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Operationalizing ―One Health: a Policy Perspective Taking Operationalizing “One Health”: A Policy Perspective— Taking Stock and Shaping an Implementation Roadmap MEETING OVERVIEW | MAY 4–6, 2010 STONE MOUNTAIN, GEORGIA National Center for Emerging and Zoonotic Infectious Diseases Division of High-Consequence Pathogens and Pathology PART I. Executive Summary The U.S. Centers for Disease Control and Training: Develop and build skills, expertise, Prevention (CDC), at the request of and in close and competencies through a One Health training collaboration with the World Organisation for curriculum, and identify opportunities to integrate Animal Health (OIE), the Food and Agriculture One Health approaches into existing curricula. Organization of the United Nations (FAO) and the World Health Organization (WHO), hosted a One Health Global Network (OHGN): Advocate meeting entitled Operationalizing “One Health”: and garner international support for One Health A Policy Perspective—Taking Stock and Shaping through a network that serves as a vehicle for an Implementation Roadmap in Stone Mountain, further global collaboration on One Health Georgia, USA, May 4-6, 2010. The Stone Mountain programs. meeting was the latest in a series of One Health meetings organized by diverse global institutions Information Clearing House: Promote One Health with the intent of providing a forum for national advocacy through a centralized area where One and international specialists to focus on policies Health success stories and lessons learned are and implementation of a One Health approach to gathered and made available to a wide-ranging improving human and animal health. audience. The specific goal of the Stone Mountain meeting Needs Assessment: Develop country-level was to identify clear and concrete actions to self-assessment methods that will identify move the concept of One Health from vision to programmatic areas that could benefit from a One implementation. Fifty-four select global leaders Health approach, and specific areas for targeting from government, non-government, academic, improvement. policy and economic sectors reviewed progress to date and identified key policy decisions and Capacity Building: Identify ways to leverage financial commitments necessary to support existing programs and capacity-building efforts to sustainability and expansion. To provide have a major impact at minimal cost. background for participants, the meeting began with a series of presentations about recent Proof of Concept: Demonstrate through a One Health events, followed by short panel retrospective and prospective evidence base that presentations and in-depth discussions where the use of One Health interventions leads to better speakers described their own experience in cross-species health outcomes. advancing the concept of One Health within their sector and/or country. Participants had the Business Plan: Articulate the concept of and opportunity to comment on panel presentations rationale for One Health more clearly and present during group discussion periods and provide their this information to policymakers and donors own perspective through small group sessions and worldwide. activities. Meeting participants defined a 3-5 year vision of One Health encompassing four main Each group was asked to develop One Health areas: culture change, increased visibility, political plans and partnerships that would occur within will/financial support, and optimal coordinated a designated timeframe. These workgroups will efforts. Seven specific activities were identified convene and continue their development to as being critical steps in attaining the defined finalize their actions plans, develop timelines and 3-5 year vision and separate workgroups were carry out activities. formed to address each of these activities. These workgroups include: 2 PART II. Overview of Events Leading Up to the Stone Mountain Meeting Background remarks, Danielle Grondin of the Public Health Agency of Canada noted that because the According to the World Health Organization political economic agenda is the priority of world (WHO), new infectious diseases have emerged at leaders today, One Health must be translated the rate of one or more per year since the 1970s. into language that is relevant to finance ministers SARS, HIV/AIDS, West Nile virus encephalitis, to facilitate the evolution of this concept from Nipah virus encephalitis, dengue hemorrhagic principle to practice. fever, and other diseases of zoonotic origin are well known examples of this increase in disease threats. In 2008, the Food and Agriculture Stone Mountain Meeting Organization of the United Nations (FAO), the Much progress was made at the Winnipeg meeting World Organisation for Animal Health (OIE), and toward defining approaches for achieving One WHO (the three major international organizations Health objectives; however, a complementary dedicated to issues concerning animal health meeting was necessary in order to define the and human health) collaborated with the United specific action steps needed to further move Nations Children’s Fund (UNICEF), the United the One Health concept forward. Therefore, Nations System for Influenza Coordinator (UNSIC), a Scientific Planning Committee composed and the World Bank to develop a joint strategic of representatives from the U.S. Centers for framework to address risks associated with Disease Control and Prevention (CDC), OIE, emerging and re-emerging infectious diseases. The FAO, WHO, the European Union, and Princeton document in which this framework was originally University was assembled to organize a follow- communicated, Contributing to One World, One up meeting. This subsequent expert consultation Health*—A Strategic Framework for Reducing titled, Operationalizing “One Health”: A Policy Risks of Infectious Diseases at the Animal-Human- Perspective – Taking Stock and Shaping an Ecosystems Interface, set out six specific inter- Implementation Roadmap, was held May 4-6, 2010 linked objectives for countries to consider in in Stone Mountain, Georgia, USA. The Scientific their approach to infectious-disease control at the Planning Committee developed a rich and animal-human-ecosystem interface. interactive agenda and carefully selected leaders from national Ministries of Health and Agriculture, In March 2009, the Public Health Agency of the European Commission, the United Nations, Canada hosted an expert consultation titled and the World Bank; in addition, representatives “One World, One Health: from ideas to action” from other diverse institutions from the academic, in Winnipeg, Manitoba. The purpose of the policy, and economic sectors were invited to consultation was to discuss the Strategic participate and contribute their expertise and Framework and to identify and shape country- experience to the discussion. level recommended actions to globally advance the framework. Participants recommended the development of supra-country approaches that use multidisciplinary/trans-disciplinary methods in addition to trans-boundary/regional approaches to ensure an integrated approach. In her closing 3 PART III. Welcome and Overview Opening Remarks Dr. Khabbaz stressed that the large number of attendees at this meeting is evidence in itself of Rima Khabbaz, CDC Deputy Director for the worldwide commitment to One Health. She Infectious Diseases went on to explain that each participant invited to attend the Stone Mountain meeting was identified During her opening remarks, Dr. Khabbaz thanked and selected to ensure a global, multi-disciplinary everyone for their participation, recognizing that representation. Together, the participants everyone was present for the same reason – a represented the inter-sectoral collaboration belief that One Health is the best approach for needed to move forward on One Health initiatives. attaining better health for humans and animals and for improving the environment. Dr. Khabbaz said that CDC was honored to host this meeting and hoped that the agency could Dr. Khabbaz pointed out that One Health is serve as a strong partner in advancing this effort. not a new idea. While historically, physicians She pointed out that One Health is an important and veterinarians had worked closely, the 20th priority for CDC’s infectious disease programs Century brought about a wide separation between overall. Dr. Khabbaz ended by emphasizing the these specialties. Moving from generalists to need for participants to continue working to move specialists further hindered interactions between One Health forward by assessing the current these practices which became even more critical state of the One Health approach; identifying as the century progressed. The tremendous and building upon successes and lessons mid-century advancements in technology and learned; identifying opportunities and barriers industry, increasing ecologic and environmental to implementing One Health; and formulating changes, and new human patterns of travel and strategies to address needs. Participants also were consumption created a highly connected world encouraged to identify concrete action steps for that provided multiple opportunities for the each of these critical components associated with introduction and spread of new and One Health implementation. re-emerging diseases. In September 2004, health experts from around Purpose and Proposed Scope the world met in New York City to discuss One for One Health Health. The meeting, titled “One World, One Speakers: Alex Thiermann, OIE, Liz Health: Building Interdisciplinary Bridges to Mumford, WHO, Jan Slingenbergh,
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