuestros sistemas sanitarios mundiales, las cadenas de suministro de alimentos y nuestras economías.

Si bien las repercusiones de las zoonosis son variables, en muchos países se ha observado una carencia de mecanismos adecuados que faciliten una colaboración duradera y sostenible en torno al concepto “Una salud”. Con el propósito de ayudar a los países a cubrir esas carencias, la Organización de las Naciones Unidas para la Alimentación y la Agricultura (FAO), la Organización Mundial de la Salud (OMS) y la Organización Mundial de Sanidad Animal (OMSA) desarrollaron nuevas herramientas operacionales que permitan establecer mecanismos de coordinación multisectorial, así como sistemas de vigilancia e intercambio de información.

El liderazgo y las funciones técnicas que se necesitan para hacer frente a las zoonosis deben ser el resultado de una coordinación entre todos los sectores implicados. Por ejemplo, en Qatar, el brote de MERS-CoV sirvió para reforzar la coordinación multisectorial a escala nacional, ampliando así las áreas de trabajo para la gestión de otras enfermedades zoonóticas. La herramienta operacional sobre mecanismos de coordinación multisectorial (MCM OT, por sus siglas en inglés) brinda un enfoque estándar progresivo para que los países establezcan o fortalezcan su mecanismo de coordinación de “Una salud” destinado a gestionar las enfermedades zoonóticas, en base a los principios y las buenas prácticas descritas en la Guía Tripartita sobre las Zoonosis.

Puesto que las enfermedades zoonóticas tienen la capacidad de transmitirse entre seres humanos y animales, por medio de vectores, o incluso a través del medio ambiente, la vigilancia coordinada debe abordar todas las vías de transmisión. La herramienta operacional sobre la vigilancia y el intercambio de información (SIS OT, por sus siglas en inglés) acompaña a las autoridades nacionales en sus esfuerzos por establecer o fortalecer un sistema de vigilancia coordinado y multisectorial para las enfermedades zoonóticas. Se trata de un sistema esencial para la detección temprana de eventos sanitarios. El intercambio oportuno de información puede disminuir el riesgo de transmisión de enfermedades de los animales a los seres humanos.

Estas herramientas operacionales complementan a la ya existente herramienta para la evaluación conjunta de riesgos.

El impacto de las enfermedades emergentes supera los sectores de la salud pública y la sanidad animal: casi todos los ámbitos se ven gravemente afectados. Por tanto, todos deben trabajar mancomunados para responder a los actuales desafíos sanitarios. Esto se aplica igualmente a los mecanismos de coordinación, a la vigilancia y a diversos aspectos de los sistemas sanitarios nacionales.

En un momento en que el mundo se recupera del impacto causado por la pandemia de COVID-19, las herramientas operacionales contribuirán a mejorar la respuesta colaborativa de los países frente a las enfermedades zoonóticas, así como a otros riesgos sanitarios en la interfaz humano-animal-medio ambiente.

Comunicado de prensa conjunto de la FAO/OMSA/OMS/PNUMA

El fin de la asociación reforzada es acelerar la estrategia coordinada sobre la salud de los seres humanos, los animales y los ecosistemas

Roma/París/Ginebra/Nairobi – La labor, encaminada a abordar los problemas relacionados con la salud humana, animal y de los ecosistemas utilizando un enfoque más integrado, ha registrado un avance considerable en el último año, según dijeron los líderes de las tres organizaciones internacionales que cooperan en estos sectores, al ampliar el grupo para incluir un cuarto organismo: el Programa de las Naciones Unidas para el Medio Ambiente (PNUMA).

En su reunión ejecutiva anual de esta semana, la asociación tripartita en favor de Una Salud, que agrupa a la Organización de las Naciones Unidas para la Alimentación y la Agricultura (FAO), la Organización Mundial de Sanidad Animal y la Organización Mundial de la Salud (OMS), se convirtió oficialmente en cuadripartita al firmar un memorando de entendimiento con el PNUMA. 

El enfoque “Una sola salud” tiene por fin equilibrar y optimizar de manera sostenible la salud de las personas, los animales, los ecosistemas y el medio ambiente en general. Moviliza múltiples sectores, disciplinas y comunidades para que colaboren a fin de fomentar el bienestar y hacer frente a las amenazas contra la salud y los ecosistemas. Y aborda la necesidad colectiva de disponer de agua, energía y aire limpios y alimentos inocuos y nutritivos, adoptar medidas con respecto al cambio climático y contribuir al desarrollo sostenible. 

“Con la incorporación del PNUMA a la asociación tripartita nos hacemos más fuertes”, dijo el Sr. QU Dongyu, Director General de la FAO, añadiendo que “el PNUMA actúa ya en varias esferas de interés para la labor de la asociación”. En el memorando de entendimiento se señala que el PNUMA establece el programa ambiental a nivel mundial, promueve la aplicación coherente de la dimensión ambiental del desarrollo sostenible dentro del sistema de las Naciones Unidas y actúa como firme defensor del medio ambiente en todo el mundo. 

La labor de la alianza recientemente ampliada se centrará en el Plan de acción conjunto sobre Una Salud, el cual comprende seis líneas de acción principales: aumentar la capacidad de los países para reforzar los sistemas sanitarios con arreglo al enfoque “Una salud”; reducir los riesgos de aparición o reaparición de epidemias y pandemias zoonóticas; controlar y erradicar las enfermedades zoonóticas endémicas, enfermedades tropicales desatendidas y enfermedades transmitidas por vectores; reforzar la evaluación, la gestión y la comunicación de los riesgos en materia de inocuidad de los alimentos; frenar la pandemia silenciosa de la resistencia a los antimicrobianos; integrar mejor el medio ambiente en el enfoque “Una salud”.

La puesta en práctica del Plan de acción como desafío principal 

Cuando la FAO cedió la Presidencia rotatoria de la Secretaría a la OMS, el Director General de la Organización, Sr. QU, afirmó que en el último año se habían logrado grandes avances en la elaboración colectiva del Plan de acción, a lo que añadió: “Ahora el desafío reside en la puesta en práctica: ¿cómo traducimos nuestra labor a medidas sobre el terreno para ayudar a nuestros Miembros? ¿Y cómo movilizamos fondos y mecanismos de financiación en apoyo al Plan de acción conjunto?”

En su discurso de apertura, el Director General de la OMS, Sr. Tedros Adhanom Ghebreyesus, dijo: “Debemos construir una estructura de gobernanza de ‘Una Salud’ más integral y coordinada a nivel mundial. Necesitamos una fuerza de trabajo fuerte, una firme voluntad política y una continua inversión financiera. Tenemos que desarrollar una forma más proactiva de comunicarnos y colaborar entre sectores, disciplinas y comunidades para inducir el cambio requerido.”

La Directora General de la OMSA, Sra. Monique Eloit, reconoció el hito fundamental que representa el memorando de entendimiento con el PNUMA con estas palabras: “Hoy, me complace especialmente que nuestra colaboración tripartita se amplíe para incluir al PNUMA como asociado en pie de igualdad. El mandato, los conocimientos especializados y las redes que posee harán una contribución importante a fomentar Una Salud. Este nuevo capítulo en nuestra asociación nos hará más fuertes y nos permitirá estar mejor preparados para prestar asistencia a nuestros Miembros y abordar los problemas sanitarios mundiales.” 

La Directora Ejecutiva del PNUMA, Sra. Inger Andersen, dijo, por su parte: “Lo que es evidente para todos los que participamos en Una Salud es que ningún sector puede resolver por sí solo los numerosos problemas a los que nos enfrentamos”. Para proteger la salud humana, animal y ambiental —y garantizar el futuro mismo de este planeta— necesitamos más colaboración y asociaciones. Debemos permanecer unidos y trabajar en colaboración si queremos prosperar juntos. El PNUMA, como nuevo miembro de pleno derecho de la asociación tripartita, está dispuesto a cumplir su parte como asociado en pie de igualdad”. 

Mayor conciencia sobre Una sola Salud 

En estos momentos en que el mundo entra en el tercer año de la pandemia de COVID-19, con un costo estimado de 8 a 16 trillones de dólares, hay una mayor conciencia y un amplio reconocimiento de la importancia de “Una salud”, como enfoque a largo plazo, viable y sostenible. Y el enfoque está ya muy arraigado en el programa mundial, desde el Grupo de los Siete (G7) y el Grupo de los Veinte (G20) hasta la Cumbre de las Naciones Unidas sobre los Sistemas Alimentarios. Para apoyar una coalición mundial en favor de Una Salud, en la Cumbre se suscribió un compromiso al respecto, destinado a fomentar la colaboración entre distintos sectores y disciplinas, y en todos los estratos de la sociedad. Dicho compromiso ayudará a configurar las vías de transformación de los sistemas agroalimentarios nacionales en el marco del seguimiento de la Cumbre. 

El año pasado, la asociación tripartita puso en marcha una serie de iniciativas en relación con Una Salud, entre ellas, iniciativas relacionadas con la resistencia a los antimicrobianos. El Grupo de expertos de alto nivel sobre Una Salud desempeñó una importante función de asesoramiento científico. Se reforzaron las plataformas regionales sobre Una Salud y se crearon otras nuevas para compartir información y mejores prácticas. También se lograron importantes progresos en el establecimiento del Marco conjunto y el Grupo de liderazgo mundial sobre la resistencia a los antimicrobianos, así como en la labor encaminada a crear una plataforma de asociación entre múltiples partes interesadas en la materia y a movilizar recursos y medidas para combatir la resistencia a los antimicrobianos que representa una amenaza contra la vida de millones de personas. Estos logros reflejan el éxito de la cooperación entre la asociación tripartita y el PNUMA, que ahora ha alcanzado un gran hito con la firma de un acuerdo de colaboración oficial.

Foto: (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.

Geneva/Paris/Rome, 20 May 2021 – International organisations have come together to launch a new One Health High-Level Expert Panel to improve understanding of how diseases with the potential to trigger pandemics, emerge and spread.

The panel will advise four international organisations – the Food and Agriculture Organization of the United Nations (FAO); the World Organisation for Animal Health (OIE); the United Nations Environment Programme (UNEP); and the World Health Organization (WHO) – on the development of a long-term global plan of action to avert outbreaks of diseases like H5N1 avian influenza; MERS; Ebola; Zika, and, possibly, COVID-19. Three quarters of all emerging infectious diseases originate in animals.

It will operate under the One Health Approach, which recognizes the links between the health of people, animals, and the environment and highlights the need for specialists in multiple sectors to address any health threats and prevent disruption to agri-food systems.

Key first steps will include systematic analyses of scientific knowledge about the factors that lead to transmission of a disease from animal to human and vice versa; development of risk assessment and surveillance frameworks; identification of capacity gaps as well as agreement on good practices to prevent and prepare for zoonotic outbreaks.

The panel will consider the impact of human activity on the environment and wildlife habitats. Critical areas will include food production and distribution; urbanization and infrastructure development; international travel and trade; activities that lead to biodiversity loss and climate change; and those that put increased pressure on the natural resource base – all of which can lead to the emergence of zoonotic diseases.

The panel will guide development of a dynamic new research agenda and draw up evidence-based recommendations for global, regional, national and local action.

Dr Tedros Adhanom Ghebreyesus, WHO Director-General said: “Human health does not exist in a vacuum, and nor can our efforts to protect and promote it. The close links between human, animal and environmental health demand close collaboration, communication and coordination between the relevant sectors. The High-Level Expert Panel is a much-needed initiative to transform One Health from a concept to concrete policies that safeguard the health of the world’s people.”

Dr QU Dongyu, FAO Director General, told the panel: “This panel will contribute to advancing the One Health agenda, by helping to better understand the root causes of disease emergence and spread, and informing decision-makers to prevent long-term public health risks. I encourage it to be a shining example of silo-breaking, systems thinking and open dialogue. Expectations for collective action and the need for effective collaboration have never been higher.”

Dr Monique Éloit, Director General of the World Organisation for Animal Health noted: “The COVID-19 pandemic is a stark reminder that collaboration across sectors is absolutely critical for global health. The newly established One Health High-Level Expert Panel will contribute to bringing together diverse scientific expertise. United, we will better anticipate global health threats and work to control risks at the animal source. Our Organisation is proud to provide high-level expertise, along with our partners, to develop science-based ‘One Health’ strategies and programmes.“

Inger Andersen, Executive Director of UNEP observed: “To end the triple planetary crisis of climate change, biodiversity loss and pollution that threaten our peace and prosperity, we have to understand that human, animal and planetary health go hand in hand. We must do more to promote transformative actions that target the root causes of nature’s destruction. The One Health High-Level Expert Panel is an important step in recognizing the complex, multidisciplinary issues at the interface of human, animal, and environmental health.“

The Ministers for Foreign Affairs of France and Germany also joined the public launch of the One Health High-Level Expert Panel:

Mr Jean-Yves Le Drian, Minister for Europe and Foreign Affairs, France commented: “The COVID-19 pandemic, whose zoonotic origin is strongly suspected, underlines how closely human, animal and environmental health are linked. It demonstrates the importance of the ‘One Health’ approach. It is in this context that France, together with Germany, proposed the creation of such a Panel at the meeting of the Alliance for Multilateralism organized on the occasion of the Paris Peace Forum on 12 November 2020.”

Mr Heiko Maas, Minister for Foreign Affairs, Germany, said: “COVID-19 has painfully reminded us that the health of humans, animals and the environment around the world is closely connected: Nobody is safe until everybody is safe. This is what we have to bear in mind to prevent future pandemics. The establishment of the One Health High-Level Expert Panel thus marks an important step in the right direction. Germany and France will continue to support the panel’s work.”

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