UNEP joins three international organizations in expert panel to improve One Health

UNEP joins three international organizations in expert panel to improve One Health

UNEP joins three international organizations in expert panel to improve One Health

The United Nations Environment Programme (UNEP), as well WHO, OIE and FAO have agreed to set up a One Health High-Level Expert Council to collect, distribute and publicize reliable scientific information on the links between human, animal and environmental health.

Deliberations during the Third Paris Peace Forum held on 12 November 2020 by the Alliance for Multilateralism 

The COVID-19 health crisis has highlighted the close links between human, animal and environmental health, in a context of increased human-livestock-wildlife contacts and ecosystems degradation. In order to better understand pandemics such as COVID-19 and to reduce the risk of zoonotic diseases, determined actions are needed. The “One Health” approach is a cross-cutting and systemic approach to health based on the fact that human health and animal health are interdependent and linked to the health of the ecosystems in which they co-exist, as stated by the “Berlin Principles”, which were developed at the “One Planet, One Health, One Future” conference and presented during the ministerial meeting of the Alliance for Multilateralism of 25 September 2020.

The heads of WHO, OIE, FAO and UNEP agreed to strengthen their work together, building upon the existing FAO, OIE and WHO Tripartite cooperation, to address risks at the human-animal-environment interface and have a joint secretariat. To do so, they agreed to create a One Health High-Level Expert Council involving all four agencies and other key international experts on human, animal, environment and social sciences. The Council will collect, distribute and publicize reliable scientific information on the links between human, animal and environmental health in order to assist public officials make appropriate decisions to address future crises and to inform citizens. 

https://www.unep.org/news-and-stories/story/unep-joins-three-international-organizations-expert-panel-improve-one-health

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Kenya national antimicrobial stewardship guidelines for healthcare settings

Kenya national antimicrobial stewardship guidelines for healthcare settings

Kenya national antimicrobial stewardship guidelines for healthcare settings

The purpose of this guideline is to give direction to health care workers on how to establish and run Antimicrobial Stewardship (AMS) programmes in health care settings and the community at large. It describes the framework, approach, and available resources that support successful development and implementation of AMS in Kenya. These guidelines address the full spectrum of AMS, including development and implementation of systems, infrastructure, and interventions. Target audiences, the scope for implementation, and roles and responsibilities at various stakeholder levels are specified. Additionally, checklists and available resources that could be leveraged to facilitate progression through the spectrum of AMS are included.

In this guidance document, stakeholders are defined in the context of national and county leadership, including the private sector, health care institutions (public and faith based), and community leadership levels. The target groups differ across levels, each with defined sets of actions. The scope of this AMS guidance document accommodates application at multiple health service centres that serve as health care points of entry, including hospitals, outpatient clinics, health centres, dispensaries, and community pharmacies. It also includes defined roles for the Pharmacy and Poisons Board (PPB). The focus of this guidance document is on human health, with linkages to the veterinary and agricultural sectors mentioned briefly.

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E book: pandemics, global health and consumer choices

E book: pandemics, global health and consumer choices

E book: pandemics, global health and consumer choices

I want to share a resource prepared by Cynthia Schuck and Wladimir Alonso, two public health experts who are also passionate about the plight of farm animals. They’ve prepared a short free e-book to provide factual information on the connection between farm animals and pandemics to the general public.

Below are excertps from the E-book. All info in this post should be credited to the authors (Cynthia and Wladimir).

 A brief account of our history with animals

In our interactions with wild animals, companions, livestock and commensals, pathogens commonly known to us were imported: scavenging and hunting gave us tapeworms, and probably hepatitis and poliomyelitis through the hunting of our close relatives, primates; companion animals, rabies; livestock gave us measles, Salmonella, smallpox and anthrax (a disease that became famous for its potential use as a biological weapon); commensals, the plague, hantavirus and typhus. Of course, the reverse is also true: most human infectious diseases can also be transmitted to animals.

But the advancements in technology and the rapidly growing population were also catalysts of a massive increase of food animal populations and the intensification of farming practices, which accelerated sharply in the decades following World War II. As is discussed in the E-book, these conditions created efficient routes for the transmission of pathogens that gained, or re-gained, access to human populations. We are now in what scientists call the ‘third epidemiological transition’, characterized by a resurgence of familiar infections along with the emergence of new ones. Many have their origin in those animals we use as food.

With the human population approaching 8 billion people interconnected in a global village, where all forms of interactions with animals (from hunting to industrial complexes with enormous numbers of animals) are not only still present, but amplified (80 billion land animals are used for meat every year), new challenges are bound to happen in the form of local epidemics and global pandemics 6–9. These challenges will test not only our ability to react to these events appropriately, but also to identify (and rectify) the elements that most contribute to their emergence.

Direct contact with wild viruses

The brutality of Ebola (its death rate and the dreadful course of the illness on patients) is well known. Ebola is one among many other infectious diseases that find its way into humans when we expose ourselves to the large diversity of viruses that are tolerated by wild animals, but that can be harmful if they spill over to people. In the case of the Ebola outbreak in West Africa, such a jump was traced back to a two-year-old boy from Meliandou, a small village in Guinea. The boy used to play with other children in a hollow tree full of bats. According to the villagers, children would sometimes catch them, and perhaps even roast them on sticks to eat them. 

Eating wild animals is an important route of human exposure to pathogens harbored by wild animal species. Of course, it is not the only one: another popular means of human infection is through a vector, such as a mosquito or a tick, through which the pathogen makes its way from an animal to a person. Yet, because every infection transaction requires the intermediation of a middleman (the vector), the spread of the disease can be addressed more objectively by targeting the vector. In contrast, diseases that find their way to a person, and from that single human case (the ‘patient zero’) can be transmitted from human-to-human in a sustained way are more likely to become pandemic, especially if transmission occurs through behaviours that are common (such as physical greetings, sharing of objects, close proximity and sex).

There are many ways through which pathogens can find their way to human beings without the help of a vector. In the water, breathing dust from highly contaminated environments (such as caves), eating food chewed by infected animals or having close physical contact with those animals are among them. But one route that has been particularly important is the use of wild animal species as food. The origin of most Ebola outbreaks – which still happen, mainly in Central Africa – is believed to be associated with the consumption of bushmeat. It is not so much the consumption of a cooked animal that is risky, but the process of hunting and butchering the animal. In this (literally) bloody affair, plenty of opportunities exist for the direct exposure of vulnerable human tissues (skin wounds, mucosa) to the pathogens and for the cross-contamination of other food items with the bodily fluids of the infected animal. Humans were most likely infected with precursors of the human immunodeficiency virus (HIV) in this way, when hunting chimpanzees for meat. Interestingly, chimps got infected in the same way, when hunting two other smaller species of primates. HIV infection, which  leads to the acquired immunodeficiency syndrome (AIDS), has spread to all corners of the globe since the 1980s, with 39 million people killed of  HIV/AIDS-related complications as of 2018. 

Based on those accounts, one could hope that the prevention of infectious diseases imported from wildlife would be just a matter of addressing these practices and the standards of life of populations on the fringes of urban societies. Unfortunately, the outbreaks of SARS in 2002-03 and the 2019 pandemic remind us that this is not the case.

SARS and COVID-19 outbreaks can be also traced back to the consumption of wild animals, but not in small villages from poor rural areas of developing countries. Both SARS and SARS-CoV-2 emerged in the wet markets of vibrant urban centers in China. In the case of SARS-CoV-2, the origin has been pinpointed to Wuhan, the most populous city in Central China, with approximately 11 million people . 

Wet markets are places where animals are sold for consumption, along with other perishable goods. Described this way, they would not be different from countless other grocery stores or street markets around the globe. What makes some of those places different is not only the large diversity of animal species that are sold, but also the way in which many are kept on display, to be butchered on site on the customers’ request. Cages and stand spaces are so limited that animals are mostly crammed into tight spaces, piles and shelves, where lower levels are constantly flooded with the droppings of upper ones. Wild animals (such as turtles, bamboo rats, badgers, hedgehogs, otters, civet cats, snakes, bats, pangolins) might have been taken directly from the wild, but more often they are raised in the numerous farms run by family enterprises. Many pathologists and virologists have warned authorities of the public health dangers that these conditions represent 6,7,25. The regular mixing of a high diversity of pathogens, from wild and domestic species, in an environment of acute stress for the animals and poor sanitary conditions, and where hosts from all species meet, creates the perfect conditions for the emergence of novel pathogens that can make their way to humans, be it through a wound, the cross-contamination of food or by the air, through the aerosolization of organic material.

Inconvenient truth  

We tend to approach each new epidemic and public health crisis independently, rather than recognizing their common drivers. Domesticated animals have served humanity for millenia, but in today’s modern societies we must be honest and admit that the way we commonly raise animals is a major threat for global health and the well-being of human populations. Moreover, the extensive human and financial losses associated with infectious disease outbreaks and drug resistance make this an enormous economic and social problem too. As global meat consumption continues to rise even further (it has doubled in the last 50 years, from a global average of 20 kilograms per person in 1961 to around 43 kilograms in 2014122), these risks and costs are expected to increase even further.  

The world spends billions every year in the design and control of measures to protect us against infectious diseases. In 2015, funding for the investigation of emerging and zoonotic diseases in a single US institution, the Centers for Disease Control, was nearly half a billion dollars 121. The annual cost of pandemic preparedness alone is estimated to lie somewhere within $ 3 billion to $ 5 billion 123. Yet it is disturbing that many of the most basic control policies supposed to be well established have failed when tested, even in high income countries such as the United States 121. Should we insist on making public health safety an exclusively reactive endeavor? 

While large investments are currently being poured into the development of vaccines and treatments to control the damage of the 2019 coronavirus outbreak, these (most needed and welcomed) developments are unlikely to shield us from a future epidemic. We must have this same sense of urgency to accelerate the development of modern methods of food production, which include the development of substitutes of animal protein. In fact, this is a revolution in the food sector that has already started, with a diverse range of products on that menu that include meat-like products made from plants or even grown in vats 124. Ultimately, however, the demand for alternative protein sources must come from the population, and the market will respond appropriately. Just as we exercise our citizenship by adopting the necessary measures to curb the advancement of COVID-19 and protect our communities, we must also exercise it with our wallets at the supermarket, and think how best our purchasing and dietary choices can build a safer future for generations to come.

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Farm animal welfare concerns during Covid-19 pandemic

Farm animal welfare concerns during Covid-19 pandemic

Farm animal welfare concerns during Covid-19 pandemic

At present, there is no known risk of transmission of COVID-19 (ie. SARS-COV2 virus) from livestock to humans and no direct COVID-19 infection risk with consumption of animal products, noting general food hygiene should prevail.

The World organisation for Animal (OIErecommends that production and consumption of animal products can continue as usual, following routine sanitary precautions.

There is no current evidence that livestock can be infected or carry COVID-19, though scientific research is being conducted to confirm. Livestock feed is also not directly a risk, though delays in feeding, feed transport and animal care must be mitigated.

Animal welfare organisations like World Animal Protection have also emphasized that neglect, abandonment, inhumane culling or cruelty to animals is never acceptable.

To date, we are aware or anticipate the following, but please do alert us (email or in the comment section below) if you come across these concerns or other concerns for farm animals in your area (remember the below are never acceptible when it comes to animal welfare):

  • delays in feed to animals resulting in hunger and starvation – due to lack of contingencies with border delays, trade delays, movement delays generally
  • possible delays in care – veterinary services are considered essential services in some countries, but may be not all
  • lack of feed, care, veterinary services – due to remoteness, inability to afford or access such (eg. smallholders, price fluctuations etc)
  • lack of staff – due to economics, sickness with COVID-19 infection, social distancing needs or inability to access, travel to farms / work
  • neglect, disease, death or dumping of animals – due to any of the above plus some misinformation occurring

Important resource

The OIE has posted the following technical Covid-19 Q and A 1/4/20: https://www.oie.int/en/scientific-expertise/specific-information-and-recommendations/questions-and-answers-on-2019novel-coronavirus/

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Official statement by Kenya Veterinary Board on corona virus pandemic to veterinary professionals and members of the public

Official statement by Kenya Veterinary Board on corona virus pandemic to veterinary professionals and members of the public

Official statement by Kenya Veterinary Board on corona virus pandemic to veterinary professionals and members of the public

“The Kenya Veterinary Board (KVB) wishes to applaud the government efforts in mitigating the negative effects of the COVID-19 pandemic through the National Emergency Response Committee and other state and non-state actors’ interventions. The Kenya Veterinary Board is a Statutory Body established by the Veterinary Surgeons and Veterinary Paraprofessionals (VSVP) Act. No. 29 of 2011 “to exercise general supervision and control over training, business, practice and employment of veterinary surgeons and veterinary paraprofessionals in Kenya and to advice the Government in relation to all aspects of veterinary practice thereof…” Veterinary services preserve and develop animal resources that provide incomes to households, reducing poverty and hunger in Kenya through improving rural livelihoods and feeding the country through safe good quality foods of animal origin subsequently enhancing public health and to conserve wildlife and fisheries resources for posterity.

The current pandemic christened COVID- 19 is a novel type Corona viruses Infection. Corona virus infections are common in animals and humans. Some strains of corona viruses are zoonotic, meaning they can be transmitted between animals and humans, but many strains are not zoonotic. While the current pandemic is predominantly maintained by human to human transmission, the other recent corona virus infections which have been zoonotic include the Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (BARS) that required direct veterinary intervention. More than 70% of animal diseases are zoonotic (transmissible to humans) such as the current corona infection, making animal health and public health closely related as envisioned under the ” One Health Approach.

The Kenya Veterinary Board wishes to draw attention to the roles and responsibilities of the veterinary profession and public health highlighting the specific veterinary activities which are key to ensure a continuum in food safety, disease prevention, emergency management and conservation of wildlife. To effectively tackle the challenges posed by the COVID -19 pandemic the government has taken commendable measures which the Board urges all members of the public to abide by in order to combat the spread of the disease. Effective Friday 276 March 2020, the Government of Kenya took restrictive measures to allow only essential services daily from 7pm to 5am which in their very nature veterinary services remain essential to the human health. These decisions raise questions regarding potential adaptations that need to be implemented by the veterinary profession.

It is important that COVID-19 does not lead to inappropriate measures being taken against domestic or wild animals which might compromise their welfare and health or have a negative impact on biodiversity and the human beneficiaries. The Board expects the National Veterinary Services to be part of the National Emergency Response and the County Veterinary Services playing a similar role at the county level supporting core functions of the public health response, such as screening and testing of surveillance and diagnostic samples from humans. Veterinary clinics can also support the public health response by donating essential materials such as personal protective equipment and ventilators.

In this context, the Kenya Veterinary Board recognizes specific activities that comprise Veterinary Services as essential services and have engaged the relevant authorities to ensure that this clarity is set out for the benefit of the public and delivery of the services outlined.

  1. Veterinary Public Health Activities

Veterinarians play a key role in disease prevention and management including those transmissible to humans and to ensure food safety for the populations. In the current situation, it is crucial that, amongst their numerous activities, they can sustain those necessary to ensure that:

  • national and county veterinary regulatory and inspection services can oversee the integrity of public health with activities such as meat inspection,
  • only healthy animals and their by-products enter the food supply to guarantee food safety for the populations,
  • emergency situations can be addressed,
  • preventative measures, such as vaccination against diseases with a significant public health or economic impact, are maintained,
  • veterinary supplies are sustained and priority research activities continue.
  1. Supporting veterinary activities in their context

When conducting their work, veterinarians have the responsibility to safeguard their health, the health of those they work with and their clients’ health. Hence, they must ensure that appropriate levels of biosecurity are implemented, that their personnel are protected with the necessary equipment, and that animal owners are informed of precautionary measures in place. It is the responsibility of each individual to ensure that appropriate behaviours are respected in the framework of these activities, to avoid further spread of COVID-19.

  1. Precautionary measures by animal handlers and owners

There have not been any reports of companion or other animals presenting clinical signs caused by COVID-19 virus infection and currently there is no evidence that they play a significant epidemiological role in this human disease. However, because animals and people can sometimes share diseases (zoonotic diseases), it is still recommended that people who are sick with COVID-19 limit contact with companion and other animals until more information is known about the virus. When handling and caring for animals, basic hygiene measures should always be implemented. This includes hand washing before and after being around or handling animals, their food or supplies, avoid petting or kissing pets and other animals, licking or sharing food. When possible, people who are sick or under medical attention for COVID-19 should avoid close contact with their pets and have another member of their household care for their animals. If they must look after their pet, they should maintain good hygiene practices and wear a face mask if possible.

  1. National and County Government Veterinary Services and role of private practitioners

Medical and Veterinary Services in public and private sectors should work together using a One Health approach to share information and conduct a risk assessment when a person with COVID-1 9 reports being in contact with companion or other animals. If a decision is made as a result of a risk assessment to test a companion animal which has had close contact with a person/owner infected with COVID-19, it is recommended that RT-PCR be used to test oral, nasal and fecal/rectal samples. While there is no evidence of a COVID-19 infection spreading from one animal to another, keeping animals that test positive for COVID-19 away from unexposed animals should be considered best practice. The detection of COVID-19 virus in animals requires to be reported to the World Organization for Animal Health (01E) including information about the species, diagnostic tests and relevant epidemiological information.

  1. Are there any precautions to take with animals?

Although there is uncertainty about the origin of the COVID-19 virus, as a general precaution, when visiting live animal markets, wet markets or animal product markets, general hygiene and biosecurity measures should be applied. Any contact with animals in the wild or stray animals including their waste especially those possibly living around the markets (e.g., stray cats and dogs, rodents, birds, bats) should be avoided. Standard recommendations to prevent infection spread include regular hand washing, covering mouth and nose with the elbow when coughing and sneezing and avoiding close contact with anyone showing symptoms of respiratory illness. As per general good food safety practices, raw meat, milk or animal organs should be handled with care, to avoid potential cross-contamination with uncooked foods. Meat and other animal products from healthy livestock that is prepared and served in accordance with good hygiene and food safety principles remains safe for consumption. Based on currently available information, trade restrictions on animals or animal products are not recommended. Precautions for packaging materials should be grounded on the observation of basic hygiene, ensuring it is clean and free of visible contamination. In meat and other animal product outlets handlers of money should not be allowed to handle or pack raw foods simultaneously.

Finally, following the directive of working from our homes, we are all required to adjust to these changes to our usual way of life. The KVB recognizes all the veterinary surgeons, veterinary paraprofessionals and wider veterinary teams who have worked so hard to put new measures in place to ensure public health safety. On what the announcement of essential services would mean for veterinary care and while seeking urgent clarification from the government, the KVB advices that veterinary practices need to continue to operate in order to provide emergency care, fulfil urgent prescriptions and maintain safety in human food supply chain as they follow strict disinfection and antisepsis protocol to ensure health and viable populations of domestic animals and wildlife . Veterinary practices that remain open to save lives and support disease surveillance must take effective measures such as minimizing the number of clients seen face-to-face keeping to the necessity of veterinary emergencies while the veterinary teams insist on strict social distancing measures at all times. As KVB, we expect the veterinary medical experts will continue to educate the public who are their clients on their role especially the observance of biosafety measures in breaking the Covid-1 9 Pandemic transmission cycle. I wish to apologize to those veterinarians who may have been caught up by the law enforcement agents during curfew enforcement and assure you that the respective government authorities are consulting to ensure that the essential services you offer are not disrupted. We know this period is one of great uncertainties and that difficult decisions are having to be made requiring that all Kenyans of goodwill take a lead. Thank you.

Author

Dr. Christopher Wanga, PhD, EBS, Chairman, Kenya Veterinary Board

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