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Clifford Astbury C, Demeshko A, Gallo-Cajiao E, McLeod R, Wiktorowicz M, Aenishaenslin C, Cullerton K, Lee KM, Ruckert A, Viens AM, Tsasis P, Penney TL. Governance of the wildlife trade and the prevention of emerging zoonoses: a mixed methods network analysis of transnational organisations, silos, and power dynamics. Global Health 2024; 20:49. [PMID: 38902738 PMCID: PMC11188226 DOI: 10.1186/s12992-024-01055-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 05/31/2024] [Indexed: 06/22/2024] Open
Abstract
INTRODUCTION The wildlife trade is an important arena for intervention in the prevention of emerging zoonoses, and leading organisations have advocated for more collaborative, multi-sectoral approaches to governance in this area. The aim of this study is to characterise the structure and function of the network of transnational organisations that interact around the governance of wildlife trade for the prevention of emerging zoonoses, and to assess these network characteristics in terms of how they might support or undermine progress on these issues. METHODS This study used a mixed methods social network analysis of transnational organisations. Data were collected between May 2021 and September 2022. Participants were representatives of transnational organisations involved in the governance of wildlife trade and the prevention of emerging zoonoses. An initial seed sample of participants was purposively recruited through professional networks, and snowball sampling was used to identify additional participants. Quantitative data were collected through an online network survey. Measures of centrality (degree, closeness, and betweenness) were calculated and the network's largest clique was identified and characterised. To understand the extent to which organisations were connected across sectors, homophily by sector was assessed using exponential random graph modelling. Qualitative data were collected through semi-structured interviews. The findings from the quantitative analysis informed the focus of the qualitative analysis. Qualitative data were explored using thematic analysis. RESULTS Thirty-seven participants completed the network survey and 17 key informants participated in semi-structured interviews. A total of 69 organisations were identified as belonging to this network. Organisations spanned the animal, human, and environmental health sectors, among others including trade, food and agriculture, and crime. Organisation types included inter-governmental organisations, non-governmental organisations, treaty secretariats, research institutions, and network organisations. Participants emphasised the highly inter-sectoral nature of this topic and the importance of inter-sectoral work, and connections were present across existing sectors. However, there were many barriers to effective interaction, particularly conflicting goals and agendas. Power dynamics also shaped relationships between actors, with the human health sector seen as better resourced and more influential, despite having historically lower engagement than the environmental and animal health sectors around the wildlife trade and its role in emerging zoonoses. CONCLUSION The network of transnational organisations focused on the governance of wildlife trade and the prevention of emerging zoonoses is highly multi-sectoral, but despite progress catalysed by the COVID-19 pandemic, barriers still exist for inter-sectoral interaction and coordination. A One Health approach to governance at this level, which has gained traction throughout the COVID-19 pandemic, was shared as a promising mechanism to support a balancing of roles and agendas in this space. However, this must involve agreement around equity, priorities, and clear goal setting to support effective action.
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Affiliation(s)
- Chloe Clifford Astbury
- Global Food Systems & Policy Research, School of Global Health, York University, Toronto, ON, Canada
- Dahdaleh Institute for Global Health Research, York University, Toronto, ON, Canada
- Global Strategy Lab, York University, Toronto, ON, Canada
| | - Anastassia Demeshko
- Global Food Systems & Policy Research, School of Global Health, York University, Toronto, ON, Canada
| | - Eduardo Gallo-Cajiao
- School of Marine and Environmental Affairs, University of Washington, Seattle, WA, USA
- Department of Human Dimensions of Natural Resources, Warner College of Natural Resources, Colorado State University, Fort Collins, CO, USA
| | - Ryan McLeod
- Global Food Systems & Policy Research, School of Global Health, York University, Toronto, ON, Canada
| | - Mary Wiktorowicz
- Global Food Systems & Policy Research, School of Global Health, York University, Toronto, ON, Canada
- Dahdaleh Institute for Global Health Research, York University, Toronto, ON, Canada
- School of Health Policy and Management, York University, Toronto, ON, Canada
| | - Cécile Aenishaenslin
- Faculté de médecine vétérinaire, Université de Montréal, Montréal, Québec, Canada
- Centre de recherche en santé publique de l'Université de Montréal et du CIUSSS du Centre-Sud-de-l'Île- de-Montréal, Montréal, Québec, Canada
| | | | - Kirsten M Lee
- Global Food Systems & Policy Research, School of Global Health, York University, Toronto, ON, Canada
- Dahdaleh Institute for Global Health Research, York University, Toronto, ON, Canada
| | - Arne Ruckert
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - A M Viens
- Global Food Systems & Policy Research, School of Global Health, York University, Toronto, ON, Canada
- Global Strategy Lab, York University, Toronto, ON, Canada
| | - Peter Tsasis
- School of Health Policy and Management, York University, Toronto, ON, Canada
| | - Tarra L Penney
- Global Food Systems & Policy Research, School of Global Health, York University, Toronto, ON, Canada.
- Dahdaleh Institute for Global Health Research, York University, Toronto, ON, Canada.
- Global Strategy Lab, York University, Toronto, ON, Canada.
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Sabin NS, Calliope AS, Simpson SV, Arima H, Ito H, Nishimura T, Yamamoto T. Implications of human activities for (re)emerging infectious diseases, including COVID-19. J Physiol Anthropol 2020; 39:29. [PMID: 32977862 PMCID: PMC7517057 DOI: 10.1186/s40101-020-00239-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 09/16/2020] [Indexed: 12/12/2022] Open
Abstract
Since 1980, the world has been threatened by different waves of emerging disease epidemics. In the twenty-first century, these diseases have become an increasing global concern because of their health and economic impacts in both developed and resource-constrained countries. It is difficult to stop the occurrence of new pathogens in the future due to the interconnection among humans, animals, and the environment. However, it is possible to face a new disease or to reduce the risk of its spread by implementing better early warning systems and effective disease control and prevention, e.g., effective global surveillance, development of technology for better diagnostics, effective treatments, and vaccines, the global political will to respond to any threats and multidisciplinary collaboration involving all sectors in charge of good health maintenance. In this review, we generally describe some factors related to human activities and show how they can play a role in the transmission and spread of infectious diseases by using some diseases as examples. Additionally, we describe and discuss major factors that are facilitating the spread of the new pandemic known as COVID-19 worldwide.
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Affiliation(s)
- Nundu Sabiti Sabin
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Leading Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Akintije Simba Calliope
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Leading Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Shirley Victoria Simpson
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Leading Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Hiroaki Arima
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Hiromu Ito
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
| | - Takayuki Nishimura
- Department of Human Science, Faculty of Design, Kyushu University, Fukuoka, Japan
- Department of Public Health, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Taro Yamamoto
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
- Leading Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
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Ravi SJ, Meyer D, Cameron E, Nalabandian M, Pervaiz B, Nuzzo JB. Establishing a theoretical foundation for measuring global health security: a scoping review. BMC Public Health 2019; 19:954. [PMID: 31315597 PMCID: PMC6637489 DOI: 10.1186/s12889-019-7216-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 06/20/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Since the 2014-2016 West Africa Ebola epidemic, the concept of measuring health security capacity has become increasingly important within the broader context of health systems-strengthening, enhancing responses to public health emergencies, and reducing global catastrophic biological risks. Efforts to regularly and sustainably track the evolution of health security capabilities and capacities over time - while also accounting for political, social, and environmental risks - could help countries progress toward eliminating sources of health insecurity. We sought to aggregate evidence-based principles that capture a country's baseline public health and healthcare capabilities, its health security system performance before and during infectious disease crises, and its broader social, political, security, and ecological risk environments. METHODS We conducted a scoping review of English-language scholarly and gray literature to identify evidence- and practice-based indicators and proxies for measuring health security at the country level over time. We then used a qualitative coding framework to identify recurrent themes in the literature and synthesize foundational principles for measuring global health security. Documents reviewed included English-language literature published after 2001 until the end of the research period-September 2017-to ensure relevance to the current global health security landscape; literature examining acute infectious disease threats with potential for transnational spread; and literature addressing global health security efforts at the country level. RESULTS We synthesized four foundational principles for measuring global health security: measurement requires assessment of existing capacities, as well as efforts to build core public health, healthcare, and biosecurity capabilities; assessments of national programs and efforts to mitigate a critical subset of priority threats could inform efforts to generate useful metrics for global health security; there are measurable enabling factors facilitating health security-strengthening efforts; and finally, measurement requires consideration of social, political, and ecological risk environments. CONCLUSION The themes identified in this review could inform efforts to systematically assess the impacts and effectiveness of activities undertaken to strengthen global health security.
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Affiliation(s)
- Sanjana J. Ravi
- The Johns Hopkins Center for Health Security, 621 East Pratt Street, Pier IV Building, Suite 210, Baltimore, MD 21201 USA
| | - Diane Meyer
- The Johns Hopkins Center for Health Security, 621 East Pratt Street, Pier IV Building, Suite 210, Baltimore, MD 21201 USA
| | - Elizabeth Cameron
- Nuclear Threat Initiative, 1776 Eye Street NW, Suite 600, Washington, DC 20006 USA
| | - Michelle Nalabandian
- Nuclear Threat Initiative, 1776 Eye Street NW, Suite 600, Washington, DC 20006 USA
| | - Beenish Pervaiz
- Watson Institute for International & Public Affairs, Brown University, 111 Thayer Street, Suite 215, Box 1970, Providence, RI 02912 USA
| | - Jennifer B. Nuzzo
- The Johns Hopkins Center for Health Security, 621 East Pratt Street, Pier IV Building, Suite 210, Baltimore, MD 21201 USA
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Connolly J. Governing Towards 'One Health': Establishing Knowledge Integration in Global Health Security Governance. GLOBAL POLICY 2017; 8:483-494. [PMID: 32336994 PMCID: PMC7165607 DOI: 10.1111/1758-5899.12505] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Recent global threats (e.g. Ebola, avian influenza, the Zika virus) have demonstrated the need for policy makers to focus on the detection of risks at the animal-human interface. Yet epistemic knowledge across these domains is not sufficiently joined-up. The article argues that, despite some progress, in order for the policy agenda for global health security to develop towards a 'One Health' model there is a need for integration across public and animal health domains. This article sets out an evaluation framework for establishing knowledge integration across these sectors. The article concludes that although 'One Health may seem utopian, given there are key challenges when it comes to reaching integration, there are important steps that can be taken the short to medium-term. These include reforms to education and training programmes and interdisciplinary research collaborations. A key determinant of whether One Health becomes a paradigm which frames public policy, and leads to policy and institutional changes to enable public value creation and sustainability, is the presence of an 'epistemic community' that bridges health networks.
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Eng CLP, Tong JC, Tan TW. Predicting Zoonotic Risk of Influenza A Viruses from Host Tropism Protein Signature Using Random Forest. Int J Mol Sci 2017; 18:E1135. [PMID: 28587080 PMCID: PMC5485959 DOI: 10.3390/ijms18061135] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 05/18/2017] [Accepted: 05/19/2017] [Indexed: 11/17/2022] Open
Abstract
Influenza A viruses remain a significant health problem, especially when a novel subtype emerges from the avian population to cause severe outbreaks in humans. Zoonotic viruses arise from the animal population as a result of mutations and reassortments, giving rise to novel strains with the capability to evade the host species barrier and cause human infections. Despite progress in understanding interspecies transmission of influenza viruses, we are no closer to predicting zoonotic strains that can lead to an outbreak. We have previously discovered distinct host tropism protein signatures of avian, human and zoonotic influenza strains obtained from host tropism predictions on individual protein sequences. Here, we apply machine learning approaches on the signatures to build a computational model capable of predicting zoonotic strains. The zoonotic strain prediction model can classify avian, human or zoonotic strains with high accuracy, as well as providing an estimated zoonotic risk. This would therefore allow us to quickly determine if an influenza virus strain has the potential to be zoonotic using only protein sequences. The swift identification of potential zoonotic strains in the animal population using the zoonotic strain prediction model could provide us with an early indication of an imminent influenza outbreak.
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Affiliation(s)
- Christine L P Eng
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, 117597 Singapore, Singapore.
| | - Joo Chuan Tong
- Institute of High Performance Computing, A*Star, 138632 Singapore, Singapore.
| | - Tin Wee Tan
- National Supercomputing Centre, 138632 Singapore, Singapore.
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Offeddu V, Cowling BJ, Peiris JM. Interventions in live poultry markets for the control of avian influenza: a systematic review. One Health 2016; 2:55-64. [PMID: 27213177 PMCID: PMC4871622 DOI: 10.1016/j.onehlt.2016.03.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 02/17/2016] [Accepted: 03/14/2016] [Indexed: 11/19/2022] Open
Abstract
Background Live poultry markets (LPMs) pose a threat to public health by promoting the amplification and dissemination of avian influenza viruses (AIVs) and by providing the ideal setting for zoonotic influenza transmission. Objective This review assessed the impact of different interventions implemented in LPMs to control the emergence of zoonotic influenza. Methods Publications were identified through a systematic literature search in the PubMed, MEDLINE and Web of Science databases. Eligible studies assessed the impact of different interventions, such as temporary market closure or a ban on holding poultry overnight, in reducing i) AIV-detection rates in birds and the market environment or ii) influenza incidence in humans. Unpublished literature, reviews, editorials, cross-sectional studies, theoretical models and publications in languages other than English were excluded. Relevant findings were extracted and critically evaluated. For the comparative analysis of findings across studies, standardized outcome measures were computed as i) the relative risk reduction (RRR) of AIV-detection in LPMs and ii) incidence rate ratios (IRRs) of H7N9-incidence in humans. Results A total of 16 publications were identified and reviewed. Collectively, the data suggest that AIV-circulation can be significantly reduced in the LPM-environment and among market-birds through (i) temporary LPM closure, (ii) periodic rest days (iii) market depopulation overnight and (iv) improved hygiene and disinfection. Overall, the findings indicate that the length of stay of poultry in the market is a critical control point to interrupt the AIV-replication cycle within LPMs. In addition, temporary LPM closure was associated with a significant reduction of the incidence of zoonotic influenza. The interpretation of these findings is limited by variations in the implementation of interventions. In addition, some of the included studies were of ecologic nature or lacked an inferential framework, which might have lead to cosiderable confounding and bias. Conclusions The evidence collected in this review endorses permanent LPM-closure as a long-term objective to reduce the zoonotic risk of avian influenza, although its economic and socio-political implications favour less drastic interventions, e.g. weekly rest days, for implementation in the short-term. •Avian influenza viruses (AIVs) can infect humans. Bird-to-human transmission is particularly intense in live poultry markets. •Periodic rest days, overnight depopulation or sale bans of certain species significantly reduce AIV-circulation in the markets. •Market closure would lastingly reduce the risk of animal and human infection.
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Key Words
- influenza a virus
- live poultry market
- a/h7n9
- a/h9n2
- closure
- rest day
- c/d, cleansing and disinfection
- glm, general linear model
- irr, incidence rate ratio
- lbm, live bird market
- lpm, live poultry market
- ndv, newcastle disease virus
- or, odds ratio
- pue, pneumonia of unknown etiology
- rlpm, retail live poultry market
- rr, relative risk
- rrr, relative risk reduction
- rt-pcr, reverse transcription polymerase chain reaction
- wlpm, wholesale live poultry market
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Affiliation(s)
- Vittoria Offeddu
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Benjamin J. Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region
| | - J.S. Malik Peiris
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region
- Centre of Influenza Research, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region
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Eng CLP, Tong JC, Tan TW. Distinct Host Tropism Protein Signatures to Identify Possible Zoonotic Influenza A Viruses. PLoS One 2016; 11:e0150173. [PMID: 26915079 PMCID: PMC4767729 DOI: 10.1371/journal.pone.0150173] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 02/10/2016] [Indexed: 12/25/2022] Open
Abstract
Zoonotic influenza A viruses constantly pose a health threat to humans as novel strains occasionally emerge from the avian population to cause human infections. Many past epidemic as well as pandemic strains have originated from avian species. While most viruses are restricted to their primary hosts, zoonotic strains can sometimes arise from mutations or reassortment, leading them to acquire the capability to escape host species barrier and successfully infect a new host. Phylogenetic analyses and genetic markers are useful in tracing the origins of zoonotic infections, but there are still no effective means to identify high risk strains prior to an outbreak. Here we show that distinct host tropism protein signatures can be used to identify possible zoonotic strains in avian species which have the potential to cause human infections. We have discovered that influenza A viruses can now be classified into avian, human, or zoonotic strains based on their host tropism protein signatures. Analysis of all influenza A viruses with complete proteome using the host tropism prediction system, based on machine learning classifications of avian and human viral proteins has uncovered distinct signatures of zoonotic strains as mosaics of avian and human viral proteins. This is in contrast with typical avian or human strains where they show mostly avian or human viral proteins in their signatures respectively. Moreover, we have found that zoonotic strains from the same influenza outbreaks carry similar host tropism protein signatures characteristic of a common ancestry. Our results demonstrate that the distinct host tropism protein signature in zoonotic strains may prove useful in influenza surveillance to rapidly identify potential high risk strains circulating in avian species, which may grant us the foresight in anticipating an impending influenza outbreak.
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Affiliation(s)
- Christine L. P. Eng
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Joo Chuan Tong
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Institute of High Performance Computing, Singapore, Singapore
| | - Tin Wee Tan
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Peiris JSM, Cowling BJ, Wu JT, Feng L, Guan Y, Yu H, Leung GM. Interventions to reduce zoonotic and pandemic risks from avian influenza in Asia. THE LANCET. INFECTIOUS DISEASES 2016; 16:252-8. [PMID: 26654122 PMCID: PMC5479702 DOI: 10.1016/s1473-3099(15)00502-2] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 04/15/2015] [Accepted: 04/23/2015] [Indexed: 01/29/2023]
Abstract
Novel influenza viruses continue to emerge, posing zoonotic and potentially pandemic threats, such as with avian influenza A H7N9. Although closure of live poultry markets (LPMs) in mainland China stopped H7N9 outbreaks temporarily, closures are difficult to sustain, in view of poultry production and marketing systems in China. In this Personal View, we summarise interventions taken in mainland China, and provide evidence for other more sustainable but effective interventions in the live poultry market systems that reduce risk of zoonotic influenza including rest days, and banning live poultry in markets overnight. Separation of live ducks and geese from land-based (ie, non-aquatic) poultry in LPM systems can reduce the risk of emergence of zoonotic and epizootic viruses at source. In view of evidence that H7N9 is now endemic in over half of the provinces in mainland China and will continue to cause recurrent zoonotic disease in the winter months, such interventions should receive high priority in China and other Asian countries at risk of H7N9 through cross-border poultry movements. Such generic measures are likely to reduce known and future threats of zoonotic influenza.
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Affiliation(s)
- J S Malik Peiris
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China.
| | - Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Joseph T Wu
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Luzhao Feng
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yi Guan
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Hongjie Yu
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Gabriel M Leung
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
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Mackey TK, Liang BA, Cuomo R, Hafen R, Brouwer KC, Lee DE. Emerging and reemerging neglected tropical diseases: a review of key characteristics, risk factors, and the policy and innovation environment. Clin Microbiol Rev 2014; 27:949-79. [PMID: 25278579 PMCID: PMC4187634 DOI: 10.1128/cmr.00045-14] [Citation(s) in RCA: 118] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
In global health, critical challenges have arisen from infectious diseases, including the emergence and reemergence of old and new infectious diseases. Emergence and reemergence are accelerated by rapid human development, including numerous changes in demographics, populations, and the environment. This has also led to zoonoses in the changing human-animal ecosystem, which are impacted by a growing globalized society where pathogens do not recognize geopolitical borders. Within this context, neglected tropical infectious diseases have historically lacked adequate attention in international public health efforts, leading to insufficient prevention and treatment options. This subset of 17 infectious tropical diseases disproportionately impacts the world's poorest, represents a significant and underappreciated global disease burden, and is a major barrier to development efforts to alleviate poverty and improve human health. Neglected tropical diseases that are also categorized as emerging or reemerging infectious diseases are an even more serious threat and have not been adequately examined or discussed in terms of their unique risk characteristics. This review sets out to identify emerging and reemerging neglected tropical diseases and explore the policy and innovation environment that could hamper or enable control efforts. Through this examination, we hope to raise awareness and guide potential approaches to addressing this global health concern.
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Affiliation(s)
- Tim K Mackey
- Department of Anesthesiology, University of California, San Diego, School of Medicine, San Diego, California, USA Division of Global Public Health, University of California, San Diego, Department of Medicine, San Diego, California, USA
| | - Bryan A Liang
- Department of Anesthesiology, University of California, San Diego, School of Medicine, San Diego, California, USA
| | - Raphael Cuomo
- Joint Doctoral Program in Global Public Health, University of California, San Diego, and San Diego State University, San Diego, California, USA
| | - Ryan Hafen
- Department of Anesthesiology, University of California, San Diego, School of Medicine, San Diego, California, USA Internal Medicine, University of California, San Diego, School of Medicine, San Diego, California, USA
| | - Kimberly C Brouwer
- Division of Global Public Health, University of California, San Diego, Department of Medicine, San Diego, California, USA
| | - Daniel E Lee
- Department of Anesthesiology, University of California, San Diego, School of Medicine, San Diego, California, USA Pediatrics Department, University of California, San Diego, School of Medicine, San Diego, California, USA
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Mbabu M, Njeru I, File S, Osoro E, Kiambi S, Bitek A, Ithondeka P, Kairu-Wanyoike S, Sharif S, Gogstad E, Gakuya F, Sandhaus K, Munyua P, Montgomery J, Breiman R, Rubin C, Njenga K. Establishing a One Health office in Kenya. Pan Afr Med J 2014; 19:106. [PMID: 25722779 PMCID: PMC4337352 DOI: 10.11604/pamj.2014.19.106.4588] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 08/08/2014] [Indexed: 11/16/2022] Open
Abstract
A One Health (OH) approach that integrates human,animal and environmental approaches to management of zoonotic diseases has gained momentum in the last decadeas part of a strategy to prevent and control emerging infectious diseases. However, there are few examples of howan OH approach can be established in a country. Kenya establishment of an OH office, referred to asthe Zoonotic Disease Unit (ZDU) in 2011. The ZDU bridges theanimal and human health sectors with a senior epidemiologist deployed from each ministry; and agoal of maintaining collaboration at the animal and human health interface towards better prevention and control of zoonoses. The country is adding an ecologist to the ZDU to ensure that environmental risks are adequately addressed in emerging disease control.
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Affiliation(s)
- Murithi Mbabu
- Ministry of Agriculture, Livestock and Fisheries Nairobi, Kenya
| | | | - Sarah File
- One Health Office, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Eric Osoro
- Zoonotic Disease Unit, Government of Kenya, Nairobi, Kenya
| | - Stella Kiambi
- Zoonotic Disease Unit, Government of Kenya, Nairobi, Kenya
| | - Austine Bitek
- Zoonotic Disease Unit, Government of Kenya, Nairobi, Kenya
| | - Peter Ithondeka
- Ministry of Agriculture, Livestock and Fisheries Nairobi, Kenya
| | | | | | - Eric Gogstad
- Global Disease Detection Division, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya ; Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | | | - Peninah Munyua
- Global Disease Detection Division, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya
| | - Joel Montgomery
- Global Disease Detection Division, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya ; Global Implementation Solutions, Chicago, Illinois, USA
| | - Robert Breiman
- Global Disease Detection Division, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya ; Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Carol Rubin
- One Health Office, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kariuki Njenga
- Global Disease Detection Division, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya
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Djordjevic SP, Stokes HW, Roy Chowdhury P. Mobile elements, zoonotic pathogens and commensal bacteria: conduits for the delivery of resistance genes into humans, production animals and soil microbiota. Front Microbiol 2013; 4:86. [PMID: 23641238 PMCID: PMC3639385 DOI: 10.3389/fmicb.2013.00086] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Accepted: 03/27/2013] [Indexed: 01/07/2023] Open
Abstract
Multiple antibiotic resistant pathogens represent a major clinical challenge in both human and veterinary context. It is now well-understood that the genes that encode resistance are context independent. That is, the same gene is commonly present in otherwise very disparate pathogens in both humans and production and companion animals, and among bacteria that proliferate in an agricultural context. This can be true even for pathogenic species or clonal types that are otherwise confined to a single host or ecological niche. It therefore follows that mechanisms of gene flow must exist to move genes from one part of the microbial biosphere to another. It is widely accepted that lateral (or horizontal) gene transfer (L(H)GT) drives this gene flow. LGT is relatively well-understood mechanistically but much of this knowledge is derived from a reductionist perspective. We believe that this is impeding our ability to deal with the medical ramifications of LGT. Resistance genes and the genetic scaffolds that mobilize them in multiply drug resistant bacteria of clinical significance are likely to have their origins in completely unrelated parts of the microbial biosphere. Resistance genes are increasingly polluting the microbial biosphere by contaminating environmental niches where previously they were not detected. More attention needs to be paid to the way that humans have, through the widespread application of antibiotics, selected for combinations of mobile elements that enhance the flow of resistance genes between remotely linked parts of the microbial biosphere. Attention also needs to be paid to those bacteria that link human and animal ecosystems. We argue that multiply antibiotic resistant commensal bacteria are especially important in this regard. More generally, the post genomics era offers the opportunity for understanding how resistance genes are mobilized from a one health perspective. In the long term, this holistic approach offers the best opportunity to better manage what is an enormous problem to humans both in terms of health and food security.
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