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Hobeika A, Stauffer MHT, Dub T, van Bortel W, Beniston M, Bukachi S, Burci GL, Crump L, Markotter W, Sepe LP, Placella E, Roche B, Thiongane O, Wang Z, Guérin F, van Kleef E. The values and risks of an Intergovernmental Panel for One Health to strengthen pandemic prevention, preparedness, and response. Lancet Glob Health 2023; 11:e1301-e1307. [PMID: 37474236 DOI: 10.1016/s2214-109x(23)00246-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 05/08/2023] [Accepted: 05/19/2023] [Indexed: 07/22/2023]
Abstract
The COVID-19 pandemic has shown the need for better global governance of pandemic prevention, preparedness, and response (PPR) and has emphasised the importance of organised knowledge production and uptake. In this Health Policy, we assess the potential values and risks of establishing an Intergovernmental Panel for One Health (IPOH). Similar to the Intergovernmental Panel on Climate Change, an IPOH would facilitate knowledge uptake in policy making via a multisectoral approach, and hence support the addressing of infectious disease emergence and re-emergence at the human-animal-environment interface. The potential benefits to pandemic PPR include a clear, unified, and authoritative voice from the scientific community, support to help donors and institutions to prioritise their investments, evidence-based policies for implementation, and guidance on defragmenting the global health system. Potential risks include a scope not encompassing all pandemic origins, unclear efficacy in fostering knowledge uptake by policy makers, potentially inadequate speed in facilitating response efforts, and coordination challenges among an already dense set of stakeholders. We recommend weighing these factors when designing institutional reforms for a more effective global health system.
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Affiliation(s)
- Alexandre Hobeika
- UMR MoISA, CIRAD, Montpellier, France; MoISA, University of Montpellier, Montpellier, France; CIHEAM-IAMM, INRAE, Institut Agro, Montpellier, France
| | - Maxime Henri Tibault Stauffer
- Geneva Science-Policy Interface, University of Geneva, Geneva, Switzerland; Simon Institute for Longterm Governance, Geneva, Switzerland
| | - Timothée Dub
- Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Wim van Bortel
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Martin Beniston
- Institute for Environmental Sciences, University of Geneva, Geneva, Switzerland
| | - Salome Bukachi
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Gian Luca Burci
- Graduate Institute of International and Development Studies, Geneva, Switzerland
| | - Lisa Crump
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; Human and Animal Health Unit, University of Basel, Basel, Switzerland
| | - Wanda Markotter
- Centre for Viral Zoonoses, Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Ludovico Pasquale Sepe
- Department of Biological Safety, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | | | - Benjamin Roche
- Research Institute for Development, PREZODE Initiative, Montpellier, France
| | | | - Zhanyun Wang
- Empa-Swiss Federal Laboratories for Materials Science and Technology, Technology and Society Laboratory, St Gallen, Switzerland
| | - Frédérique Guérin
- Geneva Science-Policy Interface, University of Geneva, Geneva, Switzerland
| | - Esther van Kleef
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium; Julius Center for Health Sciences and Primary Care, Utrecht University, Utrecht, Netherlands.
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Mburu CM, Bukachi S, Majiwa H, Ongore D, Baylis M, Mochabo K, Fevre E, Howland O. Prioritization of livestock diseases by pastoralists in Oloitoktok Sub County, Kajiado County, Kenya. PLoS One 2023; 18:e0287456. [PMID: 37436965 DOI: 10.1371/journal.pone.0287456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 06/06/2023] [Indexed: 07/14/2023] Open
Abstract
INTRODUCTION Livestock diseases are a big challenge for the livelihood of pastoralists in sub-Saharan Africa because they reduce livestock productivity and increase mortality. Based on the literature available there is limited understanding on how pastoralists prioritize these diseases in the context of their culture, ecosystems and livelihoods. A study was conducted to provide insights on lay prioritization of animal diseases by pastoralists in Kenya. METHODOLOGY A qualitative study was undertaken between March and July 2021. Thirty in-depth interviews and six focus group discussions (FGDs) were conducted with community members to explore community attitudes on livestock diseases prioritization. Male and female livestock keepers were purposively selected and interviewed and they were all long-term residents of the area. Fourteen key informant interviews (KIIs) were conducted with professionals from different key sectors to provide detailed stakeholder perspectives on livestock diseases. The interviews were analyzed thematically using the QSR Nvivo software to identify the emerging themes related to the study objectives. RESULTS The pastoralists prioritized livestock diseases based on effect on their economic wellbeing, cultural values and utilization of ecosystem services. There were gender variabilities in how diseases were prioritized among the pastoralists. Men cited high priority diseases as foot and mouth disease and contagious bovine pleuropneumonia due to their regular occurrence and effect on livelihood. Notably, women regarded coenuruses as very important because it affected sheep and goats with a high mortality rate and lumpy skin disease because it rendered the meat from the carcasses inedible. Malignant catarrhal fever and trypanosomiasis were noted as some of the common diseases in the livestock-wildlife interface but not cited as priority diseases. Challenges related to disease control in pastoralist contexts exist including limited access to livestock treatment services, inadequate information on disease impact and complex environmental factors. CONCLUSION This study sheds light on the body of knowledge in Kenya regarding livestock diseases and their prioritization by livestock keepers. This could aid in the development of a common disease control framework and prioritization at the local level which would take into consideration the dynamic socio-cultural, ecological, livelihood and economic contexts of the communities.
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Affiliation(s)
- Caroline M Mburu
- Department of Social Anthropology, University of St Andrews, St Andrews, Scotland, United Kingdom
| | - Salome Bukachi
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Hamilton Majiwa
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Dismas Ongore
- School of Public Health, University of Nairobi, Nairobi, Kenya
| | - Matthew Baylis
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Kennedy Mochabo
- Faculty of Veterinary Medicine and Surgery, Egerton University, Nakuru, Kenya
| | - Eric Fevre
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
| | - Olivia Howland
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
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Drew S, Blake C, Monterrosa E, Rampalli K, Khan ANS, Reyes L, Bukachi S, Ngutu M, Frongillo E, Iruhiriye E, Girard A, Dominguez-Salas P. How Schwartz’ Basic Human Values Influence Food Choices in Kenya and Tanzania. Curr Dev Nutr 2022. [PMCID: PMC9193813 DOI: 10.1093/cdn/nzac059.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objectives To identify and describe how values drive food choice of vulnerable consumers in two East African countries, Kenya and Tanzania. Methods Secondary data analysis was conducted on focus group discussions from studies in Kenya and Tanzania. A codebook was developed based on Schwartz's theory of basic human values. A priori coding was conducted in NVivo 12 followed by a narrative comparative analysis, which included review by original principal investigators. Results Values of conservation (security, conformity, tradition), openness to change (self-directed thought and action, stimulation, indulgence), self-enhancement (achievement, power, face), and self-transcendence (benevolence dependability and caring) were prominent drivers of food choice in both settings. While tradition was an important value in food choice, new social situations and food environments rendered reprioritization, especially pertaining to youth and animal source foods. Openness to change values were readily cited, especially in peri-urban Kenya with many new foods and diverse neighborhoods. Values of independent thought and action were drivers of mothers’ food choices for families. Benevolence security and caring were drivers choices for child feeding and selecting trustworthy food vendors. Many participants described how values existed in tension. For example, changes in livelihood led to a reprioritization of values like stimulation or indulgence over tradition. Conclusions Values were important drivers of food choice in both settings, particularly for meat. Future efforts to promote healthy, sustainable diets will require policy and broad consumer support to succeed. Examining the values that drive food choice in different contexts is necessary especially to minimize unintended consequences, controversy, and perhaps opposition in the implementation of policies and programs. Funding Sources UK Government's Foreign, Commonwealth, and Development Office and the Bill & Melinda Gates Foundation; the views expressed do not necessarily reflect the UK Government's official policies.
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Mwololo D, Nthiwa D, Kitala P, Abuom T, Wainaina M, Kairu-Wanyoike S, Lindahl JF, Ontiri E, Bukachi S, Njeru I, Karanja J, Sang R, Grace D, Bett B. Sero-epidemiological survey of Coxiella burnetii in livestock and humans in Tana River and Garissa counties in Kenya. PLoS Negl Trop Dis 2022; 16:e0010214. [PMID: 35239658 PMCID: PMC8923444 DOI: 10.1371/journal.pntd.0010214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 03/15/2022] [Accepted: 01/28/2022] [Indexed: 01/17/2023] Open
Abstract
Background Coxiella burnetii is a widely distributed pathogen, but data on its epidemiology in livestock, and human populations remain scanty, especially in developing countries such as Kenya. We used the One Health approach to estimate the seroprevalance of C. burnetii in cattle, sheep, goats and human populations in Tana River county, and in humans in Garissa county, Kenya. We also identified potential determinants of exposure among these hosts. Methods Data were collected through a cross-sectional study. Serum samples were taken from 2,727 animals (466 cattle, 1,333 goats, and 928 sheep) and 974 humans and screened for Phase I/II IgG antibodies against C. burnetii using enzyme-linked immunosorbent assay (ELISA). Data on potential factors associated with animal and human exposure were collected using a structured questionnaire. Multivariable analyses were performed with households as a random effect to adjust for the within-household correlation of C. burnetii exposure among animals and humans, respectively. Results The overall apparent seroprevalence estimates of C. burnetii in livestock and humans were 12.80% (95% confidence interval [CI]: 11.57–14.11) and 24.44% (95% CI: 21.77–27.26), respectively. In livestock, the seroprevalence differed significantly by species (p < 0.01). The highest seroprevalence estimates were observed in goats (15.22%, 95% CI: 13.34-17.27) and sheep (14.22%, 95% CI: 12.04–16.64) while cattle (3.00%, 95% CI: 1.65–4.99) had the lowest seroprevalence. Herd-level seropositivity of C. burnetii in livestock was not positively associated with human exposure. Multivariable results showed that female animals had higher odds of seropositivity for C. burnetii than males, while for animal age groups, adult animals had higher odds of seropositivity than calves, kids or lambs. For livestock species, both sheep and goats had significantly higher odds of seropositivity than cattle. In human populations, men had a significantly higher odds of testing positive for C. burnetii than women. Conclusions This study provides evidence of livestock and human exposure to C. burnetii which could have serious economic implications on livestock production and impact on human health. These results also highlight the need to establish active surveillance in the study area to reduce the disease burden associated with this pathogen. Q fever caused by Coxiella burnetii is a significant zoonotic disease that affects wildlife, domestic animals and humans. This study determined the prevalence of antibodies to C. burnetii in livestock (cattle, sheep, and goats) and human populations in arid and semi-arid areas of Kenya between December 2013 and February 2014. We also identified potential factors that were associated with exposure among the above-targeted hosts. Results from this study showed considerable exposure in both livestock and human populations. However, human exposure to this pathogen at the household level was not correlated with herd-level seropositivity. Further studies are needed to elucidate the transmission routes of this pathogen among humans.
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Affiliation(s)
- Damaris Mwololo
- Directorate of Veterinary Services, Ministry of Agriculture, Livestock, Fisheries and Cooperatives, Nairobi, Kenya
| | - Daniel Nthiwa
- Department of Biological Sciences, University of Embu, Embu, Kenya
- International Livestock Research Institute, Nairobi, Kenya
- * E-mail:
| | - Philip Kitala
- Department of Public Health, Pharmacology and Toxicology, Faculty of Veterinary Medicine, University of Nairobi, Nairobi, Kenya
| | - Tequiero Abuom
- Department of Clinical Medicine, Faculty of Veterinary Medicine, University of Nairobi, Nairobi, Kenya
| | | | - Salome Kairu-Wanyoike
- Department of Veterinary Services, Ministry of Agriculture, Livestock and Fisheries, Nairobi, Kenya
| | - Johanna F. Lindahl
- International Livestock Research Institute, Nairobi, Kenya
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
- Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Enoch Ontiri
- International Livestock Research Institute, Nairobi, Kenya
| | - Salome Bukachi
- Institute of Anthropology, University of Nairobi, Nairobi, Kenya
| | - Ian Njeru
- Division of Disease Surveillance and Response, Ministry of Public Health and Sanitation, Kenyatta National Hospital, Nairobi, Kenya
| | - Joan Karanja
- Division of Disease Surveillance and Response, Ministry of Public Health and Sanitation, Kenyatta National Hospital, Nairobi, Kenya
| | | | - Delia Grace
- International Livestock Research Institute, Nairobi, Kenya
- Natural Resources Institute, University of Greenwich, Kent, United Kingdom
| | - Bernard Bett
- International Livestock Research Institute, Nairobi, Kenya
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Braam DH, Srinivasan S, Church L, Sheikh Z, Jephcott FL, Bukachi S. Lockdowns, lives and livelihoods: the impact of COVID-19 and public health responses to conflict affected populations - a remote qualitative study in Baidoa and Mogadishu, Somalia. Confl Health 2021; 15:47. [PMID: 34118985 PMCID: PMC8197606 DOI: 10.1186/s13031-021-00382-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 06/03/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Authorities in Somalia responded with drastic measures after the first confirmed COVID-19 case in mid-March 2020, closing borders, schools, limiting travel and prohibiting most group functions. However, the impact of the pandemic in Somalia thereafter remained unclear. This study employs a novel remote qualitative research method in a conflict-affected setting to look at how some of the most at-risk internally displaced and host populations were impacted by COVID-19, what determined their responses, and how this affected their health and socio-economic vulnerability. METHODS We conducted a remote qualitative study, using Katikati, a 1-to-1 conversation management and analysis platform using short message service (SMS) developed by Lark Systems with Africa's Voices Foundation (AVF), for semi-structured interviews over three months with participants in Mogadishu and Baidoa. We recruited a gender balanced cohort across age groups, and used an analytical framework on the social determinants of health for a narrative analysis on major themes discussed, triangulating data with existing peer-reviewed and grey literature. RESULTS The remote research approach demonstrated efficacy in sustaining trusted and meaningful conversations for gathering qualitative data from hard-to-reach conflict-affected communities. The major themes discussed by the 35 participants included health, livelihoods and education. Two participants contracted the disease, while others reported family or community members affected by COVID-19. Almost all participants faced a loss of income and/or education, primarily as a result of the strict public health measures. Some of those who were heavily affected economically but did not directly experienced disease, denied the pandemic. Religion played an important role in participants' beliefs in protection against and salvation from the disease. As lockdowns were lifted in August 2020, many believed the pandemic to be over. CONCLUSIONS While the official COVID-19 burden has remained relatively low in Somalia, the impact to people's daily lives, income and livelihoods due to public health responses, has been significant. Participants describe those 'secondary' outcomes as the main impact of the pandemic, serving as a stark reminder of the need to broaden the public health response beyond disease prevention to include social and economic interventions to decrease people's vulnerability to future shocks.
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Affiliation(s)
- Dorien H Braam
- Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, Cambridge, UK.
| | - Sharath Srinivasan
- Department of Politics and International Studies, University of Cambridge, Cambridge, UK
| | - Luke Church
- Department of Computer Science and Technology, University of Cambridge, Cambridge, UK
| | | | - Freya L Jephcott
- Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Salome Bukachi
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
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Hassell JM, Zimmerman D, Fèvre EM, Zinsstag J, Bukachi S, Barry M, Muturi M, Bett B, Jensen N, Ali S, Maples S, Rushton J, Tschopp R, Madaine YO, Abtidon RA, Wild H. Africa's Nomadic Pastoralists and Their Animals Are an Invisible Frontier in Pandemic Surveillance. Am J Trop Med Hyg 2020; 103:1777-1779. [PMID: 32918410 PMCID: PMC7646752 DOI: 10.4269/ajtmh.20-1004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
The effects of COVID-19 have gone undocumented in nomadic pastoralist communities across Africa, which are largely invisible to health surveillance systems despite the fact that they are of key significance in the setting of emerging infectious disease. We expose these landscapes as a “blind spot” in global health surveillance, elaborate on the ways in which current health surveillance infrastructure is ill-equipped to capture pastoralist populations and the animals with which they coexist, and highlight the consequential risks of inadequate surveillance among pastoralists and their livestock to global health. As a platform for further dialogue, we present concrete solutions to address this gap.
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Affiliation(s)
- James M Hassell
- Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, Connecticut.,Global Health Program, Smithsonian Conservation Biology Institute, Washington, District of Columbia
| | - Dawn Zimmerman
- Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, Connecticut.,Global Health Program, Smithsonian Conservation Biology Institute, Washington, District of Columbia
| | - Eric M Fèvre
- International Livestock Research Institute, Nairobi, Kenya.,Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Jakob Zinsstag
- University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Salome Bukachi
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Michele Barry
- Center for Innovation in Global Health, Stanford University, Stanford, California.,School of Medicine, Stanford University, Stanford, California
| | - Mathew Muturi
- Kenya Zoonotic Disease Unit, Ministry of Agriculture, Livestock and Fisheries, Nairobi, Kenya.,International Livestock Research Institute, Nairobi, Kenya
| | - Bernard Bett
- International Livestock Research Institute, Nairobi, Kenya
| | | | - Seid Ali
- Jigjiga University, Jigjiga, Ethiopia.,University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Stace Maples
- Stanford Geospatial Center, Stanford University, Stanford, California
| | - Jonathan Rushton
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Rea Tschopp
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia.,University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Yahya O Madaine
- Jigjiga University, Jigjiga, Ethiopia.,University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Rahma A Abtidon
- Jigjiga University, Jigjiga, Ethiopia.,University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Hannah Wild
- Department of Surgery, University of Washington, Seattle, Washington
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Byskov J, Maluka S, Marchal B, Shayo EH, Blystad A, Bukachi S, Zulu JM, Michelo C, Hurtig AK, Bloch P. A systems perspective on the importance of global health strategy developments for accomplishing today’s Sustainable Development Goals. Health Policy Plan 2019; 34:800. [PMID: 31557286 PMCID: PMC6913699 DOI: 10.1093/heapol/czz124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Byskov J, Maluka S, Marchal B, Shayo EH, Blystad A, Bukachi S, Zulu JM, Michelo C, Hurtig AK, Bloch P. A systems perspective on the importance of global health strategy developments for accomplishing today's Sustainable Development Goals. Health Policy Plan 2019; 34:635-645. [PMID: 31363736 PMCID: PMC6880334 DOI: 10.1093/heapol/czz042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2019] [Indexed: 12/01/2022] Open
Abstract
Priority setting within health systems has not led to accountable, fair and sustainable solutions to improving population health. Providers, users and other stakeholders each have their own health and service priorities based on selected evidence, own values, expertise and preferences. Based on a historical account, this article analyses if contemporary health systems are appropriate to optimize population health within the framework of cross cutting targets of the Sustainable Development Goals (SDGs). We applied a scoping review approach to identify and review literature of scientific databases and other programmatic web and library-based documents on historical and contemporary health systems policies and strategies at the global level. Early literature supported the 1977 launching of the global target of Health for All by the year 2000. Reviewed literature was used to provide a historical overview of systems components of global health strategies through describing the conceptualizations of health determinants, user involvement and mechanisms of priority setting over time, and analysing the importance of historical developments on barriers and opportunities to accomplish the SDGs. Definitions, scope and application of health systems-associated priority setting fluctuated and main health determinants and user influence on global health systems and priority setting remained limited. In exploring reasons for the identified lack of SDG-associated health systems and priority setting processes, we discuss issues of accountability, vested interests, ethics and democratic legitimacy as conditional for future sustainability of population health. To accomplish the SDGs health systems must engage beyond their own sector boundary. New approaches to Health in All Policies and One Health may be conducive for scaling up more democratic and inclusive priority setting processes based on proper process guidelines from successful pilots. Sustainable development depends on population preferences supported by technical and managerial expertise.
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Affiliation(s)
- Jens Byskov
- Research and Health Systems Advisor, School of Public Health, Ridgeway Campus, University of Zambia, Lusaka, Zambia
| | - Stephen Maluka
- Institute of Development Studies, University of Dar Es Salaam, Tanzania
| | - Bruno Marchal
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Nationalestraat 155, B Antwerpen, Belgium
| | - Elizabeth H Shayo
- National Institute for Medical Research (NIMR), Dar Es Salaam, Tanzania
| | - Astrid Blystad
- Department of Global Health and Primary Care, University of Bergen, Norway
| | - Salome Bukachi
- Institute of Anthropology, Gender and African Studies University of Nairobi, Nairobi, Kenya
| | - Joseph M Zulu
- School of Public Health, Ridgeway Campus, University of Zambia, Lusaka, Zambia
| | - Charles Michelo
- School of Public Health, Ridgeway Campus, University of Zambia, Lusaka, Zambia
| | - Anna-Karin Hurtig
- Department of Epidemiology and Global Health, Umeå University, SE, Umea, Sweden
| | - Paul Bloch
- Steno Diabetes Center Copenhagen, Niels Steensens Vej 6, DK Gentofte, Denmark
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Kairu-Wanyoike S, Nyamwaya D, Wainaina M, Lindahl J, Ontiri E, Bukachi S, Njeru I, Karanja J, Sang R, Grace D, Bett B. Positive association between Brucella spp. seroprevalences in livestock and humans from a cross-sectional study in Garissa and Tana River Counties, Kenya. PLoS Negl Trop Dis 2019; 13:e0007506. [PMID: 31622339 PMCID: PMC6818805 DOI: 10.1371/journal.pntd.0007506] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 10/29/2019] [Accepted: 09/23/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Brucella spp. is a zoonotic bacterial agent of high public health and socio-economic importance. It infects many species of animals including wildlife, and people may get exposed through direct contact with an infected animal or consumption of raw or undercooked animal products. A linked livestock-human cross-sectional study to determine seroprevalences and risk factors of brucellosis in livestock and humans was designed. Estimates were made for intra-cluster correlation coefficients (ICCs) for these observations at the household and village levels. METHODOLOGY The study was implemented in Garissa (specifically Ijara and Sangailu areas) and Tana River (Bura and Hola) counties. A household was the unit of analysis and the sample size was derived using the standard procedures. Serum samples were obtained from selected livestock and people from randomly selected households. Humans were sampled in both counties, while livestock could be sampled only in Tana River County. Samples obtained were screened for anti-Brucella IgG antibodies using ELISA kits. Data were analyzed using generalized linear mixed effects logistic regression models with the household (herd) and village being used as random effects. RESULTS The overall Brucella spp. seroprevalences were 3.47% (95% confidence interval [CI]: 2.72-4.36%) and 35.81% (95% CI: 32.87-38.84) in livestock and humans, respectively. In livestock, older animals and those sampled in Hola had significantly higher seroprevalences than younger ones or those sampled in Bura. Herd and village random effects were significant and ICC estimates associated with these variables were 0.40 (95% CI: 0.22-0.60) and 0.24 (95% CI: 0.08-0.52), respectively. In humans, Brucella spp. seroprevalence was significantly higher in older people, males, and people who lived in pastoral areas than younger ones, females or those who lived in irrigated or riverine areas. People from households that had at least one seropositive animal were 3.35 (95% CI: 1.51-7.41) times more likely to be seropositive compared to those that did not. Human exposures significantly clustered at the household level; the ICC estimate obtained was 0.21 (95% CI: 0.06-0.52). CONCLUSION The presence of a Brucella spp.-seropositive animal in a household significantly increased the odds of Brucella spp. seropositivity in humans in that household. Exposure to Brucella spp. of both livestock and humans clustered significantly at the household level. This suggests that risk-based surveillance measures, guided by locations of primary cases reported, either in humans or livestock, can be used to detect Brucella spp. infections in livestock or humans, respectively.
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Affiliation(s)
- Salome Kairu-Wanyoike
- Department of Veterinary Services, Ministry of Agriculture, Livestock and Fisheries, Nairobi, Kenya
| | - Doris Nyamwaya
- International Livestock Research Institute, Nairobi, Kenya
| | | | | | - Enoch Ontiri
- International Livestock Research Institute, Nairobi, Kenya
| | - Salome Bukachi
- Institute of Anthropology, University of Nairobi, Nairobi, Kenya
| | - Ian Njeru
- Division of Disease Surveillance and Response, Ministry of Public Health and Sanitation, Kenyatta National Hospital, Nairobi, Kenya
| | - Joan Karanja
- Division of Disease Surveillance and Response, Ministry of Public Health and Sanitation, Kenyatta National Hospital, Nairobi, Kenya
| | | | - Delia Grace
- International Livestock Research Institute, Nairobi, Kenya
| | - Bernard Bett
- International Livestock Research Institute, Nairobi, Kenya
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Leach M, Bett B, Said M, Bukachi S, Sang R, Anderson N, Machila N, Kuleszo J, Schaten K, Dzingirai V, Mangwanya L, Ntiamoa-Baidu Y, Lawson E, Amponsah-Mensah K, Moses LM, Wilkinson A, Grant DS, Koninga J. Local disease-ecosystem-livelihood dynamics: reflections from comparative case studies in Africa. Philos Trans R Soc Lond B Biol Sci 2018; 372:rstb.2016.0163. [PMID: 28584171 PMCID: PMC5468688 DOI: 10.1098/rstb.2016.0163] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2017] [Indexed: 12/16/2022] Open
Abstract
This article explores the implications for human health of local interactions between disease, ecosystems and livelihoods. Five interdisciplinary case studies addressed zoonotic diseases in African settings: Rift Valley fever (RVF) in Kenya, human African trypanosomiasis in Zambia and Zimbabwe, Lassa fever in Sierra Leone and henipaviruses in Ghana. Each explored how ecological changes and human–ecosystem interactions affect pathogen dynamics and hence the likelihood of zoonotic spillover and transmission, and how socially differentiated peoples’ interactions with ecosystems and animals affect their exposure to disease. Cross-case analysis highlights how these dynamics vary by ecosystem type, across a range from humid forest to semi-arid savannah; the significance of interacting temporal and spatial scales; and the importance of mosaic and patch dynamics. Ecosystem interactions and services central to different people's livelihoods and well-being include pastoralism and agro-pastoralism, commercial and subsistence crop farming, hunting, collecting food, fuelwood and medicines, and cultural practices. There are synergies, but also tensions and trade-offs, between ecosystem changes that benefit livelihoods and affect disease. Understanding these can inform ‘One Health’ approaches towards managing ecosystems in ways that reduce disease risks and burdens. This article is part of the themed issue ‘One Health for a changing world: zoonoses, ecosystems and human well-being’.
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Affiliation(s)
- Melissa Leach
- Institute for Development Studies, University of Sussex, Brighton BN1 9RE, UK
| | - Bernard Bett
- International Livestock Research Institute, Nairobi, Kenya
| | - M Said
- International Livestock Research Institute, Nairobi, Kenya
| | | | | | - Neil Anderson
- Royal (Dick) School of Veterinary Studies and the Roslin Institute, University of Edinburgh, Edinburgh, UK
| | - Noreen Machila
- College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Joanna Kuleszo
- Geography and Environment, University of Southampton, Southampton, UK
| | | | | | | | | | | | | | - Lina M Moses
- Department of Microbiology and Immunology, Tulane University, New Orleans, LA, USA
| | - Annie Wilkinson
- Institute for Development Studies, University of Sussex, Brighton BN1 9RE, UK
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Dzingirai V, Bukachi S, Leach M, Mangwanya L, Scoones I, Wilkinson A. Structural drivers of vulnerability to zoonotic disease in Africa. Philos Trans R Soc Lond B Biol Sci 2018; 372:rstb.2016.0169. [PMID: 28584177 PMCID: PMC5468694 DOI: 10.1098/rstb.2016.0169] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2017] [Indexed: 01/25/2023] Open
Abstract
This paper argues that addressing the underlying structural drivers of disease vulnerability is essential for a ‘One Health’ approach to tackling zoonotic diseases in Africa. Through three case studies—trypanosomiasis in Zimbabwe, Ebola and Lassa fever in Sierra Leone and Rift Valley fever in Kenya—we show how political interests, commercial investments and conflict and securitization all generate patterns of vulnerability, reshaping the political ecology of disease landscapes, influencing traditional coping mechanisms and affecting health service provision and outbreak responses. A historical, political economy approach reveals patterns of ‘structural violence’ that reinforce inequalities and marginalization of certain groups, increasing disease risks. Addressing the politics of One Health requires analysing trade-offs and conflicts between interests and visions of the future. For all zoonotic diseases economic and political dimensions are ultimately critical and One Health approaches must engage with these factors, and not just end with an ‘anti-political’ focus on institutional and disciplinary collaboration. This article is part of the themed issue ‘One Health for a changing world: zoonoses, ecosystems and human well-being’.
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Affiliation(s)
- Vupenyu Dzingirai
- Centre for Applied Social Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Salome Bukachi
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Melissa Leach
- Institute of Development Studies, University of Sussex, Brighton BN1 9RE, UK
| | - Lindiwe Mangwanya
- Centre for Applied Social Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Ian Scoones
- Institute of Development Studies, University of Sussex, Brighton BN1 9RE, UK
| | - Annie Wilkinson
- Institute of Development Studies, University of Sussex, Brighton BN1 9RE, UK
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Bett B, Said MY, Sang R, Bukachi S, Wanyoike S, Kifugo SC, Otieno F, Ontiri E, Njeru I, Lindahl J, Grace D. Effects of flood irrigation on the risk of selected zoonotic pathogens in an arid and semi-arid area in the eastern Kenya. PLoS One 2017; 12:e0172626. [PMID: 28562600 PMCID: PMC5450996 DOI: 10.1371/journal.pone.0172626] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Accepted: 02/07/2017] [Indexed: 11/19/2022] Open
Abstract
To investigate the effects of irrigation on land cover changes and the risk of selected zoonotic pathogens, we carried out a study in irrigated, pastoral and riverine areas in the eastern Kenya. Activities implemented included secondary data analyses to determine land use and land cover (LULC) changes as well as human, livestock and wildlife population trends; entomological surveys to characterize mosquitoes population densities and species distribution by habitat and season; and serological surveys in people to determine the risk of Rift Valley fever virus (RVFV), West Nile fever virus (WNV), dengue fever virus (DFV), Leptospira spp. and Brucella spp. Results demonstrate a drastic decline in vegetation cover over ≈25 years particularly in the irrigated areas where cropland increased by about 1,400% and non-farm land (under closed trees, open to closed herbaceous vegetation, bushlands and open trees) reduced by 30-100%. The irrigated areas had high densities of Aedes mcintoshi, Culex spp. and Mansonia spp. (important vectors for multiple arboviruses) during the wet and dry season while pastoral areas had high densities of Ae. tricholabis specifically in the wet season. The seroprevalences of RVFV, WNV and DFV were higher in the irrigated compared to the pastoral areas while those for Leptospira spp and Brucella spp. were higher in the pastoral compared to the irrigated areas. It is likely that people in the pastoral areas get exposed to Leptospira spp by using water fetched from reservoirs that are shared with livestock and wildlife, and to Brucella spp. by consuming raw or partially cooked animal-source foods such as milk and meat. This study suggests that irrigation increases the risk of mosquito-borne infections while at the same time providing a protective effect against zoonotic pathogens that thrive in areas with high livestock population densities.
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Affiliation(s)
- Bernard Bett
- International Livestock Research Institute, Nairobi, Kenya
- * E-mail:
| | | | | | - Salome Bukachi
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Salome Wanyoike
- Department of Veterinary Services, Ministry of Agriculture, Uthiru, Nairobi, Kenya
| | - Shem C. Kifugo
- International Livestock Research Institute, Nairobi, Kenya
| | | | - Enoch Ontiri
- International Livestock Research Institute, Nairobi, Kenya
| | - Ian Njeru
- Division of Disease Surveillance and Response, Ministry of Public Health and Sanitation, Kenyatta National Hospital, Nairobi, Kenya
| | - Johanna Lindahl
- International Livestock Research Institute, Nairobi, Kenya
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
- Zoonosis Science Center, Dept. of Medical Biochemistry and Microbiology Uppsala University, Uppsala, Sweden
| | - Delia Grace
- International Livestock Research Institute, Nairobi, Kenya
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Sang R, Lutomiah J, Said M, Makio A, Koka H, Koskei E, Nyunja A, Owaka S, Matoke-Muhia D, Bukachi S, Lindahl J, Grace D, Bett B. Effects of Irrigation and Rainfall on the Population Dynamics of Rift Valley Fever and Other Arbovirus Mosquito Vectors in the Epidemic-Prone Tana River County, Kenya. J Med Entomol 2017; 54:460-470. [PMID: 28011732 PMCID: PMC5850818 DOI: 10.1093/jme/tjw206] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 11/01/2016] [Indexed: 06/06/2023]
Abstract
Rift Valley fever (RVF) is a mosquito-borne viral zoonosis that is found in most regions of sub-Saharan Africa, and it affects humans, livestock, and some wild ungulates. Outbreaks are precipitated by an abundance of mosquito vectors associated with heavy persistent rainfall with flooding. We determined the impact of flood-irrigation farming and the effect of environmental parameters on the ecology and densities of primary and secondary vectors of the RVF virus (RVFV) in an RVF-epidemic hotspot in the Tana River Basin, Kenya. Mosquito sampling was conducted in farms and villages (settlements) in an irrigated and a neighboring nonirrigated site (Murukani). Overall, a significantly higher number of mosquitoes were collected in farms in the irrigation scheme compared with villages in the same area (P < 0.001), or farms (P < 0.001), and villages (P = 0.03) in Murukani. In particular, key primary vectors of RVFV, Aedes mcintoshi Marks and Aedes ochraceous Theobald, were more prevalent in the farms compared with villages in the irrigation scheme (P = 0.001) both during the dry and the wet seasons. Similarly, there was a greater abundance of secondary vectors, particularly Culex univittatus Theobald and Culex pipiens (L.) in the irrigation scheme than in the Murukani area. Rainfall and humidity were positively correlated with mosquito densities, particularly the primary vectors. Adult floodwater mosquitoes and Mansonia spp. were collected indoors; immatures of Ae. mcintoshi and secondary vectors were collected in the irrigation drainage canals, whereas those of Ae. ochraceous and Aedes sudanensis Theobald were missing from these water bodies. In conclusion, irrigation in RVF endemic areas provides conducive resting and breeding conditions for vectors of RVFV and other endemic arboviruses.
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Affiliation(s)
- R Sang
- Center for Virus Research, Kenya Medical Research Institute, P. O. Box 54840-00200, Mbagathi Way, Nairobi, Kenya (; ; ; ; ; ; ; )
| | - J Lutomiah
- Center for Virus Research, Kenya Medical Research Institute, P. O. Box 54840-00200, Mbagathi Way, Nairobi, Kenya (; ; ; ; ; ; ; )
| | - M Said
- Food Safety and Zoonosis Research Program, International Livestock Research Institute, P. O. Box 30709-00100, Nairobi, Kenya (; ; ; )
| | - A Makio
- Center for Virus Research, Kenya Medical Research Institute, P. O. Box 54840-00200, Mbagathi Way, Nairobi, Kenya (; ; ; ; ; ; ; )
| | - H Koka
- Center for Virus Research, Kenya Medical Research Institute, P. O. Box 54840-00200, Mbagathi Way, Nairobi, Kenya (; ; ; ; ; ; ; )
| | - E Koskei
- Center for Virus Research, Kenya Medical Research Institute, P. O. Box 54840-00200, Mbagathi Way, Nairobi, Kenya (; ; ; ; ; ; ; )
| | - A Nyunja
- Center for Virus Research, Kenya Medical Research Institute, P. O. Box 54840-00200, Mbagathi Way, Nairobi, Kenya (; ; ; ; ; ; ; )
| | - S Owaka
- Center for Virus Research, Kenya Medical Research Institute, P. O. Box 54840-00200, Mbagathi Way, Nairobi, Kenya (; ; ; ; ; ; ; )
| | - D Matoke-Muhia
- Center for Virus Research, Kenya Medical Research Institute, P. O. Box 54840-00200, Mbagathi Way, Nairobi, Kenya (; ; ; ; ; ; ; )
| | - S Bukachi
- Institute of Anthropology, University of Nairobi, P.O. Box 30079-00100, Nairobi, Kenya
| | - J Lindahl
- Food Safety and Zoonosis Research Program, International Livestock Research Institute, P. O. Box 30709-00100, Nairobi, Kenya (; ; ; )
| | - D Grace
- Food Safety and Zoonosis Research Program, International Livestock Research Institute, P. O. Box 30709-00100, Nairobi, Kenya (; ; ; )
| | - B Bett
- Food Safety and Zoonosis Research Program, International Livestock Research Institute, P. O. Box 30709-00100, Nairobi, Kenya (; ; ; )
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Byskov J, Maluka SO, Marchal B, Shayo EH, Bukachi S, Zulu JM, Blas E, Michelo C, Ndawi B, Hurtig AK. The Need for Global Application of the Accountability for Reasonableness Approach to Support Sustainable Outcomes Comment on "Expanded HTA: Enhancing Fairness and Legitimacy". Int J Health Policy Manag 2017; 6:115-118. [PMID: 28812788 PMCID: PMC5287928 DOI: 10.15171/ijhpm.2016.106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 08/06/2016] [Indexed: 11/09/2022] Open
Abstract
The accountability for reasonableness (AFR) concept has been developed and discussed for over two decades. Its interpretation has been studied in several ways partly guided by the specific settings and the researchers involved. This has again influenced the development of the concept, but not led to universal application. The potential use in health technology assessments (HTAs) has recently been identified by Daniels et al as yet another excellent justification for AFR-based process guidance that refers to both qualitative and a broader participatory input for HTA, but it has raised concerns from those who primarily support the consistency and objectivity of more quantitative and reproducible evidence. With reference to studies of AFR-based interventions and the through these repeatedly documented motivation for their consolidation, we argue that it can even be unethical not to take AFR conditions beyond their still mainly formative stage and test their application within routine health systems management for their expected support to more sustainable health improvements. The ever increasing evidence and technical expertise are necessary but at times contradictory and do not in isolation lead to optimally accountable, fair and sustainable solutions. Technical experts, politicians, managers, service providers, community members, and beneficiaries each have their own values, expertise and preferences, to be considered for necessary buy in and sustainability. Legitimacy, accountability and fairness do not come about without an inclusive and agreed process guidance that can reconcile differences of opinion and indeed differences in evidence to arrive at a by all understood, accepted, but not necessarily agreed compromise in a current context - until major premises for the decision change. AFR should be widely adopted in projects and services under close monitoring and frequent reviews.
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Affiliation(s)
- Jens Byskov
- Department of Public Health, University of Zambia, Lusaka, Zambia
- Faculty of Health and Medical Sciences, University of Copenhagen, København, Denmark
| | - Stephen Oswald Maluka
- Institute of Development Studies, University of Dar Es Salaam, Dar Es Salaam, Tanzania
| | - Bruno Marchal
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
| | | | - Salome Bukachi
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Joseph M. Zulu
- Department of Public Health, School of Medicine, University of Zambia, Lusaka, Zambia
| | - Erik Blas
- International Public Health Consultant, Copenhagen, Denmark
| | - Charles Michelo
- Department of Public Health, School of Medicine, University of Zambia, Lusaka, Zambia
| | | | - Anna-Karin Hurtig
- Umeå International School of Public Health, Umeå University, Umeå, Sweden
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