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Catherine Machalaba is the Program Coordinator for Health and Policy at EcoHealth Alliance, a scientific organization working at the intersection of global health, environment and capacity building. Her work centers on operationalizing One Health for more coordinated and preventive systems that promote human, animal and environmental health given their integral links. As part of the USAID Emerging Pandemic Threats PREDICT-2 project she is assessing multisectoral impacts of health disasters and the investment case for risk mitigation opportunities, and is a researcher on a field and epidemiology study in South Africa investigating the effects of climate, vegetation, mosquito ecology, ruminant and human exposure to Rift Valley Fever virus. Catherine works closely with partners at the Secretariat of the Convention on Biological Diversity, UNISDR and the World Bank to advance environment, health and sustainable development synergies. She has published in journals including The Lancet, EcoHealth, Solutions, and Annals of Global Health. Catherine serves as officer for the Future Earth oneHEALTH project and the IUCN Species Survival Commission Wildlife Health Specialist Group, and chairs the American Public Health Association’s Veterinary Public Health group. She holds a degree in Biology, a Masters in Public Health, and is currently completing a doctorate in environmental health.
Biological hazards are increasingly recognized as health emergencies, with Highly Pathogenic Avian Influenzas, Ebola and Zika viruses among the many epidemics seen over the past decade. These have occurred at enormous cost, both in loss of human lives and of local and global economies. The Ebola outbreak in West Africa accounted for over 11,000 deaths and the disruption of public and private sector activities. In total, the three highly affected countries (Sierra Leone, Liberia and Guinea) suffered a GDP growth loss of 12% in 2015 (World Bank estimate).
As with earthquakes and tsunamis, severe and large-scale epidemics and pandemics are considered low probability, high-impact events. But their frequency and intensity is increasing, and with it, the toll on human life, societies and economies. While disease outbreaks typically happen at small-scale and are viewed as unpredictable, we currently have many tools to move from reactive to preventive approach to reduce the risk of future health emergencies.
Targeting Risk Factors
Our increasing encroachment into natural areas for resource extraction, development activities, and human settlements is changing ecosystems and putting humans and domestic species in contact with wildlife at a rate never seen before. These interactions can facilitate the transmission of novel pathogens between animals and humans (“zoonotic” diseases)- the origins of HIV/AIDS, Marburg virus, and Severe Acute Respiratory Syndrome (SARS). Pathogens may then spread further in humans via rapid trade, travel and crowded slums and urban centers.
Infection control measures, such as hand washing, wearing masks and gloves in high-risk settings and thoroughly cooking meat, may reduce individual exposures to infectious diseases. Broader risk reduction requires multi-sectoral collaboration and action to address the underlying drivers. For example, biosecurity and biosafety measures should accompany changes in agricultural production systems, and regulations put on trade of high-risk species (such as bats and non-human primates). The One Health Approach that brings human, animal and ecosystem sectors to work together is the way to shifting from emergency response to prevention of zoonotic disease threats at their source. Health impact assessments can be built into development projects and land use planning to help anticipate and mitigate risks and optimize health, environmental and economic outcomes. Many of the drivers of emerging diseases are also reducing ecosystem resilience, leaving populations vulnerable to other disasters.
Multi-hazard Early Warning Systems
Surveillance of infections in species can alert us to risks. This involves using animals as “sentinels” for visible signs of disease before human cases occur (observed for Ebola virus outbreaks in Great Apes, Yellow Fever in howler monkeys, and Rabies in domestic dogs), and screening for known and novel pathogens to identify future human disease threats. As some diseases are closely linked with climate and weather conditions forecasting may help inform risk management. Similarly risk profiling and assessment tools and mapping of hot spots to show where new diseases are likely to emerge can inform risk reduction.
In line with the Sendai Framework, we have a compelling opportunity to shift from reacting to the next epidemic or pandemic to proactively managing risks. Strengthening capacity for prevention, early detection and rapid response and control will help in curbing health emergencies that could occur after other types of disasters, creating a more resilient overall public health system. This is also in line with the International Health Regulations (IHR) to provide countries with technical guidance to develop their core capacities; facilitate reporting of outbreaks; and to identify areas where support is needed.
This post was co-authored with Dr. Chadia Wannous, Senior Advisor at the UN Office for Disaster Risk Reduction (UNISDR) and Dr. William Karesh, Executive Vice President for Health and Policy at the EcoHealth Alliance.
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