Intersectoral collaboration between the medical and veterinary professions in low-resource societies: The role of research and training institutions

Abstract

Background

Neglected zoonoses continue to significantly affect human health in low-resource countries. A symposium was organised in Antwerp, Belgium, on 5 November 2010 to evaluate how intersectoral collaboration among educational and research institutions could improve the situation.

Results

Brucellosis and echinococcosis were presented as models for intersectoral collaboration. Low-resource societies face evident knowledge gaps on disease distribution, transmission within and across species and impact on human and animal health, precluding the development of integrated control strategies.

Recommendations

While veterinarians have been the main driver of the One Health initiative, the medical profession does not seem to be fully aware of how veterinary science can contribute to human public health. It was postulated that transdisciplinarity could help fill knowledge gaps and that encouraging such transdisciplinarity should start with undergraduate students. Furthermore, intersectoral collaboration on zoonoses should not ignore the social sciences (e.g. assessment of indigenous knowledge and perception; participatory surveillance), which can contribute to a better understanding of the transmission of diseases and improve communities’ participation in disease control activities.

Introduction

In low-resource societies, neglected zoonoses (i.e. anthrax, bovine tuberculosis, brucellosis, leptospirosis, echinococcosis, cysticercosis, fasciolosis, leishmaniasis, trypanosomiasis, Rift Valley fever and rabies) continue to significantly affect human health [1]. This is often due to the close contact with animals, the lack of recognition when zoonoses occur in humans and the lack of resources to control them. In fact, domestic and wild animals harbour a huge pool of micro-organisms that are potentially pathogenic to humans. Some authors estimated that more than 60% of human pathogens originate from animals [2]. As such, most human emerging diseases, including haemorrhagic fevers, H5N1 influenza, SARS and HIV/AIDS, have a zoonotic origin. Furthermore, the emotional value of pets in Northern societies and the impact of the culling of infected herds on their owners’ psychological health have been increasingly recognised [3].

The strong case for intersectoral collaboration between the veterinary and medical professions, particularly in developing countries, that Calvin Schwabe clearly made in his book “Veterinary Medicine and Human Health” in 1984 [4], [5] is even more relevant in today's world which is characterised by major ecological changes [5], [6], [7]. Human population development, growth and movement have a tremendous impact on the likelihood of inter- and intra-species transmission of diseases, including wildlife. In such a context, transdisciplinarity initiatives, defined as epistemological perspectives unique to the collaborative effort and distinct from those of any of the cooperating disciplines [8], could prove useful to address infectious disease surveillance and control more efficiently. The focus should therefore not be on debating whether and why one discipline should be considered more important than the other, but on collaboration and on finding ways to combine each discipline's strengths in order to improve the surveillance and the control of diseases.

A symposium was organised in Antwerp on 5 November 2010 to evaluate the needs and relevance of intersectoral collaboration between the medical and the veterinary disciplines in low-resource societies. While it is acknowledged that One Health also encompasses wildlife and environmental health, the aim of this symposium was to present the One Health approach as an opportunity to improve human health and well-being through an integrated management of pathogens in humans and domestic animals. The issue of disease prioritisation and impact quantification, the challenge of reconciling disease impact on human and animal health and the need to provide decision makers with disease impact evidence were discussed. Finally, examples of intersectoral collaboration successes and failures were presented and discussed, and ways to improve intersectoral collaboration at research and educational levels were suggested. A total of 224 participants from 41 different countries and with various backgrounds attended the meeting.