The Manhattan principles:
One medicine panacea to animal zoonotic diseases
By Dr Olutayo Babalobi
Tuesday,
April 1, 2008
The human population has battled infections spread via animals,
but public awareness of zoonotic disease may never have been
more acute. Bovine Spongiform Encephalitis (BSE) - the Mad
Cow Disease-, Avian influenza, Marburg hemorrhagic fever,
Ebola virus disease and West Nile virus have gained a high
profile as animal-related (zoonotic) diseases.
Bovine tuberculosis (which predisposes to HIV/AIDS), Leptospirosis
(dog-which has recorded increased incidence), Hantavirus (mice),
salmonella (chicken), E. coli (cattle), Newcastle disease
(wild and domesticated birds), toxoplasmosis (cats), giardiasis
(beaver fever), trichinosis (swine), neuro-cysticercosis (swine)
and rabies (dogs/bats), have all long existed.
Developing a new integrative "one medicine" approach,
which combines the resources of public health, veterinary
medicine (more specifically zoonoses) , and environmental
epidemiology/Epizootiology, to Foreign Animal and Zoonotic
Diseases (FAZD), has been recognized as the major approach
to meeting the challenge of emerging zoonotic diseases- diseases
transmitted to humans from animals. This approach is one of
agenda of a USA National Conference on establishing an "Academic
Network on Foreign Animal and Zoonotic Disease.”, organized
by the Department of Homeland Security's National Center for
Foreign Animal and Zoonotic Diseases Defense.
Health experts from around the world met on 29 Sep 2004 for
a symposium organized by the New York-based Wildlife Conservation
Society and hosted by Rockefeller University. Focusing on
the current and potential movements of diseases among human,
domestic animal, and wildlife populations and using case studies
on Ebola, avian influenza, and chronic wasting disease as
examples, the assembled expert panelists delineated priorities
for an international, interdisciplinary approach for combating
threats to the health of life on Earth.
The product, called the "Manhattan Principles" by
the organizers of the "One World, One Health" event,
focuses on 12 recommendations for establishing a more holistic
approach to preventing epidemic/epizootic disease and for
maintaining ecosystem integrity for the benefit of humans,
their domesticated animals, and the foundational biodiversity
that supports us all. (http://www.oneworldonehealth.org/index.html).
Said Dr. Robert A. Cook, Chief Veterinarian & Vice President,
Wildlife Health Sciences, Wildlife Conservation Society, Bronx,
New York 10460, USA “It is clear that no one discipline
or sector of society has enough knowledge and resources to
prevent the emergence or resurgence of diseases in today’s
globalized world. No one nation can reverse the patterns of
habitat loss and extinction that can and do undermine the
health of people and animals.
Only by breaking down the barriers among agencies, individuals,
specialties and sectors can we unleash the innovation and
expertise needed to meet the many serious challenges to the
health of people, domestic animals, and wildlife and to the
integrity of ecosystems. Solving today’s threats and
tomorrow’s problems cannot be accomplished with yesterday’s
approaches.
We are in an era of “One World, One Health” and
we must devise adaptive, forward-looking and multidisciplinary
solutions to the challenges that undoubtedly lie ahead”.
Representatives from the World Health Organization; the UN
Food and Agriculture Organization; the Centers for Disease
Control and Prevention; the United States Geological Survey
National Wildlife Health Center; the United States Department
of Agriculture; the Canadian Cooperative Wildlife Health Centre;
the Laboratoire Nationale de Sante Publique of Brazzaville,
Republic of Congo; the IUCN Commission on Environmental Law;
and the Wildlife Conservation Society were among the many
participants.
Support for the One Health Concept cuts across physicians
and veterinarians worldwide: US Senator, Dr.Bill Frist's October
4 Aspen Institute Health Forum plenary address to an audience
of 300 opinion makers, scientists, distinguished leaders,
and entrepreneurs from around America issued a call to action
to address emerging health challenges through One Health.
Citing his personal interest in the One Health concept sparked
by his infectious disease experience as a transplant surgeon,
his direct experience in responding to anthrax at the U.S.
Capitol, his many medical mission trips to Africa, and his
participation in gorilla veterinary health, Dr. Frist presented
the history of One Health, an overview of emerging zoonotic
disease, its intersection with bioterrorism, and recommendations
for human and veterinary medicine. The audience's active engagement
and participation reflected broad interest and a clear understanding
of the limitless potential presented by cooperation between
physicians and veterinarians.
President-elect of the American Society of Tropical Medicine
and Hygiene (ASTMH) Thomas P. Monath, MD on October 4, 2007
notified that ASTMH has officially endorsed the One Health
Initiative. Previous endorsements from major allied health
organizations include the American Veterinary Medical Association,
American Medical Association, Society of Tropical Veterinary
Medicine, and Croatian Society for Infectious Diseases.
Prof. Stephen Leeder, MD, PhD, Director, Australian Health
Policy Institute, The University of Sydney, Australia recently
joined the One Health supporter list. Dr. Leeder subsequently
shared an important article that he published in the August
7, 2007, Australian Doctor. Dr.Leeder’s piece cogently
reinforces the argument in favor of One Health/One Medicine.
Garth Gall, dean of the faculty of medicine at the University
of Calgary, has stated that because the intersection of human
and animal health is the leading edge of medical research,
when the U of Calgary School of Veterinary Medicine opens
in September 2006, it will be affiliated with the faculty
of medicine, where it will be interlinked with nursing, medicine
and kinesiology. “We have a strong biomedical research
program. We wanted to base the faculty of veterinary medicine
on a solid foundation of inquiry and research. The people
we recruit would become part of our research-intensive biomedical
enterprise. All aspects of the research overlap."
Ole Nielsen, a veterinary pathologist and a retired educator
who has been dean of the veterinary colleges at the University
of Saskatchewan and the University of Guelph and is chair
of the Alberta Veterinary Medicine Steering Committee, was
quoted a saying, "SARS is a good example of comparative
medicine. When you're trying to deal with disease and prevention,
a comparative approach is a powerful way to understand disease
phenomena." Doctors were able to get a handle on SARS
very quickly because there was a tremendous body of basic
knowledge about the corona virus in the literature of animal
medicine.
The University of Guelph recently took a group of journalists
through workshops, lectures and discussions on the work that's
being done in different areas at the Ontario Veterinary College.
Carlton Gyles, acting dean of the Ontario Veterinary College,
University of Guelph, was cited as saying the general public
doesn't always realize it but veterinary scientists are often
on the cutting edge of research that has significant human
implications.
A lot of it is about how we can use animal models to study
human diseases." Dorothee Bienzle, a professor in pathobiology
at the Ontario Veterinary College, who gave a lecture to the
group of journalist about Feline Infectious Virus, was cited
as saying veterinary researchers are always thinking about
any implications that their work might have for medical research
Attendees to the 2005 National Institute for Animal Agriculture’s
(NIAA) symposium, ‘Protecting the Global Food Supply:
Growing Concerns for Emerging Zoonotic Diseases’, were
left with a very key message: we must strengthen animal and
human health together. “There is a need for linkages
to veterinarians, medical doctors—all health sectors,”
said Dr. Michael Osterholm, director of the Center for Infectious
Disease Research and Policy and associate director for the
Department of Homeland Security’s National Center for
Food Protection and Defense at the University of Minnesota.
The unique challenges facing animal agriculture in the 21st
century such as bioterrorism and zoonotic diseases as well
as new technologies require schools of veterinary medicine
to prepare their graduates to do more than “simply treat
animal diseases” according to Dr. Bennie I. Osburn,
Dean of the University of California School of Veterinary
Medicine. Dr. Osburn further points out that with the large
concentration of animals in various areas, emerging new diseases
such as avian flu and BSE(Mad Cow Disease) as well as the
treat of bioterrorism, veterinarians today need a different
skill set.
CONCLUSION: THE NIGERIAN SITUATION
Issues such as food safety, public health and zoonoses are
not merely the concern of individual states but are of national,
and even global, importance (Hoblet et al 2003). Public Health
Veterinarians in Nigeria are poised to respond to the challenge
of recurrent and emerging zoonoses, with the recent approval
for the resuscitation of the National Zoonoses Center at the
Department of Veterinary Public Health and Preventive Medicine,
University of Ibadan, by the National Council on Agriculture.
The One Medicine collaborative approach with relevant health
disciplines will be a basic strategy. An appropriate review
and strengthening of the Animal Disease Control Act (Decree
10) of 1988, in the light of present universal public health
realities, is a necessary perquisite in this regard.
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