GUIDANCE FOR INCLUSION OF EMERGING …...infectious diseases while minimizing exposure to food-,...

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GUIDANCE FOR INCLUSION OF EMERGING INFECTIOUS DISEASES IN HEALTH AND ENVIRONMENTAL IMPACT ASSESSMENTS

i PlanningTool|July2017

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TableofContents

SectionExecutiveSummary

IndustrialDevelopmentProjectsandEmergingInfectiousDiseases

EmergingInfectiousDiseasesandImpactAssessments

Screening

Checklist

AdditionalBaselineDatatobeCollected

AssessingPotentialVulnerabilitiestoEmergingInfectiousDiseases

ActionPlan

MonitoringandEvaluation

FiguresFigure1:HotspotRiskMapofWildlifeEIDsFigure2:PlanningToolApplicationsinProjectCycleFigure3:CascadingEffectsofOn-ShoreOilDevelopmentFigure4:TransmissionRoutes Figure5:PreventativeMeasures

AppendicesA:ZoonoticandVector-BorneVirusesofConcernB:ExamplePreventativeMitigationMeasures

SelectedReferences 25

1 PlanningTool|July2017

ExecutiveSummaryRecentoutbreaksofemerginginfectiousdiseases(EIDs)—includingthe2014-2016EbolaviruscrisisinWestAfrica—havehadmajoreconomicimpactsonindustriesoperatingintheaffectedareasintheformoftrade,travel,andsupplychaindisruptions.Insomecases,theyhavecompletelyshutdownoperations.EIDshavecosttheglobaleconomybillionsofdollarsoverrecentdecades,andtherateofdiseaseemergenceappearstobeincreasing,withthemajorityofrecentEIDsoriginatingfromanimals(“zoonoses”),primarilywildlife.Thehighestriskisin“hotspots”thathaverichbiodiversity,poorpublichealthinfrastructure,andecologicaldisruptionstolandscapes.WhileEIDsseemtoappearwithoutwarning,andpublichealthmeasurestoaddressEIDshaveprimarilybeenreactive,itispossibletoanticipaterisksandtakepreventativestepsagainstvulnerabilitiesandpotentialimpactstobusinessoperations.

ThisPlanningToolanditsassociatedAuditGuidelinesareintendedasresourcestoaidindustriesandfundersinidentifyingpotentialprojectvulnerabilitiestoEIDsandproactivelytakingstepstobemoreresilienttotheriskofmanydifferenttypesofcommunicablediseaseevents.Thesedocumentsareintendedtosupplement(notreplace)existingguidelines(e.g.IFC,WorldBank,andinternal),asexposuretozoonoticpathogensrequiresamoreholisticanalysisthannormallytakeninenvironmentandsocialimpactassessmentsorhealthimpactassessments.Importantly,manyofthemeasuresthatcanbeusedtopreventemergenceandspreadofzoonoticdiseasesmayalsoreducetheburdenofvector-borne,water-borne,andfood-borneillness,andotherendemicdiseases(e.g.TB,Malaria,Dengue,HIV&otherSTIs,etc.),inadditiontopromotingenvironmentalsafeguards.

ThePlanningToolprovidesbackgroundinformationonEIDs,includingriskfactorsfortheiremergenceandtheirtransmissionroutes.AscreeningchecklistisprovidedtodeterminewhetherEIDriskshouldbeconsideredinanimpactassessment(health,environment,orsocial).Thetoolhighlightsadditionalbaselineinformationnotroutinelycollectedduringenvironmental,social,andhealthimpactassessments.Inaddition,itdetailshowsuchinformationcanenhancetheexistingplanningprocess,andprovidesexamplesandtemplatesforknownzoonoticdiseaseriskforspecificlocations(mostbasedonpublicallyavailableinformation).Mosttangibly,specifictransmissionmitigationopportunitiesarehighlightedwiththeirindicators,surveillancemethods,andsectoralresponsibilitiesnoted.

Whileindividualpathogensandtransmissionfactorsmaybecomplex,thePlanningToolandAuditChecklistfocusonexposureandtransmissionpathways,andbroadmeasuresthatcanhelpidentifyandreducetransmissionrisk.Manyoftheassessmenttopicswillbefamiliartoplanningmanagers,butthetoolsprovideadditionalconsiderationsthatcanhelpassessEIDvulnerabilities.

Whiletheguidelinesemphasizeminimizingcontactoravoidingopportunitieswithanimalsandvectors(mosquitos,ticks,etc.),itisimportanttonotethatanimalextermination/cullingmeasuresaroundafacilityarerarelyappropriateastheassociatedlossofbiodiversitymayhavenegativehealthoutcomes(selectexceptionsmaybewarranted,e.g.exterminationofcommensalratsinlivingareas,butemphasisshouldbeplacedonrodent-proofingstructuresandfoodsourcesthatmayattractpests).Thus,thePlanningandAuditToolspromotemeasuresbasedonthebestavailablescience,andaredesignedtobalancehealthandenvironmentalconsiderations,encouraginginvolvementofwildlifeauthorities/environmentalmanagersinadditiontohealthexpertsondecision-makingforpestcontrol.

ThePlanningToolandAuditGuidelinesprovidescience-basedguidance(withkeytechnicalsourcesprovided)compiledbyateamofinfectiousdisease,biodiversityandinternationaldevelopmentexpertsundertheUSAIDEmergingPandemicThreatsprogram.Pleasenotethatthisisalivingdocumentandissubjecttorevisionasnewinformationbecomesavailable.

IndustrialDevelopmentProjectsandEmergingInfectiousDiseasesThe2014-2016EbolaoutbreakinWestAfricabroughttolightthedevastatingeffectsofemerginginfectiousdiseasesonthelocalpopulationaswellastheseveredisruptiontoeconomiesandinmanycases,large-scaleindustrialactivities.AlthoughEbolahadneverbeendocumentedinthatpartofWestAfrica,theconditionswerepresentandnotfullyappreciatednotonlyforthepresenceofEbola,butalsoforitswidespreadtransmission.Ebolaisnottheonlyemerginginfectiousdiseasedisruptingworkflows.OutbreaksofMarburghemorrhagicfever,causedbyavirusrelatedtoEbolaandharboredbyselectbatspecies,resultedintheshutdownofgoldandleadminingsitesaswellascavespopularwithecotourists.Themajorityofhumaninfectiouspathogenshaveoriginatedfromanimaltransmissiontohumans(“zoonoticdiseases”),andofthese,themajorityofemergingandre-emerginginfectiousdiseasesoriginateinwildlife.Threewildanimalgroups,whichcompriseapproximately70percentofmammalspecies,areconsideredmostlikelytospreadnewinfectionstopeople:bats(CoronavirusresponsibleforSARSandMarburg,Nipah,andRabiesviruses),rodents(Lassa,hanta,andmonkeypoxviruses)andnon-humanprimates(transmissionofEbolaandoriginsofHIV).Peoplecontractthesediseasesbyinhalationofaerosolizedcontaminatedfecesandurine;throughdirectcontactviascratches,bites,andbodilyfluids—suchasbloodandsaliva—thatcanoccurduringhunting,butchering,andfoodpreparation;andbyingestingcontaminatedfood,water,orundercookedmeat.

Figure 1: Hotspot Risk Map of Wildlife Emerging Infectious Diseases

AstudyconductedbyJoneset.al.(2008)analyzedthedriversfordiseaseemergenceandidentifiedwhereemerginginfectiousdiseasesarelikelytooriginate.Theseplacesareinformallyknownasdisease“hotspots”(seeFigure1).Theemergenceofinfectiousdiseasesofzoonoticoriginwasassociatedwithhighwildlifebiodiversityandhumanpopulationdensity.Whilethe“hotspot”map

identifieslocationsinbothdevelopedanddevelopingcountries,theweakerhealthcare,water,food,andwastemanagementinfrastructuresofdevelopingcountriesmaynotbeabletoidentifyoraddressexistinghealthneedsoronesthatcouldbeassociatedwithemergingorre-emergingdiseasesofzoonoticorigin.Industrialdevelopmentinthesetypesofareascancauseapopulationinfluxofjobseekersandtheirfamiliesthatfurtherstressesthealreadytaxedinfrastructures.Stressedsystemsaremorelikelytobreakdown,creatingidealconditionsforincreasedcommunicableorinfectiousdiseasetransmission.

Populationgrowthincombinationwithindustrialdevelopmentcanleadtochangesinthedistributionandabundanceofwildlifeanditsassociatedpathogens.Especiallyinremoteareas,peoplemayinteractwithwildlifewithwhichhumancontactwaspreviouslylimitedornon-existent,exposingthemtonovelpathogensforwhichtheyhavenopriorimmunity.Increasingcontactamongpeople,domesticanimals(e.g.livestock),andwildlifepopulationsincreasesthelikelihoodofdiseasetransmissionamong/betweenspecies.Forexample,wildlifemaybecomeanuisancebytakingadvantageofnewfoodsourcesandhabitatscreatedatconstructioncamps,canteens,andvillages.Wildlifemayraidcropsinfieldsthatbordertheirhabitat,invadelaborcampsandhomes,becomeviolent,oreatinfectedanimals.Huntingpressureforbushmeatmayincrease.

Althoughwecannotpredictexactlywhenemerginginfectiousdiseaseoutbreaksaregoingtooccur,therearepublichealthprevention,environmental,andsocialstrategiesthatindustrycanemploytominimizerisksassociatedwithbothknownandemerginginfectiousdiseases.Thistoolisdesignedforindustriestoproactivelyexaminetheirproposedprojectsin“hotspot”areasinordertoidentifyvulnerabilitiestozoonoticpathogensandtodevelopstrategiestominimizerisksofemerginginfectiousdiseaseswhileminimizingexposuretofood-,water-,andcertainvector-borneinfectiousdiseases.

EmergingInfectiousDiseasesandImpactAssessments

Addressingemerginginfectiousdiseasesisanenvironmental,health,andsocialissue,requiringacollaborativeapproachthatbridgesthesefields.Thisdocumentprovidesthestepstoincorporateemerginginfectiousdiseasesofzoonoticoriginintoahealth,social,orenvironmentalimpactassessment,andintoacompany’sinternalhazardorriskassessmentprocess.Examiningtheissuesthatcanleadtozoonoticpathogenexposurerequiresamoreholisticanalysisthannormallytakenbecausethoseissuesareassociatedwitharangeofindustrialactivitiesincludingbiodiversity/conservationmanagement,facilitiesmanagement(camp,canteen,water,andwaste),workerhealth,andcommunityhealth/corporatesocialresponsibility.Otheranalyseswouldnotnormallybeconductedineitheranenvironmental,health,orsocialimpactassessment,sothisdocumentprovidesguidanceonthetopicstoconsider,howanalysescouldbeconducted,andwhatmitigationmeasurescouldbeadopted.

Whilethisdocumentisnotintendedtoprovidedefinitiveguidanceonhowtoincorporatezoonoticdiseasesintoimpactassessments,itdoesaimtoprovidesufficientinformationandguidanceforapractitionertoknowwhatinformationneedstobegatheredandanalyzedtodeterminethepossibilityofexposureandguideriskmitigation.Thisdocumentispartofasetofguidancedocumentsandothertoolsthatcanbeusedbyindustrytoassessandaddresstheirvulnerabilitiestozoonoticdiseases.Figure2illustrateswherethisplanningtoolfallsintheindustrialprojectcycleandtheenvironmental,social,andhealthimpactassessmentcycle.

Figure2:PlanningToolApplicationsinProjectCycle

Thisdocumentassumesthatapractitionerhasabasicknowledgeofimpactassessmentprocesses.

AddingthistypeofanalysissupplementsthedepthofanimpactassessmentandaddressesportionsofthefollowingIFCPerformanceStandards:

• PerformanceStandard1:AssessmentandManagementofEnvironmentalandSocialRisksandImpacts

• PerformanceStandard2:LaborandWorkingConditions

• PerformanceStandard4:CommunityHealth,Safety,andSecurity

• PerformanceStandard6:BiodiversityConservationandSustainableManagementofLivingNaturalResources

Screening

Todeterminewhetheremerginginfectiousdiseasesofzoonoticoriginshouldbeconsideredinanimpactassessment,abasicunderstandingofthezoonoticdiseaseexposurepotentialisessential.Thefollowingscreeningchecklistseekstoidentifywhetheraproposed/existingprojectisinanareawithapotentialforzoonoticdiseaseexposureandtoidentifyiftherewillbe/areactivitiesthatmightexacerbatetheriskoftransmission.

Table1

ScreeningQuestions Yes/No Notes1. Willtheprojectbelocatedinanarea

wheretherearewildlifespeciesthatcouldhostzoonoticdiseases?(SeeAppendixA.)Isthesiteecologicallysimilartoareaswherezoonoticdiseaseshaveemerged?

Hotspotswithahigherriskofemerginginfectiousdiseasesarelocatedthroughouttheworld,butespeciallyinthoseplaceswithincreasedland-usechange,humanpopulationgrowth,andhighbiodiversity.(SeeFigure1.)

2. Willtheprojectbelocatedinapreviouslyundevelopedareaornaturalarea?Willexistinglandusecoverchangesignificantlysothatwildlifehabitatwillbelostorsignificantlymodifiedinorneartheprojectsite?

Thelikelihoodofcontactwithwildlife,theirfluids,orexcretaincreasesinareasbeingconvertedfromnaturalhabitatstodevelopedareas.

3. Willtheprojectrequireconstructingnewroadsorrailortransmissionline/pipelinecorridorsthroughrelativelyintactforestorotherwisenaturalhabitats?

Roadsandcorridorsincreasetheinteractionofhumanandwildlifebyopeningupnewareasforhunting,logging,andagriculturalcolonization.Habitatsareoftenmodified,andcertainspeciesarefavoredattheroadinterface.Roadsareusedtotransportbushmeat,livestock,andanimalsdestinedforthewildlifetrade.

4. Willanonsitetemporaryorpermanentcampbeestablished?

Camps,canteens,andfood/waste/watermanagementfacilitiescanattractpests/wildlife,increasingpotentialcontactbetweenpeopleandwildlifeandtheirexcreta,andincreasingtransmissionrisk.

ScreeningQuestions Yes/No Notes5. Willtherebeafly-in/fly-outpopulation?

Willworkerstravelinandoutoftheprojectarea,withthepotentialtocarryinfectiousdiseasesacquiredintheprojectlocationtotheirhomelocationsandintroducediseasesfromoutsideintotheprojectarea?Withinthecountry?Internationally?

Exposedpeoplecouldleavethefacilitywithoutknowingthattheyaresickandexposeothersalongtransportationroutes.

6. Willtheinfrastructureinsurroundingcommunitiesbeinsufficienttoaccommodateanyanticipatedpopulationexpansion?Isthisalreadyaproblem?

Insufficientpotablewater,sanitation,healthcare,andvectorcontrolcanamplifyanyinfectiousdiseasethatoccurslocally.

7. Dothelocalcommunitieshaveinadequatehealthcarefacilitiestoaddresslocalhealthcarerequirements?Areexistingmedicaltreatmentanddiagnosticservicesinsufficienttomanageanoutbreakofinfectiousdiseasesknowntobeintheprojectlocation?

Inadequateorinsufficientlocalhealthcarefacilitiescanmeanthatdiseasesinthelocalcommunitiescanbebroughttothefacility.

8. Willaninternationalmedicalevacuationplanberequiredoravailabletotransportandtreatworkerswithpotentiallycontagiousinfectiousdiseases?

Internationalmovementmayfacilitateinternationalspread.

9. Willarelativelylargelaborinfluxoccurcomparedtotheexistingpopulation?

Newimmigrantstoanareamaynothaveimmunitytoendemicdiseasesormaybringnewdiseasestoanarea.Project-inducedlaborandotherin-migrationcanstrainlocalhealthandotherinfrastructuresystems.Poorlyfunctioningwaterandwastemanagementaswellashealthcaresystemscanresultintheamplificationofinfectiousdiseasetransmission.

10. Willtheemployeeshavetosourcetheirownfood(i.e.,thecompanywillnotprovideafoodsource)?

Theincreaseonfooddemandfromthenewfacilityonthelocalareacouldexacerbatepressureonexistingfoodsources,availabilityandpricing,andnaturalresources,thereforeincreasinghuntingpressureandtheuseofnon-foresttimberproducts,includingexpandingagricultureintonewareasthatmayhavebeenpreviouslyundisturbed.Ifareliableproteinsourceisnotprovided,employeesmayhavetorelyonfoodfromhunting.

11. Willlivestockbeon-siteornearthesite?Willstaffbeallowedtohavepetson-site?

Pathogenscanbetransmittedbetweenwildlifeanddomesticanimals.Peoplecanthenacquirepathogensfromdomesticanimals.Likewise,livestockintroducedtonewareasmaybringdiseasesforwildlifeandpeople.

12. Willtherebeon-siteagriculturalproduction?Willadditionalin-migrationleadtoagricultureexpansioninadjacentareas?

Grainandfruitproductionattractswildlifeandpests.Foodproductscanbecontaminatedfromanimalbyproductsand/ordirectcontactwithwildlife.

Whilenoindividualitem(s)fromthechecklistnecessarilyimpliesthataprojectwouldbevulnerabletozoonoticdiseases,acombinationoffactorscouldincreasethepotentialforexposuretozoonoticorothercommunicablediseases.Therefore,iftheanswertoquestion1andanyotherquestion(s)is“yes,”itisworthwhiletofurtherexaminethepotentialofemerginginfectiousdiseasesforyourprojectarea.

Pleasekeepinmindwhengoingthroughthescreeningchecklistthatemergenceeventsarerare,butwhentheyoccurtherecanbedevastatingconsequences.Theriskofpotentialexposureneedstobebalancedwiththeotherrisksinherentintheproposedproject.However,manyofthestepshighlightedcanalsoreducetheriskofendemic,food-,water-,andvector-bornediseases,aswellasmanageenvironmentalandsocialrisks.

Sincethisassessmentisintendedtobeincorporatedintoanexistingorongoingassessment,itispresumedthatthegeographicandtemporalboundariesofanyanalysishavealreadybeenestablishedashavethepotentiallyvulnerablepopulations.Unlikemanystandardenvironmental,social,orhealthimpactassessments,bothworkerandlocalpopulationsmustbeconsidered.Workerpopulationsareconsideredincompanyriskorhazardassessments,butinthisassessmenttheyareconsideredonacontinuumwiththelocalpopulationastheymayresideinthecommunity(ifon-sitehousingisnotprovided),orcomeintofrequentcontactwiththecommunity.

AdditionalBaselineDatatobeCollected

Baselineenvironmental,social,andhealthdataarecollectedtosupporttheimpactassessmentprocess.Toassessthepotentialforexposuretozoonoticpathogens,itisnecessarytonotonlyunderstandthecharacteristicsandbehaviorsofwildlifespeciesendemictoaprojectarea,buttoalsotakeintoaccountalocalcommunity’srelationshiptothem.Thesedatawouldsupplementvariouscomponentsofthebaselinedata.Table2providessuggestedtopicareaswherethesedatawouldsupplementthebaselinedatacollectionandindicateswhetherthatdataisnormallycollectedaspartofanESIAorHIA.

Table2

DataToBeCollected ESIA HIAUsuallyIncluded?

Obtainorgenerateaspecieslistofwildlifeendemictothearea,includingrodents.

Yes No

Determinewhetherthemostcommonwildlifespeciesareknowncarriersofzoonoticpathogens,whattheirecologicalbehaviorsare(e.g.roostingincaves),andwhattheytypicallyeat.

No Maybe

Havetherebeenoutbreaksofthosediseases?Amongpeople?Wildlife?Livestock?When?Arethereanyundiagnosedillnessesreportedbyhealthauthoritiesorlocalclinics?

No Maybe

Determinehowtheprojectwillfeeditspersonnel.Willtheprojectprovidefoodforallstafforonlyexpatriatestaff?

No Maybe

Determinesourcesofproteinforexistingandincreasedpopulation;ifbushmeatisusedasasourceofprotein,whatspeciesarehunted?

Determinewhatmethodsareusedinharvesting,butchering,transporting,andpreparingbushmeat.

DataToBeCollected ESIA HIAUsuallyIncluded?

Determinehowlocalcommunitiesinteractwithrodents,bats,andnon-humanprimates,andwhatpotentialexposurepathwaysexistbetweentheseanimalsandhumansinthearea.

Whatwildlifespeciesareconsideredpests?Whatarethelocalmethodstocontrolthesepests?

Determinethecapacityofthelocalcommunity’sinfrastructurewithrespecttopotablewatersupply,sanitation,andvectorcontrol.

No Yes

Determinethecapacityofthelocalcommunity’sinfrastructurewithrespecttohealthcareandveterinaryservices.

No Maybe

Assesspotentialsourcesoffoodforrapidlyincreasingpopulation,includingtheextentandlocationofpotentiallyarableland.

No Yes

Currentpopulationoftheprojectarea. Yes YesIfpossible,collectdatafromlocalgovernmentalandnon-governmentalorganizationsregardingexistinglocalwildlifediseases.

No Maybe

Assesstypesofnearbywildlifehabitat,itsintegrity,andtheextenttowhichitisatriskofconversion,fragmentation,and/ordegradationduetoproject-inducedpopulationinflux.

Yes No

Pleasenotethatageneralsocial/livelihoodsbaselineisimportanttoenableholisticunderstandingoflocalcommunityandtheirpotentialtoadapttochangesandsocialmanagementplans(includingmanagementofhealthrisks).

AssessingPotentialVulnerabilitiestoEmergingInfectiousDiseasesAproject’spotentialvulnerabilitytoemerginginfectiousdiseaseswereidentifiedinthescreeningchecklistandillustratedbelow.

Toassessareasofvulnerability,thisguidance’sapproachistoexaminethecomponentsofprojectsthatcouldincreaseordecreasevulnerabilitytoEIDexposureasameansofidentifyingwherepreventionmeasurescouldbeused.Unlikeotherimpactanalysesthatfocusonthechangesthatoccurtotheenvironmentandlocalpopulations,thisanalysisalsoevaluateshowtheprojectwillprotectitsemployeesfromexposuretofood-andwater-bornediseasesandcommunicablediseases.Therefore,oneofthefirststepsistoexaminehowthecampandfacilitieswillbemanaged.Theotherareasthathavetobeexaminedarewildlifemanagement,communityhealth,andinfrastructure.Thefollowingprovidesquestionsthatshouldbeevaluatedduringimpactsforeachtopicareas.

Table3

WORKERHEALTH1. LivingQuarters:Iftemporaryorpermanentlivingquarterswillbeconstructedatthefacility,itis

necessarytodeterminewhetherthequartersaredesignedtominimizethepotentialfortransmissionofcommunicabledisease.

a. Willtheon-sitehousingcomplywithinternationalstandardswithrespecttoventilation,space,andsanitation?Willitbedesignedtopreventcommunicablediseasetransmission?

b. Willtherebemeasurestoprotectfacilitiesagainstnon-humanprimate,rodent,andbatinfestations–Arepestanimalsconsideredinthedesign?Aretheremeasurestopreventpestwildlifeandvectorsfromenteringoffices,residences,andfacilities?

2. Canteen:Ifthecampwillhaveacanteen,measurestoensurethequalityofthefoodaswellashowwastefoodwouldbehandledshouldbeconsidered.

a. Foodhandling–Willfoodhandlingproceduresbeinplacetominimizetransmissionofany

Figure 3: Cascading Effects of On-Shore Oil Development on Increasing Contact Among People, Domestic Animals, Vectors and Wildlife

WORKERHEALTHcommunicablediseaseinthefoodpreparationorservingprocess?

b. Foodsupplychainandstorage–Willfoodstoragebesuchthatfoodcannotbecontaminatedbypestanimalsorinsects?Willthefoodsupplychainbeinspectedtoensurenocontamination?

c. Foodwaste–Willfoodbedisposedofinamannerthatitwillnotattractpestanimalsorinsects?

3. Clinic:Ifanon-sitehealthcarefacilitywillbeavailable,measurestoaddresscommunicablediseaseandpotentialoutbreaksshouldbeconsidered.

a. Capacity(fortreatment;forpreventiveservices)–Willthefacilitybeabletodiagnosecommunicablediseases?Willthefacilityhavesufficientcapacitytotreatanoutbreak?

b. Diseaseoutbreakpreparednessplan–Willthefacilityhaveanoutbreakplan?Willitcovertheendemiccommunicablediseases?Willitaddresshowtodealwithunknowndiseases?Dohealthtechniciansqueryaboutcontactwithanimalsortheirexcreta?

c. Laboratory–Willtheon-siteclinichaveanon-sitelaboratory?Willtheclinichaveaccesstoalaboratoryforadvanceddiagnosticsiftheon-sitelaboratoryisunabletoconfirmdiagnoses?

d. Willthecliniccommunicateandshareinformationwiththelocalhealthfacilityaboutinfectiousdiseaseincidencesandunusualillnesses?Willitprovideweeklysurveillancedatatothelocalhealthauthority?

e. Willtherebealaboratoryand/ordedicatedhealthcarewastemanagementsystem?4. WasteManagement/PestControl:Allcampsandfacilitieshavetomanagewaste.Improperwaste

managementcanattractpestornuisanceanimals.Aspectsofwastemanagementtoconsiderarelistedbelow.

a. Landfillmanagement–Willinternationalorlocalstandardsbeusedfortheconstructionandoperationofthelandfill?Willthelandfillbemanagedsothatitdoesnotattractpestanimals?

b. Trashmanagement–Willgarbagebemanagedsothatitwillnotattractpestanimals?(coveredcontainers,pickedupregularly)

c. Pestcontrolmeasures–Willthefacilityhaveapestmanagementcontrolprogramtoaddresspest/nuisanceanimalsandothervectors?

d. Ifagriculturalproductionisallowedwithinaconcession:i. Willtherebemeasurestoprotectlivestockfromwildlife?ii. Willtherebemeasurestoexcludewildlifefromcropsorfruittrees?iii. Willtherebemeasurestoexcludewildlifeorpestsfromcropstorageareas?iv. Willtherebemeasurestosafelymanagelivestockbiowaste(e.g.fromdiseased

animals,animalwasteiftreatedwithpharmaceuticals,etc.)?5. WaterManagement:Watercanbeahabitatforinsectvectorsandcanalsobecontaminatedifnot

properlystored.a. Vectorcontrolmeasures–Willmeasuresbeinplacetominimizetheamountofstandingwater

thatcouldprovidevectorhabitat?b. Waterpurification–Willdrinkingwaterbetreated?c. Waterstorage–Willwaterstoragebesecurefrompotentialcontamination?d. Otherwastes–Arewastewater,sewage,food,andanyotherwastematerialsdisposedof

accordingtolocalorIFC/WorldBankstandards?1

BIODIVERSITY/WILDLIFEMANAGEMENT6. WildlifeSpeciesandPathogens:Allwildlifespeciesmayhostpathogens;however,notallwilladversely

affectpeople.a. Arethewildlifespeciespresentknowntohostpathogensofconcernforpeople?

1 Waterandsanitation,includingwastewaterandsewage:http://www.ifc.org/wps/wcm/connect/e22c050048855ae0875cd76a6515bb18/Final%2B-%2BWater%2Band%2BSanitation.pdf?MOD=AJPERESWastemanagement,includingfoodwaste,trash,andlandfills:http://www.ifc.org/wps/wcm/connect/1cd72a00488557cfbdf4ff6a6515bb18/Final%2B-%2BWaste%2BManagement%2BFacilities.pdf?MOD=AJPERES&id=1323162538174

7. Biodiversitymonitoringandmanagementstrategy:Habitatchanges,suchascreatingcorridorsorfragmentinghabitatcanalterbiodiversity,favoringanimalspeciesthataremoretolerantofpeopleorthatseekouthuman-maderesources,suchasrodents.Someofthesetypesofanimalsareknowntohostzoonoticdiseases.

a. Willthebiodiversitymanagementprogramconsideranimalsthatcarryzoonoticdiseases,suchasrodents?

b. Willhuntingbeallowedontheconcession?Withintheprojectfootprint?c. Willtherebeaninternalsystemforreportingwildlifemorbidityormortality?Willtherebean

externalsysteminplaceforreportingwildlifemorbidityormortalitytowildlifeauthorities?

COMMUNITYHEALTH8. CommunityClinic:Manyon-siteworkersarefromthelocalcommunities,soinfectiousdiseasesinthe

communitycanspreadtotheworkplace.Communityhealthcanalsobeaffectedbytheinfluxofworkersandothermigrants.

a. Dothelocalcommunitieshaveahealthcarefacility?b. Doesthecommunityhealthcarefacilityhavethecapacityandequipmenttoaddressthehealth

needsofthecommunitiesitserves?c. Doesthehealthcarefacilitytracklocaldiseaseoutbreaks?Doesithavealaboratory?Doesit

haveaccesstoalaboratoryforadvanceddiagnosticsforunknowndiseases?d. Doesthefacilityhaveahealthcarewastemanagementstrategy?

9. CommunityInfrastructure:Isthecommunityvulnerabletoinfectiousdiseasetransmissionduetodeficienciesinitsinfrastructure?Istheinfrastructureadequatetoaddresstheneedsoftheexistingpopulationandtheanticipatedgrowthinpopulation?

a. Dothecommunitieshavefeaturestopreventpest/nuisanceanimalsfromaccessingagricultureandfoodstorage?Communitywastedisposal?Drinkingwatersources?

b. Doesthecommunityhaveasanitationsystem?c. Doesthecommunitymaintainalandfill?d. Dothecommunitieshaveadequatedrainagetopreventcreationofvectorhabitat?

10. CommunityPractices:Isthecommunityvulnerabletoinfectiousdiseasetransmissionduetoculturalpractices?

a. Doesthecommunityhaveabushmeatmarketorinvolvementinotherwildlifetrade?b. Doesthecommunityengageinsubsistencehunting?c. Doesthecommunitypracticetraditionalactivitiesthatcouldfacilitatethespreadof

communicablediseases(e.g.burialpractices)?11. CommunityFoodSupply:Willtheprojectbefeedingitsworkers?

Thepresenceofalarge-scaleprojectduringbothconstructionandoperationscouldputincreaseddemandsonlocalfoodsuppliers.Asaresult,pricescouldriseandmakelocalslooktobushmeatandforestproductstosupplementtheirfoodsupplies.

• Whatarethelocalsourcesofagriculturalgoods?• Whatarethelocalsourcesofprotein?• Aretheresufficientsourcesofbothtoaccommodatetheincreaseddemandoftheproject?• Whatwillbethesourcesoftheproject’sfood?

Table4providesacross-walkofwhereinformationfromthisanalysiscouldbeaddedtoanESIAoranHIA.

Table4

AnalysisArea ESIASection HIASection NewAnalysisRequiredWorkerHealthLivingQuarters ProjectDescription Respiratoryand

HousingCompliancewithInternationalBestPractices2orlocalrequirementsforhousing

Canteen–Foodsafety/security

- Food&Nutrition CompliancewithInternationalBestPracticesorlocalrequirementsforfood.

FoodManagement(storageanddisposal)

WasteManagementorTerrestrialBiologicalResources

Food&Nutrition/Vector-RelatedImpacts/Soil,Water,&Sanitation

Adequacyoffoodprotectiontopreventcontaminationandnotattractpests(animalsandinsects)

On-siteClinic - - Evaluatetheadequacyoftheclinicandcommunityinfrastructuretoidentifyandaddressoutbreaks

WasteManagement HazardsandPublicSafetyorWasteManagement

Vector-RelatedImpacts/Soil,Water,&Sanitation

Adequacyofwastemanagementtopreventattractingpests(animalsandinsects)

WaterManagement WaterResources/WasteManagement

Soil,Water,&Sanitation

CompliancewithInternationalBestPracticesorlocalrequirementsforwaterandwastemanagement

Adequacyofprotectionofwaterresourcestopreventcontaminationfromanimals,notprovidevectorhabitat,andnotattractanimals

Biodiversity/WildlifeManagementWildlifeEndemicZoonoticDiseases

TerrestrialBiologicalResources

CommunityProfile– CommunicableDiseases/VeterinaryMedicine

Arelocalwildlifespeciespresentthatareknowntoharborzoonoticpathogensofconcern?

BiodiversityManagement:WildlifePopulationasaResultofHabitatChanges

TerrestrialBiologicalResources

VeterinaryMedicine

Howchangesinhabitatandbiodiversitycanchangewildlifedynamicsandincrease/decreasewildlifecommunitiesand/orpopulationsthatmayharborzoonoticpathogensofconcerntohumans

BiodiversityManagement:BushmeatPolicy

TerrestrialBiologicalResources–ManagementandMitigations

- Bushmeathuntingcanincreaseexposuretozoonoticpathogens

CommunityHealthCommunityClinic Socioeconomics,

UtilitiesandInfrastructure,

HealthServices,Infrastructure,&Capacity

Evaluatetheadequacyoftheclinicandcommunityinfrastructurestoidentifyandaddressoutbreaks

2e.g.,guidancefromtheIFC:http://www.ebrd.com/downloads/about/sustainability/Workers_accomodation.pdf

AnalysisArea ESIASection HIASection NewAnalysisRequiredCommunityInfrastructure

and/orProject-InducedMigrationRiskAnalysis

Evaluatetheadequacyoftheinfrastructurewithrespecttopreventingorfacilitatingthespreadofcommunicableorotherdiseases

CommunityPractices

CulturalHeritage CulturalHealthPractices

Howculturalpracticescanincreasethepotentialexposuretozoonoticpathogens

CommunityFoodSupply

Socioeconomics Food&Nutrition Willtheincreasedfooddemandoftheprojectresultinincreasesinfoodprices?Willthisresultinlocalsseekingforest/wildlife-basedproteinsources?

Cumulativeimpactsarethosethatcouldresultfromtheadditiveeffectsfrompast,existing,andreasonablyforeseeableprojects.Thesetypesofimpactsareoftendifficulttoevaluatebecausetheyrequirelookingbeyondtheboundariesoftheprojectandexaminingbothhistoricalcontextandpotentialfutureprojectsintheregion.Cumulativeimpactscouldoccurthatwouldbeassociatedwithincreasingthepotentialexposuretozoonoticpathogens:

1. Ifthecombinationofexistingandnewprojectssufficientlychangethehabitatsuchthatitfavorsspeciesthathostpathogensofconcern.Ifwildlifehabitatisremovedcompletely,thenmanyspecieswouldnotsurvive;however,otherspeciesmaybecomeestablishedand/orbecomemoreabundant(e.g.manyrodentspeciesthriveinhumanhabitats).

2. Iftheexistingcommunityinfrastructureisalreadystressedorinadequate,theadditionofonenewprojectmayormaynotaddfurtherstress,butifmultipleprojectsareplannedforthesamegeneralarea,thecommunityinfrastructurecouldbestressedtothepointthatsystemsbegintobreakdown.

ActionPlan

Preventingorminimizingexposuretoemergingorexistinginfectiouspathogensofzoonoticoriginshouldbeaddressedatmultiplelevels.AppendixBincludesrepresentativemitigationmeasuresthatcouldbeincludedinanactionplan.

Atacompany/community/regionallevel,mitigationmeasuresshouldfocuson:• Maintainingintacthabitatsandpreservingbiodiversity• Educatingandinstitutionalizinggeneralpublichealthmeasurestopreventinfectiousdisease

transmissionandoutbreaks• Preparingfordiseaseoutbreaks

Preparingfordiseaseoutbreaksnotonlyinvolveshavinganoutbreakplan,butalsoestablishingandmaintainingcommunicationnetworkswithhealthcareproviders,localgovernments,NGOs,andothercompaniesandindustrygroups.Thismaytaketheformofjointsimulations,meetings,phonenetworks,designatedpointsofcontactandtriggerpoints,andstandingtaskforces,amongotherapproaches.

Forindividuals,mitigationmeasuresshouldfocusonpreventingdirectorindirectcontactwithwildlifeortheirexcretaby:

• Notcreatinghabitatorfoodsourcesforwildlifeorpestswherepeopleliveandwork• Limitingorpreventingcontactwithwildlifeortheirexcreta• Institutionalizingbasicpublichealthcontrolmeasurestominimizethetransmissionof

pathogens

• Educatingindividualstosafeguardagainstpathogentransmission

Figures4and5provideframeworkstouseinformulatingprevention/mitigationstrategies.

Whilepreventingexposureispreferable,allactionplansshouldhaveapreparednessplanfordiseaseoutbreaks.TheEbolaoutbreakprovidedexamplesofactionsthatfacilitiescantaketolimittransmissionduringanoutbreaksuchas:

• Installinghand-washingfacilitieswithpotablewaterandsoapattheentrypointtoallcamps,offices,canteens,andresidentialareas,andeducatingtheworkforcetousethem

• Installingtemperaturescreeningdevicesattheentranceofcamps• Ensuringsafehandlingofhealthcarewasteanddeadbodiesforinfectioncontrol• Providingaccurateevidence-basedinformationaboutdiseasestodispelrumors

Generaluseofhand-washingfacilitiescanreducetransmissionofmultiplecommunicablediseases.TemperaturemonitoringduringtheEbolaepidemicidentifiedotherfebrilediseases.

Figure4:PracticesIndividualsCanTaketoReducethePotentialforZoonoticDiseaseTransmissionRisk

Transmission Routes

Fomite/skin Food Water AirBites, scratches and cuts while

butchering

Bitten fruits, contaminated

stored grains and undercooked

AerosolsShared water

and open water sources

Avoid eating bitten fruit

Avoid contact with sick or dead animals

Practice good hygiene

Transmission Prevention

Wash cuts and scratches with soap

Cook all meat at 56°C

Wash fruit before eating

Transmission Prevention

Drink treated water

Cover mouth and nose (using a mask or respirator) in risk

areas (e.g. caves, mines, storage areas)

INFECTED ANIMAL

Blood Saliva Urine/Feces

HUMAN DISEASE

Figure5:PracticesCompaniesCanTaketoMitigatethePotentialforZoonoticDiseaseTransmission

MonitoringandEvaluationMonitoringandevaluation(M&E)ofanymitigationstrategiesshouldbeimplemented.Keyperformanceindicatorsusedcouldbestructural,process,andoutcomebased.

Structural• Staffhousingcharacteristics(adequateandappropriatespaceperindividual,sanitation,

foodstorage)• Landfillcharacteristics(adequatesize;appropriatecovertodiscouragepests;appropriate

andadequaterunoffcontrol;appropriatedistancefromhousing,village,andotherhuman-usedfacilities)

• Wastebins(coveredandsecuretopreventraidingbywildlife,andemptiedregularly)• Reductionoreliminationofopenwater(gutters,ditches,watercontainers,etc.)• Facilitystructurecharacteristics(measurestodiscouragebatroostingandrodentinvasion)

Process• ImplementationofBiodiversityMonitoringPlanandestablishmentandenforcementof

policiesonbushmeatandotherwildlifetrade• Implementationofintegratedpestmanagementtoreduceanimalpestandinsect

abundance,includingimplementationofappropriatewastemanagementprocedurestopreventattractinginsectsandvermin

• Implementationoffood–procurement,safety/security,handling,anddisposal–procedurestoeliminatepotentialcontaminationbypests

• Operationaldiseasemonitoring,surveillance,andreportingplan• Operationaldiseaseoutbreakplanthatisevaluatedannually• Compliancewithlocalandnationalhealthreportingrequirements,consistentwiththe

WorldHealthOrganizationInternationalHealthRegulations

Outcome• Maintenanceofintacthabitatsandbiodiversityaroundthefacility• Numberofinfectiousdiseaseeventsoroutbreaks• Numberofpeststrappedorfrequencyofpestsobserved• Numberofadversewildlifeencounters(e.g.bites,scratches)• Amountofon-sitehunting• Numberofoccurrencesofbushmeatprocurement• Amountofbushmeatandanimalproductsdestinedforwildlifetradefoundincompany

vehiclesoratexitgates

APPENDIXA:ZoonoticandVector-BorneVirusesofConcern

TableA-1providesanexampleofthetypesofinformationthatshouldbeassessedtoidentifywildlifepathogensthathavebeenidentifiedinandaroundtheprojectarea,potentialpathogensassociatedwithwildlifeendemictotheprojectarea,andthecorrespondingtransmissionpathwaysofinfectionassociatedwiththesepathogens.

Thesetypesofcountry-leveltablescanbegeneratedwithdiseasedatafromWHOGlobalHealthObservatory(http://www.who.int/gho/en/)andPandemicandEpidemicDiseaseReports(http://www.who.int/csr/disease/en/),FAOEmergencyPreventionSystemforTransboundaryAnimalandPlantPestsandDiseases(http://www.fao.org/ag/againfo/programmes/en/empres/home.asp),OIEWorldAnimalHealthInformationDatabaseforOIE-ListedDiseases(http://www.oie.int/wahis_2/public/wahid.php/Wahidhome/Home),andselectnon-listeddiseasesreportedinwildlife(http://www.oie.int/wahis_2/public/wahidwild.php),andmaybesupplementedbyatoolonHealthMap(http://www.healthmap.org/en/).SpeciesrangeinformationmayalsobeavailableviatheIUCNRedListofThreatenedSpecies(http://www.iucnredlist.org/)andtheMapofLife(https://www.mol.org/).Otherwise,aliteraturesearchwillhavetobeconductedbycountry,pathogen,andresearchdatabases(e.g.Olivaletal.inreview,EcoHealthAlliance).

Thepresenceofthesetypesofpathogenscouldbeincorporatedintoacompany’sriskassessmentprogram.

TableA-1.ExamplesofKnownZoonoticandVector-BorneVirusesofConcernThistableisdesignedasafirstlevel“HazardIdentification”element.

Virus TransmissionPathway

ExamplesofKnownSpeciesAffected

MarburgVirus

Directcontactwithinfectedanimal

Franquet’sepaulettedfruitbat(Epomopsfranqueti),Hammer-headedbat(Hypsignathusmonstrosus),Egyptianfruitbat(Rousettusaegyptiacus),Greatlong-fingeredbat(Miniopterusinflatus)

WestNileVirus Vector-borne Straw-colouredfruitbat(Eidolonhelvum),humansEbolaVirus Direct

contactwithinfectedanimals

Bats:Straw-colouredfruitbat(Eidolonhelvum),Franquet’sepaulettedfruitbat(Epomopsfranqueti),Hammer-headedfruitbat(Hypsignathusmonstrosus),Peter'sdwarfepaulettedfruitbat(Micropteropuspusillus),Littlecollaredfruitbat(Myonycteristorquata),Egyptianfruitbat(Rousettusaegyptiacus)

Non-humanprimates:Gorilla(Gorillagorilla),Chimpanzee(Pantroglodytes)

HumansChikungunyaVirus Vector-borne Bats:Egyptianfruitbat(Rousettusaegyptiacus),CapeLeaf-nosed

batorSundevall’sroundleafbatorCommonAfricanLeaf-nosedBat(Hipposideroscaffer)

Rodents:Natalmultimammatemouse(Mastomysnatalensis)

Humans

Virus TransmissionPathway

ExamplesofKnownSpeciesAffected

Simianimmunodeficiencyvirus(SIV)

Directcontactwithinfectedanimals

Non-humanprimates:Cercopithecusspp.,Lophocebusalbigena,Drill(Mandrillusleucophaeus),Mandrill(Mandrillussphinx),Guerza(Colobusguereza),Chimpanzee(Pantroglodytes)

MonkeypoxVirus Directcontactwithinfectedanimals

Non-humanprimates:Cercopithecusspp.,

Rodents:Northerngiantpouchedrat(Cricetomysspp.),

Tableincludesexamplesofknownzoonoticpathogensinmammalsandbirdsasdocumentedinthescientificliterature(2000-2011).

APPENDIXB:ExamplePreventativeMitigationMeasures

TableA-2presentsexamplesofpreventativemitigationmeasuresthatcanbeimplementedforalargeprojectwithinacommunityinaruralsetting.Itisnotmeanttoserveasatemplate,butrathertoillustratesomeoftheactionsthatcanbetaken.

C&C=CompanyandContractorHealthPlanPACs=PotentiallyAffectedCommunities

Timing:

Timing ActionPlan Responsibility3 CollaboratingAgencyorOrganization

Indicators SurveillanceMethodC&C PACs

EmergingZoonoticDiseaseTransmissionRisk:Directcontactwithinfectedanimals(Directcontactwithinfectedanimalscanoccurwhileworkingoutdoors,inaditsorcaves,inagriculturalsettings,inlocationswherefoodorwasteisstored)Instituteano-bushmeat-huntingpolicywithintheconcessionifpossible.Otherwisediscouragebushmeathuntingandenforcelocalbushmeatregulationsinareasofcompanycontrol.

C→DC X Company Localenviron-mentdepartment

Presence/absenceofon-sitepoaching,#ofconfiscations

CompanysecurityorCommunityRelationsDepartment

Trainworkersaboutissuesassociatedwithbushmeathunting–inparticularspeciesandtheirassociateddiseases–anddiscouragethepurchasingofbushmeat

C→DC X Companyeducationdepartment

Localenviron-mentdepartment

Presence/absenceofon-sitepoaching,#ofconfiscations

CompanysecurityorCommunityRelationsDepartment

3Theremaybeinstanceswheretheresponsibilityisthecompany’s,butpartneringwithagencieswithingovernmentorwithNGOscanmaketrainingandcapacitybuildingmoreeffective.

Ifworkershavetoenterareaswithknownconcentrationsofbatsorrodents(e.g.adits,caves,etc),conductanassessmentofthepotentialforexposuretowildlifeandselectappropriatepersonalprotectiveequipmenttopreventcontactwithfecesandurineandbodilyfluids(e.g.inacavesetting).

C→DC X Companyhealthandenvironmentdepartment

NumberofworkersthatusePPEwhenoperatinginareaswithknownconcentrationsofrodentsorbats

Educateprojectworkersaboutzoonoticdiseaserisks,howtoavoidencounterswithwildlife,andwhattodoifbitten,scratched,etc.

C→DC X Companyeducationdepartment

Localenviron-mentdepart-ment/healthdepartment

Numberofworkerstrained;numberofadverseencounters

Incidencerecordedatcompanyclinic

Minimizehabitatfragmentation/creationofedgethroughlimitingroaddevelopment

D→O X Company Localenviron-mentaldepart-ment

Lengthoflinearcorridor

Annualmapping

Maintainbiodiversitythroughimplementationofabiodiversityplan

D→DC X Company Localenviron-mentaldepart-ment

Speciescounts Semi-annualinventories

Monitoron-siteagricultureforpestinvasion. C→O X Company Localenviron-mentdepart-ment/healthdepartment

Presence/absenceofpests;cropdestruc-tion

Companyenviron-mentalaudit

Conducttrainingwithlocalcommunitiesaboutissuesassociatedwithbushmeathuntingandpropermethodstobutcher

C→DC x Companyeducationdepartment

Numberofpeopletrained

Conducteducationalcampaignswithlocalcommunitiesaboutzoonoticdiseaserisks,howtoavoidencounterswithwildlife,andwhattodoifbitten,scratched,etc.

Numberoflocalstrained;numberofadverseencountersatlocalclinic

Incidentsrecordedatlocalclinic

Establishinternalandexternaldatacollectionandreportingmechanismforwildlifemorbidityandmortality

C→DC X x Companyenvironmentdepartment

Numberofreports Worker/communityreporting

Conducteducationalcampaignaboutwildlifeconflictmitigation&domesticanimalbiosecurity

Localnaturalresourcedepartment

Numberofpeopletrained

Risk:Indirectcontactwithinfectedanimals(Indirectcontactcanoccurthroughconsumptionoffoodorliquidsthathavebeencontaminatedwithanimalexcretaorfrominsectvectors)Reviewfoodsafetyandsecurityprocedures D→O X Company Localhealth

departmentFoodsafetyprocedureimple-mented

Foodsafetyaudit

Reviewfoodstoragemethodsandprotections D→O X Company Localenviron-mentdepart-ment/healthdepartment

Presence/absencesofpestpreventionmeasures

Foodsafetyaudit

Reviewwastedisposalandmanagement D→O X Company Localenviron-mentdepart-ment/healthdepartment

Dailycover,pestcontrol

Environmentalmanagementreview/audit

Reviewhousingdesigntoensureadequatemeasuresexistnottopromoteorfacilitateinfectiousdiseasetransmission

D->DC X Company,engineeringdesign

Localhealthdepartment

Occupantsperroom,foodstorage,sanitation

Housingaudit

Conducthealtheducationprogramsforprojectworkersregardinginfectiousdiseasestransmission

C→DC X Companyhealthoreducationdepartment

Districthealthofficer

Numberofworkerstrained

Workertesting;auditpractices,incidenceofinfectiousdiseases

Conducthealtheducationprogramsforprojectworkersregardingfoodsafety

C→DC X Companyhealthoreducationdepartment

Districtenviron-mentalhealthofficer

Numberofworkerstrained

Workertesting;auditpractices,incidenceoffood-borneillnesses

Assistwithprovidingfoodsanitationawarenessmaterialstolocaldistrictenvironmentalsanitationofficersforeducationalsessionswithfoodhandlersandslaughterhouses,particularlyvendorswhosellfoodtoprojectworkers

C→O x Companyhealthoreducationdepartment

Localenviron-mentalhealthdepartment

Foodhandlerpractices

Auditoffoodhandlerpractices

ImplementanentomologicalsurveyprogramforinsectvectorsatthefacilityandinthePACs

C→DC X x Company Countryhealthservices:vector-controldivision

Entomologicalinfectionrate/parasiteprevalenceratesinchildren

Reviewsurveyreports

Risk:Changestothesurroundingcommunitiesduetothepresenceofafacilitythatcouldincreasecontactwithwildlife(directcontact)and/orresultinincreasedtransmissionofinfectiousdiseasesthatoccurlocally(amplification)Assistlocalcommunitywithspatialplanning(locationofagricultural,wastedisposal,potablewater)

D→DC X x Companyengineer/planner

Localenviron-mentalhealthandplanningdepartments

Localspatialplaninplace

Periodicreviewsofthespatiallayout

Assistthelocalcommunitytoplaninfrastructureandutilities(wastedisposal,potablewater,healthcarefacilities)

Localenviron-mentalhealth,infrastructure,andutilitiesdepartments

Numberofplansdevelopedandimple-mented

Workwithcommunityrepresentativestoimprovevectormanagement(e.g.controlofmosquitobreedinggroundsinstagnantwaterandmaintainingdrainageduringrainyseasons)

Numberofmeetings/workshops

Siteaudit

Providesupporttodistricthealthvectorcontrolprograms

D→DC X x Companyenvironmentalhealthofficer

Numberofmeetingsandlevelofsupport

Provideassistancewithretrofittingordesigningboreholessothattheycomplywithlocalregulations,areprotectedagainstpotentialcontamination,anddonotcreatevectorbreedinghabitat

D→DC x Companyenvironmentalhealthofficer

Numberofboreholesthatarecompliant

Collaboratewithlocalwastemanagementservicestodevelopnon-hazardouswastemanagementplansforlocalcommunitiesthatcaninclude:

• Sufficientgarbagecansanddumpsters

• Garbagestoredinrodent-proofcontainers

• Sanitaryandsolidwastecollecteddailyandcovereddailywithasolidlayerofsoil(15to30cm)

• Appropriatecontainerprogramtoavoidwaterborneinsectbreeding

• Prohibitmovinglargequantitiesoffoodstuffstoanimalfarmerstoavoidgeneratingrodentorreptilehabitat

D→DC x Companyenvironmentalhealthofficer

Numberofplansinplaceandimple-mented

Siteassessment

Supportthetrainingoflocalcommunityhealthpersonnelininfectiousdiseasesurveillanceandoutbreakresponse

D→DC x Companyhealthofficer

Numberofpeopletrained;Presence/absenceofplan

Presenceofafunctioningdiseasesurveillanceprogram

Supportimprovementoflocalmarketbiosecuritymeasures

D→DC x Companyhealthofficer

Improvedbiosecuritymeasures

Supportlocalland-useplanningandmanageproject-inducedpopulationinfluxtopreserveareasofintacthabitat

PD->O X X Companycorporatesocialresponsibilityofficer

Localplanningdepartment

Presence/absenceofintacthabitatsandtheirsize

Identifyintacthabitatandthentracktheirintegrity

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