ZOONOSES: BLURRED LINES OF EMERGENT DISEASE AND ECOSYSTEM HEALTH
Managing zoonoses for human, animal and ecosystem health
Zoonotic diseases affect human health, agriculture, the economy, and environmental integrity. In just the last decade, around US$20 billion have been directly spent in responding to emerging zoonoses and in implementing initiatives for better progressive control of zoonoses, with a further estimate of US$200 billion in indirect costs to affected economies.27 Zoonoses management requires an integrated and inter- sectoral approach. At the global level, three organizations have mandates that cover zoonotic disease: the World Health Organisation (WHO), the World Animal Health Organisation (OIE), and the Food and Agriculture Organization of the United Nations (FAO).
Environmental health initiatives have been less well represented in global zoonoses control programs. However, ecosystem integrity is a key factor in the innovative approaches taken by One Health and EcoHealth initiatives that are spearheading zoonoses control at regional and national levels. Applying inter-sectoral approaches has had some notable successes, which ultimately improved human health, such as controlling rabies in the Serengeti ecosystem, understanding the burden of brucellosis in Mongolia, and controlling leishmaniasis in Tunisia using ecosystem-based approaches and community-based interventions.28-31
There
has also been a surge in novel surveillance of wildlife and livestock health and reporting tools that draw on a wide range of field reports. These include the Program for Monitoring Emerging Diseases (ProMed), GeoChat, the World Animal Health Information Database (WAHIS) interface and WAHIS- Wild interface, HealthMap, Wildlife Health Australia and US Wildlife Health Information Sharing Partnership event reporting system (WHISpers).
Transmission of zoonotic diseases and amplification in people
Wild animal cases Domestic animal cases Human cases
10 20 30 40 50 60 70 80 90
0 Source: Karesh et al. (2012)25 Source: Karesh et al. (2012)25
There have been many cases of successful management of endemic zoonotic disease such as pig tapeworm and rabies. Several developed countries have succeeded in reducing zoonotic foodborne disease over relatively short periods by instituting control mechanisms all along the food value chain, with an emphasis on reducing disease in the animal host. However, if such control measures are not maintained, the diseases will recur after an initial suppression. For this reason, several high-priority zoonoses have been targeted for ‘progressive control towards elimination’, including bird flu, rabies, and pig tapeworm.32,33
The track record on managing emerging zoonoses is mixed. For example, the rapid containment of SARS is considered one of the biggest success stories in public health in recent years. In 2003, WHO alerted the world that a severe acute respiratory syndrome of unknown cause was rapidly spreading from Southeast Asia. Within six months, this entirely new disease
24 Vectors
Domestic animal amplification
Spillover
Spillover
Spillover Human amplification
Number of cases
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