One Health Approach: Combating Zoonotic Diseases and Antimicrobial Resistance

It calls for a holistic, integrated and systems-based approach that recognises the interconnection between the health of humans, animals and the environment. Focus on the one health initiative has increased to address the complex health challenges such as ecosystem degradation, food system failures, zoonotic diseases and antimicrobial resistance (AMR) faced by our society today.

Antimicrobial Resistance: A Growing Threat

• • Antimicrobials and Their Use: Antimicrobials ( including antibiotics, antivirals, antifungals, and antiparasitics) are medicines used to prevent and treat infectious diseases in humans, animals and plants.
  • Antimicrobial Resistance (AMR): It occurs when microbes (bacteria, viruses, fungi and parasites) no longer respond to antimicrobial medicines. 
    • As a result of drug resistance, antibiotics and other antimicrobial medicines become ineffective, and infections become difficult or impossible to treat.
    • AMR is a natural process that happens over time through genetic changes in pathogens.

• Human Acceleration of AMR: However, its emergence and spread is accelerated by human activity, mainly the misuse and overuse of antimicrobials. [UPSC 2019] 

• Impact of Superbugs: Superbugs are strains of bacteria that are resistant to several types of antibiotics.

• Each year, these drug-resistant bacteria infect more than 2 million people nationwide and kill at least 23,000, according to the U.S. Centers for Disease Control and Prevention (CDC). 

• • Drug-resistant forms of tuberculosis, gonorrhoea, and staph infections are just a few of the dangers we now face.
  • Other examples of superbugs include resistant bacteria that can cause pneumonia, urinary tract infections and skin infections.
• Contribution of Vaccines: Vaccines can contribute to the fight against AMR by preventing microbial diseases and their transmission reducing antibiotic misuse.

Emergence of Zoonotic Diseases

• Zoonosis is an infectious disease that has jumped from a non-human animal to humans. Zoonotic pathogens may be bacterial, viral or parasitic, or may involve unconventional agents and can spread to humans through direct contact or through food, water or the environment.
• It’s estimated that 60% of known infectious diseases and up to 75% of new or emerging infectious diseases are zoonotic in origin.
• Some of the most dangerous zoonotic diseases worldwide include COVID-19, avian flu, salmonellosis and the Ebola virus disease (Ebola).
• Zoonotic diseases common in India include Nipah virus infection, rabies, anthrax, brucellosis, plague, bovine tuberculosis, leptospirosis and salmonellosis.
• Deforestation and other land use changes, Intensified agriculture and livestock production, Illegal or poorly regulated wildlife trade, Climate change, and Antimicrobial Resistance are some of the factors which have contributed to an increase in the emergence of zoonotic diseases.

One Health Joint Plan of Action (2022-26)

• Recently, four multilateral agencies, FAO, UNEP, WHO and World Organisation for Animal Health, have launched a One Health Joint Plan of Action (2022-26) (OH JPA). 
• The plan is aimed at mitigating the health challenges at global, regional, and country levels. 
• It will create a framework and integrate systems and capacity to collectively better prevent, predict, detect and respond to health threats to all living beings as well as the environment.

Joint Plan of Action: Key Points

• Framework for Collective Action: Offers a plan for working together using the One Health approach.
• Aims to coordinate efforts and make them more effective.
• Policy and Legislative Support: Provides advice and assistance in setting national goals and priorities.
  • Helps in making laws and rules to address health and environmental issues.
• Collaboration and Knowledge Sharing: Encourages sharing of ideas, solutions, and technologies.
  • Promotes learning and cooperation among different sectors.
• Values and Principles: Emphasizes cooperation, shared responsibility, and partnership.
  • Advocates for gender equity and inclusiveness in health initiatives.
• Action Tracks for Sustainable Health and Food Systems: Strengthening Health Systems: Enhances capacities in healthcare to improve services.
• Preventing Zoonotic Diseases: Reduces risks from diseases that spread between animals and humans.
• Controlling Endemic Diseases: Works to eliminate diseases common in certain areas or populations.
• Ensuring Food Safety: Improves how we assess, manage, and communicate food safety risks.
• Addressing Antimicrobial Resistance: Focuses on tackling the problem of antibiotics becoming less effective.
• Integrating Environmental Concerns: Considers environmental factors in One Health strategies for better outcomes.

National One Health Mission (India)

• India envisaged ‘National One Health Mission’ under the Office of the Principal Scientific Advisor.
• Objective: To coordinate, support, and integrate all existing One Health initiatives in the country.
  • The mission will also focus on essential aspects of preparedness by prioritizing research and development for crucial tools like vaccines, diagnostics, and treatments. 
  • It will enhance readiness in terms of clinical care, improve connections for sharing data and information across different sectors, and encourage active community involvement to maintain our ability to respond effectively.

The National One Health Mission will focus on the following specific initiatives:

• Integrated Disease Surveillance Implementation: Establishing integrated disease surveillance systems across human, animal, and environmental sectors.

• • • Focus on communicable diseases including zoonotic diseases, transboundary animal diseases, and those with epidemic/pandemic potential.
    • Develop early warning systems to detect outbreaks promptly.
    • Integration of clinical and epidemiological data for comprehensive disease monitoring.
    • Utilize information from diverse surveillance programs across sectors, irrespective of the implementing agencies.
    • Deploy innovative approaches such as environmental surveillance to enhance the timely and accurate detection of diseases.

• Robust Outbreak Investigation Mechanisms:

• National Level:

• • • • Establishing outbreak response teams linked to state programs.
      • Strengthening district-level Rapid Response Teams (RRTs).
      • Clear framework for joint investigations across human, animal husbandry, and wildlife sectors.

• Effective Investigation and Control:

• • • • Develop mechanisms for joint investigations.
      • Establish connected systems for routine disease control programs.
      • Address both endemic and emerging diseases.

• Environmental Surveillance System: The One Health Mission aims to establish a strong network of sentinel-based surveillance for ongoing monitoring of pathogen spread.
• • Sentinels in this system include sewage, vectors like mosquitoes and ticks, milk, animal trade centers, water holes, abattoir effluents, and ports of entry such as airports.
  • This surveillance system helps bridge gaps in understanding disease transmission dynamics across human, animal husbandry, and wildlife.
  • It also monitors environmental components like habitat changes, antimicrobial resistance (AMR), and water quality.
  • Environmental surveillance offers cost-effective and sensitive approaches to detect diseases targeted for elimination or eradication.
  • As disease prevalence decreases, traditional surveillance methods may become less sensitive, making environmental surveillance a valuable addition to disease elimination efforts.
  • Priority diseases for elimination will be targeted for implementation of sentinel-based surveillance.
• The government launched the “ Animal Pandemic Preparedness Initiative (APPI)” as well as the World Bank-funded Animal Health System Support for One Health (AHSSOH) project under the aegis of the National One Health Mission.

Conclusion

• Through initiatives like the National One Health Mission and the Joint Plan of Action, efforts are underway to strengthen global, regional, and national responses to health threats. 
• By integrating systems and promoting cooperation, we can better prevent, detect, and respond to diseases, safeguarding the health of all living beings and the environment.