ONE WORLD, ONE HEALTH: PREVENT ZOONOSES
PUBLIC AWARENESS HOLDS THE KEY
DR LALIT KUMAR SHARMA
Family Veterinarian, Science Communicator,
Managing Trustee – Vigyan Setu Foundation
Navi Mumbai (Maharashtra)
Abstract
The concept of “One World-One Health” underscores the interconnectedness of human, animal, and environmental health, emphasizing the need for global cooperation and a holistic approach for disease prevention and management. The COVID-19 pandemic served as a potent reminder of the urgency of this approach, offering invaluable lessons for future preparedness. Veterinarians possess the knowledge and skills to ensure the ethical treatment and well-being of animals, thus reducing the risk of zoonotic outbreaks originating from animal farms or wildlife. Public awareness campaigns, spearheaded by veterinarians and public health authorities, prove instrumental in educating communities about zoonotic risks, preventive measures, and responsible animal ownership. Effective communication strategies and community engagement enhance the implementation of disease control measures and encourage collective responsibility towards global health. To reinforce the impact of public awareness in zoonosis prevention, an effort and an initiative made in this direction, by the author, have been elucidated in this article.
Key words
One Health, Pandemic, Zoonoses prevention, Veterinarians, Public awareness
One World, One Health
In present times, the perils of emerging zoonotic diseases with global spread calls for active coordinated and collaborative efforts. The energies need to be focussed on the integrated approach by way of creating awareness and education, continually, of the institutions engaged in providing human, animal, and environmental health services. To counteract the global threats arising out of zoonotic diseases, it is essential to coordinate the knowledge and experience of these three sectors. The key indicator of the success would be the extension of One Health to local and community levels. Since partnering is strategic to accomplishment, by joining hands, more can be achieved. More of such actions are needed, particularly in the developing countries.
The common approaches to manage zoonoses are being carried out, but in isolation. Every professional is dealing within their own premise; veterinarians with animals, wildlife specialists with wild animal populations, ecologists with ecosystem biodiversity and public health experts with human diseases. Meanwhile, separate groups work on disease management and disease eradication. There is evidently a need and a demand for a new approach (IDS, 2013). A broader understanding of health and disease demands a unity of approach achievable only through a consilience of human, domestic animal and wildlife health – One Health.
The One Health idea is a paradigm shift in the way we look at human and animal health in the world. The agents of change giving rise to One Health are a complex set of multi-factorial circumstances such as population growth, changes in nutritional, agricultural and trade practices, globalization, shifts in land use, accelerated urbanization, deforestation, encroachment on wildlife and climate change. Population growth and the globalization of economic networks have resulted in a rapidly changing, highly interconnected world (UN, 2011).
The sum total of needs that prevail within the human, livestock, and wildlife health domains is beyond the scope of any one discipline. The focus of One Health, then, is on areas of convergence and which therefore generally excludes diseases that lack the potential to jump species, from animals to humans. Improved coordination among public, veterinary, and ecosystems health agents will rely on: consultation on priority setting, joint preparedness planning, and providing an appropriate institutional framework with their respective benefits (World Bank, 2010).
Solving today’s threats and tomorrow’s problems cannot be accomplished with yesterday’s approaches since we are in an era of One World, One Health. This new concept, is based on the understanding that humans, animals, and the environment are inextricably linked, indicating that the world has suddenly realized the interrelation between ecology, animal diseases, and public health, striving to restore and maintain harmony and synergy (Garg and Banerjee, 2021).
Pandemic – lessons learnt
The COVID-19 outbreak provided a window (a pause) for us to investigate public understanding of zoonoses (Rutz et al., 2020). Outbreaks of zoonoses (e.g., SARS, MERS, and COVID-19) have seriously impacted global society. Zoonoses that originate from animals and spread to people, is factually a spillover (Vora et al., 2022).
One Health focuses on the interactions between biological (flora, fauna including human) and non-biological environments, consistent with the general principles of environmental literacy (Scholz and Binder, 2011). It is indeed imperative to consider public awareness of One Health as an extension of environmental literacy, which refers to the public understanding of the interactions between the environment and human (including other animals) – environment, and includes three primary aspects; knowledge, attitude, and behaviour (Pe’er et al., 2007).
For the prevention of zoonoses, the COVID-19 pandemic accentuated for a more integrated and proactive approach including emphasis for improved risk communication and perception of the relevance of zoonotic diseases in community health. This involves effectively communicating information about zoonotic diseases to the public, raising awareness about the risks and preventive measures, and addressing misconceptions, misinformation, and infodemics (D’Souza and Pattanshetty, 2023).
Role of veterinarians
One Health concept seems to confirm the fact that the health of humans and animals should not be addressed in isolation. This approach urges the veterinarian to look beyond the level of the individual animal and of disease symptoms. Due to the strong interrelation of human, animal and ecosystem health, keeping animals healthy and caring for their welfare will automatically contribute to the reduction of health risks for all involved, especially in the context of zoonotic diseases (van Herten and Meijboom, 2019).
Societal expectations with regard to the professional responsibilities of veterinarians are changing. The work of veterinarians is no longer restricted to curative medicine in the interest of individual animals and their owners. A modern veterinarian must also have the competence to take collective and global perspectives into account and has responsibilities to care for animal welfare and public health as well (Meijboom, 2018). It is broadly recognized that with their cross-species expertise, veterinarians can make a significant contribution to public health.
Central to the success of One World-One Health is the pivotal role of veterinarians. Veterinarians possess unique expertise in zoonotic diseases, which account for a significant proportion of emerging infectious threats.
Veterinarians – beyond the call of duty
The response of the veterinary profession in meeting the axioms of One Health is also a litmus test for the future of this profession. When founding the first veterinary school in Lyon, France in 1761, Claude Bourgelat emphasized the importance of comparative biopathology. Later, Rudolph Virchow, William Osler, and John McFaydean carried the concept forward by incorporating veterinary perspectives into human health care through their respective work in comparative medicine, veterinary pathology, microbiology, and veterinary and medical education (Monath et al, 2010). In the twentieth century, veterinarians Karl Meyer, Calvin Schwabe, and James Steele maintained this inclusive approach through their work on public health and zoonoses (Monath et al, 2010). Schwabe and Steele used the term “One World, One Medicine, One Health” to refer to their transdisciplinary work (Monath et al, 2010). Only missing link from this early work in the nineteenth and twentieth centuries was the ecologists and environmental health experts. Recognizing that environment played a crucial role in the well-being of humans and animals, the value of environmental health for the benefit of the ecosystem itself was not emphasized.
The renewed One Health concept now encompasses a new generation of veterinarians, physicians, ecologists, biologists, and social scientists is shaping the concept in novel ways. For the veterinarian’s involvement with the One Health is now being adjusted and shifted according to the changing needs of society. A new dimension has been added for this profession and that is ecosystem health, arising particularly in wake of the emerging zoonoses.
Public awareness
Public awareness is a crucial and indispensable aspect of preventing zoonotic diseases. The key role it plays in zoonosis prevention lies in empowering individuals and communities with knowledge and understanding of the risks associated with zoonotic transmission and the preventive measures that can be taken.
Most of the zoonotic diseases and resultant deaths could be prevented or controlled through awareness and educational programmes. For successful implementation of this strategy, the primary focus should be on the training / educational programmes including awareness and the secondary focus on knowledge, understanding and behaviour or attitude of people about zoonotic diseases, priorities for zoonotic diseases, the role of veterinary public health and post exposure prophylaxis. The combination of educational programmes and awareness campaign could become a useful tool making a significant difference in the prevention and control of zoonoses.
Continuing education for the health experts, those dealing with animals and animal products, and awareness for the general public about zoonotic diseases, arising risk, potential reservoir, its impact on their health, and different ways of safeguarding against zoonotic infections like the post exposure prophylaxis and good personal hygiene could tackle the prevention and control of zoonoses, rather effectively. For the general public, especially, it is very critical to be aware of zoonoses and well informed concerning its adverse impact on their health and what steps to be taken in the event of exposure. This can certainly be achieved through a strong and proper zoonoses awareness campaign, aimed at the general public, and experts ranging from animal and human health professionals. Such campaigns should cut across all settings; be it from rural to urban, and should take place in both developing and developed countries.
The key role of public awareness campaigns is as a primary tool in preventing zoonotic outbreaks. By educating communities about zoonotic risks, transmission pathways, and preventive measures, these campaigns empower individuals to make informed decisions about their interactions with animals and their environments. Heightened public awareness leads to increased vigilance in identifying potential disease hotspots and reporting suspicious cases, enabling early detection and containment of outbreaks.
Effective methods of prevention and control of zoonoses includes provision of information, communication, awareness, knowledge, education, and technology transfer. Examples of effectiveness of awareness are seen in the knowledge of most general public of Europe concerning the risk of human infection from beef meat that are contaminated with prions (bovine spongiform encephalopathy) and also in North America, there is now a full awareness among the general public concerning the West Nile virus and its connection with dead birds and also that it is capable of causing humans death (Chomel, 2008). This was the positive outcome of the effective and timely dissemination of information about zoonoses to the health professional and the general public, alike, at various locations and settings.
Thus, public awareness campaigns educate people about the symptoms of zoonotic diseases, enabling early detection and timely reporting of suspected cases. Rapid reporting facilitates swift responses from health authorities, helping to prevent the spread of the disease to a larger population. Knowledge about zoonotic risks encourages responsible practices when interacting with animals and their habitats. Individuals become aware of the potential dangers of consuming certain animal products, handling wildlife, or participating in risky animal-related activities. This increased awareness can lead to behavioural changes that reduce the likelihood of zoonotic spillover.
In addition, public awareness fosters the understanding that human, animal, and environmental health are interconnected. This One Health approach emphasizes the need for collaborative efforts between human and veterinary health professionals, researchers, policymakers, and communities to combat zoonoses effectively. Informed and aware communities are better prepared to respond to potential zoonotic threats. When people understand the risks and know the appropriate steps to take, they are more likely to adopt preventive measures and contribute to early outbreak response efforts.
Public awareness initiatives engage local communities, allowing for a better understanding of cultural practices and customs that may influence zoonotic transmission. Tailoring awareness campaigns to specific cultural contexts improves their effectiveness and ensures a higher level of cooperation from the community.
Furthermore, public awareness initiatives facilitate community engagement and foster collaborative efforts between health authorities, veterinarians, and the general public. By promoting an inclusive dialogue, these campaigns strengthen the sense of collective responsibility towards zoonosis prevention. Engagement with local communities is crucial for gaining insights into cultural practices, animal husbandry methods, and ecological factors that may contribute to zoonotic transmission.
The potential challenges and strategies for implementing successful public awareness campaigns are also to be looked into. Effective communication channels, tailored messaging, and culturally sensitive approaches are critical components in reaching diverse populations and achieving the desired behavioural changes. Public awareness campaigns may include the use of print and digital media at rural, urban, local, regional, national and global level, and innovative use of social media platforms could also be utilised for the purpose.
The following case studies reinforce the impact of public awareness in zoonoses prevention.
An effort
Case study – I
Realizing the fact that zoonosis believes in equality and do not make any differentiation between its victims, an effort was conceptualized to raise awareness among the community. In the early 2020, when the pandemic was at the doorstep of humanity, entire world was in quarantine, virtual mode of communication was in the process of becoming a new norm, Zoonosis Ambassador 2020 (ZA2020) programme was launched at the behest of a voluntary organization, Vigyan Setu Foundation. Under-graduates and post-graduates from zoology department were invited to participate in ZA2020 programme. In all, 37 from Mumbai and around, and 113 from the state of Rajasthan registered. These participants, through randomized online survey, garnered 5770 responses. These surveys were aimed at analysing understanding, knowledge, and attitude of the respondents towards zoonoses. Thereafter, the eligible participants were groomed and their communications skills honed. This was followed by raising awareness by them about zoonosis in their own social circles, through online mode.
Similar exercise was undertaken during the year 2022, as ZA22 programme. The participation for ZA22 was not kept restricted to zoology students but left open for one and all who wished to offer voluntary services to the society in making them aware of zoonotic diseases. In all, 231 participants registered comprising of 61.47% from Gujarat, 14.71% from Delhi, 3.46% from Uttar Pradesh, 2.59% each from Chhattisgarh, Maharashtra, Punjab, and Tamil Nadu, 2.16% from Jammu, 1.74% each from Madhya Pradesh, and Rajasthan, 0.86% each from Bihar and Kashmir, 0.44% each from Dadra and Nagar Haveli and Daman and Diu, Haryana, Karnataka, Puducherry, Sikkim, and West Bengal. Around 2650 responses were collected through the randomized online survey, which formed the baseline of the level of understanding, knowledge, and attitude of the respondents towards the zoonoses. Of those who had registered, 15.58% were found eligible for the next stage. They were provided with resource material for making presentations in schools, colleges, or open fora, in order to raise awareness about zoonoses.
Hence, through these efforts, we could reach out to the unreached, to spread the word on how to remain vigilant about zoonosis. Likewise, in the present year, Rabies Ambassador 2023 (RA23) programme has been launched, pan India. Since RA23 programme is in progress, details are presently not available for sharing.
An initiative
Case study – II
During the year 2022-23, more than thirty lectures were delivered in different schools, colleges and open platform. These interactive deliverances were made using PowerPoint presentations. These talks were aimed at apprising the audience, encompassing various aspects of zoonoses; its impact, prevention and control, peppered with examples relevant to Indian context.
So as to form a baseline of their knowledge and understanding about the topic, to be covered, a few questions were asked to the audience, prior to the deliberations. This interaction helped in streamlining the content, the language (particularly the technical terms), and the depth to be delved into. The information was put across in such a simple manner, that it could have been easily understood even by a layman. Interaction attracted number of queries pertinent to their personal experiences, which were addressed to the best of their satisfaction.
Based on the queries raised, learnings made, and experiences gathered during these discussions, led to conversion of the presentation into such a format that can actually get ingrained in the minds of the audience. Hence, a time-tested medium of communication, doha or couplet was chosen. This led to the creation of two e-books, Zoonosis par Dohe (Couplets on Zoonosis), and Rabies Chalisa (Forty Couplets on Rabies). These e-books carry gist and explanation in bilingual (Hindi-English) format, and are gaining popularity among the trainee teachers, particularly, who are using the couplets while engaging their classes.
Conclusion
In conclusion, the “One World-One Health” concept serves as a potent framework for pandemic preparedness and emphasizes the imperative of integrating human, animal, and environmental health. The COVID-19 pandemic has brought to light the valuable lessons learned, underscored the essential role of veterinarians in disease surveillance and control, and showcased their dedication in the face of adversity. Strengthening public awareness initiatives further reinforces the collaborative effort required to safeguard our interconnected world from future health crises.
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