Wednesday, September 24, 2014

What does One Health actually look like?

A sick sea turtle. How is a One Health approach to this animal different?
SAT HQ has relocated to beautiful Darwin, for the 10th Anniversary AMRRIC (Animal Managementin Rural and Remote Indigenous Communities) conference. I’ve been fortunate enough to be involved with AMRRIC since its inception, and attended the conference of its precursor, Big Lick, up in Darwin in (gulp) 2000. Fourteen years ago!

Another delegate who was around back then is Rick Speare, whose title should be “Emeritus Professor Dr Dr Dr Dr Rick Speare”, as he has degrees in veterinary science, medicine, a PhD and a Doctor of Veterinary Science in amphibian medicine.

The same turtle. Note the scales are peeling away.
He gave a stirring talk yesterday about the concept of One Health – we use the term but not everyone responds to it in the same way. It is accepted at the highest levels and written into policy, but people on the ground have mixed feelings about it. Some of us think we’re doing it anyway, some think it just applies to the topic of zoonotic disease, and some think it means human health should be number one.

Professor (if I may be so bold as to abbreviate) Speare looked at different models of One Health and suggested that in some ways it is limiting. He also discussed some of the differences between veterinary patients and those of human doctors and made some interesting points. For example in veterinary medicine quality of life is more important than life itself (a bold statement but look at practice and policies in human and animal medicine), that our patient’s lives are expendable, that some animals exist solely for economic gain, and that we have more control over our patients than doctors do.

Prof. Speare talked about the need to understand what One Health looks like on the ground. There remains a need to prove the concept, i.e. to show that an integrated approach to human, animal and environmental health improves outcomes, for example better prediction and control of communicable disease. He suggested that while it has been long discussed that dog health programs in communities are a good model for promoting public health, that assumption needs to be tested. Can such models be built on? Do healthy dogs give communities a sense of control? What determines the incidence of dog bites in communities?

As Prof. Speare concluded, the term One Health is here to stay. But if we are going to use it, we need to understand what it means, how outcomes can be measured and ultimately what “One Health” looks like.

Today I am honoured to be facilitating a hypothetical rabies incursion scenario in Arnhem Land, along with Dr Malcolm Anderson (NT’s Chief Veterinary Officer), Dr Charles Douglas (NT Health Department’s Centre for Disease Control), Dr Joe Schmidt (from the Australian Government’s Northern Australian Quarantine Strategy) and Dr Helen Scott-Orr (former Chief Veterinary Officer of NSW).

What would happen if a rabies case was detected in this area? What agencies would become involved and who would be responsible? How would the outbreak be controlled and would we have enough resources? Stay tuned.

Meantime if you’d like to find out more about AMRRIC, visit their site here.