One Health Meeting in the African Region

One Health Meeting
in the African Region
Okoumé Palace Hotel
Libreville - Gabon
12-14 November 2012
«Each time the sun rises, we should be reminded of the strength that we get from working together»
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ONE HEALTH MEETING
IN THE AFRICAN REGION
Okoumé Palace Hotel
Libreville Gabon
12-14 November 2012
Q
REPORT
Contents
List of figures
Abbreviations
4
5
1. Opening ceremony
6
2. The One Health approach
8
2.1 Zoonotic diseases in the African Region
2.2 The One Health approach in the African Region
2.3 Global and regional efforts to implement the One Health approach
8
8
9
3. The One Health approach and response to outbreaks
11
3.1 Approaches to policy development and implementation of One Health in the African Region
3.2 Operationalizing One Health in Cameroon
3.3 Development of a national One Health office in Kenya
3.4 Strengthening preparedness and response plannning in Democratic Republic of Congo
3.5 Multisectoral collaboration for zoonoses in Uganda
3.6 Regional economic communities’ support for the One Health approach
3.7 Operationalizing One Health through capacity-building and training
3.8 Veterinary training strategies for One Health
3.9 USAID support for implementing the One Health approach
3.10 Supporting the One Health approach through joint simulations
3.11 Networking animal and human laboratories
3.12 Establishing and operationalizing the Integrated Regional Coordination Mechanism
3.13 Building international consensus on cross-sectoral approaches
11
11
12
13
13
14
14
15
15
15
16
17
18
4. Mechanisms for strengthening the One Health approach at country level
20
5. Recommendations
21
6. Closing ceremony
22
Annex 1: List of participants
Annex 2: One Health meeting agenda
Annex 3: Country roadmaps with initial short-term activities for institutionalizing the One Health
approach
23
28
31
3
List of figures
1.
Distribution of common zoonotic diseases in the WHO African Region
2.
One Health: four examples
3.
The national programme for the prevention and control of emerging and re-emerging diseases:
Cameroon
4
4.
Ebola in Isiro, Democratic Republic of Congo: field visit by WHO and Ministry of Health staff
5.
Ebola epidemics in Gabon
6.
Dengue and chikungunya in Gabon
7.
CIRMF One Health framework
8.
The role of the Integrated Regional Coordination Mechanism as a key One Health initiative of AU-IBAR
ONE HEALTH MEETING
IN THE AFRICAN REGION
Okoumé Palace Hotel
Libreville Gabon
12-14 November 2012
Q
REPORT
Abbreviations
AU-IBAR
African Union-InterAfrican Bureau for Animal Resources
CDC
Centers for Disease Control and Prevention
CIRMF
Centre International de Recherches Medicales de Franceville
DRRT
District Rapid Response Teams
DPC
Disease Prevention and Control
EPT
Emerging Pandemic Threat
FAO
Food and Agriculture Organization
HLTM
High Level Technical Meeting
HPAI
Highly Pathogenic Avian Influenza
IDSR
Integrated Disease Surveillance and Response
IHR
International Health Regulations
INFOSAN
Information and Food Safety Authorities Network
IRCM
Integrated Regional Coordination Mechanism
MoH
Ministry of Health
MSF
Médecins sans Frontières
NGO
Nongovernmental Organization
NTD
Neglected Tropical Disease
OHCEA
One Health in Central and Eastern Africa
OIE
World Organization for Animal Health (formerly, the International Office of Epizootics)
RVF
Rift Valley Fever
SOP
Standard Operating Procedure
UNICEF
United Nations Children’s Fund
UNSIC
United Nations System Influenza Coordination
USAID
United States Agency for International Development
WHO
World Health Organization
WTO
World Trade Organization
ZDU
Zoonotic Disease Unit
5
1. Opening Ceremony
The changing dynamics of human, animal and
environmental health and the new alliances,
partnerships and players involved in these sectors
have necessitated a paradigm shift. In order to address
the challenges of health delivery using the “One
Health approach”, the first One Health meeting in
the African Region was held from 12 to 14 November
2012 in Libreville, Gabon. The overall objective was
to contribute to strengthening the prevention,
preparedness, response and control of endemic,
emerging and re-emerging zoonotic disease threats
in the African Region.
The meeting was officially opened by the Minister
of Health of Gabon, His Excellency Prof N’Zouba,
in the presence of government representatives
from Cameroon, Congo, Democratic Republic of
Congo, Equatorial Guinea, Ethiopia, Gabon, Kenya,
Tanzania, Uganda and United States of America. Also
in attendance were the One Health partners: USAID,
EPT projects, OHCEA, FAO, OIE, WHO, CDC, University
of Evora and University of Lisbon (see Annex 1 List of
participants).
In his introductory remarks, the Ambassador of
the United States of America to Gabon, Mr Eric
Benjaminson, informed the meeting that over the
last few decades several diseases have emerged from
animal reservoirs. He noted that three quarters of all
emerging or re-emerging diseases have been caused
by pathogens from animals or animal products.
He called for a shift in the responsibility of Member
States to monitor and report disease threats with the
understanding that national health systems cannot
address complex risks alone. Hence, there was need to
promote cross-sectoral approaches. He thanked the
Government of Gabon for hosting the meeting and
added that he looked forward to reading the meeting
report.
6
In his opening remarks, the World Health Organization
Regional Director for Africa, Dr Luis G. Sambo, thanked
the President and Government of Gabon for accepting
to host this important meeting. The Regional Director
informed the meeting participants that 24% of
infectious diseases reported in the African Region
are zoonotic diseases. Deforestation and mining in
new ecological areas result in an increased interface
between animals and humans and thus contribute to
the spread of these zoonotic diseases. The Regional
Director said that the WHO Regional Office for Africa
had worked with key partners in organizing the One
Health meeting and looked forward to continued
collaboration. He reaffirmed the WHO commitment to
continue working with Member States and partners in
ensuring the success of the One Health approach in
the African Region.
The Guest of Honour, the Minister of Health for
Gabon, HE Prof Léon N’Zouba, welcomed the country
delegates and One Health partners to Gabon. The
Minister informed the meeting that people live in
an environment where they are exposed to the risk
of diseases originating from animals. He reminded
participants of the Ebola outbreaks that occurred in
1996 and 2002 in Gabon. He added that changes in
the environment, cross-border movement of people,
and poverty contribute to the emergence of zoonoses.
The Minister reaffirmed Gabon’s commitment to
supporting the implementation of the One Health
approach in the country and looked forward to the
meeting discussions and recommendations. He then
officially opened the conference.
ONE HEALTH MEETING
IN THE AFRICAN REGION
Okoumé Palace Hotel
Libreville Gabon
12-14 November 2012
Q
REPORT
JGeneral objective
JMethod of work
The general objective of the meeting was to contribute
to strengthening the prevention and response to
emerging zoonotic disease threats in the African
Region.
Methods of work used during the meeting included
plenary sessions with presentations and discussions
on essential topics. Group work allowed participants
to identify thematic areas. Later , country –specific
teams were established to develop country One
health roadmaps.
JSpecific objectives
The specific objectives of the meeting were:
a) to brief participants on the One Health approach;
b) to review implementation of the One Health
approach and its added value in responding to
outbreaks;
c) to identify challenges and barriers to implementing
the One Health at country level;
d) to propose ways in which countries can strengthen
implementation of the One Health approach.
JExpected results
a) Participants briefed on the One Health approach;
b) implementation of the One Health approach and
its added value in responding to outbreaks reviewed;
c) the challenges and barriers to implementing the
One Health approach at country level identified;
d) proposals for ways in which countries can
strengthen implementation of the One Health
approach proposed.
7
2. The One Health approach
Three presentations were delivered during the first
plenary session: zoonotic diseases in the African
Region; overview and rationale for the One Health
approach; and overview of global and regional efforts
to implement the One Health approach.
J 2.1
Zoonotic diseases in the African
Region
The first presentation was made by Dr Benido
Impouma from the WHO Regional Office for Africa. Dr
Impouma emphasized the fact that zoonotic diseases
were a common occurrence in the African Region
accounting for 24% of all infectious diseases reported
in the Region between 2000 and 2012 (Figure 1). A
number of factors contributed to the risk of spread
of zoonotic diseases namely: population pressure,
food security, economic growth, climate change,
international travel and globalization.
The presentation highlighted the various strategic
approaches in the prevention and control of
zoonotic diseases. These include improved
surveillance; strengthening of International Health
Regulations (IHR) 2005 core capacities; putting in
place comprehensive emergency preparedness
and response plans; strengthening communication;
research; and promoting multi-sectoral collaboration
in areas of animal health and human health.
J 2.2
The One Health approach in the
African Region
The second presentation was made by Dr Dennis Caroll
of USAID. He informed participants that emerging
pandemic threats were closely linked to factors that
intensify animal-human interactions. These factors
include changing habitats, population pressure, food
security, economic growth and globalization (Figure 2).
Figure 1: Distribution of common zoonotic diseases in the WHO African Region 2001-2011
Zoonotic disease outbreaks
reported to WHO AFRO,
2001-2011
8
Yellow Fever
Ebola
Marburg
Lassa Fever
Rift Valley Fever
Anthrax
Plague
Rabies
Monkeypox
Crimean-Congo Haemorrhagic Fever
Okoumé Palace Hotel
Libreville Gabon
12-14 November 2012
ONE HEALTH MEETING
IN THE AFRICAN REGION
Q
REPORT
The One Health approach requires recognition of the
important connection between human, animal and
environmental health; a more efficient alignment
of limited human, financial and material resources;
and provides the opportunity to build systems that
enable not just earlier detection of emerging threats
to human, animal and environmental health but
also mobilization and deploying of interventions to
mitigate their potential emergence and spread.
Dr Caroll concluded that people live in an
extraordinary period of human history characterized
by an unprecedented increase in the emergence of
new health threats that span human, animal and
environmental health. To meet this challenge, it is
necessary that people recognize that the solutions do
not exist in individual sectors; rather, the solutions are
found in forging new One Health alliances that span
the human-animal-ecosystem sectors.
2.3 Global and regional efforts to
implement the One Health approach
the development of the One Health concept. The
experience of dealing with highly pathogenic avian
influenza (HPAI) revealed the need for a larger policy
forum involving different sectors for high-level policy
and strategy discussions.
Although the initial focus was on emerging zoonotic
diseases, the One Health approach has evolved to
address many endemic diseases. Rabies (an endemic
disease) has been a public health problem for many
years and continues to pose challenges. Antimicrobial
resistance, which is a health risk at the global level,
could also represent a risk in the African Region.
Some of the key strategies and guidelines that
highlight the need for intersectoral collaboration
include the International Health Regulations (2005);
Codex Alimentarius; OIE codes and manuals including
the Performance of Veterinary Services tool; and
specific regional strategies such as that for Integrated
Disease Surveillance and Response (IDSR).
J
Dr Katinka De Balogh of FAO informed participants that
the One Health approach was not a new concept and
that the initial interministerial meetings on this were
held in 2005 at the height of the avian and pandemic
influenza outbreaks. These initial discussions led to
Dr De Balogh ended the presentation with a call
for the development of global guidance on best
practices for implementing intersectoral approaches
in countries and for facilitating country and regional
collaboration as needed, e.g. interministerial
committees and strategies, prioritization, integrated
simulation exercises.
Figure 2: One Health: four examples
9
The One Health Approach
Discussions were held following the three
presentations.
Participants
commended
the
significant progress made in implementing the
One Health approach in the African Region. They
suggested that efforts to address zoonotic disease
outbreaks should be extended to the control of
neglected tropical diseases (NTDs), vector control
and food production. Since it may not be possible to
10
have sufficient laboratory capacity in all countries, it is
essential that laboratories are effectively networked to
support rapid diagnosis of emerging and re-emerging
threats. Each country must strengthen capacity for
sample collection and transport. “One Health” should
be defined broadly to include more than infectious
diseases.
ONE HEALTH MEETING
IN THE AFRICAN REGION
Okoumé Palace Hotel
Libreville Gabon
12-14 November 2012
Q
REPORT
3. The One Health Approach and
Response to Outbreaks
During the second plenary session, 13 presentations
were made. Topics covered areas such as policy
development; update on the Emerging Pandemic
Threats Programme; country updates on One Health
approach (Cameroon, DRC, Kenya, and Uganda);
Integrated Regional Coordination Mechanism;
operationalizing One Health through capacitybuilding; One Health capacity-building through
fellowship programmes; joint simulations; networking
laboratories through the Identify project; and building
international consensus on cross-sectoral approaches.
3.1 Approaches to policy
development and implementation of
One Health in the African Region
J
EPT could facilitate implementation of the One Health
approach at global, regional and national levels.
In the ensuing discussion, participants noted with
satisfaction the added value of the One Health
approach in addressing animal, human and
environmental health. They called for updating
policies and legislation to facilitate implementation
of the One Health approach by Member States;
development of strategic plans for the One Health
approach; development of guidelines and standard
operating procedures (SOPs) to guide One Health
implementation; and promoting One Health
partnerships including the conduct of biennial
simulation exercises.
3.2 Operationalizing One Health in
Cameroon
J
Dr Zabulon Yoti of the WHO Regional Office for
Africa highlighted the rationale and challenges of
implementing the One Health approach in the African
Region. Challenges included limited collaboration and
coordination mechanisms; minimum multisectoral
engagement; limited sharing of information;
inadequate and inequitable distribution of resources;
inadequate laboratory capacity; and inadequate
knowledge of emerging health threats.
The presenter informed participants of the actions
being taken to align the One Health approach at all
levels. These actions included revising surveillance
guidelines to incorporate zoonotic diseases;
collaboration between animal health and human
health; and developing a regional strategy for
prevention and control of zoonoses.
Dr Yoti further informed participants that harmonizing
existing policies was critical for implementation of
the One Health approach; the draft regional zoonosis
strategy could be used as a tool for addressing aspects
of the One Health approach; and multi-partner
agreements such as the FAO-OIE-WHO tripartite on
Dr Etoundi Mballa Alain Georges of the Ministry of
Health, Cameroon, told about the processes that the
country had used in 1)developing the programme for
prevention and control of zoonotic diseases; and 2)
developing The strategy for the One Health approach
(Figure 3). Previously, the control of zoonotic diseases
was poorly coordinated. Then the country put in
place a multisectoral committee to address zoonoses.
Membership included various national agencies
in charge of public health, animal health, and
environment as well as a number of NGOs working in
these areas. A secretariat was established to support
this committee.
Formation of the multisectoral committee was
followed by adoption of the One Health approach;
situation analysis of zoonotic diseases in Cameroon;
development of a draft One Health strategy; and
development of a One Health plan of action. The
programme and plan of action were then adopted
and co-signed by the ministers of health, environment
and animal services.
11
The One Health Approach and Response to Outbreaks
In Cameroon, a number of lessons were learnt
while implementing the One Health approach.
These lessons are: i) there is a need to develop one
coordination mechanism; ii) it is necessary to sensitize
all committee members on the One Health approach;
and iii) information exchange between partners is
useful and ensures programme success.
J 3.3
Development of a national One
Health office in Kenya
Dr Ian Njeru of the Kenya Ministry of Health and
Sanitation described the steps that Kenya had taken
in developing a national office for One Health. This
included the formation of the National Influenza Task
force in 2005; formation of the Zoonotic Technical
Working Group in 2008; formation of One Health in
Central and Eastern Africa (OHCEA) Kenya chapter in
2010; development of the national priority zoonotic
diseases list in 2011; revision of IDSR technical
guidelines to incorporate zoonotic diseases in 2011;
creation of the One Health office Zoonotic Disease
Unit (ZDU) in 2011; development of the Strategic Plan
for Implementing One Health in Kenya (2012–2017) in
2012 and the subsequent revision of national policies
to incorporate One Health.
Kenya’s ZDU vision is to have a country with a reduced
burden of zoonotic diseases and better able to
respond to epidemics of emerging and re-emerging
infectious diseases. The mission is “To establish and
maintain active collaboration at the animal, human,
and ecosystem interface towards better prevention
and control of zoonotic diseases”. Implementation
of Strategic Plan (2012–2017) priorities included
the development of guidelines for intersectoral
collaboration and a communication strategy.
Meeting participants appreciated the progress that
Cameroon and Kenya had made in implementing the
One Health approach and called on WHO to facilitate
the sharing of good practices from these countries.
Figure 3: The national programme for the prevention and control of emerging
and re-emerging zoonotic diseases: Cameroon
12
ONE HEALTH MEETING
IN THE AFRICAN REGION
Okoumé Palace Hotel
Libreville Gabon
12-14 November 2012
Q
REPORT
3.4 Strengthening preparedness
and response planning in Democratic
Republic of Congo
J
The Director of Public Health, DRC, Dr Benoit Ilunga
Kebela, presented facts about the number of zoonotic
outbreaks in the country over the past four decades.
These included Yellow fever in Titule and Buta in 2010;
Ebola in Yambuku in 1976, Kikwit in 1995, and Mweka
in 1997 and 1998; Marburg in Watsa in 1998; plague in
Ituri, Isiro and Zobgia; monkey pox and chikungunya.
He also informed participants of an ongoing outbreak
of Ebola in Isiro. As of 11 November 2012, a total of
63 cases and 39 deaths had been reported resulting
in a case fatality ratio of 62%. WHO, UNICEF, MSF and
other partners had continued to provide support to the
Ministry of Health to contain the outbreak (Figure 4).
In response to these repeated outbreaks, in 2011 the
country set up a multisectoral committee at national
level to coordinate preparedness and response to
public health events and outbreaks. The committee
includes representatives from the following sectors:
public health, agriculture and rural development,
environment, academic institutions, journalists,
security and local government.
A number of challenges hampered the smooth operation
of this committee namely: absence of a system to verify
events that were being reported, communication
between sectors and coordination at the lower level.
3.5 Multisectoral collaboration for
zoonoses in Uganda
J
Dr Winyi Kaboyo of the Ugandan Ministry of Health
reported that a number of key sectors were actively
involved in the prevention, control and management
of zoonoses. These included the Ministry of Health;
Ministry of Agriculture, Animal Industry and Fisheries;
Coordinating Office for Control of Trypanosomiasis in
Uganda; Uganda Wildlife Authority; local government
authorities; the army; as well as partners such as Red
Cross and UN agencies.
Figure 4: Ebola in Isiro, Democratic Republic of Congo: field visit by WHO
and Ministry of Health staff
13
The One Health Approach and Response to Outbreaks
Mechanisms for intersectoral collaboration have
been defined and include joint technical committees;
joint national task forces; field disease investigations
and management during outbreaks; and outbreak
simulation exercises. Collaboration also takes place
during project design, appraisal and implementation.
Challenges in implementing One Health in Uganda
include inadequate funding for the key sectors; lack of
political will to promote the One Health agenda; and
lack of enough technical expertise among the DRRTs,
especially at district level, to respond to emerging
zoonoses. Moreover, the concept of One Health has not
yet been explained at the district level and therefore is
not appreciated by relevant sector officials.
Participants were reminded that prompt disease
outbreak communication and management in the
human, domestic animal and wildlife sectors were key
in controlling zoonoses.
J3.6 Regional Economic Communities’
to embrace the One Health approach as a way of
addressing the problems of zoonotic diseases.
3.7 Operationalizing One Health
through capacity-building and training
J
Prof William Bazeyo of One Health in Central and
Eastern Africa (OHCEA) reported that OHCEA is a
universities network established in October 2010 with
support from USAID Respond. The network is made
up of 14 institutions of higher education (schools
of public health and veterinary medicine) in six
countries. The network is promoting the One Health
approach by establishing cross-disciplinary applied
training programmes; working with governments
and private sector partners to support their missions
and strengthen collaboration across disciplines and
sectors; building trans-disciplinary and trans-sectoral
research teams to improve understanding and control
of complex disease systems; and providing outreach
to key One Health constituents to strengthen crosssectoral engagement.
support for the One Health approach
Dr Samuel Muriuki informed meeting participants
that the mandate of the African Union-InterAfrican
Bureau for Animal Resources (AU-IBAR) was to support
and coordinate the development and utilization of
animals (livestock, fisheries and wildlife) as a resource
for human well-being in the Member States and to
contribute to economic development. The strategic
plan for implementing this mandate focuses on
reducing the impact of trans-boundary animal diseases
and zoonoses on livelihoods and public health in
Africa; natural resources management; investment and
competitiveness; standards and regulations; policies,
capacity-building and knowledge management.
The participants were reminded of the importance of
zoonotic diseases and the potential disruption that
their outbreaks cause to both animal and human
health. Because of the economic importance of these
diseases, AU-IBAR has embarked on a strategy for
working with Regional Economic Communities (RECs)
to implement prevention and control.
Dr Muriuki called upon participants and countries
14
The mission of OHCEA is to drive transformational
change for the continuous improvement of human,
animal, and ecosystem health and well-being. Since
its inception OHCEA has recorded some success.
Deans of the network schools have engaged key
intergovernmental organizations (WHO, OIE, FAO and
WTO) in the development of guidelines for rolling
out One Health implementation. In addition, OHCEA
institutions participate in the control of disease
outbreaks (e.g. yellow fever and anthrax) in their own
countries by involving faculty members.
Prof Bazeyo ended by stating that the One Health
approach, partnerships and collaboration between
sectors and disciplines are key to improving teamwork
and efficiency in the control of zoonotic diseases. He
reiterated that OHCEA is committed to building the
capacity of future public health personnel both at preservice and in-service levels who are ready to improve
human and animal health in a holistic manner.
ONE HEALTH MEETING
IN THE AFRICAN REGION
Okoumé Palace Hotel
Libreville Gabon
12-14 November 2012
Q
REPORT
J 3.8 Veterinary
training strategies for
3.10 Supporting the One Health
approach through joint simulations
Dr Manuela Vilhena of the University of Evora, Portugal,
informed meeting participants about SAPUVETNET,
a veterinary public health network. He said that
SAPUVETNET members included 16 universities, 11
from Latin America and 5 from Europe. The latest
SAPUVETNET project has developed a curriculum
and manuals for training veterinarians in the One
Health approach. The training materials include case
studies, videos, games, music, podcasts and other
relevant teaching aids. Dr Vilhena indicated that more
information on the SAPUVETNET project could be
accessed at www.sapuvetnet.org
Dr Katinka De Balogh of the Food and Agriculture
Organization informed participants that FAO had
developed tools for integrated simulation exercises
to test and enhance coordination, collaboration and
communication between sectors during outbreak
situations. These exercises were initially developed
to address highly pathogenic avian influenza (HPAI
H5N1) and have now been expanded to address a
broader range of outbreaks.
One Health
J3.9
USAID support for implementing
the One Health Approach
Rob Henry of the USAID Emerging Pandemic Threats
(EPT) project gave a presentation emphasizing the fact
that the world is experiencing an extraordinary period
of human history characterized by an unprecedented
increase in the emergence of new infectious diseases
with enormous potential for global impact. Mr Henry
highlighted the five key drivers underlying most
emerging diseases that converge at the humananimal-ecosystem interface as population pressure,
changing habitats (climate change), food security,
globalization and economic growth. These drivers have
led to increased interaction between animals, humans
and ecosystems resulting in the emergence of diseases.
The EPT projects underscore the need for
comprehensive and proactive approaches for
predicting, timely detection, and response to
potential zoonotic threats of international concern.
The four intricately-related EPT projects are known as
Predict, Identify, Respond and Prevent; the projects
aim at strengthening measures that enable better
understanding of the interfaces between animals,
humans and the ecosystems in which they live. The
related interventions focus on pre-empting the disease
threats at an early stage before they become significant
public health events. Key areas of concern include
pathogen discovery, risk determination, human risk
reduction and enhancing outbreak response capacity.
J
Simulation activities have allowed for testing the chain
of command; identifying strengths and weaknesses
of existing contingency plans; and improving
coordination and collaboration of the different sectors
involved. Simulations are particularly effective in
testing the quality of response activities during the
alert phase (Pandemic Phase 3) when there is limited
human-to-human transmission.
Recent simulation exercises were conducted over a twoday period with about 50–60 participants drawn from
the following sectors: central and local governments,
public health, veterinary, wildlife, laboratory, academia,
police forces, civil defense, private sector. Observers
from neighbouring countries as well as regional and
international institutions attended.
Various lessons were learnt from these simulation
exercises. They include: i) it is important to conduct
simulations in local languages so that participants are
able to engage fully in the activities; ii) the command
team is an essential factor; and iii) regional exercises
are more complex than country-level exercises as they
focus more on cross-border transmission as well as
trade and travel restrictions and regulations.
Various follow-up activities were conducted after the
simulation exercises. These included discussion of
identified needs within the country; development of a
plan of action; and resource mobilization.
15
The One Health Approach and Response to Outbreaks
J 3.11
Networking animal and human
laboratories
Dr Dieudonne Nkoghe of Gabon reported that the
CIRMF laboratory has the capacity to diagnose various
zoonotic, waterborne and vector-borne diseases as
well as other diseases of public health concern. Over
the past 20 years, CIRMF has played a critical role in
diagnosing various viral haemorrhagic fevers that
occurred in Gabon and the Republic of Congo (Figure
5) and vector-borne diseases in Gabon (Figure 6). In
addition, they have supported serological surveys
that contributed to better understanding of the
epidemiology of Ebola, chikungunya, dengue, Rift
Valley fever and West Nile virus in Gabon.
Figure 5: Ebola epidemics in Gabon (source: CIRMF)
CAMEROUN
Mekouka,
emoMayibo
Mekambo,
Mbandza,
Libreville
Etoumbi,
Booué,
Kelle,
GABON
Franceville
RÉPUBLIQUE
DU CONGO
Brazzaville
CIRMF
Figure 6: Dengue and chikungunya in Gabon (source: CIRMF)
Dengue
Chikungunya
16
Ebola
ONE HEALTH MEETING
IN THE AFRICAN REGION
Okoumé Palace Hotel
Libreville Gabon
12-14 November 2012
Q
REPORT
Based on experience acquired over the years, CIRMF
has developed a framework that clarifies its role
in promoting and implementing the One Health
approach (Figure 7).
The facility is also capable of supporting capacitybuilding for zoonotic disease diagnosis in the Region.
In spite of CIRMF having the capacity to support or
even conduct field investigations, it has encountered
difficulties in providing such support especially the
collection of samples at the operational level.
J3.12
Establishing and operationalizing
the Integrated Regional Coordination
Mechanism
Dr Baba Soumare of AU-IBAR gave a presentation on
the activities of AU-IBAR towards the achievement of
the One Health approach. It highlighted African Union
initiatives to operationalize the Integrated Regional
Coordination Mechanism (IRCM) (Figure 8) and One
Health to include implementation and resource
mobilization; support for sectoral and intersectoral
coordination activities; capacity development for
implementation at national and regional levels; and
advocacy. The major challenges were institutionalizing
and operationalizing the One Health approach. The
recommendations included strengthening the One
Health approach at the national level by revitalizing,
expanding and converting the Avian Influenza Task
Force into a national zoonotic diseases committee;
creating a zoonotic diseases desk; updating legislation
and policies to enhance intersectoral collaboration;
developing guidelines and SOPs for collaboration;
and using a multisectoral approach in joint strategic
planning, zoonotic diseases prioritization and outbreak
investigation.
Figure 7: CIRMF One Health framework
17
The One Health Approach and Response to Outbreaks
J3.13 Building international consensus
on cross-sectoral approaches
Dr Katinka De Balogh of FAO reported on the High Level
Technical Meeting (HLTM) held in Mexico City, Mexico
in November 2011. The meeting was held to address
both ministerial level engagement and practical tools
for the implementation of the One Health approach.
The meeting was supported by the ministries of
public health, agriculture and environment of the
Government of Mexico as well as well as the tripartite
(FAO, OIE, WHO) and UNSIC.
To facilitate discussions aimed at building international
consensus on cross-sectoral approaches, three topics
were used as entry points namely: zoonotic influenza,
rabies, and antimicrobial resistance. The diverse work
groups arrived at very similar recommendations which
formed the basis for 12 key supporting elements and 6
key operational elements (Table 1).
Dr De Balogh further reflected on the outcomes of
the Mexico meeting, noting that trust is difficult to
build but easy to destroy. Regarding shared benefits,
it is important to reflect on what the various sectors
stand to gain. There is need for equitable distribution
of resources since investment may be in the animal
health sector while the benefits may be shared with
the human health sector; hence it may be necessary
to engage the Ministry of Finance to ensure that
finances are equitably distributed across sectors. There
is need for joint capacity development: when the rapid
response teams from the human health sector and
animal health sector are able to meet face- to-face it
facilitates their work at present and in the future. Strong
individual systems in the health sector and the animal
sector will be necessary to allow for collaboration.
It is important to have real time communication
when sharing data. Equally important is the need to
recognize different sector priorities.
The meeting participants acknowledged the
significant progress that countries and organizations
have made in moving forward the One Health agenda.
They called on WHO and Member States to strengthen
laboratory capacities for the success of the One Health
approach. In addition, they requested the various
partners present to continue supporting countries in
implementing the One Health approach. Participants
also noted that it was essential that political authorities
take responsibility by ensuring that legislation be put
in place to support the One Health approach.
Figure 8: The central role of the Integrated Regional Coordinated Mechanism
as a key One Health initiative of AU-IBAR
18
ONE HEALTH MEETING
IN THE AFRICAN REGION
Okoumé Palace Hotel
Libreville Gabon
12-14 November 2012
Q
REPORT
Table 1: Elements for building international consensus on cross-sectoral approaches
Key Supporting Elements
Key Operational Elements
1. Political will and high-level commitment
A. Joint cross-sectoral coordination mechanisms
2. Trust
B. Routine communication
3. Common objectives and priorities
C. Joint simulation exercises
4. Shared benefits
D. Data sharing
5. Strong governance structures, aligned legal E. Joint risk assessment
frameworks, and recognition of existing international
standards
6. Adequate and equitably distributed resources
F. Active cooperation on disease control programmes
7. Identification and involvement of all relevant partners
8. Coordinated planning of activities
9. Guidance on implementation of cross-sectoral
collaborations
10. Capacity development
11. Strong and effective health systems within the
individual sectors
19
4. Mechanisms for Strengthening the
One Health Approach at Country Level
During the third session, participants were requested
to work in groups to discuss the One Health approach
and how it could be implemented at country level.
Country representatives were asked to develop a One
Health roadmap for implementing the approach after
the meeting. In addition, participants were tasked
to review the draft regional strategy for prevention
and control of zoonoses and provide the necessary
comments and suggestions to improve this document.
20
In the ensuing plenary session, participants reaffirmed
their commitment to implementing the One Health
approach using their suggested individual country
roadmaps. Several comments were made on the
draft regional strategy for prevention and control of
zoonoses which will be considered when finalizing
the Regional strategy.
ONE HEALTH MEETING
IN THE AFRICAN REGION
Okoumé Palace Hotel
Libreville Gabon
12-14 November 2012
Q
REPORT
5. Recommendations
The meeting observed that there are still substantial
challenges and gaps in implementing the one health
approach at national and sub-national levels and
made the following recommendations:
JPartners
6. The partners are called upon to scale up their
collective support to the Member States in the African
Region in developing and implementing of the One
Health Approach.
JMember States
1. Member States with the support of partners should
strengthen and integrate wildlife surveillance into the
overall One Health agenda.
2. Member State with the support of partners should
strengthen national laboratory quality systems and
diagnostic capacities for emerging and re-emerging
diseases as a way of ensuring rapid detection of
potential zoonotic threats
3. Member States with the support of partners should
improve and/or establish coordination structures
and partnership for One Health approach as a way of
ensuring a cross –sectoral collaboration.
7. The Partners are called upon to finalise the regional
strategic plan on zoonotic diseases and distribute this
to countries for use in developing national strategies
JWHO
8. WHO/AFRO should work with the African Union and
Regional Economic communities to harmonise draft
strategies and road map in advocating for increased
national support and funding towards the one health
approach.
4. Member States with the support of partners should
encourage local universities and institution of higher
learning to commission training in research in the area
of potential zoonotic diseases as a way of improving
knowledge on the human and animal interface.
5. Member States, with support from partners should
work on developing and/or expanding data collection
and sharing of information related to one health
approach
21
5. Closing Ceremony
Before concluding the meeting, participants adopted
the eight recommendations. The One Health meeting
was then officially closed by the Director-General,
Gabon Ministry of Health, Dr Jean Damascene Khouilla,
who thanked participants, the WHO Regional Director
for Africa and partners present for having organized
and conducted this important meeting in Gabon.
Dr Khouilla reminded participants of the important
discussions that had taken place over the past three
days and expressed his satisfaction that participants
had adequately addressed the objectives of the
22
meeting. He called upon the countries represented to
fully implement the recommendations made. Finally,
he wished all participants safe travel back to their
home countries and proceeded to officially close the
meeting.
ONE HEALTH MEETING
IN THE AFRICAN REGION
Okoumé Palace Hotel
Libreville Gabon
12-14 November 2012
Q
REPORT
Annex 1: List of participants
One Health Meeting Libreville, Gabon 12–14 November 2012
N°
Country
Organization
Name
Title
GOVERNMENT REPRESENTATIVES
1
Cameroon Ministère de la Santé Publique
Dr Fifen Alassa
Secrétaire Exécutif de l’Observation
National de la Santé Publique
2
Ministère de la Santé Publique
Dr Etoundi Mballa Alain
Georges
Directeur de la Lutte contre la Maladie
3
Ministère de l’Elévage, des
Pêches et des Industries
Animales
Mme Ouli Ndongo Monique
Secrétaire Général
4
Ministère de l’Elévage, des
Pêches et des Industries
Animales
Dr Loul Séverin
Point focal «une santé» Chef Service de
l’Epidémio-Surveillance
5
Ministère des Forêts et de la
Faune
Dr Linjouom Ibrahim
Sous Directeur de la Conservation de
la Faune
6
Ministère de l’Environnement,
Protection de la Nature et du
Dévéloppement Durable
Mme Sanjoh Delphine
Chef de Service de la Restauration
Ministère de la Santé Publique
Mr Baitsura Musowa
Shadrac
Directeur du Cabinet du Ministre de la
Santé
8
Ministère de la Santé Publique
Dr Benoit Kebela Ilunga
Directeur de la Direction de la Lutte
contre la Maladie du Ministère de la
Santé Publique
9
Ministre de la l’Agriculture
Dr Pius Bitakuya Dunia
Conseiller en charge de la Production
Animale
10
Ministre de la l’Agriculture
Dr Hubert Ali Ramazani
Secrétaire Général à l’Agriculture, Pêche
et Elevage
Ministry of Health
Mr Tekalign Moges Kebede
Senior Officer/Chief Health Science
Professional
12
Ministry of Health
Mr Abebe Alemu Aga
Expert
13
Ministry of Agriculture
Dr Alemayehu Mekonnen
Anbessie
Senior veterinary
14
Ministry of Agriculture
Dr Gedion Yilma
Defabachew
Senior veterinarian
15
Ministry of Culture & Tourism
Dr Kifle Argaw
workagegnehu
Wildlife Veterinarian
16
Ministry of Culture & Tourism
Dr Fekede Regassa Joka
Doctor of Veterinary medicine
7
11
DRC
Ethiopia
23
Annex 1: List of participants
N°
Country
17
Equatorial
Guinea
Name
Title
Ministère de la Santé et Bienêtre Socialf Health
Dr Camilo Ela Ela Obono
Medico Epidemiology Director Salud
Public
18
Ministère de la Santé et Bienêtre Socialf Health
Dr Antonio Maria Oyono
Service Epidemiologique
19
Ministère de l’Agriculture et
des Forêts
Dr Antonio-Bonifacio Mba
Ndong
Medico Vétérinario
20
Ministère de l’Agriculture et
des Forêts
Mr Victor Ondo Nsang
Vétérinaire responsbale de la
Surveillance Epidémiologique
21
Ministère des Pêches et de
l’Environnement
Mr Paulino Nguema Maba
Secrétaire Général au Ministère des
Pêches et de l’Environnement
22
Ministère des Pêches et de
l’Environnement
Mr Pedro Malavo Nsene
Chef Cabinet Ministre
Ministère de la Santé
Dr Jean Damascene Khouilla Directeur Général de la Santé
24
Ministère de la Santé
Dr Etienne Nzengue
Directeur PNLP
25
Ministère de la Santé
Dr Roger Otchague
Directeur de l’Institut d’Epidemiologie
de Lutte contre les Endemies
26
Ministère de la Santé
Mme Augustine
Ngouessoukou Wolbert
Chef de Service de la Reglémentation
27
Ministère de la Santé
Dr Ondo Eyene Catherine
Inspecteur Général Adjoint à la Santé
28
Ministere de l’Agriculture,
Elevage Pêche et
Développement Rural
Dr Patrick Mba Bekoung
Directeur General Adjoint de l Elevage
29
Ministere de l’Agriculture,
Elevage Pêche et
Développement Rural
Dr Morgan Bignoumba
Chef de Service Sante Publique
Vétérinaire
30
Ministere de l’Agriculture,
Elevage Pêche et
Développement Rural
Dr Ogandaga Mbezo Pierre
Léon
Chef de Service Animale
31
Ministere de l’Econonomie de
l’Emploi et du Developpement
Durable
Mr Ange Boukinda
Directeur Adjoint
32
Ministère de l’Econonomie de
l’emploi et du Developpement
Durable
Mr Faustin Ondamba
Ombanda
Directeur de l’Environnement et de la
Nature
33
Primature
Dr M. Bakary Ozavino
Conseiller, chef département Santé,
Famille Affaires sociales
34
Primature
Mme Florence Ilama
Conseiller chargé des questions
d’Agriculture et Elevage
Ministry of Health and
Sanitation
Dr Ian Njeru
Epidemiologiste
36
Ministry of Health and
Sanitation
Dr Mohammed A. Sheikh
Provincial Director of Public Health &
Sanitation-Northeastern-Kenya
37
Ministry of Livestock
Development
Philomena B. Koech
Permanent Secretary Ministry of
Livestock Development
38
Ministry of Livestock
Development
Dr Rees Muriithi Mbabu
Epidemiologist
39
Ministry of Forestry and
Wildlife
Mr Stephen Manegene
Director Wildlife Conservation
41
Ministry of Forestry and
Wildlife
Dr Francis Gakuya
Head of Veterinary and Capture
Services
23
35
24
Organization
Gabon
Kenya
ONE HEALTH MEETING
IN THE AFRICAN REGION
Okoumé Palace Hotel
Libreville Gabon
12-14 November 2012
Q
REPORT
N°
Country
42
Republic
of Congo
Organization
Name
Title
Ministere de la Sante et de la
Population
Mr Alfred Ibouanga
Directeur des soins et services de
Santé/Representant Directeur General
de la Sante
43
Ministere de la Sante et de la
Population
Mr Vivien Moumbouli
Directeur de la Recherche au
Laboratoire National de Santé
publique/Point focal zoonoses
44
Ministère de l’Agriculture et de
l’Elévage
Mr Ibara Dominique
Directeur Général de l’Elevage
45
Ministère de l’Agriculture et de
l’Elévage
Mr Ikolakoumou Jean
Directeur de la Santé Animale
46
Ministère du Tourrisme et de
l’Environnement
Mme Gaempio Ngaloua
Chef de Service Assainissement et
Qualite de vie a la DGE
Ministry of Health
Dr Leonard Mboera
Chief Research Scientist
48
Ministry of Natural Resources
Dr Simon Mduma
Director General
49
Ministry of Natural Resources
Mrs Nebbo Mwina
Asstistant Director Research Training
and Statistics
50
Ministry of Livestock
Development
Dr Charles Nyamrunda
Permanent Secretary
51
Ministry of Livestock
Development
Mr Eberhad Mbunda
Principal veterinary officer
Ministry of Health
Dr Denis D.K. Lwamafa
Commissioner for Health Services,
National Disease Control
53
Ministry of Health
Dr Winyi Kaboyo
Assistant Commissioner Vet Public
health
54
Ministry of Agriculture, Animal
Industry and Fisheries
Dr. Chris Rutebarika
Assistant Commissioner Disease
Control
55
Ministry of Agriculture, Animal
Industry and Fisheries
Mr Collins Dombo
Permanent Secretary
56
Wildlife Authority
Dr Patrick Atimnedi
Veterinary Coordinator
57
Wildlife Authority
Dr Enyel Eric
Senior Wildlife Officer
US Embassy
Eric D. Benjaminson
47
52
58
Tanzania
Uganda
Gabon
59
Chinese Ambassador
Mr Sun Jiwen
60
Uganda
AFENET
Dr Monday Busuulwa
Medical Epidemiologist
61
Portugal
Instituao Hygiene E Medecina
Tropical
Prof Henrique Silveira
Deputy Director
University of Evora
Dr Manuela Vilhena
Professor
CIRMF
Dr Dieudonné Nkoghe
Chercheur
CIRMF
Ollomo Benjamin
Chercheur
USAID
Dennis Carroll
66
USAID
Robbie Henry
67
USAID
Lisa Kramer
Regional Emerging Pandemic Threats
Advisor
OCEAC
Ayeneugoye
Conseiller Technique
CEEA/ECCAS
Baschirou Moussa Demsa
Coordonateur Veterinaire Gov-CEEAC
62
63
Gabon
64
65
68
USA
Gabon
69
70
Mali
FAO
assoc. Prof. William Bazeyo
71
Italy
FAO
De Balogh Katinka
Senior Officer
72
Gabon
FAO
Hassane Abdeurahamane
LPO
FAO
Dr Enkoro Sylvain Patrick
Dr Veterinaire Consultant FAO
OIE
Dr Neo Mapitse
Sub-Regional Representative
73
74
Botswana
25
Annex 1: List of participants
N°
Country
Name
Title
75
USA
CDC
M. Kariuki Njenga
76
Kenya
AU-IBAR
Dr Baba Soumare
77
DRC
OHCEA
Prof. Mahangaiko Muyumba Dean, Lubumbashi School of Veterinary
Gaspard
Medicine
75
Kenya
OHCEA
Dr Dismas Ongore Oluoch
Director, University of Nairobi, School
of Public Health
76
Uganda
OHCEA
Prof John David Kabasa
Principal college of Veterinary
Medicine, Makerere University
77
Kenya
OHCEA
Grace Adisa Ettyang
Dean School of Public Health, Moi
University
78
Ethiopia
OHCEA
Gebrehiwot Tadesse
OHCEA
Dr Berihu Gebrekidan
Teklehaymanot
Dean Mekelle University, college of
Veterinary Medicine
79
Chief Animal Health
80
Kenya
OHCEA
Prof. Charles Mulei Matiku
Dean University of Nairobi Faculty of
Veterinary Medicine
81
Tanzania
OHCEA
Prof. Wambura Philemon
Nyangi
Sokoine University of Agriculture,
Faculty of Veterinary Medicine
82
Uganda
OHCEA
Assoc. Prof. William Bazeyo
Makerere University School of Public
Health
83
DRC
OHCEA
Prof. Tshefu Kitoto
Antoinette
Kinshasa University School of Public
Health
84
Ethiopia
OHCEA
Dr Yigeremu Mulugeta
Tefera
Dean Jimma School of Veterinary
Medicine
85
Rwanda
OHCEA
Dr Robert Kibuuka
Lecturer umutara polytechnic
86
Tanzania
OHCEA
Dr David Paradiso Urassa
Dean Muhimbili University School of
Public Health and Social Sciences
87
Uganda
OHCEA
Dr Geoffrey Kabagambe
Rugamba
Programme Manager
88
USA
USAID/Predict
Dr. Stephen Morse
Co-Director
Predict
Dr. Joseph Fair
Investigator
89
90
DRC
Respond
Jean-Luc Tshimpanga
Logistics Coordinator
91
Gabon
WHO
Dr Lucile Imboua
IST/Coordonnateur pour lAfrique
Centrale
WHO
Dr Fernando Da Silveira
IST/IDS/DSR Afrique Centrale
92
93
26
Organization
WHO
Dr Mamadou Lamine Kone
IST/DSR Afrique Centrale
94
Burkina
Faso
WHO
Dr Adama Berthe
DSR/IST-WA
95
Congo
WHO
Dr Luis G. Sambo
RD
96
WHO
Dr Roungou Jean Baptiste
DPC
97
WHO
Dr Kasolo Francis
DSR/DPC
98
WHO
Dr Impouma Benido
EPR/DPC
99
WHO
Dr Yahaya Ali Ahmed
LAB/DSR
100
WHO
Mr Tukuru Michael
RSU/DPC
101
WHO
Ms Tegelvik Jenny
ETO/DSR
102
WHO
Dr Gaturuku Peter
TRN/DSR
103
WHO
Mrs Tekeste Senait
SHOCROOM
104
WHO
Dr Yoti Zabulon
ERI/EPR/DSR
105
WHO
Ms Koria Viviane
SEC/DSR
106
WHO
Ms Mouele Lolo
A/TRAV/DSR&NCD
ONE HEALTH MEETING
IN THE AFRICAN REGION
Okoumé Palace Hotel
Libreville Gabon
12-14 November 2012
Q
REPORT
N°
Country
Organization
Name
Title
107
Eritrea
WHO
Dr Ghebrat Yohannes
DPC
108
South
Africa
WHO
Dr Opata Harry
DPC
109
Gabon
WHO
Dr Yam Abdoulaye
EPI/DPC
110
Cameroon WHO
Dr Besong Samuel
NPO/EDM
111
Equatorial
Guinea
WHO
Dr Manuel Nguema Ntumu
NPO/MPN/WHO
112
DRC
WHO
Dr Vital Mondonge Makuma
DPC/DRC
113
Ethiopia
WHO
Dr Abebayehu Assefa
Mengistu
DPC
114
Rwanda
WHO
Dr Rusanganwa André
NPO/DPC
115
Tanzania
WHO
Dr Grace Saguti
NPO/DPC
116
Gabon
WHO
Dr Ndihokubwayo Jean
Bosco
WR/Gabon
WHO
Umurerwa Angelique
OO/Gabon
117
118
WHO
Dr Inoua Aboubacar
MPN
119
WHO
Dr Nganga Omer
MOB/SOC/IVD/IST Afrique Centrale
120
WHO
Dr Nkone Asseko
NPO/ATM
121
WHO
Mrs Moussouamy Gislene
122
WHO
Mme Jocktane
123
WHO
Mme Sossa
124
WHO
Dr Christopher Oxenford
Technical Officer
125
WHO
Dr de La Rocque Stephane
Technique Officer
Interpreters
Mr Assogho Romuald
Interpretes
126
Gabon
127
Cameroon Interpreters
Sindeu Honorine
Interpretes
128
Interpreters
Mr Forsab Joseph Enoh
Interpretes
129
Interpreters
Bousomog Antoine
Interpretes
27
Annex 2: Agenda of One Health meeting
Monday, November 12, 2012
Time
Session
8H30 – 8H45
Registration of participants
8H45 – 9H45
Opening session
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t0QFOJOHBEESFTTPGIJT&YDFMMFODZUIF.JOJTUFSPG)FBMUI(BCPO
9H45 – 10H00
Group photo
10H00 – 10H30
Coffee break
10H30 – 10H45
Administrative Announcements
10H45 – 10H50
Election of the Chairperson and Rapporteurs
10H50 – 11H05
Overview of meeting Objectives, expected results & method of work
Presenter
Objective 1: Brief participants on the One Health approach
11H05 – 11H20
Zoonotic diseases in the African Region
WHO/AFRO
11H20 – 11H35
Overview and Rationale for One Health
USAID
11H35 – 11H50
Overview of Global and Regional Efforts to Implement One Health
11H50 – 12H30
Discussion
FAO
Objective 2: Review the implementation of the One Health approach and its added value in
responding to zoonotic diseases outbreaks
Strengthening Institutional Framework for One Health Implementation
12H30 – 12H45
Discussion
12H45 – 13H00
Approaches to policy development and implementation of One
Health in the African Region
13H00 – 14H15
Lunch
14H15 – 14H30
The Emerging Pandemic Threats Program: overview, current status of
implementation and lessons learned
14H30 – 15H00
Discussion
15H00 – 15H15
Operationalizing One Health in Cameroon
Cameroon
15H15 – 15H30
Development of a National One Health Office in Kenya
Kenya
15H30 – 16H00
Discussion
16H00 – 16H15
WHO/AFRO
USAID
Coffee break
Strengthening Disease Surveillance and Response to Zoonotic Disease Threats
28
16H15 – 16H30
Strengthening preparedness and response planning for zoonoses in
DR Congo
DR Congo
16H30 – 16H45
Uganda: Multi-sectoral collaboration for early detection and response
to zoonoses
Uganda
16H45 – 17H00
Discussion
17H00
Wrap up
ONE HEALTH MEETING
IN THE AFRICAN REGION
Okoumé Palace Hotel
Libreville Gabon
12-14 November 2012
Q
REPORT
Tuesday, November 13, 2012
Time
Session
Presenter
Objective 2: Review the implementation of the One Health approach and its added value
when responding to zoonotic disease outbreaks (cont.)
8H30 – 8H45
Welcome and review of previous day
8H45 – 9H00
Implementation of One Health in Africa through Establishment
and Operationalization of Integrated Regional coordination
mechanism
AU-IBAR
9H00 – 9H15
Operationalizing One Health through Capacity Building and
Training
OHCEA
9H15 – 9H30
Veterinary training strategies in One Health
9H30 – 10H10
Discussion
10H10 – 10H30
Coffee Break
10H30 – 10H45
Support for implementation of One Health through joint
simulations
FAO
10H45 – 11H00
Implementation of One Health through the networking of
animal and human laboratories
CIRMF, Gabon
11H00 – 11H15
Networking of human and animal health laboratories: IDENTIFY FAO/OIE/WHO
Project
11H15 – 11H30
Building international consensus on cross sectoral approaches:
High Level Technical Meeting to Address Health Risks at the
Human-Animal-Ecosystem Interface
11H30 – 12H00
Discussion
FAO
Objectives 3 and 4: Identify challenges and barriers to implementing the One Health at
country levels and Propose ways in which countries can strengthen the implementation of
the One Health approach
12H00 – 12H15
Introduction to work groups and methodology
12H15 – 13H00
Working group on One Health Approach at country level
13H00 – 14H00
Lunch
14H00 – 16H30
Working group on One Health Approach at country level
16H30 – 16H45
Coffee break
16H45 – 17H00
Wrap-up
29
Annex 2:Agenda of One Health meeting
Wednesday November 14, 2012
Time
Session
Presenter
Objectives 3 and 4: Identify challenges and barriers to implementing the One Health at
country levels and Propose ways in which countries can strengthen the implementation of
the One Health approach
8H30 – 8H45
Welcome and review of previous day
The way forward towards One Health: Countries present highlights from work groups and next steps
8H45 – 8H55
Cameroon
8H55 - 9H05
DRC
9H05 – 9H15
Equatorial Guinea
9H15 – 9H25
Ethiopia
9H25 – 9H35
Gabon
9H35 – 9H45
Discussion
9H45 - 10H10
Coffee Break
The way forward towards One Health: Countries present highlights from work groups and next steps
30
10H10 – 10H20
Kenya
10H20 – 10H30
Republic of Congo
10H30 – 10H40
Rwanda
10H40 – 10H50
Tanzania
10H50 – 11H00
Uganda
11H00 – 11H30
Discussion
11H30 – 12H00
Recommendations and next steps
12H00 – 12H30
Closing ceremony
ONE HEALTH MEETING
IN THE AFRICAN REGION
Okoumé Palace Hotel
Libreville Gabon
12-14 November 2012
Q
REPORT
Annex 3: Country roadmaps with initial short-term
activities for institutionalizing the One Health approach
Country
Ethiopia
Objectives
Establish OH
Ethiopia
Cameroun
Activities
Timeline
Responsible
person
Co-responsible
Report preparation and ministerial briefing
Nov. 2012
Each Participant
Nil
Identification of additional stakeholder to the
membership of OH
Nov. 2012
JU/OHCEA
Nil
organizing of National consensus building workshop
Jan. 2013
MOH/OHCEA
Finance and
Tech
Auditing of diagnosis capacities - respective labs
Nov 2012
ZDU
Heads of DDSR,
VEEU
Development of SOPs
Jan 2013
ZDU
Heads - DDSR,
VEEU, HVS
(KWS)
Conduct training needs assessment- pre/in Service
courses
End May 2013 OHCEA KENYA
ZDU
Assessments of laboratory bio-safety, bio-security and
quality standards
End May 2013 CVIO/NPHLS
ZDU
Establish joint response mechanisms within the sectors
End May 2013 ZDU
Heads of DDSR,
VEEU,HVS(KWS)
Conduct debriefig meeting at ministerial levels and PMO
office
Q2 2013
All
OHCEA
Establishing a One Health Working group
Q1 2013
PMO
WHO/FAO/
OHCEA
Develop advocacy strategy and tools
Q1 2013
OH/WG
WHO/FAO/
OHCEA
Conduct advocacy meeting for the high level officials
Q1 2013
PMO
Key sectors &
Partners
Trickling down of the One Health concept to the
peripheral level;
Elaborate harmonized One Health training modules
for the different levels of learning according to needs
(professionals, universities, etc.)
Capacity development of existing laboratories;
Create a network of laboratories (Centre pasteur
Cameroun, Hygiene mobile, GVFI, LANAVET, etc.)
Build capacity on integrated investigation and response
Institution of a surveillance system in the wildlife
protected areas
Put in place the integrated alert system for information
relay on zoonoses
Kenya
Tanzania
1. Strengthen
inter-sectoral
collaboration
framework
31
Annex 3:Country roadmaps with initial short-term activities
for institutionalizing the One Health approach
Country
Objectives
Responsible
person
Coresponsible
Q1 2013
PMO
Conduct policy review and harmonization
Q2 2013
PMO
Key sectors
Develop TOR (guidelines, SOP) for inter-sectoral
coordination
Q2 2013
OH/WG
WHO/FAO/
OHCEA
Develop a One health National Strategy and Plan of
Action for the control of zoonotic diseases.
Q2 2013
PMO
Key
stakeholders
Identify priority diseases
Q1-Q2 2013
Technical group
WHO/FAO/
OHCEA
Map the available laboratory epidemio-surveillance tools Q1-Q2 2013
Technical group
WHO/FAO/
OHCEA
Develop SOP and guidelines for reporting and
communication
Q1-Q2 2013
Technical group
WHO/FAO/
OHCEA
Develop mechanism for data storage and exchange
Q1-Q2 2013
Technical group
WHO/FAO/
OHCEA
Develop risk communication strategy
Q1-Q2 2013
Technical group
WHO/FAO/
OHCEA
Conduct regional and cross border meeting
Q2-Q4 2013
OH Working
Group
WHO/FAO /
OHCEA
Share information with regional bodies (EAC, SADC, AU,
Q2-Q4 2013
OH Working
Group
WHO/FAO/
OHCEA
Harmonise strategies for preventing and control of
priority zoonotic diseases
Q1-Q2 2013
OH Working
Group
WHO/FAO/
OHCEA
Conduct curricula review
Q1-Q2 2013
OH Working
Group
WHO/FAO/
OHCEA
Conduct pre and in-service training
Q1-Q4 2013
OH Working
Group
WHO/FAO/
OHCEA
Strengthen laboratory capacities (surveillance, training)
Q1-Q4 2013
OH Working
Group
WHO/FAO/
OHCEA
Conduct monitoring and evaluation
Q2 & Q4 2013
OH Working
Group
All sectors
Conduct simulation exercises
Q2 & Q4 2013
OH Working
Group
All key
stakeholders
To inform sector
leadership on
the Gabon
Regional
OH meeting
develop a
Provide joint feedback report on the Gabon meeting to
the relevant sectors.
Nov. 2012
Uganda Wildlife
Authority (UWA)
MOH
To document
the status of OH
in the country
Conduct baseline assessment on OH at central and
district levels
Jan. 2013
MAAIF, UWA,
MOH, OHCEA
MAAIF, UWA,
MOH,OHCEA
To develop a
draft country
frame work and
strategy for OH
Hold preparatory meeting to discuss the OH structure
for Uganda.
Jan. 2013
OHCEA/ Uganda
MAAIF
To finalize
and present
the country
framework and
strategy for OH
Hold meeting of top management and key partners to
discuss the final draft of OH structure for Uganda.
Jan. 2013
OHCEA/Uganda
MAAIF, UWA,
MOH
To develop
operational
guideline s for
OH
Hold meetings and consultations to develop guidelines
Feb. 2013
MAAIF, UWA,
MOH, OHCEA
MAAIF, UWA,
MOH, OHCEA
3. Strengthen
regional and
cross border
collaboration
4. Build
capacities on
One Health
approach
32
Timeline
Conduct key stakeholders meeting
2. Set up an
intersectional
EWS for
detection,
confirmation
and reporting of
priority zoonotic
diseases
Uganda
Activities
ONE HEALTH MEETING
IN THE AFRICAN REGION
Okoumé Palace Hotel
Libreville Gabon
12-14 November 2012
Q
REPORT
Country
Equatorial
Guinea
Objectives
Rrenforcement
Coordination
Timeline
Responsible
person
Co-responsible
1. Extension du Comité de Technique (MPE)
Q1 2013
Gouv.
Agences
d’appui
2. Reunions Sensibilisat. autres membres
Q1 2013
Gouv.
Agences
d’appui
3. Campañas sensibilisat. differents niveaux
Q1 2013
Gouv.
Agences
d’appui
1. Assurer la formation en Bacteriologie
Q2 2013
Gouv.
Agences
d’appui
2. Doter des materiels essent. p diagnostic
Q2 2013
Gouv.
Agences
d’appui
3. Seminaire national x Adaptation Guide WHO
Q1 2013
Gouv.
Agences
d’appui
3. Renforcement
sisteme de
Notification
1. Doter de materiels Informatique au prog.
2. Formation du personnel de labo x investigation
3. Assurer la Notification Rapide d’evenements
Q1 & Q3
Q1 & Q3
Q1 - Q4
Gouv.
Agences
d’appui
4. Renforcement
des capacites
des Labo en
matiere de
Biosecurite
1. Assurer la formation en gestion de labo (quality
management)
2. Seminaire national sur (Biorisk management)
Q1 & Q3
Gouv.
Agences
d’appui
5. Renforcement
Reseaux
Laboratoires
1. Promouvoir la collab. et support technique aux labo
nationaux (Sante publique – vétérinaires)
Q1 - Q4
Gouv.
Agences
d’appui
2. Promouvoir la collaboration entre les labos nationaux
et les Centres collaborateurs
Q1 – Q4
Gouv.
Agences
d’appui
A1 : Organiser une réunion de restitution par
département Responsables
Q1 2013
Santé
Elevage,
Environnement
A2 : Organiser une réunion de concertation pour
l’indentification des différents responsables à la
restitution nationale
Q1 2013
Santé
Elevage,
Environnement
A3 : Organiser un atelier de -finalisation de la feuille de
route nationale sur l’approche « une seule santé »
Q1 2013
Santé
Elevage,
Environnement
A4 : Organiser un atelier de validation de la feuille de
route nationale sur l’approche « une seule santé »
Q2 2013
Santé
Elevage,
Environnement
A5 : Identifier les parties prenantes
Q2 2013
Santé
Elevage,
Environnement
2. Renforcement
des capacites
des Labo
Gabon
Activities
Q2
A6 : Elaborer les outils intégrés et procédures
Q3 2013
Santé
A7 : Renforcer les capacités des différentes parties
prenantes
Q3 2013
Santé
A8 : Assurer la coordination des activités
Q3 2013
Santé
Elevage,
Environnement
A9 : Organiser un atelier de finalisation du plan d’action
sur la coordination des activités
Q3 2013
Santé
Elevage,
Environnement
A10 : Organiser un atelier d’adaptation des directives du
concept « une Seule Santé »
Q4 2013
Santé
Elevage,
Environnement
A11 : Reproduire et diffuser les directives du concept «
une Seule Santé »
Q4 2013
Santé
Elevage,
Environnement
A12 : Former les parties prenantes sur les directives du
concept « une Seule Santé »
Q4 2013
Santé
Elevage,
Environnement
A13 : Mener les campagnes de sensibilisation pour la
mise en œuvre des directives du concept « une Seule
Santé »
Q4 2013
Santé
Elevage,
Environnement
A14 : Faire le suivi et évaluation du processus de mise en
œuvre des directives du concept « une Seule Santé »
Q1-Q4 2013
Santé
Elevage,
Environnement
33
Annex 3:Country roadmaps with initial short-term activities
for institutionalizing the One Health approach
Country
Objectives
DRC
Republic of
Congo
Mettre en
place un cadre
national pour
la collaboration
intersectorielle
Mettre en place
un système
de détection
rapide, de
confirmation et
de rapportage
des zoonoses
prioritaires
34
Activities
Timeline
Responsible
person
Conduire le plaidoyer auprès des décideurs
Q1 2013
Sensibiliser les parties prenantes
Q1 2013
CCUS
Mettre en place comite intersectoriel au niveau central
et provincial
Q2 2013
Gouvernement
Co-responsible
CCUS
Définir le rôle des parties prenantes
Q2 2013
Gouverne
Mettre en place un groupe de travail
Q2 2013
Gouvernement
Elaborer les politiques
Q3, 2013
Les SG
Harmoniser les guides et outils
Q3, 2013
Les SG
Elaborer le plan conjoint des activités
Q3, 2013
Les SG
Elaborer la cartographie des partenaires
Q4, 2014
Les SG
Mobiliser les ressources
Q4, 2014
Minis, ONG NU
Mise en œuvre conjointe des activités planifies
Q1, 2015
SG
Créer un groupe de travail intersectoriel sur l’approche
OH
Q1
Ministère de la
Santé et de la
Population
Elaborer les documents juridiques instituant le cadre
institutionnel
Q1-Q2
Groupe
de travail
intersectoriel
Organiser un atelier de Validation des documents
juridiques
Q1-Q2
Ministère de la
Santé et de la
Population
Faire adopter les documents juridiques en Conseil des
Ministres
Q3
Ministère de la
Santé et de la
Population
Organiser des rencontres trimestrielles de coordination
intersectorielle
Q1-Q4
Ministère de la
Santé et de la
Population
Ministère de
l’Agriculture et
de l’Elevage;
Ministère du
Tourisme et de
Mettre en place un système d’alerte précoce
intersectoriel
Q3-Q4
Ministère de la
Santé et de la
Population
MAE, MTE,
MDDEF
Elaborer et valider un guide de formation
communautaire sur les zoonoses prioritaires
Q3-Q4
Ministère de la
Santé et de la
Population
MAE, MTE,
MDDEF
Editer le guide de formation
Q3-Q4
Ministère de la
Santé et de la
Population
MAE, MTE,
MDDEF
Former les relais communautaires
Q3-Q4
Ministère de la
Santé et de la
Population
MAE, MTE,
MDDEF
Ministère de
l’Agriculture et
de l’Elevage;
Ministère du
Tourisme et de
Ministère de
l’Agriculture et
de l’Elevage;
Ministère du
Tourisme et de
ONE HEALTH MEETING
IN THE AFRICAN REGION
Okoumé Palace Hotel
Libreville Gabon
12-14 November 2012
Q
REPORT
Country
Objectives
Mettre en place
un système
de détection
rapide, de
confirmation et
de rapportage
des zoonoses
prioritaires
Développer
un cadre
national de
suivi-évaluation
conjoint
Activities
Timeline
Responsible
person
Co-responsible
Elaborer et valider un guide de formation des agents
techniques opérationnels sur les zoonoses prioritaires
Q3-Q4
Ministère de la
Santé et de la
Population
MAE, MTE,
MDDEF
Editer le guide de formation
Q3-Q4
Ministère de la
Santé et de la
Population
MAE, MTE,
MDDEF
Former les agents techniques opérationnels de tous les
secteurs
Q3-Q4
Ministère de la
Santé et de la
Population
MAE, MTE,
MDDEF
Equiper et former/recycler les agents techniques
opérationnels sur la collecte des échantillons et des
données
Q3-Q4
Ministère de la
Santé et de la
Population
MAE, MTE,
MDDEF
Renforcer les capacités des laboratoires centraux de
santé humaine et animale
Q1-Q4
Ministère de la
Santé et de la
Population
MAE, MTE,
MDDEF
Elaborer les indicateurs communs de la SMIR, du RSI et
du PVS
Q3-Q4
Ministère de la
Santé et de la
Population
MAE, MTE,
MDDEF
35