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Small world, big risks

on December 5, 2012 Impact, Research, School and Tags: , , , ,

SPH helps foster a new approach to global health

When the bubonic plague ravaged 14th century Europe, Russia, and Asia, few understood disease vectors or that the tiny flea was the ideal host for Yersinia pesti and rats were the literal jumping off point for human infection.

Animals harbor thousands of viruses— most yet undiscovered—that can potentially infect humans with grave results. We’ve witnessed the damage they can cause in the AIDS epidemic and in the estimated 65,000 deaths each year from rabies.

But a new approach has developed to understand, prevent, and respond to emerging high-impact zoonotic diseases, those that pass from animals to humans. Called One Health, it views animals, people, and the environment as a single system. Doing One Health demands a common strategy and way of thinking that crosses disciplines, national boundaries, and public and private domains.

GLOBAL CONCERNS

Barbara Knust, an epidemiologist at the Centers for Disease Control and Prevention in Atlanta, traveled to Uganda early this summer to help deal with the outbreak of Ebola, an untreatable, deadly zoonotic disease. The past few months, she has been investigating an emergence of hantavirus, which is transmitted by rodents—deer mice, in this instance—to humans, at Yosemite National Park. Out of nine campers sickened, three have died.

Knust received her MPH from the School of Public Health in 2010 after working as a veterinarian for several years. Bringing veterinary expertise together with public health training is an especially useful path for a One Health approach. In the case of hantavirus, the three components of animal health, human health, and the environment must be investigated together.

“We are still studying the effects of climate on the mouse population and hantavirus infection, but we know that the higher the deer mouse population, the more likely humans and mice will come into contact, thereby increasing the risk of a person becoming infected,” says Knust.

FORMALIZING ONE HEALTH

SPH environmental health sciences professor Debra Olson thinks of One Health as “one science, one health, one world.” For her, this phrase emphasizes the notion of dropping the boundaries between science disciplines; between human, animal, and ecosystem health; and between countries and societies. And it is an essential way to approach the multiple layers at play in a disease outbreak. “With the One Health approach, you’re not jumping from one part of the crisis to another, you’re integrating the problem solving,” says Olson.

Just how and how well we solve problems together is Olson’s concern. As associate dean for education, she is helping to facilitate One Health efforts at SPH, the University, and across the globe in two specific ways—one is through the school’s involvement with RESPOND, a component of USAID’s Emerging Pandemic Threats (EPT) program; the other is by engaging with colleagues from the Academic Health Center to create coordinated services in support of global health and social responsibility.

WORKING AS ONE COMMUNITY

The hot spots for emerging zoonotic diseases are the world’s tropical zones, particularly countries in Africa and Asia where relationships between humans, animals, and the environment are always in flux. When land is cleared for farming or roads are cut through rain forests, humans come in contact with more wildlife. Domestic animals often live near wild animals, and many people still kill and butcher “bushmeat,” native animals that can harbor viruses. All this activity raises the stakes for the emergence of novel zoonotic diseases.

SPH is a key player in RESPOND, a highly collaborative project that includes Tufts University. RESPOND brings together faculty from across the health sciences, education, and environmental sciences to build capacity for One Health in universities in 10 countries.

“RESPOND is increasingly focused on the role universities play in supporting One Health,” says Katey Pelican, RESPOND’s University co-lead with John Deen, both in the Department of Veterinary Population Medicine. “Universities can build programs to create a whole different kind of health worker—a One Health worker, who can be comfortable working across disciplines and across public, private, and governmental realms.”

COMMON COMPETENCIES

RESPOND has established a network of schools of public health, medicine, nursing, and veterinary medicine in Central and East Africa (OCHEA) and in Southeast Asia (SEAOHUN) to develop common competencies and a unified, strategic response to global disease threats.

For the past two years, RESPOND has been addressing its capacity- building mandate through small group meetings, international conferences, exchange programs, short courses, and residencies, including those at Makerere University in Uganda and Chaing Mai University in Thailand being modeled on the University of Minnesota Veterinary Public Health Residency.

This summer, RESPOND used a model already in place—SPH’s Public Health Institute—to bring together faculty from Tufts University, OHCEA, and SEAOHUN. The RESPOND team used the three weeks they were together to address cultural barriers with a One Health approach and to begin to devel- op a One Health curriculum for participants to take back to and apply in their respective countries and universities.

REVITALIZING A GLOBAL MISSION

When the University was established as a land-grant institution in 1862, part of its mission was to make knowledge accessible to the world. In the past several decades, the University’s reputation as a health and science educator, leader, and innovator has gone global.

People from multiple disciplines at the University, along with their international colleagues, are addressing the world’s wicked health problems with an increasingly One Health approach. But what the University doesn’t have yet is a coordinated way to bring these efforts together to enhance their reach and impact.

Olson and her fellow Academic Health Center deans have proposed a coordinated infrastructure for global health and social responsibility that would lead, foster, and engage those involved with
One Health activities at the University. It would support colleges, units, and departments from economics to ecology, veterinary medicine to public policy, and technology to agriculture, as they build on their global portfolios that address issues at the intersection of animal, human, and ecosystem health.

Already associate professor Jeff Bender is leading a partnership between the College of Veterinary Medicine and SPH to expand One Health educational opportunities at the University to prepare the next generation to manage the world’s complex health issues.

It’s no surprise that the School of Public Health would be so deeply invested in supporting and nurturing this game-changing approach to global health. The nature of public health professionals is to make human connections, learn as much as they teach, and be aware of and work from an appreciation of the many elements that have an impact on health.

As Barbara Knust says: “One Health is a great term to capture the goal and the concept that has been sought and achieved by public health practitioners for a long time.”

Illustration by Olaf Hajek

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