The new Director General of the World Health Organisation, Dr Tedros Adhanom Ghebreyesus, is a former minister of health in Ethiopia. Africa – at last – is now at the centre of global health policy. This is good news, as persistent ill-health and threats of disease emergence remain, and a different approach to the standard western solutions is required. This must be centred on a One Health approach – where human, veterinary and ecosystem health are seen together. This will require new approaches to research, policy and practice, and must be a major priority for WHO and member states.
But realising these ideals is easier said than done. What might a One Health approach look like for Africa? Today a new Special Issue of the Royal Society’s Philosophical Transactions (Biology) journal is published. Across 12 papers, this offers some clues. The issue is called – One Health for a Changing World: Zoonoses, Ecosystems and Human Well-being, and all articles are available, free online here. You can also download individual articles from the links below.
These papers mostly emerged from a long-term interdisciplinary collaboration under the Dynamic Drivers of Disease in Africa research programme, hosted by the ESRC STEPS Centre. This involved work in Ghana, Sierra Leone, Kenya, Zambia and Zimbabwe, looking at different zoonotic diseases (see earlier coverage on this blog on work on trypanosomiasis in Zimbabwe, here and here).
Through a combination of detailed fieldwork and broader integrative modelling, we aimed to ask how diseases emerge, who they affect, and what to do about them, taking a One Health approach as the starting point. The papers highlight the importance of taking local knowledge of diseases seriously, understanding how both local ecological and social factors generating disease risk and affect poverty and wellbeing, but also how long-term vulnerabilities are generated by politics and changing environments. The papers highlight the importance of modelling as a route to thinking about complex dynamics over time and space, but emphasise the need to link modelling approaches, generating a conversation between modelling approaches. This may involve ‘constructive conflict’ at the centre of a negotiation around how to respond, and will require a rethinking of policy approaches, as well as organisational mandates.
Providing an effective platform for a One Health response to complex and dynamic disease challenges must be a priority for Africa – and the new African DG of the WHO. Hopefully this Special Issue can provide some important pointers, as well as highlighting the real challenges of realising interdisciplinary, cross-sectoral engagement in a changing world.
Here are the details of the papers:
- One Health for a changing world: new perspectives from Africa by Andrew Cunningham, Ian Scoones and James Wood.
- Local disease-ecosystem-livelihood dynamics: reflections from comparative case studies in Africa by Melissa Leach, Bernard Bett, M Said, Salome Bukachi, Rosemary Sang, Neil Anderson, Noreen Machila, Joanna Kuleszo, Kathryn Schaten, Vupenyu Dzingirai, Linidiwe Mangwanya, Yaa Ntiamoa-Baidu, Elaine Lawson, Kofi Amponsah-Mensah , Lina Moses, Annie Wilkinson, Donald Grant and James Koninga.
- One Health contributions towards more effective and equitable approaches to health in low- and middle-income countries by Sarah Cleaveland, Jo Sharp, Bernadette Abela-Ridder, Kathryn Allan, Joram Buza, John; Crump, Alicia Davis, Victor Del Rio Vilas, Will de Glanville, Rudovick Kazwala, Tito Kibona, Felix Lankester, Ahmed Lugelo, Blandina Mmbaga, Matthew Rubach, Emmanuel Swai, Linda Waldman, Daniel Haydon, Katie Hampson and Jo Halliday.
- Poor livestock keepers: ecosystem-poverty-health interactions by Delia Grace, Johanna Lindahl, Francis Wanyoike, Bernard Bett, Thomas Randolph and Karl Rich.
- One Health, emerging infectious diseases and wildlife: two decades of progress? by Anrew Cunningham, Peter Daszak, and James Wood.
- Views from many worlds: unsettling categories in interdisciplinary research on endemic zoonotic diseases by Hayley MacGregor and Linda Waldman.
- Facility-based surveillance for emerging infectious diseases; diagnostic practices in rural West African hospital settings: observations from Ghana by Freya Jephcott, James Wood and Andrew Cunningham.
- Structural drivers of vulnerability to zoonotic diseases in Africa by Vupenyu Dzingirai, Lindiwe Mangwanya, Melissa Leach, Salome Bukachi, Ian Scoones and Annie Wilkinson.
- Integrative modelling for One Health: pattern, process and participation by Ian Scoones, Kate Jones, Giovanni Lo Iacono, David Redding, Annie Wilkinson and James Wood.
- Spatial, seasonal and climatic predictive models of Rift Valley Fever disease across Africa by David Redding, David, Sonja Tiedt, Giovanni Lo Iacono, Bernard Bett and Kate Jones.
- Zoonoses, One Health, and complexity: wicked problems and constructive conflict by David Waltner-Toews.
- Engaging research with policy and action: what are the challenges of responding to zoonotic disease in Africa? by Kevin Bardosh, Jake Cornwall Scoones, Delia Grace, Gladys Kalema-Zikusoka, Kate Jones, Katinka de Balogh, David Waltner-Toews, Bernard Bett, Susan Welburn, Elizabeth Mumford and Vupenyu Dzingirai.