Why is it that in the past there were very few diseases than today?

Why is it that in the past there were very few diseases than today?

The ever increasing human population and greater global connectivity today, provides rapid dissemination of infectious diseases from the initial focus. Whereas in previous centuries a disease focus might have died out through failing to establish a chain of transmission, now it has the opportunity to rapidly recruit susceptible hosts on a global stage. To draw an analogy, there is now so much available tinder on the forest floor that the flickering early flame can rapidly be fanned into a forest fire. In support of this thesis, consider the following:

  • The human population of Earth took until 1800 to reach one billion; by 2000 it had
    exceeded six billion; and it reached the seven billion mark in 2011;
  • In 1800, the time taken to circumnavigate the globe by sailing ship was approximately one year. Today, no two cities served by commercial aircraft are more than 24 hours apart;
  • Annually, the world’s airlines carry a total approaching two billion passengers. At any one moment, about half a million people worldwide are flying in commercial aircraft ;
  • In 2011, there were 219 million passenger departures/arrivals at British airports;
  • In lieu of precise trade data, Billy Karesh of the Wildlife Conservation Organization in New York conservatively estimates that in east and southeast Asia, tens of millions of wild animals are shipped each year regionally and from around the world, for food or use in traditional medicine (Karesh and others 2005).

Wildlife often acts as a reservoir for diseases of domestic animal and humans see figure Figure 1.2 published in an article in Science in 2000 (Daszak et al. 2000).

Daszak et al 2000.jpg

Most emerging diseases exist within a host and parasite continuum between wildlife, domestic animal, and human populations. Few diseases affect exclusively any one group, and the complex relations between host populations set the scene for disease emergence. Examples of emerging infectious diseases that overlap these categories are canine distemper (domestic animals to wildlife), Lyme disease (wildlife to humans), cat scratch fever (domestic animals to humans) and rabies (all three categories). Arrows denote some of the key factors driving disease emergence (Daszak et al. 2000).

References

Daszak P, Cunningham AA, Hyatt AD. (2000) Emerging infectious diseases of wildlife-threats to biodiversity and human health. Science, 287: 443-449. Available at: http://science.sciencemag.org/content/287/5452/443.full

Gibbs EPJ. (2016): Week One Lecture notes for the course: An Introduction to trans-boundary diseases and their impact on trade and wildlife populations. University of Edinburgh-MSc One Health. Available at: https://www.learn.ed.ac.uk/bbcswebdav/pid-1677759-dt-content-rid-3167481_1/courses/ls_transboundary_diseases_2015/2015%202016/Week%201/Week%201%20Lecture%20Gibbs%20EM%20FINAL%202016copy.pdf

 

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Proceedings of Pathways Kenya 2016

Proceedings of Pathways Kenya 2016

Pathways Kenya 2016-3

The conference Pathways Kenya 2016 (http://sites.warnercnr.colostate.edu/pathways/), took place from January 10-13, 2016 in Nanyuki, Kenya.

This conference and training program was designed to address the myriad of issues that arise as people and wildlife struggle to coexist in a sustainable and healthy manner.

Their mission is to increase professionalism and effectiveness in the human dimensions of fisheries and wildlife management field.

The schedule, associated abstracts and proceedings are available online (schedule:http://programme.exordo.com/pathways2016/).

Source

Communication via email subscription at: Network for Evaluation of One Health

 

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Deforestation linked to rise in cases of emerging zoonotic malaria

Deforestation linked to rise in cases of emerging zoonotic malaria

Research suggests environmental changes are driving increase in Plasmodium knowlesi malaria – an infection usually found only in monkeys – among people in Malaysia.

MacaqueA steep rise in human cases of P. knowlesi malaria in Malaysia is likely to be linked to deforestation and associated environmental changes, according to new research published in Emerging Infectious Diseases. The study, led by the London School of Hygiene & Tropical Medicine, is the first to explore how changes in land use are impacting the emergence of the disease.

Plasmodium knowlesi is a zoonotic malaria parasite, transmitted between hosts by mosquitoes, which is common in forest-dwelling macaque monkeys. Although only recently reported in humans, it is now the most common form of human malaria in many areas of Malaysia, and has been reported across southeast Asia. In recent years, Malaysia has seen widespread deforestation alongside rapid oil palm and other agricultural expansion. It is thought changes in the way land is used could be a key driver in the emergence of P. knowlesi, but until now this has not been investigated in detail.

The study focused on the Kudat and Kota Marudu districts in Sabah, Malaysia, covering an area of more than 3,000km² with a population of approximately 120,000 people. Researchers used hospital records for 2008-2012 to collect data on the number of P. knowlesi malaria cases from villages in the districts. Information collected from satellite data helped the team to map the local forest, land use, and environmental changes around 450 villages, in order to correlate how these changes might affect human infection.

They found that the number of P. knowlesi cases was strongly linked to deforestation in areas surrounding the villages.  This could be explained by a number of factors, including humans coming into closer contact with the forest inhabited by the macaques and the mosquito vectors, due to employment in tree clearance and expanding agriculture. Another factor could be that as land use changes in this way, macaque populations are becoming more densely concentrated in areas of forest where humans are present.

Lead author Kimberly Fornace, Research Fellow at the London School of Hygiene & Tropical Medicine, said: “The dramatic rise in the number of P. knowlesi malaria cases in humans in Malaysia in the past ten years has been most common in areas with deforestation, as well as areas that are close to patches of forest where humans, macaques and mosquitoes are coming into closer and more frequent contact. This suggests that there is a higher risk of P. knowlesi transmission in areas where land use is changing, and this knowledge will help focus efforts on these areas and also predict and respond to future outbreaks. Given our findings, we view deforestation as having distinct public health consequences which need to be urgently addressed.”

The findings show the study region had undergone significant environmental changes, with many villages substantially affected by deforestation. During the five-year study alone, 39% of the region’s villages lost more than 10% of the forest cover in their surrounding 1km radius, and half of villages lost more than 10% within a 5km radius. Overall, forest cover in Kudat and Kota Marudu declined by 4.8% during the study period.

The findings also confirmed that P. knowlesi is the most common cause of human malaria cases in the region.

The authors note that some cases of malaria may have been unreported as they were asymptomatic or resolved without treatment. P. knowlesi can be mistaken for other forms of human malaria in microscope diagnosis, however the authors adjusted for this uncertainty in the study. They also highlight that the environmental data were limited as they could not discriminate between types of forest or crops, meaning further work is needed to investigate whether vegetation type is a risk factor for P. knowlesi.

This study was funded by the Biotechnology and Biosciences Research Council, Economic and Social Research Council, Medical Research Council, and Natural Environment Research Council, through the Environmental and Social Ecology of Human Infectious Diseases Initiative (ESEI).

The research was carried out in collaboration with the Infectious Disease Society Kota Kinabalu Sabah, Malaysia; Hospital Queen Elizabeth Clinical Research Centre, Malaysia; Menzies School of Health Research, Australia; Sabah Department of Health, Malaysia; and the University of Glasgow, UK.

Publication:

Article originally appeared on the London School of Hygiene and Tropical Medicine website on 18th December, 2015 at: http://www.lshtm.ac.uk/newsevents/news/2015/deforestation_malaria_link.html

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The 5 C’s of innovation ecosystems

The 5 C’s of innovation ecosystems

The application of innovative models in international development has captured the attention of program implementers, funders, researchers and policymakers alike. Numerous innovations have been conceived and launched, however, there are many obstacles to identifying and accelerating the spread of innovative policies and practices that improve the lives of the poor.

Throughout our five years documenting and tracking innovations across health, education, and water, sanitation and hygiene, we noted that there were few examples of programs reaching scale. Innovations have potential for impact, but many of them face challenges of quality, affordability and sustainability, which limit their potential to scale and adapt. We also noted promising models seeking to scale require iteration to learn and improve upon their practices, but the cost of learning can be steep, and available sources of funding do not always align with programs’ “learning” needs.

Informal providers gather for a meeting with hospital staff and researchers outside of Dhaka, Bangladesh. Photo by: Alex Robinson / Center for Health Market Innovations

Informal providers gather for a meeting with hospital staff and researchers outside of Dhaka, Bangladesh. Photo by: Alex Robinson / Center for Health Market Innovations

Results for Development Institute has launched a series of innovation platforms — including the Center for Health Market Innovations, the Center for Education Innovations, and Innovations in WASH — to address these critical challenges and find new approaches to creating system-level change and diffusing promising components of programs beyond scaling one or two organizations. Early on, we realized that our simple mandate translated into a very complex set of activities. When we set out to document innovative programs, we found that the tools available for obtaining and spreading information about innovations were lacking. There was little information on which innovations work well and “how and why” these models are working. And few steps had been made toward and obvious way of addressing these deficiencies.

The evolution of our work in health, education and WASH has shown that while our activities resulting in the scale-up of individual innovations are necessary and important, the effects of connecting multiple organizations to funders, governments and each other has a much greater impact on the broader innovation ecosystem. We’ve learned a lot about what innovators and other actors need to drive successful innovations forward.

The five C’s reflect the lessons we’ve learned in this process and the essential approaches for anyone working to transform promising innovations into opportunities for social change.

1. Core components.

While we began documenting innovative models, we saw stakeholder demand for guidance to develop coordinated, comprehensive and long-term approaches that go beyond the effects of scaling one organization to create system-level change through the identification of proven practices and “core components,” such as the use of telemedicine to bridge access challenges or training of community health workers to deliver maternal health services.

Highlighting these “core components” of innovation, in addition to specific innovators that have applied this concept, can help adapt that innovation to a new context. CHMI has already launched some initial work in this area — for example, recognizing that many organizations and individuals want to find and adapt relevant promising practices from others.

Few program models, though, are replicable in their entirety. R4D has launched a framework that seeks to facilitate the transfer of innovation. Organizations are now using the R4D adaptation framework to better understand the steps necessary to adapt innovations to new contexts.

2. Continuous learning.

In the process of understanding “what works” in innovation, we have learned that most programs are really still works in progress. Promising models seeking to scale require iteration to learn and improve upon their practices, but the cost of learning can be steep, and available sources of funding do not always align with programs’ learning needs.

We’ve supported such process by bringing multiple organizations together for face-to-face learning exchanges, which are designed to provide targeted learning opportunities for innovators. R4D also has a new approach to program monitoring, evaluation, and learning called the Learning Lab. R4D is working with select health and education programs to focus monitoring and evaluation efforts at an earlier stage of the program cycle, by putting structured learning, experimentation and feedback at the heart of program design, piloting and scale-up efforts.

3. Co-creation and collaboration.

Few existing opportunities allow programs themselves to take ownership of the learning process and work collaboratively with peers who face some of the same challenges and with funders looking to engage in the problem-solving process. To make true progress, we must engage collaboratively with innovators and across sectors.

We have found that innovators — sometimes even people working on similar problems or models in the same city — don’t know each other. Collaborative networks bring together groups of innovators working on similar models to collectively problem-solve and publicly document their lessons.

In the past year, we experimented with a group of primary care innovators who have now produced a primary care innovators handbook as a way to share tacit knowledge gained in the field. Other network examples include multisectoral groups seeking to address a particular problem through government and private sector collaboration.

We have measured the great opportunity for people working on similar innovations to learn a lot from each other. The global institutions working with many innovators can be mediators to help them find each other and offer platforms for interaction.

4. Country innovation partners.

We work through a global network of country-based organizations. Our partners act as facilitators of key local and regional actors, carrying out the dual role of connecting programs to opportunities and encouraging system-level change. Our country innovation partners have added value at the country level in several distinct ways: raising awareness about the potential of innovations; creating large, in-country networks that leverage global learning and lower barriers to collaboration; leveraging our platforms, networks and other work to amplify the impact of their own and others’ efforts; and working with governments and funders to foster the uptake of promising innovations.

As part of their work, partners have developed a number of country-level mechanisms to source and support programs, such as competitions, innovation hackathons and pitch series aimed at fostering country-level support to innovations among donors, investors and policymakers. These locally driven efforts have generated new awareness of what works and sparked increased momentum around the potential of innovations.

5. Copycats.

If we are truly ready to scale innovation and move beyond just a few organizations doing well, we need to create copycats. Currently, we are systematically identifying receptor sites through the lens of adaptation and replication of innovations.

How do we find organizations that can be good copycats?  These organizations play a slightly different role than the initial innovators but are no less important in strengthening entire systems or industries that are able to engage with the government and other ecosystem players.

We have found that to help countries build highly performing health and education systems that serve the poor, we need larger industries of providers that go beyond one or two successful organizations. Copycats should be encouraged as a way of promoting promising models and vibrant systems and industries.

Our work over the past five years has taught us the importance of working directly with innovators, country and regional partners, researchers and governments to understand how innovations can gain success and get to scale. This group of stakeholders represents the sixth “C” of building vibrant innovation ecosystems — community. We hope you’ll join ours.

This article originally appeared on the devex website.

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