Anna Fagre˚, Francisco Olea-Popelka˚, Sue VandeWoude˚, Mark Stetter˚, & William Kareshˆ

˚Colorado State University ˆEcoHealth Alliance Overview  Importance of One (OH) in professional training programs  Survey design & distribution  Results  Analysis of integration  Future directions

https://www.avma.org/KB/Resources/Reference/PublishingImages/OneHealthIntersection.gif Introduction  Multifaceted problems require multifaceted solutions  Value of collaboration  Increasing rate of infectious disease  75% are zoonotic & many have wildlife reservoirs (Taylor et al. 2001)

 Prevent re-emergence and spillover events (Daszak et al. 2007)

http://i1.ytimg.com/vi/j_SjhcdF_J4/maxresdefault.jpg … Introduction

 One Health – term coined in 2003 (Karesh, 2005)  One Health ≠ Public Health, One , Zoonotic Diseases, Comparative Medicine, Food Safety, Conservation Medicine  Ecosystem Health (Zinsstag et al. 2011)  Scarce in professional training programs (Steele 2008; King et al. 2008) … Introduction  One Health = “single most important new opportunity” for the veterinary profession  One Health knowledge as a NAVMEC core competency for young (Wong & Kogan 2013) Challenges facing OH sustainability  Lack of funding  Faculty & student time constraints  Inertia and/or confusion relating to diverse usage of the term One Health  Lack of inter-institutional collaborations Objective  Assess integration of One Health programs in veterinary schools in Canada, the Caribbean, & the US  Characterize examples of current undertakings

http://mizzoumagarchives.missouri.edu/2011-Spring/features/one-health/images/one-health.jpg Survey Design  Two surveys (www.surveymonkey.com)  One administered to students  One administered to administration  Veterinary schools in Canada, the Caribbean, & the US  N = 36

http://www.survey-reviews.net/wp-content/uploads/2012/02/onlinesurvey.jpg Administrative survey 1. Which veterinary school are you affiliated with? 2. Does your veterinary school have a One Health institute or initiative? 1. If so, what is it called? 2. Please provide primary contact information or web URL for institute/initiative 3. Is One Health incorporated into the veterinary school curriculum? 1. If so, please briefly elaborate. Student survey 1. Which veterinary school do you attend? 2. Does your veterinary school have a One Health student organization/association? 1. If so, what is the name of the organization? 2. Please provide primary contact information or web URL for organization. Results

Proportion of veterinary colleges in Canada, the Caribbean, and United States in which a One Health initiative is implemented at the administrative or student body level. Administrative Student-led Either administrative School Location initiative initiative or student-led

Canada 4/5 (80%) 3/5 (60%) 4/5 (80%) Caribbean 2/3 (66.7%) 1/3(33.3%) 2/3 (66.7%) United States 19/28 (67.9%) 17/28 (60.7%) 23/28 (82.1%) Overall 25/36 (69.4%) 21/36 (58.3%) 29/36 (80.6%) Presence of One Health at administrative level

31% "One Health" in name of 36% institution Self-described as One Health (varied verbage) No One Health Institute/Initiative

33% Univ. Admin. : “One Health” in title of initiative

Interprofessional Calvin Schwabe One Education (IPE) Global Health Institute’s Center for One Health Health Project Program: One Health One Health Center Module

One One Health Grand One Health/One Health/Interprofessional One Health Initiative Challenge Medicine Health Initiatives

One Health Clinic (in One Health Leadership One Health Institute conjunction with Experience medical school) Univ. Admin. : Efforts self-described as One Health with different names

Center for Public Ecosystem Health Institute of Public and Corporate Initiative Health Studies Veterinary Medicine

Department of Microprogrammes Centre for Public Ecosystem and en santé publique Health and Public Health vétérinaire Zoonoses

International Global Health Initiative Health Pathway Exposure to “One Health” in veterinary coursework?  94% (34/36) of schools indicated OH exposure occurs in veterinary coursework  Ranges from one lecture to campus-wide learning communities & awards  11.1% (4/36) of schools have official OH Certificate program

https://www.ma.utexas.edu/users/rjain/Lectures.jpg Levels of One Health integration in veterinary coursework

Courses offered Certificate program in through Master in Global Health Core curriculum Elective international Public Health and Elective courses (graduate AND courses rotations Veterinary undergraduate) (MPH/DVM) programs

Interprofessional Increased academic Integrated with Center Education Program interactions with Integrated “across the for Public and (mandatory university- Foundations courses medicine, dentistry, curriculum” Corporate Veterinary wide 1st year course nursing, & public Medicine with One Health health schools module)

Lectures (ranging in Undergraduate One University-wide One number from 1-6) or as Health learning Health award a section of a course community Courses provided that discuss One Health themes and efforts

Economics and Communications Ecosystem health Food safety policy

Foreign animal -animal Foundations Global health Health and society disease relationships

International Law & veterinary Preventive Infectious disease Population health veterinary medicine medicine veterinary medicine

Zoonoses Public Wildlife Translational (including virology, Principles of ethics health/veterinary health/wildlife medicine , public health disease parasitology) Presence of One Health student organizations/associations

28% "One Health" in name of organization/association 42% Self-described as One Health (varied verbiage) No One Health organization/association 30%

Ecosystems Health Three schools have Global health/solutions SCAVMA Committees on Public health One Health Public policy Discussion  100% response rate  comprehensive view of One Health in Canada, the Caribbean, & US vet schools  Very large degree of variability in names, verbiage, & levels of integration  Quantification & characterization of efforts allows us to fill in knowledge gaps

http://www.cvm.ncsu.edu/news/openhouse/images/OneHealthcollage2_000.jpg … Discussion  One Health is growing, but definition is broad and often misunderstood (or used with various meanings)  One Health ≠ public health (but encompasses it)  Environmental consequences of human & animal health interventions rarely emphasized

https://sites.google.com/a/owu.edu/endangerment-of-bald-eagles/home/the-science-of-ddt One Health is not just a new name for comparative medicine or veterinarians contributing to human health. It is a call to work together - a call to action for us to ensure that animal production and animal disease control contributes to the health of the planet and a sustainable future.

http://upload.wikimedia.org/wikipedia/commons/c/c9/Chiang_mai_province_road_1263.jpg … Discussion

 How to incorporate into curriculum?  International & transdisciplinary collaborations  Communication (webinars, video seminars, etc.)  Education (online student forums, student exchange programs)  Online training courses (Barrett 2010)  Trandisciplinary learning networks (Barrett 2010)  Case studies  Seminar speakers

http://www.sneb.org/images/webinar.jpg Future directions  Administering a similar survey in other professional health institutions or environmental science departments  Administering a more detailed survey taking inventory of various OH activities conducted  Compare and contrast OH literacy among disciplines

http://1.bp.blogspot.com/-BPU2gEYJ4AA/TyWnK-D8gSI/AAAAAAAAAEM/VoQySmpBO2Q/90806_18005924361.jpg References 1. Taylor, L.H., S.M. Latham, and M.E. Woolhouse, Risk factors for human disease emergence. Philos Trans R Soc Lond B Biol Sci, 2001. 356(1411): p. 983-9. 2. Daszak, P., et al., Collaborative Research Approaches to the Role of Wildlife in Zoonotic Disease Emergence, in Wildlife and Emerging Zoonotic Diseases: The Biology, Circumstances and Consequences of Cross-Species Transmission, J. Childs, J. Mackenzie, and J. Richt, Editors. 2007, Springer Berlin Heidelberg. p. 463-475. 3. Karesh, W.b. and R. A. Cook. The human-animal link: One World – One Health. Foreign Affairs, 2005. 4. Steele, J.H., Veterinary public health: past success, new opportunities. Prev Vet Med, 2008. 86(3-4): p. 224-43. 5. King, L.J., et al., Executive summary of the AVMA One Health Initiative Task Force report. J Am Vet Med Assoc, 2008. 233(2): p. 259-61. 6. Zinsstag, J., Schelling, E., Waltner-Toews, D., & Tanner, M., From “one medicine”to“one health”and systemic approaches to health and well-being. Prev Vet Med, 2011. 101(3-4): p. 148-156. 7. Wong, D. and L.R. Kogan, Veterinary students' attitudes on One Health: implications for curriculum development at veterinary colleges. J Vet Med Educ, 2013. 40(1): p. 58-62. 8. Rapport, D.J., Costanza, R., & McMichael, A.J., Assessing ecosystem health. TREE, 1998. 13(10): p. 397-402. 9. Barrett, M.A., et al., Integrating a One Health approach in education to address global health and sustainability challenges. Frontiers in Ecology and the Environment, 2010. 9(4): p. 239-245.