ONE HEALTH LEADERSHIP EXPERIENCEDr. Mark Raizenne

Centre for Food-Borne, Environmental and Zoonotic Infectious Diseases

Public Health Agency of Canada

Breaking Down Barriers, Creating Connections• Public health has had a long history of recognizing that

animal health and human health are linked – veterinary public health

• Some initiatives such as EcoHealth programs have explored the importance of human and ecosystem health

• Traditional silos exist between

public health professionals,

doctors, vets, ecologists,

social scientists

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Habitat disruption or modification (agricultural practices)

Catastrophicnatural events

Climate change

Movement of people, animals, goods

Casual exposures

Occupational exposures

Human population growth

Food and water consumption

Drivers of Public Health Threats Today

Ecosystems

Animals Humans

Economics

Public Health Agency of Canada | Agence de la santé publique du Canada

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What is One Health?

Transcending Borders: One Health recognizes the linkages among human, animal and ecosystem health domains.

Source: “Contributing to One World, One Health”Strategic Framework, Oct. 14, 2008

A Whole-of-Society Approach:It proposes an international, interdisciplinary, cross-sectoral approach to surveillance, monitoring, prevention, control and mitigation of emerging diseases, as well as to environmental conservation.

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The Environment/Ecosystem Connection

• Environmental health is often forgotten

» Challenge to engage environmental health researchers and scientists

• Climate change creates favourable conditions for the emergence and establishment of disease vectors

• Examples of environmental issues

» Antimicrobial resistance

» Prions

» Shale gas and oil sands

» Arboviruses

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One Health Helps us Focus on the Margins

• Big problems cross disciplines…and solutions are not specific to any one of us

• We need to focus on the margins – the spaces between human, animal and ecosystem health

• Risk of missing “causes of the causes” – what expertise don’t we need?

http://lasirenagrill.wordpress.com/2012/03/03/the-green-iceberg/

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One Health Advantages

• Multiple perspectives are better than one» Looking at human disease without including the context in which human illness occurs will not inform our decision-making ability

• One Health is a useful paradigm to frame complex public health issues

• A way to foster information sharing and integrative surveillance

• Improved professional competencies and education

• One Health is an integrated approach to risk management and decision making

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How Can One Health Improve What We Do?Current SituationCurrent Situation With One HealthWith One Health

Focus on outbreak response

Focus is generally on health and scientific aspects of disease

Approach tends to be siloed and fragmented

Focus is primarily national

Education tends to be discipline-specific

Communities engaged and mobilized only after outbreak event

Focus on preventing outbreaks

Focus includes social and cultural determinants of health

Approach is holistic, integrative and interdisciplinary

Focus includes international cooperation and prevention

Education is cross-sectoral, including other disciplines and perspectives

Early education and information sharing with communities to prevent zoonotic outbreaks

One Health Activities• PHAC’s One Health activities

» PHAC is highly engaged in promoting One Health; collaborating with other departments (CFIA)

» PHAC is applying a One Health approach to AMR policy development, CIPARS, C-EnterNet, West Nile and Lyme disease surveillance, Science-Policy Integration

» One Health Operational Model• Provinces and Territories

» Manitoba, Ontario, Alberta, Saskatchewan, Quebec

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ONE HEALTH AND THE PUBLIC HEALTH AGENCY OF CANADA

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Infectious Disease Prevention and Control Branch

(IDPC) One Health

Operational Model

International One Health Activities• United States:

» CDC – One Health Office

» USDA-APHIS – OH Coord’n Office

» Multiple Universities

• European Union:

» Animal Health Strategy (2007 – 2013)

• Australia

• World Health Organization (WHO), World Organization for Animal Health (OIE), Food and Agriculture Organization (FAO), the World Bank

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Upcoming International Events

• 2nd GRF One Health Summit 2013» One Health - One Planet –

One Future: Risks and Opportunities» Davos, Switzerland November 17 – 20, 2013

• 3rd International One Health Congress» Amsterdam, Netherlands March 15-18, 2015» Would be an excellent meeting to showcase

the One Health activities at the University

of Saskatchewan

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One Health Education

• One Health curriculum needs to address the effects of climate on ecosystem health, wildlife, and the movement of plant, animal, and human diseases

• There is an opportunity for veterinary medicine to leverage its expertise in One Health and lead advances in food-animal husbandry and welfare, water safety and security, and the health of wildlife and ecosystems

• Need to integrate the key disciplines of human medicine, veterinary medicine, conservation biology, public health, basic sciences, agriculture, economics, social sciences and environmental sciences

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Education Recommendations• One Health is an “… opportunity to connect and educate health

professionals at an early stage, when they are naturally learning together. As undergraduates, these students are excited about integrating new ideas, and their academic schedule may be more accommodating to a variety of classes. Presenting One Health concepts to students at this stage of their education could have a positive impact on their awareness of and attitudes toward public health.”

» Farone TS. Incorporating the one-health concept into undergraduate education.J Am Vet Med Assoc. 2011 Dec 1;239(11):1406-7.

• “Introducing this concept to students early in their academic careers is important to ensure that they are still open to broad-based, interdisciplinary ways of thinking.

» Kahn LH. Educating undergraduates on one health. J Am Vet Med Assoc. 2012 Jan 15;240(2):144.

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Challenges for One Health Leaders• Labelled as a non-expert

• Issues with common language when mixing disciplines

• Lack of funding – public, private and industry, competing priorities

• Small number of One Health mentors and senior faculty

• No unifying vision for One Health in Canada and abroad - poor coordination among Canadian health actors, “siloes”

• Career paths in One Health are often unclear and few well-paying job opportunities are advertised for graduates

• Limited opportunities to mobilize interest in One Health outside of academia in Canada

• Will require changing behaviours and mindsets

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An Uphill Battle

• “…a shortage of collaborative student programs, insufficient environmental training for health professionals, and a lack of institutional support impede progress” » Meredith A Barrett, Timothy A Bouley, Aaron H Stoertz, and

Rosemary W Stoertz. 2010. Integrating a One Health approach in education to address global health and sustainability challenges. Frontiers in Ecology and the Environment (e-View)

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“If you always do what you've always done, you'll always get what you've always got.”

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The Benefits of One Health (AVMA 2008)

• Improving animal and human health globally through collaboration among all the health sciences, especially between the veterinary and human medical professions to address critical needs

• Meeting new global challenges head-on through collaboration among multiple professions—veterinary medicine, human medicine, environmental, wildlife and public health

• Developing centers of excellence for education and training in specific areas through enhanced collaboration among colleges and schools of veterinary medicine, human medicine, and public health

• Increasing professional opportunities for veterinarians• Adding to our scientific knowledge to create innovative programs to

improve health

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Advantages for One Health Leaders

• Marketable

• Nimble, adaptable

• Responsive to disease outbreaks, challenges

• Broader perspective, see the commonalities

• Chance to show leadership nationally and globally

• Canada has recognized leaders in One Health – available for mentoring and support

• Help to bridge the educational and research gap between the human, veterinary and environmental science fields

• Potential employers – government, educational institutions, NGOs

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The Next Generation of One Health Practitioners

Physical Environments

Humans Animals

Social Environments

Psychological

Sociological

Historical

Anthropological

Economic

Political

Public Policy

Communication StudiesBiomedical

Governance

Public Population Health

Public and Population Health

Veterinary Medical

Evolutionary and Comparative

Animal Science

Medical

Environmental and Ecological

Source: Rock et al., 2009

“Gentlemen, we can rebuild him, we have the technology”

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