Facilitating implementation of the one health approach: A definition of a one health intervention

National burden of Ebola virus disease in Democratic Republic of the Congo: the urgency to act

Ebola virus disease (EVD) has long been a major public health concern for Democratic Republic of the Congo (DR Congo). First identified in DR Congo in 1976, the country has witnessed more than 25 outbreaks of this deadly disease, which has a case fatality rate of nearly 90% and manifesting with symptoms such as diarrhoea, vomiting, stomachache and haemorrhagic fever. African fruit bats have been speculated to be the reservoir of this virus. DR Congo is currently facing another EVD outbreak simultaneously with other communicable diseases, rendering it vulnerable to a shortage of medical and paramedical staff along with distrust among remote communities towards local authorities due to armed conflict and political instability. Moreover, lack of ring vaccinations and inefficient surveillance of suspected individuals are some other significant hurdles in disease control. Despite the availability of rVSV-ZEBOV/Erbevo vaccine and many antibody-based vaccines, challenges including politicization, low access to remote communities, and illiteracy have limited their effectiveness. Recently, the Congolese govt. has put in efforts such as building local capacities at the health zone level, outbreak control intervention, community engagement and social mobilization to counter the rising EVD cases. Four successive Strategic Response Plans have been implemented to increase resource mobilization by DR Congo and her partners. The Spread of zoonotics such as EVD can be confronted by implementing the One Health approach, which involves medical staff, veterinarians and public health officials.

Current evidence of the economic value of One Health initiatives: A systematic literature review

Funding and financing for One Health initiatives at country level remain challenging as investments commonly require demonstrated evidence of economic value or returns. The objectives of this review were to i) identify, critically analyse and summarise quantitative evidence of the net economic value of One Health initiatives; ii) document methodologies commonly used in the scientific literature; and iii) describe common challenges and any evidence gaps. Scientific databases were searched for published literature following the PRISMA guidelines and an online survey and workshop with subject matter experts were used to identify relevant grey literature. Studies were included if they reported on quantitative costs and benefits (monetary and non-monetary) and were measured across at least two sectors. Relevant publications were analysed and plotted against the six action tracks of the Quadripartite One Health Joint Plan of Action to help classify the initiatives. Ninety-seven studies were included. Eighty studies involved only two sectors and 78 reported a positive economic value or return. Of those studies that reported a positive return, 49 did not compare with a sectoral counterfactual, 28 studies demonstrated an added value of using a cross-sectoral approach, and 6 studies demonstrated an added value of One Health communication, collaboration, coordination, and capacity building. Included studies most frequently related to endemic zoonotic, neglected tropical and vector-borne diseases, followed by health of the environment and food safety. However, diversity in economic analysis methodology between studies included resulted in difficulty to compare or combine findings. While there is a growing body of evidence of the value of One Health initiatives, a substantial part of the evidence still focuses on "traditional" One Health topics, particularly zoonoses. Developing a standardised and practical approach for One Health economic evaluation will facilitate assessment of the added value and gather evidence for One Health to be invested in and endorsed by multiple sectors.

Navigating One Health in research-for-development: Reflections on the design and implementation of the CGIAR Initiative on One Health

Adopting One Health approaches is key for addressing interconnected health challenges. Yet, how to best put One Health into practice in research-for-development initiatives aiming to 'deliver impacts' remains unclear. Drawing on the CGIAR Initiative on One Health - a global initiative to address zoonotic diseases, antimicrobial resistance, and food and water safety - we reflect on challenges during program conception and implementation, prompting us to suggest improvements in multisectoral collaboration, coordination, and communication. Our approach involves conducting a researcher-centered process evaluation, comprising individual interviews that are subsequently thematically analyzed and synthesized. The key takeaway is that limited time for planning processes and short program timelines compared to envisioned development impacts may impede research-for-development efforts. Yet, collaborative work can be successful when adequate time and resources are allocated for planning with minimal disruption throughout implementation. Additionally, due to the multifaceted nature of One Health initiatives, it is important to pay attention to co-benefits and trade-offs, where taking action in one aspect may yield advantages and disadvantages in another, aiding to identify sustainable One Health development pathways. Forming close partnerships with national governments and local stakeholders is essential not only to promote sustainability but also to ensure local relevance, enhancing the potential for meaningful impact. Finally, regularly assessing progress toward development goals is critical as development stands as an overarching objective.

Global One Health post-graduate programmes: a review

BACKGROUND

The One Health (OH) approach recognises that humans, animals, plants, and the environment are interrelated, and therefore seeks to facilitate collaboration, communication, coordination, and capacity building between relevant stakeholders to achieve a healthier ecosystem. This calls for integrating OH into established governance, policy, health, education, and community structures, and requires OH professionals equipped with the necessary inter and trans-disciplinary skillset. Therefore, numerous OH training programmes are currently being offered globally. However, the coordination and contents of some of these trainings have been criticised as inconsistent and inadequately standardised, and therefore could serve as a barrier to OH implementation. In this study, an up-to-date repository of a subset of OH academic programmes offered globally was provided, and their curricula contents was critically assessed.

METHODS

Between December 2022 and April 2023, an online search for key terms 'ONE HEALTH MASTERS COURSES', and 'ONE HEALTH MASTERS PROGRAMMES' together with variations of 'AFRICA', 'NORTH AMERICA', 'ASIA', 'AUSTRALIA', 'EUROPE', 'GLOBAL' was conducted. Details about course title, delivery mode, joint administration status, curricula contents, language of instruction, years to completion, host university, country, and continent were collected.

RESULTS

Forty-three programmes met inclusion criteria of the study, and almost all (n = 36, 83.7%) were tailored towards infectious diseases and population/global health, compared to the environmental and conservation perspectives. Compiled curricula contents clustered into one of these 12 sub-headings: 'principles and concepts of OH', 'epidemiology and biostatistics', 'major branches of OH', 'internship/externship/research project', 'infectious diseases, zoonoses, and surveillance', 'risk analysis and crises management', 'food safety, microbiology, immunology, and allied', 'communication', 'ethics', 'economics, policy, and management' and 'others. Of these, infectious disease themes were the most common. Regarding geography and organising institutions, North America and Europe, and veterinary institutions, respectively, were the most represented.

CONCLUSION

Despite the multi-level diversity observed, uniformity still exists across the programmes which favours interdisciplinary cross-talks. Future pedagogical studies that objectively assess the alignment of module contents with the OH core competencies and the impacts of these OH programmes is recommended. With this study, a critical information gap that has existed for long in the OH field has been bridged.

Intersectoral collaboration in a One Health approach: Lessons learned from a country-level simulation exercise

Intersectoral collaboration is an essential component of the One Health (OH) approach, which recognises the interconnectedness of the health of humans, animals, and the environment. The OH European Joint Programme (OHEJP) developed a national foodborne outbreak table-top simulation exercise (SimEx) to practice OH capacity and interoperability across the public health, animal health, and food safety sectors, improving OH preparedness for future disease outbreaks. The Portuguese OHEJP SimEx highlighted strengths and weaknesses regarding the roles and functions of available systems, the constraints of existing legislation, the importance of harmonisation and data sharing, and the creation of common main messages adapted to each target sector. However, there is still a long way to go to ensure cooperation among the Public Health, Animal Health, and Food Safety sectors, as a OH approach relies not only on the awareness of "field experts" but also on political and organisational willingness and commitment.

A systematic review on leptospirosis in cattle: A European perspective

Leptospirosis is a zoonotic disease which is globally distributed and represents a classic One Health issue that demands a comprehensive understanding of the hosts, transmission paths, and risk factors of transmission. Bovine leptospirosis often results in economic losses through its severe impact on reproduction performance while it threatens human health at human-cattle-environment interfaces. However, a clear analysis of the disease characteristics in European cattle is currently lacking. The objective of this review was to summarise the current knowledge on the epidemiology of bovine leptospirosis in Europe. We conducted a systematic literature review, screening four electronic databases, and filtered articles published between 2001 and 2021, in English, German, and French. Sixty-two articles were ultimately included in the review. The seroprevalence of leptospirosis in cattle was remarkably variable among studies, probably reflecting local variations but also heterogeneity in the study designs, laboratory methods, and sample sizes. Risk factors positively associated with the disease were diverse, related to local, environmental, and climatic parameters as well as farming practices. The most reported circulating Leptospira serogroups in European cattle were Sejroe (58.5%), Australis (41.5%), Grippotyphosa (41.5%), Icterohaemorrhagiae (37.7%), and Pomona (26.4%), which have also been associated with human infections worldwide. Abortion (58.6%) and fertility disorders (24.1%) were the most frequently reported signs of leptospirosis in European cattle and were generally associated with chronic infections. This work highlights several research gaps, including a lack of harmonisation in diagnostic methods, a lack of large-scale studies, and a lack of molecular investigations. Given that predictions regarding the climatic suitability for leptospirosis in Europe suggest an increase of leptospirosis risk it is important to raise awareness among stakeholders and motivate an integrated One Health approach to the prevention and control of this zoonotic disease in cattle and humans.

One Health approach at the heart of the French Committee for monitoring and anticipating health risks

Following the COVID-19 pandemic, the French government established a committee for monitoring and anticipating health risks. In this Comment, the authors describe the One Health approach taken by the committee, and outline its aims, composition, and initial actions.

Brief review on ebola virus disease and one health approach

Ebola virus disease (EVD) is a severe and highly fatal zoonotic disease caused by viruses in the family Filoviridae and genus Ebolavirus. The disease first appeared in Zaire near the Ebola River in 1976, now in the Democratic Republic of the Congo. Since then, several outbreaks have been reported in different parts of the world, mainly in Africa, leading to the identification of six distinct viral strains that cause disease in humans and other primates. Bats are assumed to be the main reservoir hosts of the virus, and the initial incidence of human epidemics invariably follows exposure to infected forest animals through contact or consumption of bush meat and body fluids of forest animals harboring the disease. Human-to-human transmission occurs when contaminated body fluids, utensils, and equipment come in contact with broken or abraded skin and mucous membranes. EVD is characterized by sudden onset of 'flu-like' symptoms (fever, myalgia, chills), vomiting and diarrhea, then disease rapidly evolves into a severe state with a rapid clinical decline which may lead potential hemorrhagic complications and multiple organ failure. Effective EVD prevention, detection, and response necessitate strong coordination across the animal, human, and environmental health sectors, as well as well-defined roles and responsibilities evidencing the significance of one health approach; the natural history, epidemiology, pathogenesis, and diagnostic procedures of the Ebola virus, as well as prevention and control efforts in light of one health approach, are discussed in this article.

Immuno-Colorimetric Neutralization Test: A Surrogate for Widely Used Plaque Reduction Neutralization Tests in Public Health Virology

Since their first documentation in 1952, plaque reduction neutralization tests (PRNTs) have become the choice of test for the measurement of neutralizing antibodies against a particular virus. However, PRNTs can be performed only against viruses that cause cytopathic effects (CPE). PRNTs also require skilled personnel and can be time-consuming depending on the time required for the virus to cause CPE. Hence, their application limits large-scale studies or epidemiological and laboratory investigations. Since 1978, many surrogate PRNTs or immunocolorimetric assay (ICA)-based focus reduction neutralization tests (FRNT) have been developed. In this article, ICAs and their utility in FRNTs for the characterization of neutralizing antibodies, homologous or heterologous cross-neutralization, and laboratory diagnosis of viruses of public health importance have been discussed. Additionally, possible advancements and automations have been described that may help in the development and validation of novel surrogate tests for emerging viruses.