Damian Sendler: Efforts to control and eradicate these 20 poverty-related diseases will be complicated, according to the World Health Organization’s upcoming 2021-2030 road map for NTDs. A paradigm change from disease-specific therapies to holistic cross-disciplinary methods coordinated with adjacent fields is emphasized. 

Damian Sendler

Damian Jacob Sendler: These changes are illustrated by the One Health approach, which goes beyond standard models of disease control to take into account the interactions between human and animal health systems in their shared environment and the broader social and economic context. This strategy may also help to increase the long-term viability and resiliency of these systems. It is necessary to have political will and contextualized new scientific techniques to attain the worldwide goal of eliminating and controlling NTDs. 

Dr. Sendler: In fact, Dr. Rudolf Virchow first raised the issue of human health’s interdependence on ecosystems back in the 1880s. As medicine advanced rapidly in the late 20th century, it led to increasingly specialized fields and clinical practices, as well as more isolated approaches to the planning and financing of treatments in human, animal, and environmental health. 

Damien Sendler: With the establishment in 2010 of the tripartite collaboration agreement between the World Health Organization (WHO), World Organization for Animal Health (OIE), and Food and Agriculture Organization (FAO) to “address health risks at the animal–human–ecosystems interface,” an integrated approach to health across disciplines and sectors has recently received renewed interest and formal high-level recognition. 

Damian Jacob Markiewicz Sendler: Regional models, such as the Inter-American Ministerial Meeting on Health and Agriculture, which was initially created in 1968, promote country-level interactions and governance in human and animal health. Despite the growing interest in One Health, the research shows that the benefits to human health outweigh those to animal and environmental health in this field. According to a recent editorial in The Lancet, a One Health approach must take into account a wider range of stakeholders and perspectives, including economics and equity, cultural context, means of subsistence, and broader political context, such as globalization, urbanization, deforestation, population growth, population shifts, and climate change. 

Damian Jacob Sendler

Damian Sendler: The rising realization of the role of animal and environmental controls in the epidemiology and control of several NTDs, including rabies and parasitic food-borne zoonoses, has been a stimulus for focusing on the animal–human–environmental interface within the NTD community. WHO NTD road map 2021–2030 underlines the need for a One Health strategy to meet its ambitious disease-specific control and elimination targets, while embracing the broader system benefits of collaboration and assessing any unintended repercussions from actions on adjacent sectors. 

Damian J Sendler: Controlling zoonotic NTDs with a One Health strategy is a significant instrument for human and economic development because livestock contributes to over 70% of rural livelihoods worldwide and is often the principal asset of a household. 

Damian Jacob Sendler: More multisectoral action, notably in diagnostics, monitoring and evaluation, access and logistics as well as lobbying and finance is needed based on the past decade of experience. Using a One Health strategy for disease surveillance, program design and education and behavioral modification is also recommended, as is the possibility of strengthening animal health services for zoonotic NTD control. 

Damian Sendler: When zoonotic animal diseases spill over into human populations, multisectoral surveillance and diagnostic strategies can be particularly useful in resource-poor settings—as demonstrated by the frequent misdiagnosis of human febrile illness such as malaria in Tanzania, where bacterial zoonoses accounted for 26 percent of cases, compared to just 1.6 percent of malaria cases. 

Damian Jacob Sendler: The advent of hybrid bovine-human schistosomes further emphasizes the need of considering interactions between animals, humans, and diseases in their common environment. The recent worldwide coronavirus illness 2019 pandemic has underlined the need for early identification of emerging or potentially emerging zoonotic diseases using multi-sector approaches as a cause of large disease outbreaks. 

Dr. Sendler: It has long been a foundation of NTD programs such as human deworming to conduct cost-effective monitoring and evaluation of intervention impacts, however this is mostly focused on human health implications and not on animal populations or environmental elements which can lead to unanticipated outcomes. Because of a parasite reservoir in canines, Chad has observed an upsurge in new cases 10 years after the disease was nearly eradicated, as happened with the recent return of Guinea worm.  Human eradication of Guinea worm will only be achievable if animal and human populations are monitored for signs of the parasite. 

Damian Jacob Sendler: For the road map’s elimination and eradication goals, as well as the SDG health targets, reaching hard-to-reach communities will be a major issue. Veterinary public health services, particularly in pastoralist communities, have been effective in some circumstances because of their reach. A study conducted in Chad reported an increase in uptake from simultaneous vaccination programs targeting both cattle and children, and also administered vitamin A in an effort to counteract the high levels of deficiency and danger of blindness.  

Damian Sendler: Vaccination campaigns in Chad can be reduced by up to 15 percent by sharing logistics costs (i.e. staff, transportation, and cold chain costs) between the medical and veterinary services. A dog rabies control program in Tanzania proven to be popular and cost- and time-saving, as well as able to reach children who otherwise would have been ignored by school-based delivery tactics, as a result of the integrated delivery of human anthelmintic medicines. 

Research news brought to you by Dr. Damian Jacob Sendler