Systematizing the One Health Approach in Preparedness and Response Efforts for Infectious Disease Outbreaks Proceedings of a Workshop (2022) / Chapter Skim
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3 One Health in Praxis
3 One Health in Praxis
Pages 19-42
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From page 19... ...
Supaporn Wacharapluesadee, researcher at Thai Red Cross Emerging Infectious Diseases Health Science Centre (TRC-EID) , King C hulalongkorn Memorial Hospital, Bangkok, Thailand, outlined the roles of discovery, diagnosis, and research and development in early detection and control of an outbreak.
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From page 20... ...
Houston, the fourth-largest city in the United States, is located in Harris County and has two large public health agencies: Houston Health Department and HCPH.1 Houston is also home to Texas Medical Center, the largest medical center in the world, in addition to one of the world's largest seaports, two international airports, and the nation's largest concentration of petrochemical facilities. HCPH houses the largest refugee health screening program in Texas.
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From page 21... ...
Wiltz-Beckham noted that HCPH is a comprehensive local health department, offering a full range of services, including veterinary public services, animal control, preparedness, outreach, dental, HIV prevention, mosquito vector control, inspection of pools and nuisance complaints, sanitarian services, and immunizations. Wiltz-Beckham outlined the offices and divisions that contribute to the One Health initiative at HCPH.
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to make progress in Harris County breaking down these silos through collaboration. Now, when surveillance and the EPI team identify a positive case of West Nile virus, they notify MVCD.
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Once an animal tests positive, a multidisciplinary team is alerted, and animal control officers go to the area to conduct outreach services. For example, HCPH physicians communicate with veterinarians in an effort to ensure that anyone who came into contact with the rabid bat is evaluated.
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Additionally, HCPH conducted surveillance in shelters for people and pets displaced by the hurricane. Mosquito control, environmental health, and animal management services have also been part of HCPH's Hurricane Harvey response.
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Wiltz-Beckham stated that HCPH is implementing various One Health initiatives at the local level. The organization began without any designated One Health staff positions, added part-time coordination assistance, and now has full-time One Health and global health coordinators.
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From page 26... ...
Additionally, a national, multi-sectoral collaboration among the Ministry of Public Health, private hospitals, and the academic research center expanded surveillance of variants of SARSCoV-2 that cause COVID-19. The PREDICT Diagnostic Approach Spanning from 2010 to 2019, USAID's PREDICT research project was implemented in 35 countries at high risk for zoonotic disease emergence, including Thailand, said Wacharapluesadee.3 In April 2020, it was extended to provide emergency support to Thailand during the COVID-19 pandemic.
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The workflow involved the collaboration of three national laboratories. DDC's B amrasnaradura Infectious Diseases Institute was responsible for detecting all known respi ratory pathogens from the same sample.
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The Department of National Parks, Wildlife, and Plant Conservation, Chulalongkorn University, and K asetsart University began an international collaboration with Duke-National University of Singapore's Emerging Infectious Diseases Program in June 2020 to study bats in connection with SARS-CoV-2 (Wacharapluesadee et al., 2021)
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Moreover, the contributions and collaborations of a wide variety of organizations strengthen the capabilities of the laboratory, enabling it to address novel viruses. COVID-19 RESPONSE: LESSONS LEARNED TO REINFORCE THE RELEVANCE OF ONE HEALTH PRINCIPLES Presented by Thierry Nyatanyi, Africa CDC Nyatanyi outlined existing frameworks for responding to disease outbreaks.
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, the World Organisation for Animal Health's (OIE's) Aquatic Animal Health Code and Terrestrial Animal Health Code, and the Tripartite Guide.5,6,7 Such regulations have informed frameworks that include the IHR monitoring and evaluation framework, national action plans for health security formed through WHO's Joint External Evaluation,8 OIE's Performance of Veterinary Services Pathway (PVS)
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From page 31... ...
While a One Health coordination mechanism was in place at the onset of the COVID-19 pandemic, Nyatanyi explained that the global impact led the Rwandan Prime Minister's office to establish a framework specific to COVID-19 days before the first case was diagnosed in the country. It uses an expert advisory team composed of academic institutions and development partners who provide guidance on response measures; its components include epidemiology and surveillance, logistics and administration, risk communication, and planning.
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From page 32... ...
These import gaps were addressed by efforts to boost local manufacturing. The production of protective equipment and vaccine deployment fast-tracking are other important components of the emergency response efforts that Nyatanyi noted, explaining that the pandemic has exposed challenge areas that were not addressed by the original One Health coordination mechanism.
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From page 33... ...
Expansion of Rwanda's Testing Capacity and Surveillance Highlighting the national scale-up of testing capacity, Nyatanyi noted that prior to the SARS-CoV-2 outbreak, Rwanda had only two Rotor-Gene PCR cycler machines able to test for the virus. Within 9 months, procurement of testing machines was fast-tracked, resulting in 88 more being made available in locations across the country, he said.
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Rwanda also adopted WHO's guidance for home-based care, which required the support of the entire health care system. Community health workers assisted in implementing the approach, which decongested health facilities and assured continuity of health services.
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• Domestic investments -- both government funded and from government partners -- can strengthen health systems and potentially fast-track One Health via implementation of Global Health Security Agenda country plans and improvement of WHO Joint External Evaluation scores. • Leveraging existing preparedness and response frameworks can ensure con tinuity of cross-border travel and trade during a pandemic through regional economic blocs.
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From page 36... ...
Highlighting the size of Harris County's population and the scope of HCPH's programming, Kester asked Wiltz-Beckham if all efforts rely on government funding or other funding sources are used. She replied that the majority of HCPH's efforts are via general funds and grants from the
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From page 37... ...
This relationship has established trust and enabled effective communication among MOH, traditional healers, and people treated with traditional medicine, he said, allowing the MOH to dispel misconceptions. Hypotheses on the Origin of COVID-19 Given the extensive assessments Wacharapluesadee has done thus far, Kester asked for her opinion as to the origin of COVID-19, noting that the risk for other viruses to jump from animals to humans will not disappear with the pandemic.
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Noting the impact that providing curricula about recycling in U.S. high schools in years past had on raising teenagers' awareness of recycling, Kester asked the panelists how One Health concepts can be inculcated through the education system.
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She remarked that government officers have routine work that prevents them from having time to dedicate to developing the One Health concept, and researchers can connect while working together in offices. REFLECTIONS FROM DAY 1 Eva Harris, professor of infectious diseases and director of the Center for Global Public Health at the University of California, Berkeley, summarized the day's sessions.
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From page 40... ...
This coordination is needed regardless of whether the setting is a large urban county health department in Texas, a national surveillance and detection effort in Thailand, or a broad public health response to the COVID-19 pandemic in Rwanda. Developing and maintaining coordination can be a challenging endeavor and necessitates constant sustainment, said Kester.
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From page 41... ...
ONE HEALTH IN PRAXIS 41 Kester remarked that the COVID-19 pandemic remained the global focus, with the reemergence of Ebola in Africa in early 2021 receiving little attention. Public leaders and policy makers can easily divert their attention to other issues, he noted, so strong leadership is needed to make better decisions regarding One Health or public health, which are intertwined.
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