One Health contributions towards more effective and equitable approaches to health in low- and middle-income countries

Abstract

Emerging zoonoses with pandemic potential are a stated priority for the global health security agenda, but endemic zoonoses also have a major societal impact in low-resource settings. Although many endemic zoonoses can be treated, timely diagnosis and appropriate clinical management of human cases is often challenging. Preventive ‘One Health’ interventions, e.g. interventions in animal populations that generate human health benefits, may provide a useful approach to overcoming some of these challenges. Effective strategies, such as animal vaccination, already exist for the prevention, control and elimination of many endemic zoonoses, including rabies, and several livestock zoonoses (e.g. brucellosis, leptospirosis, Q fever) that are important causes of human febrile illness and livestock productivity losses in low- and middle-income countries. We make the case that, for these diseases, One Health interventions have the potential to be more effective and generate more equitable benefits for human health and livelihoods, particularly in rural areas, than approaches that rely exclusively on treatment of human cases. We hypothesize that applying One Health interventions to tackle these health challenges will help to build trust, community engagement and cross-sectoral collaboration, which will in turn strengthen the capacity of fragile health systems to respond to the threat of emerging zoonoses and other future health challenges. One Health interventions thus have the potential to align the ongoing needs of disadvantaged communities with the concerns of the broader global community, providing a pragmatic and equitable approach to meeting the global goals for sustainable development and supporting the global health security agenda.This article is part of the themed issue ‘One Health for a changing world: zoonoses, ecosystems and human well-being’.

Prevalence and risk factors associated with Leishmania spp. and Trypanosoma cruzi infections in dogs presented at veterinary clinics in João Pessoa, Paraíba state, northeastern Brazil

“…Visceral leishmaniosis and CD in dogs and humans are becoming more frequent in urban centers, mainly due to environmental and socioeconomic imbalances. The municipality of João Pessoa has undergone rapid urbanization in the past few decades, and the results of the present study should alert the city authorities that more complex, multidisciplinary, and multisystemic approaches are needed as advocated by the "One Health" initiative particularly in the case of zoonotic diseases with a strong environmental component (CLEAVELAND et al, 2017).…”

“…Therefore, the transmission of diseases among dogs is of great concern. In this regard, massive alterations in the environment, such as deforestation and urbanization in previously preserved areas, have altered the dynamics of canine diseases (CLEAVELAND et al, 2017). In Brazil specifically, canine visceral leishmaniasis (CVL) and Chagas disease (CD) are important endemic zoonoses.…”

Zoonotic disease research in East Africa

“…Zoonoses and diseases recently emerged from animals have been estimated to contribute more than a quarter of the disability-adjusted life years (DALYs) lost to infectious diseases in low income settings such as sub-Saharan Africa, and less than 1% in high income countries [5]. The attention given to zoonotic diseases has however focused more on emerging zoonoses that pose global economic and health threats and less on the endemic zoonotic diseases which tend to occur among populations with little political voice [6][7][8].…”

Improving the provision of rabies post-exposure prophylaxis

“…In 2015, WHO and its partners set the ambitious objective 1 to reach zero human deaths from dog-mediated rabies by 2030, after the concept of effective One Health interventions. 2 Mass dog vaccination is expected to be an important part of any successful strategy. 3,4 In The Lancet Infectious Diseases, the WHO Rabies Modelling Consortium 5 reminds us that effective and timely postexposure prophylaxis, administered to humans bitten by rabid dogs to prevent the fatal onset of rabies, is another essential tool for success.…”