Looking ahead to the World Health Summit: Can we deliver on One Health?
By Georgie Boardman
As coronavirus grips the world, we see yet another disease that has crossed from animals to humans. In response, the need for a ‘One Health’ approach to global disease prevention, linking human and animal health has never been more critical.
So what is ‘One Health’? In theory the idea is simple, we need to design and implement programmes, policies and legislation across multiple sectors, communicating and working together to achieve better public health outcomes. Many of the same microbes infect animals and humans and share the same ecosystems. But the practice is much harder. Human health systems are better funded, investment has been made in hospitals, drugs, surveillance and data collection. Human health systems are far from perfect, but compared with animal health systems they are worlds apart. Oshun Partnership continues to work with the World Health Organization, the University of Glasgow and other United Against Rabies partners to accelerate the process of eliminating rabies. The aim is to meet the UN SDG target of zero human deaths from dog-mediated rabies by 2030.
Rabies is entirely fatal if not treated. Yet it is the only neglected tropical disease where the tools for control and elimination have been proven and elimination is completely viable. Rabies is a well understood disease and the pathway to eradication through mass dog vaccinations and improved surveillance is clear.
But rabies is not a political priority. It is a disease of poverty. The poorest will struggle to access post exposure prophylaxis and even if they are available, the cost will be prohibitive. Thankfully rabies will not spread like a coronavirus. However, the same approach combining human and animal health with community level engagement is required if we are to deal with rabies, Ebola, coronavirus, or the next disease that has yet to mutate and cross between species.
We have been thinking about ways in which we can not only eliminate rabies but use this disease as a vehicle to show the One Health approach in action. Is rabies the peacetime disease that will enable us to build effective animal and human health systems and create a platform of trust with communities? Governments could develop pathways which could enable them to activate disease control through a combined animal and human health approach in times of crisis.
In April 2020, the Regional World Health Summit will be held in Kampala. The University of Makerere will co-host an event alongside Rabies Free Africa, HealthforAnimals and the University of Glasgow, sponsored by MSD Animal Health. The aim will be to emphasise the feasibility of rabies elimination, raise awareness of the harm it causes to human health and highlight the links to animal health and welfare. The focus will be on accelerating progress towards regional elimination of rabies in East Africa, through the creation of a regional roadmap for successful and sustained control.
This event will be a stepping stone on the path towards elimination, building regional support which we hope can be elevated further in the following months, including at the Neglected Tropical Diseases and Malaria Summit during the Commonwealth leaders’ meeting in Kigali in June.
Rabies is a priority zoonotic disease in endemic countries but is not on the radar at global level. It is still endemic in 150 countries where it mainly affects the poorest communities. Almost half of all deaths from rabies are children under 15. If the aim of the UN’s Global Goals is to leave no one behind, the people most affected by rabies fatalities cannot be forgotten, let’s make 2020 the year that rabies gets back on the political agenda.