NOT SO LONG AGO, the widespread prevalence of avian influenza in poultry, or bird flu as it commonly became known, created nationwide panic resulting in the culling of millions of poultry birds. It was concern for human health that prompted the extreme reaction and subsequent establishment of protocols; containment of avian influenza is managed quite effectively now. Similarly, in 2003, SARS or Severe Acute Respiratory Syndrome emanated suddenly in China. This too vanished soon, but not before an emergency response that included extreme measures like travel bans and restrictions.
In both cases, panic spread much faster than the virus. Besides drawing a response from governments, these events also brought forth the hitherto forgotten philosophy of One Health, which recognises inter-connectivity among human health, the health of animals, and the environment.
The One Health concept
The World Organization of Animal Health, commonly known as OIE (an abbreviation of its French title), summarises the One Health concept as “human health and animal health are interdependent and bound to the health of the ecosystems in which they exist”. Circa 400 BC, Hippocrates in his treatise On Airs, Waters and Places had urged physicians that all aspects of patients’ lives need to be considered including their environment; disease was a result of imbalance between man and environment. So One Health is not a new concept, though it is of late that it has been formalised in health governance systems.As human populations expand, it results in greater contact with domestic and wild animals, providing more opportunities for diseases to pass from one to the other. Climate change, deforestation and intensive farming further disrupt environment characteristics, while increased trade and travel result in closer and more frequent interaction, thus increasing the possibility of transmission of diseases.According to the OIE, 60% of existing human infectious diseases are zoonotic i.e. they are transmitted from animals to humans; 75% of emerging infectious human diseases have an animal origin. Of the five new human diseases appearing every year, three originate in animals. If this is not scary enough, 80% biological agents with potential bio-terrorist use are zoonotic pathogens. It is estimated that zoonotic diseases account for nearly two billion cases per year resulting in more than two million deaths — more than from HIV/AIDS and diarrhoea. One-fifth of premature deaths in poor countries are attributed to diseases transmitted from animals to humans.
The approach needed
This builds a strong case for strengthening veterinary institutions and services. The most effective and economical approach is to control zoonotic pathogens at their animal source. It calls not only for close collaboration at local, regional and global levels among veterinary, health and environmental governance, but also for greater investment in animal health infrastructure. Developing countries like India have much greater stake in strong One Health systems on account of agricultural systems resulting in uncomfortably close proximity of animals and humans. This calls for strict health surveillance to incorporate domestic animals, livestock and poultry too. Humans require a regular diet of animal protein. Thus, loss of food animals on account of poor health or disease too becomes a public health issue even though there may be no disease transmission, and we lose 20% of our animals this way.The size of India’s human and animal populations is almost the same; 121 crore people (2011 Census) and 125.5 crore livestock and poultry. A network of 1.90 lakh health institutions in the government sector form the backbone of health governance, supported by a large number of private facilities. On the other hand, only 65,000 veterinary institutions tend to the health needs of 125.5 crore animals; and this includes 28,000 mobile dispensaries and first aid centres with bare minimum facilities. Private sector presence in veterinary services is close to being nonexistent. Unlike a physician, a veterinarian is always on a house call on account of the logistic challenge of transporting livestock to the hospital, unless they are domestic pets. There could not be a stronger case for reinventing the entire animal husbandry sector to be able to reach every livestock farmer, not only for disease treatment but for prevention and surveillance to minimise the threat to human health. Early detection at animal source can prevent disease transmission to humans and introduction of pathogens into the food chain. So a robust animal health system is the first and a crucial step in human health.We are slowly but surely moving towards a strong and effective One Health regime, establishing a collaborative mechanism for joint surveillance and monitoring, strengthening disease reporting and control programmes. While the institutional mechanism for One Health governance is in place, the concept would really catch the imagination if the critical importance of animal health in human well-being were underscored continuously. Disease surveillance has to go beyond humans and encompass preventive health and hygiene in livestock and poultry, improved standards of animal husbandry for greater food safety, and effective communication protocols between animal and public health systems.
Why it matters for India
The World Health Organization (WHO) was set up in 1948 to, among other objectives, promote cooperation to control human diseases. India, a founding member, also hosted the first meeting of WHO’s South East Asia Regional Committee in October that year. That cooperation and collaboration among nations to control and contain animal diseases is a sine qua non for achieving the WHO objectives had been recognised as early as in 1924 when OIE was established to fight animal diseases at the global level. Somewhere down the line, animal health got pushed back, more so in developing countries where scarce resources and popular priorities needed a delicate balance.
Interestingly, the trigger for OIE was the unexpected occurrence of rinderpest cattle disease in Belgium. The disease was attributed to Zebu cattle originating from India and destined for Brazil via Antwerp. So, India has been at the forefront of both these apex bodies, though for different reasons. Let us keep ourselves healthy — human, animal and environment.