One Health research and training in Australia and New Zealand

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.

International stakeholder perspectives on One Health training and empowerment: a needs assessment for a One Health Workforce Academy

BACKGROUND

One Health is defined as an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems; this approach attracts stakeholders from multiple sectors, academic disciplines, and professional practices. The diversity of expertise and interest groups is frequently and simultaneously framed as (1) a strength of the One Health approach in the process of understanding and solving complex problems associated with health challenges such as pathogen spillovers and pandemics and (2) a challenge regarding consensus on essential functions of One Health and the sets of knowledge, skills, and perspectives unique to a workforce adopting this approach. Progress in developing competency-based training in One Health has revealed coverage of various topics across fundamental, technical, functional, and integrative domains. Ensuring that employers value the unique characteristics of personnel trained in One Health will likely require demonstration of its usefulness, accreditation, and continuing professional development. These needs led to the conceptual framework of a One Health Workforce Academy (OHWA) for use as a platform to deliver competency-based training and assessment for an accreditable credential in One Health and opportunities for continuing professional development.

METHODS

To gather information about the desirability of an OHWA, we conducted a survey of One Health stakeholders. The IRB-approved research protocol used an online tool to collect individual responses to the survey questions. Potential respondents were recruited from partners of One Health University Networks in Africa and Southeast Asia and international respondents outside of these networks. Survey questions collected demographic information, measured existing or projected demand and the relative importance of One Health competencies, and determined the potential benefits and barriers of earning a credential. Respondents were not compensated for participation.

RESULTS

Respondents (N = 231) from 24 countries reported differences in their perspectives on the relative importance of competency domains of the One Health approach. More than 90% of the respondents would seek to acquire a competency-based certificate in One Health, and 60% of respondents expected that earning such a credential would be rewarded by employers. Among potential barriers, time and funding were the most cited.

CONCLUSION

This study showed strong support from potential stakeholders for a OHWA that hosts competency-based training with opportunities for certification and continuing professional development.

Capacity for One Health research in the Horn of Africa

Introduction

In low-and-middle-income countries, many people live near livestock. Rural livelihoods need improvement, however livestock-sector growth is a 'wicked' problem, needing careful management and One Health approaches which balance positive aspects of livestock ownership against deleterious impacts.

Materials and methods

A Key Informant survey was delivered to higher education and research institute Units in Horn of Africa, to quantify baseline estimates for One Health research, understand characteristics, and risk factors for usage.

Principal results

Four-fifths of Units acknowledged some One Health research; however, this was biased towards human-focused dimensions including at the human/animal/environment-interface and human/animal-interface; One Health approaches were also more often reported when all or the animal/environment dimensions were examined. We detected subject-bias impacting environment-focus in research; only research-focused Units had staff with higher environmental science degrees. Our work suggested good national research buy-in, and Units engaging with national policy-makers most often; local policy-makers were least engaged. Four-fifths of Units had laboratories, with two-thirds processing either human or animal samples and half processing both. Funding for equipment purchase, supplies and maintenance, staff training on technical/safety issues was nearly half that previously identified.

Major conclusions

The necessity for One Health research approaches is acknowledged, however our results suggest persistent and systemic neglect of the environment in approaches and research staff education, and a lack of integration across government hierarchies during policy-development, potentially driven by international organisation domination. Further, Units lack funding for laboratory equipment purchase/supplies/maintenance, and staff training on technical/safety issues.

One Health: An Effective and Ethical Approach to Leptospirosis Control in Australia

The increasing concerns over emerging infectious diseases and potential pandemics led to the formation of One Health, a collaborative, multidisciplinary approach to address the risks from human–animal–ecosystem interactions. This multi-sectoral approach is specifically important in Australia, a biodiverse country with unique flora, fauna, and many infectious diseases, including leptospirosis. Leptospirosis is a relatively rare but potentially fatal zoonosis, with an attributed mortality of around 60,000 deaths per year worldwide. In recent years, sporadic cases and alarming outbreaks of leptospirosis have been notified in many states and territories of Australia, noteworthily in 2018 and 2019. The sudden outbreaks in these two years have raised a question about the possibility of a more severe menace or a potential threat to both humans and animals. Amid the fight against leptospirosis, One Health has been shown to be an excellent and ideal framework, especially in Australia, the country that has taken the lead in zoonosis control using this approach. In this review, the focus will be put on the effectiveness and ethics of One Health in leptospirosis control under the Australian setting to further advocate the implementation of this framework for many other infectious diseases.

Systemic factors for enhancing intersectoral collaboration for the operationalization of One Health: a case study in India

Background

One Health is a collaborative, multisectoral, and transdisciplinary approach—working at the local, regional, national, and global levels—with the goal of achieving optimal health outcomes recognizing the interconnection between people, animals, plants, and their shared environment. Operationalization of the One Health approach is still unclear for various local health systems with their respective targets. In this scenario, the empirical study of intersectoral collaboration between the human and animal health systems provides an opportunity to investigate the appropriate strategies and their enabling factors at the local health system level. Thus, this study documented and validated the innovative strategy for intersectoral collaboration, focusing on effectual prevention and control of zoonotic diseases with its enabling factors for a city in western India, Ahmedabad.

Methods

This case study was conducted in three phases: phase I (qualitative data collection, i.e., vignette interview), phase II (quantitative data collection through modified policy Delphi), and phase III (participatory workshop). The vignette data were handled for content analysis, and the Delphi data, like other quantitative data, for descriptive statistics. The participatory workshop adapts the computerized Sensitivity Model^® developed by Vester to analyse the health system dynamics.

Result

Out of the possible 36 strategies, this study validated the top 15 essential (must-have) and five preferred (should-have) strategies for the study area. For operationalization of the One Health approach, the enabling factors that were identified through the systems approach are micro-level factors at the individual level (trust, leadership, motivation, knowledge), meso-level factors at the organizational level (human resource, capacity-building, shared vision, decision-making capacity, laboratory capacity, surveillance), macro-level factors at the system level (coordinated roles, relationships, common platform), and external factors outside of the system (guidelines/policies, community participation, a specific budget, political will, smart technology).

Discussion

This study reveals that the micro-level factors at the individual level are potential levers of the health system. More attention to these factors could be beneficial for the operationalization of the One Health approach. This study recommends a systems approach through a bottom-up exploration to understand the local health system and its enabling factors, which should be accounted for in formulating future One Health policies.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12961-021-00727-9.

One Health information management: health system reforms to support social well-being in Thailand

Background and Aim: The information about the health problems interaction between animal health, ecosystems, and human health that the "One Health (OH)" concept is becoming more complex. This study focused on OH information in Thailand to develop guidelines for establishing a "One Health Information Management (OHIM)" system by drafting the structure of an OH information strategic plan. Materials and Methods: A mixed methods approach was used and included questionnaires, interviews, focus groups, and observations in agencies across the country to gather evidence about actions relating to the OH concept, such as the Memorandum of Agreements between the Ministry of Public Health and eight main agencies. Results: The study concentrated on the key issue that understanding the OH concept is difficult, as the environment and human health sectors include less knowledge of this concept than the animal health sector. Further, there are concerns about the comprehension of OH concepts, and high-level information management and data storage relating to OH, including medicine, cattle, wild animal, environment, and environmental resource management. Data from OH researchers and publicly accessible government data are less integrated and inconsistently managed across agencies. Conclusion: The study of OHIM strategic development should consist of four important points: (1) Clarity in the OH concept, (2) OH staff development, (3) development of an OHIM data network and innovation, and (4) research and academic development, and global OHIM academic exchange. All of these points will lead to health system reforms to support social well-being.

Mitigating Future Respiratory Virus Pandemics: New Threats and Approaches to Consider

Despite many recent efforts to predict and control emerging infectious disease threats to humans, we failed to anticipate the zoonotic viruses which led to pandemics in 2009 and 2020. The morbidity, mortality, and economic costs of these pandemics have been staggering. We desperately need a more targeted, cost-efficient, and sustainable strategy to detect and mitigate future zoonotic respiratory virus threats. Evidence suggests that the transition from an animal virus to a human pathogen is incremental and requires a considerable number of spillover events and considerable time before a pandemic variant emerges. This evolutionary view argues for the refocusing of public health resources on novel respiratory virus surveillance at human-animal interfaces in geographical hotspots for emerging infectious diseases. Where human-animal interface surveillance is not possible, a secondary high-yield, cost-efficient strategy is to conduct novel respiratory virus surveillance among pneumonia patients in these same hotspots. When novel pathogens are discovered, they must be quickly assessed for their human risk and, if indicated, mitigation strategies initiated. In this review, we discuss the most common respiratory virus threats, current efforts at early emerging pathogen detection, and propose and defend new molecular pathogen discovery strategies with the goal of preempting future pandemics.

Biodiversity and Human Health Interlinkages in Higher Education Offerings: A First Global Overview

Introduction: Biodiversity is inextricably linked to human health. As an important area of research of the Convention on Biological Diversity and a key avenue for the dissemination of biodiversity and health knowledge, we investigated how well-embedded biodiversity and health interlinkages are in institutional higher education offerings.

Methods: Using One Health education programs as a starting point, we collected a global list of institutions potentially carrying out education in the links between biodiversity and health through previously published research, academic partners of global conglomerates, and our own networks. We then analyzed the offerings from these institutions to determine the degree of integration of biodiversity and health interlinkages.

Results: We found 105 educational offerings in biodiversity and health interlinkages from 89 institutions in 30 countries. These were primarily found in faculties of public health, veterinary sciences, and medicine, with varying degrees of coverage of the interlinkages.

Conclusion: Education incorporating the links between biodiversity and health exists globally, but should be more widely integrated, particularly through inter-faculty and inter-institutional collaboration.

Developing a Global One Health Workforce: The "Rx One Health Summer Institute" Approach

The One Health approach has gained support across a range of disciplines; however, training opportunities for professionals seeking to operationalize the interdisciplinary approach are limited. Academic institutions, through the development of high-quality, experiential training programs that focus on the application of professional competencies, can increase accessibility to One Health education. The Rx One Health Summer Institute, jointly led by US and East African partners, provides a model for such a program. In 2017, 21 participants representing five countries completed the Rx One Health program in East Africa. Participants worked collaboratively with communities neighboring wildlife areas to better understand issues impacting human and animal health and welfare, livelihoods, and conservation. One Health topics were explored through community engagement and role-playing exercises, field-based health surveillance activities, laboratories, and discussions with local experts. Educational assessments reflected improvements in participants' ability to apply the One Health approach to health and disease problem solving, as well as anticipate cross-sectoral challenges to its implementation. The experiential learning method, specifically the opportunity to engage with local communities, proved to be impactful on participants' cultural awareness. The Rx One Health Summer Institute training model may provide an effective and implementable strategy by which to contribute to the development of a global One Health workforce.

What makes an effective One Health clinical practitioner? Opinions of Australian One Health experts

Despite agreement that One Health practices facilitate effective management of zoonoses, the pathways to a coordinated and collaborative approach by general medical practitioners (GPs) and veterinarians are hampered by limited understanding of how this can be practically incorporated in routine clinical settings. Data collected during a Delphi survey of Australian One Health ‘experts’ was used to explore opinions and insights into desired knowledge, attitudes and practices of effective One Health clinical practitioners. Five categories were identified as essential for GPs and veterinarians, namely: accurate baseline knowledge of specific zoonoses; a ‘big picture’ understanding of zoonoses; understanding of professional roles within the One Health paradigm; understanding one's own professional limitations; and collaboration and referral improve outcomes. An outline of the roles and responsibilities of GPs and veterinarians as effective One Health clinicians was determined based on the opinions of the expert panel. Educational interventions that foster interprofessional communication and collaboration will be necessary to successfully bring about the cultural change required to achieve effective One Health practice in Australia, and thus expedite improved human, animal and environmental health outcomes.

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Experts identified five essential categories required by general medical practitioners and veterinarians.

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Cross professional collaboration was seen as a hallmark of effective One Health practice.

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Specific roles were identified for GPs and veterinarians with regard to zoonoses management

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Significant cultural change is required to successfully facilitate effective One Health practice at a clinical level

Beliefs, Attitudes and Self-Efficacy of Australian Veterinary Students Regarding One Health and Zoonosis Management

Simple Summary

The One Health approach provides a model for educating students, trainees and professionals in a systems approach to providing improved patient care and promoting healthy environments that benefit all species. In the present study, we designed an online survey that was communicated to senior veterinary students in a number of Australian veterinary schools. The survey evaluated the willingness of future veterinary graduates to participate positively in zoonoses (diseases transmitted between animals and humans) management through the adoption of the One Health approach in their future career. All respondents were willing to assist physicians in the management of zoonotic cases involving both patients and clients. The veterinary students were equally concerned about ensuring the best care for both animals (patients) and humans (clients). Our results demonstrate that there is strong support for future Australian veterinarians in the field of One Health.

Abstract

This study aimed to explore the beliefs and attitudes of a group of senior veterinary students regarding One Health and to evaluate their levels of confidence in advising the general public on preventative health issues at the human–animal interface. An online survey was communicated to senior veterinary students who were in their last two years of study. The questionnaire covered beliefs and attitudes, issues concerning the animal–human interface and participants’ confidence in diagnosing zoonoses. In total, 175 students from five Australian veterinary schools/colleges completed the online survey. The majority (96%) of students considered it their duty to promote the One Health approach, but only 36% believed there were sufficient practical frameworks for Australian veterinarian graduates to promote One Health. Interestingly, 81% (142/175) of respondents believed that veterinarians were more knowledgeable than physicians in managing zoonotic cases. Of the final-year students (n = 77), only 39% and 36% were confident in their ability to diagnose zoonoses in common companion animals and production animals, respectively. However, the number of those confident to diagnose zoonoses transmitted from wildlife was notably lower (22% (17/77)). Next-generation Australian veterinarians are keen to embrace their role in interprofessional collaboration; however, training efforts are required to reassure future veterinarians on aspects of zoonoses and One Health.