Operationalizing One Health: The Bangladesh Experience

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Operationalizing One Health The Bangladesh
Experience
Nitish C Debnath, DVM, MS, PhD
FAO-AI Technical Unit/ECTAD-Bangladesh
The beginning of a One Health journey

• One Health Alliance of South Asia (OHASA)
• Bengal Declaration (2009)
• Highlights
• Signing a Memorandum of Understanding between
  relevant agencies/ministries that will create a
  communication network to report emerging zoonotic
  disease surveillance results and coordinate
  response activities
• Establishing an Interagency Task Force (ITF) that
  meets between the governments that will be
  responsible for the development of standardized
  reporting guidelines and protocols both within
  and between government agencies.
• Creating a network of diagnostic laboratories in
  India and Bangladesh that will test wildlife
  samples for zoonotic pathogens.
• Promoting the investigation of all wildlife
  disease outbreaks and establishing a real-time,
  web-based disease reporting mechanism.
• Allocating government funds, and funds from other
  national and international non-governmental
  agencies to support this research in emergent
  zoonotic disease surveillance.
• Establishing One Health programs at relevant
  institutions to enhance public health
  effectiveness, increase understanding of the
  impact of anthropogenic changes on the emergence
  of new pathogens of animal and human origin, and
  accelerating biomedical research discoveries
• Enhancing public health education through public
  outreach campaigns and professional workshops and
  seminars that use the One Health paradigm to
  bridge disciplines and increase general awareness
  of the links among human, animal, and ecosystem
  health.

• One Health Bangladesh initiative
• Chittagong Declaration (2008)
• Highlights
• All professions related to the health, livestock,
  social and environment sciences should understand
  the importance of the One health approach and
  work together.
• All health professionals, Government and local
  people be made aware about the holistic approach
  and regulatory matters.
• Organizing training and developing communication
  pathway between and among the professionals is
  essential
• That develops strong bridge with the One health
  global initiatives.
• That initiatives should be taken for developing
  training, education and research programmes on
  the One Health concept.
• Development of suitable health services to the
  most neglected population in the remote rural
  areas of the country.
• Enhancement of interdisciplinary communications
  on cross-cutting issues.
• Reduction of institutional and mental barriers
  for undertaking need-based multi-disciplinary
  research, training and extension programmes.
• Seminar, symposia and open discussions should be
  staged on regular basis to take the One world,
  one health movement further forward

• Informal discussion began at Chittagong
  Veterinary Animal Sciences University (CVASU) in
  2007 at the emergence of HPAI
• Looking for relevant partners to move forward
• IEDCR and ICDDR,B showed keen interest as human
  health partners
• Positive responses from professionals working in
  Livestock, Agriculture and Forestry sector
• Civil society-BAPA, NGO-BRAC, Academia-BAU, DU
  BSMRMU and Research-BLRI, IFRB etc. got involved

Formation of a brand new team

• Representatives from 12 national and
  international organizations got together to form
  a professional organization called One Health
  Bangladesh in December 2007
• Formed a National Coordination Committee to work
  for promoting One Health concept in Bangladesh
• Membership criteria Physicians, vets,
  agriculturists, environmentalists, wildlife
  experts, ecologists, anthropologists, economists,
  allied scientists and practitioners, activists
• Currently 200 active members

The achievements and affiliations to date

• 5 year, USAID-funded project
• Builds upon USAID/USG investments in avian and
  pandemic influenza preparedness and response
• Expands efforts to address emerging zoonotic
  infections more generally, especially those of
  wildlife origin
• Vets, physicians and wildlife experts are
  undertaking collaborative research on EIDs
• Formulation of two One Health oriented
  declarations namely Chittagong declaration and
  Bengal declaration to stimulate greater
  multisectoral participation
• Actively involved with OHASA (One Health alliance
  for South Asia)
• Initiate SAVE (South Asian Veterinary Education
  Network) to Develop thinking and practices in
  South Asia in relation to One Health and to embed
  One Health in Veterinary Curriculum through SAVE
• FAO supported development of BLRN (Bangladesh
  Laboratory Response Network) with a vision of
  progressively attaining an effective community of
  practices focus on fostering nations lab.
  capacity to promote One Health strategy for
  facing the challenges of emerging human and
  animal health emergencies food safety

The key strategic approaches

• Communication, Advocacy , Networking leadership
• Need Assessment Capacity Development
• Research Collaboration
• Education Training
• Collaborative Practices

Activities of One health-Bangladesh

• Six international conferences and seminars have
  already been organised by this forum on some
  recent multidimensional burning issues
• Conference on Changing world and emerging
  challenges A One World One Health Approach
  2008 at CVASU, Chittagong, Bangladesh
• Dhaka Conference on Avian Influenza and other
  emerging zoonotic diseases in Bangladesh A One
  World One Health Approach 2008 at ICDDR,B
• Conference on Food security and food safety
  Towards a A One World One Health Approach 2009
  at CVASU, Chittagong, Bangladesh
• Seminar on Swine Flu in 2009 at IEDCR, Dhaka,
  Bangladesh
• Seminar on Pesticide Poisoning in 2009 at
  ICDDR,B, Dhaka, Bangladesh

One Health practices in Bangladesh Successful
joint outbreak Investigation in recent years
include-

• Pesticide poisoning (2008)
• Avian influenza (2008)
• Nipah virus (2009)
• Anthrax (2009)

Joint outbreak investigation The Anthrax story

• Multidisciplinary team visiting outbreak sites
• Joint Reporting Consultation
• Share laboratory findings
• Joint response to national EID outbreaks
• A new professional culture emerging

Challenges of One health in Bangladesh
Many deaths of animal and human are reported due
to pesticide poisoning each year, as a result of
unsafe use of often banned products in Bangladesh.

• Highest population density in the world
• Hot spots for EIDs and Re-emerging diseases
• Vulnerable food security and safety
• Most fragile ecosystems
• 50 of the tube wells exceed WHO standard for
  arsenic
• People are exceptionally close to animal

Sequence of events in a 2009 outbreak of anthrax
in Bangladesh where joint outbreak investigation
were in place. Figure courtesy of IEDCR and
ICDDR,B, Dhaka, Bangladesh
The distribution of Nipah virus in Bangladesh as
found by ICDDR,B researchers which comprised a
joint team of vets, physicians, anthropologists
and conservationists.
The live bird market in Bangladesh where active
surveillance are in place to identify the risk of
human infection for avian influenza
Anthrax has emerged as zoonotic disease in
Bangladesh where non-inspected or illegal
slaughter of sick animal is frequent in rural as
well as urban areas
Hundreds of cows have been infected and scores
have died during recent outbreak of anthrax in
Bangladesh where meat quality and safety issues
are mostly ignored
Recent ICDDR,B studies have shown that fruit bats
(Pteropus giganteus) often contaminate the
date-palm juice which is so popular in rural
Bangladesh during the winter months.
Around 1.25 million birds have been culled in
Banglaesh since 2007 when avian flu was first
reported
The poster is presented in the 1st International
Congress on Pathogens at the Human-Animal
Interface(ICOPHAI), September 15-17, 2011 UN
Conference Centre, Addis Ababa, Ethiopia.