African countries have been urged to adopt the One Health framework, a collaborative public health approach, amid concerns of pandemic outbreaks and for the emerging and re-emerging of highly infectious diseases such as COVID-19 and Ebola that adversely affect human health.
The call was made by a group of academics and public health experts during a discussion on 30 March titled ‘One Health and Public Health in Africa’, which formed part of the public dialogue series. The One Health event was hosted by the Alliance for African Partnership (AAP) and the University of Pretoria (UP), South Africa.
The AAP was co-created by Michigan State University and African thought leaders in 2016. It is a consortium of Michigan State University and 10 leading African universities, including UP, which collaborate to address continental and global challenges.
According to the World Health Organization, One Health is an approach to design and implement programmes, policies, legislation and research whereby multiple sectors in governments and private sectors communicate and work together to achieve better public health outcomes.
Various professionals with a range of expertise and who are active in different sectors, such as public health, animal health, plant health and the environment, are expected to join forces to support One Health approaches.
Endorsing the One Health public health strategy for Africa, Dr Yewande Alimi, the coordinator of the antimicrobial resistance programme at the Africa Centres for Disease Control and Prevention, or Africa CDC, said the continent is a hot spot of various zoonotic infectious diseases because of its forested tropical regions, rapid land-use changes and large wildlife biodiversity.
Zoonotic diseases are caused by bacteria, viruses and other germs that spread between animals and people.
According to Alimi, 60% of existing human infectious diseases are zoonotic but, even much worse, 75% of the emerging infectious diseases that include various variants of severe acute respiratory syndrome, Ebola, HIV, Marburg, monkeypox and Lassa fever have an animal origin. “Three out of five human diseases that appear every year originate from animals,” said Alimi.
Beyond traditional thinking
To deal with these challenges, Professor John David Kabasa, the principal of the College of Veterinary medicine, Animal resources and Biosecurity at Makerere University in Uganda, said the One Health framework offers opportunities that are beyond the traditional thinking about public health.
He noted that interactions of people, domestic animals, wildlife and the environment in Africa have become increasingly complex, requiring new strategies to solve public health problems.
Citing the Ugandan experience, Kabasa said that, in the recent past, there had been zoonotic epidemics that included Ebola, yellow fever, Marburg and avian influenza. “The country also had outbreaks of brucellosis, rabies, trypanosomiasis [‘sleeping sickness’] and anthrax,” said Kabasa.
To Kabasa, these challenges had not been unique to Uganda but were widespread in Sub-Saharan Africa, especially in countries within the Congo basin where, in recent decades, environmental changes and overlap between people, livestock and wildlife have increased rapidly.
In this regard, the Africa CDC in a briefing ‘Framework for One Health Practice in National Public Health Institutes: Zoonotic disease prevention and control’, noted increases in globalisation, urban density, ease of travel and animal movement have created new opportunities for the spread of old diseases and the emergence of new ones.
To avert the crisis, Professor Wanda Markotter, the director of the Centre for Viral Zoonoses at the University of Pretoria and who was a co-moderator of the session, said there is an urgent need for preparedness and workforce capacity-building, using the One Health approach.
The need for resilient approaches
Even though some African countries in the past 10 years had been trying to establish One Health multisectoral approaches, there had been constant threats of disease outbreaks as a result of increased land use, agricultural practices, climate and weather variations and urbanisation.
According to Wayne Ramkrishna, the deputy director of communicable disease control at South Africa’s Department of Health, few African countries have established resilient One Health approaches.
In a presentation, “Implementation of the One Health approach in South Africa,” Ramkrishna said although South Africa has one of the best One Health multisectoral approaches on the continent, there is still a need to enhance epidemic preparedness and response.
“Currently, coordination of stakeholders is still weak and we continue to lack a national research agenda that would guide policy development and implementation,” said Ramkrishna.
He also decried the lack of a formalised multisectoral information-sharing network, as improved communication is required at all levels. Even then, the South African approach had been able to adequately respond to outbreaks of rabies and influenza.
According to Ramkrishna, advanced research had also been carried out on brucellosis, an infectious bacterial disease that can affect people who have been in contact with infected domestic animals that include sheep, cattle, goats and pigs. South Africa is in the process of drafting a framework that will be aligned with the World Health Organization’s global One Health strategy.
Amid efforts to anchor the One Health concept into African health systems, the academics urged African universities to develop competency-based curricula to promote One Health approaches among undergraduate medical and veterinary students.
According to Kabasa, such programmes should also be introduced in diploma- and certificate-awarding colleges that train medical and veterinary frontline workers for rural areas.
Towards such initiatives, the East African Community secretariat, in collaboration with the Heidelberg Institute of Global Health in Germany, has developed short courses on pandemic surveillance and preparedness with a One Health approach.
According to Timothy Wesonga, the regional adviser on pandemic preparedness at the East African Community, the short courses have been piloted at Egerton University and Moi University in Kenya and at Makerere University in Uganda.
Commenting on the selection of the trainees, Wesonga told University World News that applicants were required to have bachelor degrees in medicine, veterinary sciences, health informatics, environmental health and pharmacy.
Other cadres were graduates in education, natural resources, agricultural sciences, community development, nutrition and food safety public administration.
They were also employees of government departments, universities, non-governmental organisations and research bodies.
Those initiatives were expected to supplement the work of One Health Central and Eastern Africa, or OHCEA, a network of universities that offer public health and veterinary medicine in eight countries in East, Central, and West Africa.
But, according to a study, ‘One Health capacity building in Sub-Saharan Africa’, that was conducted by a group of researchers that included Kabasa, most of the universities that are members of OHCEA are too focused on research on zoonotic diseases.
“With the growing interest in One Health, the focus should move away from just infectious diseases to other issues such as antimicrobial resistance, climate change, environmental degradation and other topics that will help accomplish the United Nations’ Sustainability Development Goals,” stated the study.
Members of OHCEA include the University of Buea in Cameroon; Jimma University, Mekelle University and University of Addis Ababa in Ethiopia and University of Lubumbashi and University of Kinshasa in the Democratic Republic of Congo.
Other members of the network include: Muhimbili University of Health and Allied Sciences and Sokoine University of Agriculture in Tanzania; University of Rwanda; Makerere University in Uganda; Senegal’s Interstate School of Veterinary Sciences and Medicine in Dakar and the University of Nairobi and Moi University in Kenya.
The aim of the network is to promote the One Health approaches by mounting academic programmes towards building capacity in surveillance, reporting and disease outbreak response.
In this regard, members of OHCEA are mandated to establish undergraduate and post-graduate training and research in the One Health approach with inbuilt practical and applicable field skills.
But, taking into account that success of the One Health agenda is pegged on the establishment of robust multisectoral national frameworks and regional societal co-existence, Fatimata Niang, a professor of environmental sciences at the University Cheikh Anta Diop in Senegal, said poor governance, armed conflicts by rebel groups, competition for natural resources and limited funding for health were derailing proper implementation of One Health approaches in Africa.
She said that, amid other regions of the world, the continent is at the bottom of implementation of One Health standpoints, as networking among African countries is also very weak.
But, as Alimi pointed out, since the outbreak of COVID-19, many lessons have been learned about the benefits that could be accrued from One Health approaches and many African countries are now aware of the potential danger that could be lurking in ignorance of the risks of zoonotic diseases.
In support of capacity building, Michigan State University, in collaboration with the consortium of universities of global health, has developed a two-year competency-based masters degree programme in global health studies.
This article is published in partnership with the Alliance for African Partnership (AAP). University World News is solely responsible for the editorial content.