Adopting an intersectoral One Health approach in India: Time for One Health Committees

One Health approach and zoonotic diseases in Indonesia: Urgency of implementation and challenges

The urgency of implementing the One Health approach to overcome zoonotic diseases cannot be overstated. By recognizing the interconnectedness of human health, animal health, and the environment, we can effectively prevent and respond to emerging infectious disease threats. This review article provides information on the importance of generating research on zoonotic diseases, especially in Indonesia, where research is still relatively scarce. The Indonesian government has taken steps to implement the One Health by establishing the One Health Coordinating Unit and the National Zoonosis Committee; however, implementation has not been optimal. The urgency and challenges are focused on critical implementation aspects in the community. The urgency of implementing One Health includes that Indonesia has experienced several outbreaks of zoonotic diseases; high environmental degradation; and the antimicrobial resistance issue in Indonesia has increased. The challenges faced in implementing One Health are overcoming fragmentation due to incohesive communication between important sectors, securing funding and resource investment, aligning policies to eliminate regulation barriers, capacity building to increase awareness and professionals, and addressing critical socioeconomic factors. By prioritizing implementing the One Health approach and addressing existing challenges, Indonesia can build a more resilient and integrated system to protect the well-being of all species, protect ecosystems, and prevent the devastating effects of zoonotic diseases on global health. In this review, we present the urgency of One Health implementation and its challenges comprehensively.

Organising for One Health in a developing country

Globally, zoonotic diseases pose an enormous and growing public health challenge, and developing countries like India are at the epicentre of it. Although there is general recognition of this reality, governments around the world have struggled to organise appropriately to respond to it. The widely held view is that organising for One Health requires effective cross-sectoral collaboration, but the prerequisites to enable such collaboration appear almost unattainable. Perhaps an entirely different approach is needed, which is over and above effective collaborations between competing government ministries. The approach would have to recognise that while any organisational response will need to be able to address identified zoonotic diseases and respond effectively to them in times of crises, it would also be required to have the ability to shape the response to megatrends such as climate change, deforestation, and the underlying development models of the country. The paper analyses the success and failures associated with the way in which India, Bangladesh, Kenya, and Rwanda have organised for One Health. It also studies the underlying pathways through which zoonotic spillovers take place, and epidemics gather momentum. Based on these critical analyses, the paper concludes that attempts to build single overarching units to address these challenges have only been partially effective. Given the scale and complexity of the challenge, it recommends that, even at the risk of duplication and the very real possibility that unaddressed gaps will remain, an approach, which builds multiple sharply focused units, would have a greater chance of success.

The Past, Present, and Future of One Health in India: A Narrative Review

Humans have experienced a long-lasting pandemic of COVID-19 going on since the year 2020. Such events have recently increased the demand for a competent disease outbreak response system, more precisely, a One Health platform. The interaction between humans, animals, and ecosystems is inevitable. It is a known fact that the interface between these three entities is important for survival. In rural areas, especially in developing countries, it is a common practice to keep the animal shed in close proximity to their homes. Further, this intricate relationship itself plays a role in the spread and transmission of the disease. The involvement of the human-animal interface in emerging and re-emerging diseases has caused havoc in recent times and might prove challenging to overcome. Over the years, many efforts have been made on international and national platforms to adopt and implement a transdisciplinary, collaborative, intersectoral approach in India. This review highlights the major initiatives taken for the implementation of one health and the challenges faced over the years in our country.

One Health activities to reinforce intersectoral coordination at local levels in India

India's dense human and animal populations, agricultural economy, changing environment, and social dynamics support conditions for emergence/re-emergence of zoonotic diseases that necessitate a One Health (OH) approach for control. In addition to OH national level frameworks, effective OH driven strategies that promote local intersectoral coordination and collaboration are needed to truly address zoonotic diseases in India. We conducted a literature review to assess the landscape of OH activities at local levels in India that featured intersectoral coordination and collaboration and supplemented it with our own experience conducting OH related activities with local partners. We identified key themes and examples in local OH activities. Our landscape assessment demonstrated that intersectoral collaboration primarily occurs through specific research activities and during outbreaks, however, there is limited formal coordination among veterinary, medical, and environmental professionals on the day-to-day prevention and detection of zoonotic diseases at district/sub-district levels in India. Examples of local OH driven intersectoral coordination include the essential role of veterinarians in COVID-19 diagnostics, testing of human samples in veterinary labs for Brucella and leptospirosis in Punjab and Tamil Nadu, respectively, and implementation of OH education targeted to school children and farmers in rural communities. There is an opportunity to strengthen local intersectoral coordination between animal, human and environmental health sectors by building on these activities and formalizing the existing collaborative networks. As India moves forward with broad OH initiatives, OH networks and experience at the local level from previous or ongoing activities can support implementation from the ground up.

Combating COVID-19 with Proficiency and Precision

It has been two years since the first case of Coronavirus Disease-2019 (COVID-19) was detected in India in the state of Kerala in March 2020. (1) The Government and the citizens of India have united together to combat the virus since then. India is the largest democracy in the world and the second highest populous country with an estimated 1.36 billion population. The country has witnessed three major waves of the COVID-19 pandemic in the past 3 years, the second being the worse. In the month of June 2022, India has reported a cumulative total of approximately 4.34 crore confirmed cases of COVID-19 and 511,903 deaths. The state of Maharashtra has been the worst effected in all three waves. Presently the recovery rate from COVID-19 in India has crossed 98%. (2)

Epidemiological profiling of SARS-CoV-2 with focus on one-health approaches in mitigating COVID-19 pandemic

Of the 1,415 human pathogens identified, 175 are responsible for causing emerging diseases, 132 are zoonotic and majority of the diseases are categorized as emerging or re-emerging. Emerging novel Coronavirus (COVID- 19) is one of them, and it is responsible for causing social and economically critical disease in both humans and animals. This review presents the understanding of epidemiological characteristics of the COVID-19 pandemic related to host, agent, and the environment with transmission and spread of the disease for better prevention of the COVID-19. The inclination of the viruses to spillover between different species and determining the number of the reservoir of coronaviruses in an entirely new host to create infection is of emerging importance. The understanding of disease patterns will potentiate our expertise to alert how, when, and where the potential epidemic will occur. One health approach involves co-operation from all the sectors, including healthcare (medical and veterinary), environmental, pharmaceutical, educational, research, police, and administration, to combat the COVID-19 pandemic and reduce the public health threat.

SARS-CoV-2 natural infection in animals: a systematic review of studies and case reports and series

COVID-19 pandemic is essentially a zoonotic disease. In this context, early in 2020, transmission from humans to certain animals began reporting; the number of studies has grown since. To estimate the pooled prevalence of SARS-CoV-2 natural infection in animals and to determine differences in prevalence between countries, years, animal types and diagnostic methods (RT-PCR or serological tests). A systematic literature review with meta-analysis using eight databases. Observational studies were included but analyzed separately. We performed a random-effects model meta-analysis to calculate the pooled prevalence and 95% confidence interval (95% CI) for prevalence studies and case series. After the screening, 65 reports were selected for full-text assessment and included for qualitative and quantitative analyses. A total of 24 reports assessed SARS-CoV-2 infection by RT-PCR, combining a total of 321,785 animals, yielding a pooled prevalence of 12.3% (95% CI 11.6%–13.0%). Also, a total of 17 studies additionally assessed serological response against SARS-CoV-2, including nine by ELISA, four by PRTN, one by MIA, one by immunochromatography (rest, two studies, the method was not specified), combining a total of 5319 animals, yielding a pooled prevalence of 29.4% (95% CI 22.9%–35.9%). A considerable proportion of animals resulted infected by SARS-CoV-2, ranking minks among the highest value, followed by dogs and cats. Further studies in other animals are required to define the extent and importance of natural infection due to SARS-CoV-2. These findings have multiple implications for public human and animal health. One Health approach in this context is critical for prevention and control.