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slide1

Contributing to One World, One HealthA strategic framework for Reducing Risks of Infectious Diseases at the Animal–Human–Ecosystems InterfaceSubhash MorzariaJoint FAO-OIE-WHO-UNICEF-UNSIC-WB presentationSharm El Sheikh Ministerial Conference on HPAIEgypt25-26 October 2008UNSICRegional Workshop for UN Country Teams, 30-31 March 2009

overview of the presentation
Overview of the presentation

Origin and the development of the Strategy

Components of the Strategy

Introduction

HPAI Achievements and Lessons Learned

EIDs and Existing IDs and their Impacts

The Strategic Framework

Specific Objectives and Outputs

Cross Cutting Issues

Institutional Issues

Financing the Framework

Conclusions and Way Forward

introduction
Introduction

New Delhi recommendation, Dec 2007

Disease entrenched in several countries

Continued risk of re-emergence and pandemic flu

HPAI still a priority

Also recognition HPAI is one of many other E/rEIDs

Address the larger issue of EIDs at animal-human-ecosystem interface using OWOH approach

genesis
Genesis

Planning meeting in Geneva (FAO, WHO, OIE, UNICEF with UNSIC and WB) between 3-4 June 2008 to discuss strategy development

Based on the broad discussions in Geneva, outline for the Strategy agreed upon by mid June 2008

LATEST joint document (FAO-WHO-OIE-UNICEF-WB) finalized in mid October 2008

This is still a STRATEGIC FRAMEWORK with key concepts for WIDER CONSULTATION

lessons learned
Lessons learned…

Economic development and disease

Disease control and livelihoods

Role of wildlife and transmission

Understanding epidemiology

Effective communication strategies

Cross-sectoral collaboration

Political commitment

eids main characteristics
EIDs: main characteristics

Studies show over the last 50 years:

One new disease every year

>70% are zoonotic, % increasing

Many are of transboundary in nature

Wide and significant impacts (SARS/HPAI)

Global significance, international public good

economic impact of eid
Economic Impact of EID

SARS

China, Hong Kong,

Singapore, Canada

$30-50bn

$50bn

$40bn

$30bn

Foot & Mouth

UK

$25–30bn

Estimated Cost

$20bn

Classical Swine Fever, Netherlands

$2.3bn

BSE Japan $1.5bn

Avian Flu Asia,

$5–10bn

$10bn

BSE UK,

$10-13bn

Foot & Mouth

Taiwan, $5-8bn

HPAI, Italy

$400m

BSE Canada

$1.5bn

BSE U.S.,

$3.5bn

Nipah, Malaysia

$350-400m

Avian Flu, NL

$500m

2004

2006

2003

2005

1996

1997

1998

1999

2000

2001

2002

1994

1995

Figures are estimates and are presented as relative size.

impact of pandemic influenza
Impact of pandemic influenza
  • Loss to the global economy
    • US$2 trillion
  • Prevention is cost-beneficial
slide9

Less developed nations

More developed nations

65

1950

55

60

75

80

85

90

95

2000

05

10

15

70

Drivers for emergence and spread

(Human factors)

Global Population: 1950-2015

  • >90% population growth in Africa, Asia and L. America
  • Poverty on the rise
  • Rapid economic development
  • Huge demand for livestock
  • Rapid evolution of farming systems

Total

Billions

8

7

6

5

4

3

2

1

0

Source: US Bureau of the Census

farming systems numbers and density
Farming systems: Numbers and density

2,500,000

China

Cambodia, Indonesia, Lao, Thailand and Vietnam

2,000,000

1,500,000

Duck Meat Production

(Tons)

1,000,000

500,000

0

1967

1970

1973

1976

1979

1982

1985

1988

1991

1994

1997

2000

2003

1964

1961

  • In 2007, over 21 billion food animals were produced for over 6 billion people
  • By 2020 the demand for animal protein up by 50% mainly in developing countries requiring over 30 billion animals
wildlife factor
Wildlife factor
  • Forest encroachment
    • Nipah, Hendra and Ebola
  • Bush meat
    • (HIV and chimpanzee)
  • Exotic animal farming
    • SARS
  • Trade in exotic animals
    • Monkey pox, psittacosis
    • 37.8 million counted animals imported in USA from 163 countries in 2000-2004
slide13

Climate change - diseases

  • Vector ecology and distribution (flies, ticks, mosquitoes)
  • Invading pathogen adaptation with new vectors
  • Migratory patterns
spread of pathogens globalized travel and trade
Spread of pathogens(globalized travel and trade)

Increase in international air travel (5%/yr)

Large shipments of livestock

Animals can be any part of the world in time shorter than the IPs of many diseases

pathogen risk factors
Pathogen risk factors

All pathogens

EIDs

OIE list

Human

Domestic animals

Domestic carnivores

slide16

Viruses

  • Both DNA and RNA viruses represented
  • RNA highly likely as EID
    • High mutation rate, no repair mechanisms
    • Small, Ubiquitous, Intrusive
    • Ebola, Marburg, Nipah, Hendra, Lassa, Hanta, Influenza, Polio, Hepatitis, FMD, West Nile, Rabies, Yellow fever, SARS

Cleaveland, S., Laurenson, M.K. &Taylor, L.H (2001). Phil. Trans. R. Soc. Lond. 356, 991-999

16

slide17
Goal
  • Diminish the threat and minimize the global impact of epidemics and pandemics due to highly infectious and pathogenic diseases of humans and animals

Broader vision

    • Public health and food safety
    • Food security
    • Livelihoods of poor and vulnerable people
focus
Focus

Emerging and re-emerging infectious diseases

at the animal-human-ecosystems interface with

epidemic and pandemic potential causing

wide ranging impacts

owoh manhattan principles
OWOH Manhattan Principles

Developed by WCS in 2004 in New York

Increasingly being adopted to address pathogen jumps between animals and humans

Holistic approach encompassing interfaces among the human, animal and ecosystem health domains

Proposes an international, interdisciplinary, cross-sectoral approach to disease emergence and control

major thrusts objectives
Major thrusts/objectives
  • Preventive action and root causes and drivers
  • Building more robust public and animal health systems (IHR 2005, OIE Standards)
  • Strengthening the national and international emergency response capabilities
  • Better addressing the concerns of the poor:
    • developed to developing economies
    • potential to actual disease problems
    • focusing on locally important diseases
  • Promoting cross sectoral and multi-disciplinary approach
  • Conducting strategic research
priorities
Priorities
  • Country Level
    • Long term, improve disease control capacity, including the public and animal health and food safety services based on good governance compliant with WHO IHR and OIE standards
  • Country and Regional Levels
    • Short to medium term establish risk-based disease surveillance in humans and animals to identify diseases at source (hotspots, human-animal interface)
  • International Level
    • Medium to long term strengthen capacity to improve ‘horizon scanning’ to support countries to respond early and control infectious disease events (GLEWS).
risk based surveillance for sources of infection
Risk-based surveillance for sources of infection

Hotspots

(Range of researchable issues)

Entrenchment

animal/human/ecosystems

population density

slide23

A-Zoonotic/wild

B-Zoonotic/domestic

C-Drug resistant

D-Vector-borne

slide24
Cross cutting issues

Surveillance at three health domains

Biosecurity

Bioterrorism

Socio-economics

Development issues

Communications strategies at different levels

Private-public partnership

Monitoring and evaluation

Strategy Components cont…

institutional issues
Institutional Issues
  • Guiding Principles
    • Country level initiation and implementing stronger intersectoral collaboration and political commitment
    • Country, regional and international levels coordinated action that brings together those working on human, animal and ecosystems health
    • International level engaging international institutions drawing on their unique mandates and complementary expert base
    • Permitting rapid engagement of a broader range of stakeholders, including regional organizations in order to respond effectively to a variety of disease threats
financing framework
Financing Framework

FUNDING FOR THE FOLLOWING KEY AREAS:

  • Responding to the ongoing avian influenza crisis
  • Strengthening public and animal health services
  • Improving surveillance: special attention for hotspots and strengthening wildlife surveillance
  • Providing funds for emergency response
  • Supporting communication and social mobilization
  • Conducting strategic research
  • Supporting international organizations for regional and global initiatives
preliminary cost estimates
Preliminary cost estimates
  • HPAI support
    • Annual funding needs over next 3 years: US$542–735 million
  • Estimated cost of funding the OWOH Strategic Framework to 2020
    • Average per year:
      • Scenario 1: US$ 852 million (43 low income countries)
      • Scenario 2: US$1,343 million (139 eligible countries)
    • Total
      • Scenario 1: US$ 10,228 million
      • Scenario 2: US$ 16,116 million
funding sources
Funding sources
  • Existing donors
  • Non-conventional donors and foundations
  • Emergency funds
    • Country level fund for emergencies and compensation
    • UN Central Emergency Response Fund
  • FAO Special Fund for Emergency and Rehabilitation
  • OIE’s World Animal Health and Welfare Fund
  • The World Bank and the Regional IFIs
  • Industry and other private sector
  • Meat exporting countries
conclusions
Conclusions

HPAI and EIDs are a complex problem

Multidisciplinary, multisectoral and multi-partnerships

Global challenge, requiring global solutions

Builds on HPAI successes and lessons learned

FAO, OIE, WHO, UNICEF, UNSIC and WB support

Stakeholders buy in and ownership important

sharm el sheikh response
Sharm El Sheikh response
  • All the respondent countries strongly supported the OWOH Framework
  • All the donors see this as synergistic with their future objectives
    • EC
    • Canada
    • USDA
    • Australia, Germany, Japan, Sweden
  • Canada to support Winnipeg Meeting (16-19 March 09)
    • Globally advance the framework
    • Priority actions for implementation
winnipeg response
Winnipeg Response
  • Wide range of interest groups (16-19 March 09)
    • Academic community
    • Research Institutes
    • Donors
    • Countries
    • Regional Organizations
usaid initiative
USAID Initiative
  • EPT Programme, Components
    • Detect
    • Identify
    • Respond
    • Prepare
next steps
Next steps
  • Conducting wider consultation with countries, regions and other key partners
    • Political commitment at country level
    • Importance of cross-border collaboration
  • Developing implementation strategies and plans
  • Mobilizing resources for implementation
  • Establishing timeframes for the above actions