Operationalizing One Health: The Bangladesh ExperienceNitish C Debnath, DVM, MS, PhD

FAO-AI Technical Unit/ECTAD-BangladeshOne Health Alliance of South Asia (OHASA)

Bengal Declaration (2009)Highlights

Signing a Memorandum of Understanding between relevant agencies/ministries that will create a communication network to report emerging zoonotic disease surveillance results and coordinate response activities;

Establishing an Interagency Task Force (ITF) that meets between the governments that will be responsible for the development of standardized reporting guidelines and protocols both within and between government agencies.

Creating a network of diagnostic laboratories in India and Bangladesh that will test wildlife samples for zoonotic pathogens.

Promoting the investigation of all wildlife disease outbreaks and establishing a real-time, web-based disease reporting mechanism.

Allocating government funds, and funds from other national and international non-governmental agencies to support this research in emergent zoonotic disease surveillance.

Establishing One Health programs at relevant institutions to enhance public health effectiveness, increase understanding of the impact of anthropogenic changes on the emergence of new pathogens of animal and human origin, and accelerating biomedical research discoveries

Enhancing public health education through public outreach campaigns and professional workshops and seminars that use the One Health paradigm to bridge disciplines and increase general awareness of the links among human, animal, and ecosystem health.

One Health Bangladesh initiativeChittagong Declaration (2008)

HighlightsAll professions related to the health, livestock, social and environment sciences should understand the

importance of the “One health” approach and work together.All health professionals, Government and local people be made aware about the holistic approach and

regulatory matters.Organizing training and developing communication pathway between and among the professionals is

essential;That develops strong bridge with the “One health” global initiatives.That initiatives should be taken for developing training, education and research programmes on the

“One Health” concept.Development of suitable health services to the most neglected population in the remote rural areas of

the country. Enhancement of interdisciplinary communications on cross-cutting issues.Reduction of institutional and mental barriers for undertaking need-based multi-disciplinary research,

training and extension programmes.Seminar, symposia and open discussions should be staged on regular basis to take the “One world, one

health” movement further forward

Six international conferences and seminars have already been organised by this forum on some recent multidimensional burning issues

Conference on Changing world and emerging challenges: A One World One Health Approach – 2008 at CVASU, Chittagong, Bangladesh

Dhaka Conference on Avian Influenza and other emerging zoonotic diseases in Bangladesh: A One World One Health Approach – 2008 at ICDDR,B

Conference on Food security and food safety: Towards a A One World One Health Approach – 2009 at CVASU, Chittagong, Bangladesh

Seminar on Swine Flu in 2009 at IEDCR, Dhaka, Bangladesh Seminar on Pesticide Poisoning in 2009 at ICDDR,B, Dhaka,

Bangladesh

Activities of One health-Bangladesh

Communication, Advocacy , Networking & leadership Need Assessment & Capacity Development Research Collaboration Education & Training Collaborative Practices

The key strategic approaches

Informal discussion began at Chittagong Veterinary Animal Sciences University (CVASU) in 2007 at the emergence of HPAI

Looking for relevant partners to move forward IEDCR and ICDDR,B showed keen interest as human health partners Positive responses from professionals working in Livestock, Agriculture and

Forestry sector Civil society-BAPA, NGO-BRAC, Academia-BAU, DU & BSMRMU and Research-

BLRI, IFRB etc. got involved

The beginning of a One Health journey

Representatives from 12 national and international organizations got together to form a professional organization called One Health Bangladesh in December 2007

Formed a National Coordination Committee to work for promoting One Health concept in Bangladesh

Membership criteria: Physicians, vets, agriculturists, environmentalists, wildlife experts, ecologists, anthropologists, economists, allied scientists and practitioners, activists

Currently 200 active members

Formation of a brand new team

5 year, USAID-funded project Builds upon USAID/USG investments in avian and pandemic influenza preparedness and response Expands efforts to address emerging zoonotic infections more generally, especially those of wildlife origin Vets, physicians and wildlife experts are undertaking collaborative research on EIDs Formulation of two One Health oriented declarations namely Chittagong declaration and Bengal declaration to

stimulate greater multisectoral participation Actively involved with OHASA (One Health alliance for South Asia) Initiate SAVE (South Asian Veterinary Education Network) to Develop thinking and practices in South Asia in

relation to One Health and to embed One Health in Veterinary Curriculum through SAVE FAO supported development of BLRN (Bangladesh Laboratory Response Network) with a vision of progressively

attaining an effective community of practices focus on fostering nation’s lab. capacity to promote One Health strategy for facing the challenges of emerging human and animal health emergencies & food safety

The achievements and affiliations to date

Highest population density in the world Hot spots for EIDs and Re-emerging diseases Vulnerable food security and safety Most fragile ecosystems 50% of the tube wells exceed WHO standard for arsenic People are exceptionally close to animal

Challenges of One health in Bangladesh

Joint outbreak investigation – The Anthrax story Multidisciplinary team visiting outbreak sites Joint Reporting & Consultation Share laboratory findings Joint response to national EID outbreaks A new professional culture emerging

Sequence of events in a 2009 outbreak of anthrax in Bangladesh where joint outbreak investigation were in place. Figure courtesy of IEDCR and ICDDR,B, Dhaka, Bangladesh

One Health practices in Bangladesh: Successful joint outbreak Investigation in recent years include-

Pesticide poisoning (2008) Avian influenza (2008) Nipah virus (2009) Anthrax (2009)

The distribution of Nipah virus in Bangladesh as found by ICDDR,B researchers which comprised a joint team of vets, physicians, anthropologists and conservationists.

Recent ICDDR,B studies have shown that fruit bats (Pteropus giganteus) often contaminate the date-palm juice which is so popular in rural Bangladesh during the winter months.

Anthrax has emerged as zoonotic disease in Bangladesh where non-inspected or illegal slaughter of sick animal is frequent in rural as well as urban areas

The live bird market in Bangladesh where active surveillance are in place to identify the risk of human infection for avian influenza

Around 1.25 million birds have been culled in Banglaesh since 2007 when avian flu was first reported

Many deaths of animal and human are reported due to pesticide poisoning each year, as a result of unsafe use of often banned products in Bangladesh.

Hundreds of cows have been infected and scores have died during recent outbreak of anthrax in Bangladesh where meat quality and safety issues are mostly ignored

The poster is presented in the 1st International Congress on Pathogens at the Human-Animal Interface(ICOPHAI), September 15-17, 2011: UN Conference Centre, Addis Ababa, Ethiopia.