"Hands-on care for One Health" EC-OIE

One Health concept: OIE approach and collaboration with WHO and FAO

including on rabies and avian influenza control and new disease naming

Preparation of the IHR/PVS national seminars

Dr S. de La Rocque, OIE, seconded to WHO

Key principles of ManhattanNew York, September 29, 2004

one world . one health

• "It is clear that no one discipline or sector of society has enough knowledge and resources to prevent the emergence or resurgence of diseases in today’s globalized world."

• "Only by breaking down the barriers among agencies, individuals, specialties and sectors can we unleash the innovation and expertise needed to meet the many serious challenges to the health of people, domestic animals, and wildlife and to the integrity of ecosystems. "

• "We are in an era of “One World, One Health” and we must devise adaptive, forward-looking and multidisciplinary solutions to the challenges that undoubtedly lie ahead."

OIE/FAO programme on Good Governance of Veterinary Services

Ensuring Good Governance to Address Emerging and Re-emerging Animal Disease Threats

November 2005; August 2006 and last updated in September 2007

Contributing to One World, One HealthA Strategic Framework for Reducing Risks of Infectious Diseases at the Animal-Human-Ecosystems interfaceInternational Ministerial Conference on Avian and Pandemic Influenza in Sharm el-Sheikh (Egypt) 25 -26 October 2008

Contributing to One World, One HealthA Strategic Framework for Reducing Risks of Infectious Diseases at the Animal-Human-Ecosystems interfaceInternational Ministerial Conference on Avian and Pandemic Influenza in Sharm el-Sheikh (Egypt) 25 -26 October 2008

Five strategic elements:

· Building robust and well-governed public and animal health systems compliant with the WHO IHR (2005) and OIE international standards

· Improved national and international emergency response capabilities

· shift the focus from developed to developing economies, from potential to actual disease problems

· Collaboration across sectors and disciplines

· Developing rational and targeted disease control programmes through strategic research.

One World, One Health: from ideas to ActionExpert Consultation : 16-19 March 2009, Winnipeg (Canada)

Operationalizing ‘One Health’Taking Stock & Shaping an Implementation Roadmap

4 – 6 May 2010, Stone Mountain (USA)

+ Culture change+ Increased visibility+ Political will and financial support+ Improved coordination

One Health Governance and Global networkExpert meeting: 31-Oct-1 Nov 2011, Atlanta (USA)

• Prevention and control of emerging infectious diseases are public goods;

• Support for national services and building on existing structures;

• Reference to internationally adopted standards and references;

• Shifting the focus - towards good governance and national health systems strengthening instead of short-to-medium-term ad hoc interventions

"… A framework for collaboration is necessary at national and international levels, with clear roles and responsibilities "

…. based on shared principles

Ministerial Declaration Meeting of G20 Paris, 22 -23 June 2011

Action Plan on Food Price Volatility and Agriculture (25.) …, we stress the importance of strengthening …, good governance and official services, since they ensure an early detection and a rapid response to biological threats, facilitate trade flows and contribute to global food security.

… we encourage international organizations, especially FAO, WHO, OIE, the Codex Alimentarius Commission (Codex), the IPPC and WTO to continue their efforts towards enhancing interagency cooperation.

Views strongly supported in the political area

Toward implementation of the Tripartite Concept Note : Good governance at the human-animal interface

• …"a need to strengthen animal and human health institutions" remains

and

• "protocols and standards…should be jointly developed to achieve coherence of any related global standard-setting activities, and to address gaps in the capacities of countries".

2 main guiding lines :

IHR MF

In 2005, the 58th World Health Assembly adopted the

revised International Health Regulations (IHR)

" to prevent, protect against, control and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade"

IHR (2005), article 2A legal commitment of 194 States Parties that have agreed to play by the same rules to secure international health.

Purpose of the IHR (2005)

“Each State Party shall develop, strengthen and maintain, as soon as possible but no later than five years from the entry into force of these Regulations (…), the capacity to detect, assess, notify and report events in accordance with these Regulations… and ... the capacity to respond promptly and effectively…"

IHR (2005), articles 5 and 13

Purpose of the IHR (2005)

Legi

slatio

n an

d Po

licy

Coor

dina

tion

Surv

eilla

nce

Resp

onse

Prep

ared

ness

Risk

Com

m.

Hum

an

Reso

urce

s

Labo

rato

ry

Zoonotic pathogensFood safety

Human infectious pathogens

Radio nuclear hazards

IHR (2005): Capacity to detect, assess, report and response to all Emergency Event of International Concern

Chemical hazards

IHR (2005): a multi-hazards overarching scope

Through the IHR, WHO has a dual mandate:

1 - maintain an effective global system that helps countries to be informed in a timely manner on unusual events, assess public health risks and respond appropriately;

Through the IHR, WHO has a dual mandate:

2 - provide support to countries to strengthen capacities for detection, reporting, assessment and response to health events and to prevent international spread, as specified in the IHR

IHR - Core Capacity Assessment Protocol

IHR – Indicators and checklist

IHR – indicators of Core Capacities PVS - indicators of Critcal capacities

Mapping of overlapping CRITICAL COMPETENCIES IN THE OIE PVS PATHWAY

Mapping of overlapping

Mechanisms for effective risk communication during a public health emergency are established and functioning

III –

1. C

omm

unica

tion

Joint Communication: Madagascar, Apr. 2008

FAO/HPA simulation exercise in Croatia, 2011

Gaps identified

GF-Tad

Capacity buildingTechnical support

Disease-specific Control Program

RABIES, THE 100% PREVENTABLE DISEASE

KEY RATIONALE FOR INVESTMENT

•Rationale 1: Rabies disproportionately burdens poor rural communities

•Rationale 2: Dog-mediated human rabies can be eliminated by vaccinating dogs

•Rationale 3: Rabies is preventable yet continues to kill

+A mechanism is established for the coordination of the relevant sectors

III.2

– Co

nsul

tatio

n wi

th

inte

rest

ed p

artie

s

The tool helps to open discussion on critical synergetic areas and identify way forward

"Rabies vaccines for animals should … comply with national requirements for vaccines. When there are no adequate national regulations, reference should be made to the relevant international standards."

"The success of vaccination campaigns in Latin America was due to the central coordinating role of the public health sector and the involvement of communities in rabies control."

WHO expert consultation, 2013

+Public health emergency response mechanisms are established

II.9

– Vet

erin

ary

med

icine

s an

d bi

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icals

OIE Rabies Vaccine BankDeliveries as of 1 August 2015

Country Number Year

Afghanistan 200.000 2014

Bangladesh 200.000 2013

Bhutan 100.000 2013; 2014

Indonesia 200,000 2013

Lao PDR 290,400 2012; 2013; 2014

Myanmar 200,000 2013

Nepal 200,000 2013

Philippines 1 120,000 2013; 2014; 2015

Sri Lanka 300,400 2013Vietnam 872,000 2012; 2013; 2014

TOTAL 3.682.800

Significant additional amounts are currently being scheduled through WHO projects

+Mechanisms for effective communication during a public health emergency are established and functioning

III.1

– Co

mm

unica

tion

Communication Handbook

WHOInternational

Health Regulation

OIEIntergovernmentalscience based standards

OIE/WHO Risk Communicationcommon tools

November 2015

Capacity Building collaboration

REMESA Communication Seminar on Rabies

OIE Communication Focal Points Regional Trainings

- Europe: Estonia, July 2014- South East Asia: Cambodia,

November 2015- Planned in 2016: Americas and

Africa

WHO Capacity building trainings

- Risk Communication training, Serbia October 2014

- Emergency Communication Network trainings:- Switzerland, March 2015- Jordania, November 2015

- Tunisia, November 2015- Dedicated to Rabies awareness- Gathered all the stakeholders:

(Health, Agriculture, Interior, Education, Laboratories)

- Five Maghreb countries

For more information:

communication@oie.int

+Indicator-base surveillance incudes an early-warning function for the early detection of a public health event

II. 5

– Epi

d. su

rvei

llanc

e an

d ea

rly d

etec

tion

4 ways linking

+Priority public health risks and resources are mapped and utilized

II.3

– Ri

sk a

naly

sis

• Twice a year

• Early sharing of genetic and antigenic data and their analysis from Reference labs and parent organizations

• Initially H5N1 HPAI, expanded to all H5 and H7 HPAI, H9N2 LPAI, and other LPAI viruses

Contribution to WHO Pandemic Vaccine Candidate Meeting A/waterfowl/Bangladesh/32281/2013_{2.3.2.1a}

A/poultry/Bangladesh/91423/2013_{2.3.2.1a}

A/poultry/Bangladesh/1313/2012_{2.3.2.1a}

A/poultry/Bangladesh/91439/2013_{2.3.2.1a}

A/poultry/Bangladesh/91425/2013_{2.3.2.1a}

A/duck/Bangladesh/19097/2013_{2.3.2.1a}

A/poultry/Bangladesh/91429/2013_{2.3.2.1a}

A/avian/Bangladesh/91365/2013_{2.3.2.1a}

A/poultry/Bangladesh/91392/2013_{2.3.2.1a}

A/chicken/Bangladesh/1-B/2013_{2.3.2.1a}

A/avian/Bangladesh/91402/2013_{2.3.2.1a}

A/Water Fowl/Bangladesh/51490/2013_{2.3.2.1a}

A/waterfowl/Bangladesh/51489/2013_{2.3.2.1a}

A/waterfowl/Bangladesh/51451/2012_{2.3.2.1a}

A/chicken/Bangladesh/13VIR5602-2/2013

A/poultry/Bangladesh/91414/2013_{2.3.2.1a}

A/environment/Bangladesh/1333/2013_{2.3.2.1a}

A/environment/Bangladesh/1019-G/2012_{2.3.2.1a}

A/poultry/Bangladesh/91422/2013_{2.3.2.1a}

A/poultry/Bangladesh/91421/2013_{2.3.2.1a}

A/poultry/Bangladesh/91394/2013_{2.3.2.1a}

A/poultry/Bangladesh/91391/2013_{2.3.2.1a}

A/chicken/Bangladesh/13VIR5602-1/2013

A/waterfowl/Bangladesh/31935/2011_{2.3.2.1a}

A/duck/Bangladesh/32077/2012_{2.3.2.1a}

A/chicken/Bangladesh/42010/2012_{2.3.2.1a}

A/avian/Bangladesh/NAB-440/2012_{2.3.2.1a}

A/poultry/Bangladesh/91436/2013_{2.3.2.1a}

A/crow/Bangladesh/1061/2011_{2.3.2.1a}

A/chicken/Bhutan/02CL505/2013

A/chicken/Bhutan/01TI06/2013

A/chicken/Nepal/08TI78/2013

A/chicken/Nepal/232/13

A/chicken/Nepal/225/13

A/chicken/Nepal/PT-30/13

A/chicken/Nepal/231/13

A/chicken/Nepal/T-279/13

A/chicken/Nepal/T-262/13

A/chicken/Nepal/T-272/13

A/chicken/Nepal/T-274/13

A/chicken/Nepal/T-278/13

A/chicken/Nepal/T-233/13

A/chicken/Nepal/T-234/13

A/chicken/Nepal/PT-29/13

A/chicken/Nepal/T-260/13

A/chicken/Nepal/223/13

A/chicken/Nepal/T-273/13

A/chicken/Nepal/T-271/13

A/chicken/Nepal/T-299/13

A/chicken/Nepal/T-301/13

A/environment/Chang_Sha/25/2009_{2.3.2.1a}

A/duck/Vietnam/NCVD-1171/2012_{2.3.2.1a}

A/duck/Vietnam/NCVD-1206/2012_{2.3.2.1a}

A/Hubei/1/2010_{2.3.2.1a}

A/environment/Hunan/3/2011_{2.3.2.1a}

A/chicken/Vietnam/NCVD-700/2011_{2.3.2.1a}

A/duck/Vietnam/NCVD-1210/2012_{2.3.2.1a}

A/duck/Tay Ninh/13-2064/2013

A/chicken/Vietnam/NCVD-2749/2013_{2.3.2.1a}

80

7989

73

97

98100

99

100

75

79

99

100

99

9985

96

0.01

LPAI

Clade 1

Clade 0

Clade 2.3

Clade 2.1

1. Antigen references (Clade references and

homologous ag)

2. Reference antisera panel references

1 antigenic unit = 1 2-fold HI

dilution

+Public health emergency response mechanisms are established

II.9

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icals

In kinddonations

Multi-donor approach* involving: • EU Africa (2006-2007)18 M doses

• Canada Worldwide (2007-2011) 40 M doses

• Canada (donation) 1,9 M doses

• UK (donation) (2007) 2,1 M doses

Deliveries to 8 countries including Egypt (45%) and Vietnam (43%) Total : 62 million doses of Avian Influenza vaccines

Avian Influenza Vaccine Bank Multi Donor

+Mechanisms for effective communication during a public health emergency are established and functioning

III.1

– Co

mm

unica

tion

Diseases naming

Diseases namingTo span the gap between identification of a new disease and the formal assignation of a name by the ICD (International Classification of Diseases)

WHO strongly encourage scientists, national authorities, medias and other stakeholders to follow the best practices

www.who.int/ihrwww.oie.int/en/support-to-oie-members/pvs-pathway

Thank you for your interest and support