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One Health solution to world’s epidemics

The One Health cohort and staff celebrating the conclusion of the two-year programme  

A cohort of multinationals graduated in Manawatū last month with a qualification that attempts to stem the spread of infectious diseases from animals to humans, like Ebola, by educating doctors, veterinarians and wildlife experts together.

The distance students from Afghanistan, Bangladesh, Bhutan, and Nepal have been working together for the past two years as part of the Massey One Health Epidemiology Fellowship Programme "Education into Action".

The programme involved working on projects to better understand infectious diseases that are transmitted from animals to humans, known as zoonotic diseases. The aim is to improve biosecurity, evaluate disease control economics and improve disease control policy.

The programme’s academic director, Dr Joanna McKenzie, says that the idea is to impart a new way of thinking. “The best way to tackle infectious disease epidemics like Ebola and Avian Influenza is to work across disciplines and borders.

“Throughout human history, we’ve thrived by working together to solve our most pressing problems, and this programme is a way of encouraging collaboration and actively giving the next generation of health practitioners the tools to better understand each other and work together,” Dr McKenzie says.

Reducing the impact of rabies is one example where the ‘One Health’ approach can be employed, as it is a disease that is maintained in dog populations and is spread to other animals and humans via dog bites.

One Health programme director Dr Peter Jolly says that reducing the risk of infection in humans requires collaboration between both human and animal health specialists.

“Vets understand how rabies spreads and can be controlled in animal populations, whilst doctors understand how to treat the infection in humans,” Dr Jolly says. “Eradication of this deadly disease could be possible by combined investment and effort, including better understanding of dog population dynamics and investment in dog vaccination and population control.

“Our graduates leave with the skills to cope effectively with such interdisciplinary challenges, work together on issues and ultimately make the world a safer place by spreading the skills they have picked up within their wider networks and communities.”

Becasue the Afghan students were unable to attend the graduation ceremony, a special ceremony will be held next week.

Kamrul Islam (left) Dr Jolly, and Mohammad Nizam Uddin Chowdhury

Loss of wildlife habitat - Afghanistan

Participants in the programme came from all walks of life, including Hafizullah Noori, who was previously in the Hundu-Kush mountain range of Afghanistan studying endangered snow leopards with the Wildlife Conservation Society of Afghanistan.

Dr Noori has been involved in the Afghanistan Ecosystem Health project, assessing environmental issues relating to rapid population growth and the associated loss of wildlife habitat that results from human and livestock encroachment. He also studied how increased contact between human, domestic animals and wildlife populations can provide the opportunity for potential zoonotic diseases transmission, creating threats to the overall health of the ecosystem.

“This was really a unique programme and I enjoyed studying in a cohort of six participants from human, animal and wildlife health in the country, as well as building relationships with the fellows from the other countries to strengthen collaborative approaches to investigate and control zoonotic disease among humans, animals and wildlife through integrating education and action for One Health in the region. 

“Now I am looking for a One Health-related job opportunity in either government or NGOs to serve my country. One Health is a new concept in Afghanistan; therefore this programme helped us to be the pioneers of One Health, striving to improve public and animal health through applying appropriate disease control and preventive measures.”

Dr Kinley training health workers in Bhutan

Making disease control history - Bhutan

Diagnosed early, scrub typhus is easily treated, but left undiagnosed it is often fatal. The severity of the disease is what led to another Massey project, which was the first case-control study of this disease in Bhutan. 

The project identified the people most at risk, the occupations and practices that increased risk of infection, and the most cost-effective prevention and control measures. As a result, new disease control policy and guidelines were developed, that are now being implemented by the Bhutanese Government to reduce the impact of this terrible disease in rural communities.

Dr Kinley Penjor, based in Bhutan, was one of the researchers working on the project. Before joining the programme, Dr Penjor served as chief medical officer in three different district hospitals in Bhutan, such as where he was actively involved in clinical and public health activities.

Whilst working as a clinician he developed his interest in tropical and emerging disease like rabies and scrub typhus. “A lot of my work at that time was on the ground treating diseases after the fact, but I became increasingly conscious and motivated by the adage ‘prevention is always better than cure’. When the Massey programme came along in October, 2014, I had no option but to jump into it.

“This unique programme not only expanded my fundamental knowledge, skills and understanding of epidemiology and One Health but more importantly it instilled in me a holistic view of health and collaborative team efforts, which I strongly believe is crucial to solving many of today’s health problems, including emerging and re-emerging diseases,”

The other collaborators on that project in Bhutan include medical colleagues Dr Kezang Dorji and Dr Tandin Zangpo, and veterinary colleagues Dr Chendu Dorji, Dr Kinely Penjor and Dr Yoenten Phuensthok, under the supervision of Dr Chencho Dorji and Dr Sithar Dorji from the Khesar Gyalpo University of Medical Sciences of Bhutan.

Dr Sultan interviewing a farmer in Bangladesh

The danger in date palms - Bangladesh

Another graduate from Bangladesh, Dr Sultan Mahmood, has recently joined the Institute of Epidemiology, Disease Control and Research at the Bangladesh Ministry of Health and Family Welfare, as central project coordinator for a project on climate change.

Dr Mahmood's Massey project looked at the Nipah virus, which poses a significant threat to people in Bangladesh every year. The virus causes severe disease in animals and humans, and there is no vaccine available.

The study looked to improve understanding of date palm sap collection, sale and consumption practices associated with the risk of Nipah virus infection in people in Bangladesh. The information collected has led to better policy to control and prevent Nipah encephalitis in Bangladesh.

“The Massey programme has broadened my horizon and critical thinking and given me a solid base and theoretical knowledge on outbreak investigation and disease surveillance," he says. Moreover, it has built my capacity and increased my confidence to design and implement independent research projects.

“The theoretical and behavioural competencies obtained from this programme are helping me to lead and run large projects as well as maintain sound professional relationship with the stakeholders.

One Health in practice - Nepal

Before joining the programme Manisha Bista worked in the field of wildlife genetics, where she created a genetic database of individual tigers in Nepal's national parks.

She also worked as project coordinator for the United States Agency for International Development Emerging Pandemic Threat programme in Nepal that screened for viruses of pandemic potential in wildlife populations near highly-populated urban areas.

“My experience in the Massey One Health Fellowship programme has been very fulfilling,” she says. “It is integrative and practical and has provided me with the required knowledge and analytical skills to be able to identify stakeholders and design and implement epidemiological and disease control policy evaluations.

 “I wish to work in close collaboration with the national government agencies and private organisations in conducting One Health-based research programmes and sensitising people to the concept of the One Health approach."

Stepping onto the global stage

The students completed a final workshop at Massey University last week and will now participate in the fourth International One Health EcoHealth Congress in Melbourne from December 3-7.

The visit and conference was supported by grants from the Morris Trust, the Massey University Foundation, and The Bill and Melinda Gates Foundation. The three-year programme is funded by the European Union and is part of Massey’s efforts to build capability across South Asia to detect and respond to emerging epidemic and pandemic disease threats through the implementation of the innovative ‘One Health’ programmes. This programme follows a four-year project to educate and connect professionals throughout Sri Lanka, India, Pakistan, Nepal, Bangladesh, Afghanistan and Bhutan.

Dr Jolly says “the aim is to inspire and connect these future leaders from countries facing enormous challenges with global leaders, expertise and initiatives, and to provide very timely opportunity for them to gain both distinctive New Zealand and global perspectives.”

This is the third One Health cohort to graduate through the University’s master’s degree programme, which now has 108 alumni from nine Asian countries. The programme is being redeveloped and expanded into a new Master of Science (One Health), which will be launched next year.

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