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Nujum ZT, Asaria M, Kurup KK, Mini M, Mazumdar S, Daptardar M, Tiwari H. Cost-effectiveness of One Health interventions for rabies elimination: a systematic review. Trans R Soc Trop Med Hyg 2024; 118:223-233. [PMID: 37903657 DOI: 10.1093/trstmh/trad074] [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: 08/01/2023] [Revised: 08/31/2023] [Accepted: 10/05/2023] [Indexed: 11/01/2023] Open
Abstract
The 'One Health' (OH) approach is the most promising idea in realising the global goal of eliminating canine-mediated human rabies by 2030. However, taking an OH approach to rabies elimination can mean many different things to different people. We conducted a systematic review scrutinizing economic evaluations (EEs) retrieved from MEDLINE OVID, Embase OVID, Global Health OVID, CINAHL EBSCO and ECONLIT EBSCO that used the OH approach with the intent of identifying cost-effective sets of interventions that can be combined to implement an optimal OH-based rabies elimination program and highlight key gaps in the knowledge base. Our review suggests that an optimal OH program to tackle rabies should incorporate mass dog vaccination and integrated bite case management in combination with efficient use of post-exposure prophylaxis along with a shift to a 1-week abbreviated intradermal rabies vaccine regimen in humans. We recommend that future EEs of OH interventions for rabies elimination should be performed alongside implementation research to ensure proposed interventions are feasible and adopt a wider societal perspective taking into account costs and outcomes across both the human health and animal welfare sectors. The systematic review has been registered with PROSPERO.
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Affiliation(s)
- Zinia T Nujum
- Senior Visiting Fellow, Department of Health Policy, London School of Economics and Political Science, London WC2A2AE, UK
| | - Miqdad Asaria
- Assistant Professor, Department of Health Policy, London School of Economics and Political Science, London WC2A2AE, UK
| | - Karishma Krishna Kurup
- Research Fellow, Center for Universal Health, Chatham House (Royal Institute of International Affairs) London, UK
| | - Malathi Mini
- MSc Global Health Policy Candidate, London School of Economics and Political Science, London WC2A2AE, UK
| | - Sumit Mazumdar
- Research Fellow (Global Health), Centre for Health Economics, University of York Visiting Senior Fellow, Institute for Human Development, New Delhi, India
| | | | - Harish Tiwari
- DBT Wellcome India Alliance CPH Intermediate Fellow, Indian Institute of Technology Guwahati, Assam, India
- Research Affiliate, University of Sydney, Sydney, NSW, Australia
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Vallée A. Heterogeneity of the COVID-19 Pandemic in the United States of America: A Geo-Epidemiological Perspective. Front Public Health 2022; 10:818989. [PMID: 35155328 PMCID: PMC8826232 DOI: 10.3389/fpubh.2022.818989] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 01/03/2022] [Indexed: 12/23/2022] Open
Abstract
The spread of the COVID-19 pandemic has shown great heterogeneity between regions of countries, e. g., in the United States of America (USA). With the growing of the worldwide COVID-19 pandemic, there is a need to better highlight the variability in the trajectory of this disease in different worldwide geographic areas. Indeed, the epidemic trends across areas can display completely different evolution at a given time. Geo-epidemiological analyses using data, that are publicly available, could be a major topic to help governments and public administrations to implement health policies. Geo-epidemiological analyses could provide a basis for the implementation of relevant public health policies. With the COVID-19 pandemic, geo-epidemiological analyses can be readily utilized by policy interventions and USA public health authorities to highlight geographic areas of particular concern and enhance the allocation of resources.
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Affiliation(s)
- Alexandre Vallée
- Department of Clinical Research and Innovation, Foch Hospital, Suresnes, France
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Fasina FO, Fasanmi OG, Makonnen YJ, Bebay C, Bett B, Roesel K. The one health landscape in Sub-Saharan African countries. One Health 2021; 13:100325. [PMID: 34584927 PMCID: PMC8455361 DOI: 10.1016/j.onehlt.2021.100325] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 09/06/2021] [Accepted: 09/06/2021] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES One Health is transiting from multidisciplinary to transdisciplinary concepts and its viewpoints should move from 'proxy for zoonoses', to include other topics (climate change, nutrition and food safety, policy and planning, welfare and well-being, antimicrobial resistance (AMR), vector-borne diseases, toxicosis and pesticides issues) and thematic fields (social sciences, geography and economics). This work was conducted to map the One Health landscape in Africa. METHODS An assessment of existing One Health initiatives in Sub-Saharan African (SSA) countries was conducted among selected stakeholders using a multi-method approach. Strengths, weaknesses, opportunities and threats to One Health initiatives were identified, and their influence, interest and impacts were semi-quantitatively evaluated using literature reviews, questionnaire survey and statistical analysis. RESULTS One Health Networks and identified initiatives were spatiotemporally spread across SSA and identified stakeholders were classified into four quadrants. It was observed that imbalance in stakeholders' representations led to hesitation in buying-in into One Health approach by stakeholders who are outside the main networks like stakeholders from the policy, budgeting, geography and sometimes, the environment sectors. CONCLUSION Inclusion of theory of change, monitoring and evaluation frameworks, and tools for standardized evaluation of One Health policies are needed for a sustained future of One Health and future engagements should be outputs- and outcomes-driven and not activity-driven. National roadmaps for One Health implementation and institutionalization are necessary, and proofs of concepts in One Health should be validated and scaled-up. Dependence on external funding is unsustainable and must be addressed in the medium to long-term. Necessary policy and legal instruments to support One Health nationally and sub-nationally should be implemented taking cognizance of contemporary issues like urbanization, endemic poverty and other emerging issues. The utilization of current technologies and One Health approach in addressing the ongoing pandemic of COVID-19 and other emerging diseases are desirable. Finally, One Health implementation should be anticipatory and preemptive, and not reactive in containing disease outbreaks, especially those from the animal sources or the environment before the risk of spillover to human.
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Key Words
- ACDC, Africa Centres for Disease Control and Prevention
- AFROHUN, Africa One Health University Network
- AMR, Antimicrobial resistance
- AMU, Arab Maghreb Union
- AU, African Union
- AU-IBAR, African Union Inter-African Bureau for Animal Resources
- Africa
- Animal health
- Antimicrobial resistance
- BMGF, Bill and Melinda Gates Foundation
- BSL-3, Biosafety level 3 laboratory
- CEMAC, Economic and Monetary Community of Central Africa
- CILSS, Permanent Inter-State Committee for Drought Control in the Sahel
- COCTU, Control of Trypanosomiasis in Uganda
- COMESA, Common Market for Eastern and Southern Africa
- COVID-19, Coronavirus (SARS CoV 2) disease 2019
- EAC, East African Community
- ECCAS, Economic Community of Central African States
- ECOWAS, Economic Community of West African States
- Emerging and re-emerging diseases
- Environment health
- FAO, Food and Agriculture Organization of the United Nations
- FELTP, Field Epidemiology & Laboratory Training Program
- Food safety
- GARC, Global Alliance for Rabies Control
- GHSA-ZDAH, Global Health Security Agenda's Zoonotic Diseases and Animal Health in Africa
- GIS, Geographic information system
- HPAI H5N1, Highly pathogenic avian influenza subtype H5N1
- IGAD, Intergovernmental Authority on Development
- ILRI, International Livestock Research Institute
- IRA, Institute for Resource Assessment
- ISAVET, Frontline In-Service Applied Veterinary Epidemiology Training
- KEMRI, Kenya Medical Research Institute
- M & E, monitoring and evaluation
- MALF, Ministry of Agriculture, Livestock, and Fisheries
- MRU, Mano River Union
- MoH, Ministry of Health
- NISCAI, National Inter-Ministerial Steering Committee on Avian Influenza
- NTCAI, National Technical Committee on Avian Influenza
- OH, One Health
- OIE, World Organization for Animal Health
- One health (OH)
- PMP, Progressive Management Pathway
- Public health
- RECs, regional economic commissions
- RVF, Rift Valley fever
- SACIDS, Southern African Centre for Infectious Disease Surveillance
- SACU, South African Customs Union
- SADC, South African Development Community
- SSA, Sub-Saharan Africa
- SWOT, Strengths, weaknesses, opportunities and threats
- Toxicosis
- UNICEF, United Nations Children's Fund
- UNSIC, United Nations System Influenza Coordination
- USAID, United States Agency for International Development
- WAEMU, West African Economic and Monetary Union
- WHO, World Health Organization
- ZDU, Zoonotic Disease Unit.
- Zoonosis
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Affiliation(s)
- Folorunso O. Fasina
- Emergency Centre for Transboundary Animal Diseases (ECTAD), Food and Agriculture Organization of the United Nations (FAO), Dar es Salaam, United Republic of Tanzania
- Department of Veterinary Tropical Diseases, University of Pretoria, Onderstepoort, South Africa
| | - Olubunmi G. Fasanmi
- Department of Veterinary Laboratory Technology, Federal College of Animal Health & Production Technology, Ibadan, Oyo State, Nigeria
| | - Yilma J. Makonnen
- FAO Sub-Regional Office for Eastern Africa, Food and Agriculture Organization of the United Nations, Addis Ababa, Ethiopia
| | - Charles Bebay
- Emergency Centre for Transboundary Animal Diseases (ECTAD), Food and Agriculture Organization of the United Nations (FAO), Nairobi, Kenya
| | - Bernard Bett
- International Livestock Research Institute, Nairobi, Kenya &ILRI/BMZ One Health Research, Education, Outreach and Awareness Centre (OHRECA), Kenya
| | - Kristina Roesel
- International Livestock Research Institute, Nairobi, Kenya &ILRI/BMZ One Health Research, Education, Outreach and Awareness Centre (OHRECA), Kenya
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Rivas AL, van Regenmortel MHV. COVID-19 related interdisciplinary methods: Preventing errors and detecting research opportunities. Methods 2021; 195:3-14. [PMID: 34029715 PMCID: PMC8545872 DOI: 10.1016/j.ymeth.2021.05.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 05/18/2021] [Accepted: 05/19/2021] [Indexed: 12/12/2022] Open
Abstract
More than 130,000 peer-reviewed studies have been published within one year after COVID-19 emerged in many countries. This large and rapidly growing field may overwhelm the synthesizing abilities of both researchers and policy-makers. To provide a sinopsis, prevent errors, and detect cognitive gaps that may require interdisciplinary research methods, the literature on COVID-19 is summarized, twice. The overall purpose of this study is to generate a dialogue meant to explain the genesis of and/or find remedies for omissions and contradictions. The first review starts in Biology and ends in Policy. Policy is chosen as a destination because it is the setting where cognitive integration must occur. The second review follows the opposite path: it begins with stated policies on COVID-19 and then their assumptions and disciplinary relationships are identified. The purpose of this interdisciplinary method on methods is to yield a relational and explanatory view of the field -one strategy likely to be incomplete but usable when large bodies of literature need to be rapidly summarized. These reviews identify nine inter-related problems, research needs, or omissions, namely: (1) nation-wide, geo-referenced, epidemiological data collection systems (open to and monitored by the public); (2) metrics meant to detect non-symptomatic cases -e.g., test positivity-; (3) cost-benefit oriented methods, which should demonstrate they detect silent viral spreaders even with limited testing; (4) new personalized tests that inform on biological functions and disease correlates, such as cell-mediated immunity, co-morbidities, and immuno-suppression; (5) factors that influence vaccine effectiveness; (6) economic predictions that consider the long-term consequences likely to follow epidemics that growth exponentially; (7) the errors induced by self-limiting and/or implausible paradigms, such as binary and reductionist approaches; (8) new governance models that emphasize problem-solving skills, social participation, and the use of scientific knowledge; and (9) new educational programs that utilize visual aids and audience-specific communication strategies. The analysis indicates that, to optimally address these problems, disciplinary and social integration is needed. By asking what is/are the potential cause(s) and consequence(s) of each issue, this methodology generates visualizations that reveal possible relationships as well as omissions and contradictions. While inherently limited in scope and likely to become obsolete, these shortcomings are avoided when this 'method on methods' is frequently practiced. Open-ended, inter-/trans-disciplinary perspectives and broad social participation may help researchers and citizens to construct, de-construct, and re-construct COVID-19 related research.
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Affiliation(s)
- Ariel L Rivas
- Center for Global Health, School of Medicine, University of New Mexico, Albuquerque, NM, United States.
| | - Marc H V van Regenmortel
- University of Vienna, Austria; and Higher School of Biotechnology, University of Strasbourg, and French National Research Center, France
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Ayobami O, Mark G, Kadri-Alabi Z, Achi CR, Jacob JC. COVID-19: an opportunity to re-evaluate the implementation of a One Health approach to tackling emerging infections in Nigeria and other sub-Saharan African countries. J Egypt Public Health Assoc 2021; 96:26. [PMID: 34430054 PMCID: PMC8378104 DOI: 10.1186/s42506-021-00085-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 06/01/2021] [Indexed: 11/10/2022]
Abstract
Background One Health (OH) has resurfaced in the light of the ravaging COVID-19 pandemic. It has been accepted by many local and global health authorities as a suitable approach for preventing and responding to infectious disease outbreaks including pandemics. Main body One Health (OH) is a multisectoral and interdisciplinary framework for managing the animal, human, and ecosystem determinants of health. Globally, the majority of emerging infections in humans including SARS-Cov2—the causative agent of COVID-19—are transmitted from animals through environmental contacts in the last few decades. Yet, even when the biological and social interactions at the human, animal, and environmental interface that drive spillover of zoonotic diseases have been proven, OH strategies to address associated complex health challenges today are still rudimentary in many national health systems. Despite the disproportionate burden of infectious diseases in sub-Saharan Africa, OH is minimally incorporated into routine disease control and national health security programs. Challenges include poor policy support for OH in sub-Saharan Africa, and where some form of policy framework does exist, there are significant implementation bottlenecks. In this paper, we identified ideological, technical, operational, and economic barriers to OH implementation in Nigeria and sub-Saharan Africa, and highlighted possible recommendations across these domains. In order to yield sustainable benefits, a relevant OH policy approach in the sub-Saharan African health systems must derive from a buy-in of the critical mass of stakeholders in the society. Conclusion The implementation of sustainable OH approaches as a countermeasure to recurring emerging infections is a developmental priority for sub-Saharan African countries. A deep understanding of the local context must be leveraged to develop integrative OH solutions that are bold, rooted in science, and proven to be compatible with the level of development in sub-Saharan Africa.
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Affiliation(s)
- Olaniyi Ayobami
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Godwin Mark
- Department of One Health, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Edinburgh, Scotland, UK.,Department of Internal Medicine, Federal Teaching Hospital Gombe, Gombe, Nigeria
| | | | - Chioma Rita Achi
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK.,Department of Veterinary Public Health and Preventive Medicine, Usmanu Danfodiyo University Sokoto, Sokoto, Nigeria
| | - Joy Chinwendu Jacob
- Department of Vaccinology Education, Universitat Autonoma de Barcelona, Barcelona, Spain
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