DOAG: “ONE HEALTH” – A GLOBAL, NATIONAL, AND STATE INITIATIVE





September 5, 2018

“ONE HEALTH” – A GLOBAL, NATIONAL, AND STATE INITIATIVE

Mary Joaquin, MA, REHS/RS, RN, Bureau of Regulatory Services

The Connecticut Department of Agriculture (DoAg) supports the goals and initiatives of One Health.

One Health is a global, national, state, and local initiative to unite professionals who work in human, animal, and environmental health fields. The purpose of the One Health initiative is to educate and engage stakeholders in unified risk management related to human and animal medicine, zoonotic disease, public health, environmental health, and agriculture. The One Health framework includes the basic concepts, principals, and practices associated with these subjects.

The number of occupations that fall under the One Health framework is vast and diverse. The broad fields of human medicine, environmental medicine, and veterinary medicine are most commonly named under the One Health initiative, but there are many other professions that practice at this interface including ecologists, public health professionals, molecular and microbiologists, social scientists, and health economists.

Traditionally, occupations related to these professions work separately, referred to as “silos”.  While many topics are the same, the field application is not coordinated, the information and research methods are not formatted, tracked, or stored in manners that allow for sharing. Research is conducted with parallel interest. However, it is conducted with the rules and initiatives of the field of practice guiding experimental application, objectives, outcomes, and reporting making the information that is generated cumbersome to implement by other professions. For instance, research related to food quality conducted by an agricultural organization may not have the same goals as the same research conducted on the same products by a pharmaceutical company but the information gathered by each would prove mutually beneficial.

On the federal level, a proposal is currently being considered by the Senate Committee on Health, Education, Labor and Pensions entitled “Advancing Emergency Preparedness Through One Health Act of 2018” (S. 2615).  This bill stresses the importance of professionals not only working collaboratively on emergency preparedness initiatives but also calls on them to “actively lead interdisciplinary efforts” with agencies in a nonpartisan manner.

Government agencies and private organizations, both within the United States (U.S.) and worldwide, that are supporting the creation and implementation of the One Health framework through legislation include: the American Medical Association; American Veterinary Medical Association; American Society for Microbiology; American Public Health Association; World Health Organization; Wildlife Conservation Society; World Organization for Animal Health; U.S. Department of Health and Human Services; Centers for Disease Control and Prevention; U.S. Department of Agriculture (USDA); and U.S. Environmental Protection Agency. 

Areas of focus specifically targeted for non-partisan leadership in the proposed “Advancing Emergency Preparedness Through One Health Act of 2018” are zoonotic disease with pandemic potential such as avian influenza, Ebola, food borne illness, environmental contaminants, and collaborative emergency preparedness research.  Interventions that could be implemented under the One Health framework include surveillance for zoonotic diseases, vaccines and therapeutics, vector control, and improved sanitation and food safety.

Zoonotic diseases of concern include bacterial infections, viral infections, vector borne infections, and parasitic infections.  Antimicrobial resistance, bio-threats, food safety, global health and emergency preparedness are other areas of focus. Comparative and transitional medicine groups focus on topics that affect both human and animals. These include metabolic disorders, joint and skeletal disease, cancer, cardiovascular disease, exposures to environmental hazards, and the human animal bond. These are examples of areas of greatest concern for global and national health. These are the top areas where coordination of efforts would streamline resources and workforce to maximize preparedness and effect change.

Since 1979 the Office of the Surgeon General has been making recommendations to establish initiatives that will improve human health and welfare. The most current version is entitled “Healthy People 2020” with many of the same initiatives that are reflected in the One Health framework. Healthy People 2020 outlines the goals and the One Health movement provides a road map toward accomplishing the goals. 

Many of the current Healthy People 2020 topics directly parallel goals and objectives of One Health.  For example, “Environmental Health” designates work to be done that will “provide health through a healthy environment”. This includes outdoor air quality, surface and ground water quality, toxic substances and hazardous waste, homes and community’s infrastructure and surveillance, and global environmental health. 

“Global Health” includes Food safety, immunizations and infectious disease surveillance and prevention, preparedness, education and community programs to increase awareness, health communication and information technology.

Adolescent health, cancer, diabetes, heart disease, stroke, occupational health and safety, physical activity, and respiratory disease are some other areas where the One Health framework clearly supports the Healthy People 2020 goals.

Health disparities and the social and economic impacts of the above areas of focus are extensive. The need for collaborative, interdisciplinary solutions is necessary and timely to conserve resources, maximize leverage of the work force in place, and optimize information sharing.

The goals and objectives of many of the DoAg’s programs and activities coincide with those of One Health and Healthy people 2020.

Due in large part to its diverse statutory mandates and responsibilities, DoAg is unique in its role as a state agency, in that staff have the necessary collective knowledge, skills, and abilities to practice as professionals at the One Health interface. 

DoAg staff possess the qualifications, education, and experience reflected in all the fields of animal health, human health, public health (health services to improve and protect community health, especially sanitation, immunization, and preventive medicine), and environmental health.

DoAg’s programs and services currently reflect all aspects of One Health.  An example is zoonotic disease preparedness as we engage in active and passive surveillance activities including those for Avian Influenza, Brucella, Rabies, and Bovine tuberculosis to name a few. We also actively engage in activities related to emerging diseases, foreign animal diseases, radiological preparedness, and emergency preparedness both for animal disease outbreaks and natural disasters.

Food Safety is a priority under both the One Health and Healthy People 2020 frameworks. DoAg is proud to be the boots on the ground agency for dairy safety, produce safety, aquaculture safety, egg safety, poultry slaughter, seeds, animal feeds, and fertilizer.  DoAg mitigates food safety challenges by applying the knowledge, skills, and abilities necessary to intervene at the source and use evidenced based practice to create change and positive working relationships. DoAg also conducts on farm assessments to determine if best agricultural practices are being implemented to ensure good environmental health practices are being utilized as they relate to agriculture.

DoAg is a leader in providing care to our community through programs like the Connecticut Women, Infants, and Children (WIC) and Senior Farmers’ Market Nutrition Programs, Connecticut Grown, farmer’s market inspections, Farm-to-Chef, and Farm-to-School.  These programs allow us to help create change in areas like healthy diet and nutrition, healthy living, obesity, and cardiovascular health. DoAg connects directly with the community and farmers resulting in a positive impact on our community, helping to create change in social, economic, and health disparities.

DoAg staff have also assisted the USDA with a new initiative to end the opioid crisis in our country. Through our unique relationships with state and local departments of public health and safety, we are able to collaborate and make referrals for towns interested in participating in a grant offered through the USDA.  This grant aids small communities in Connecticut that need assistance to fight the opioid crisis.

The One Health framework presents unique opportunities to advance goals and prioritize objectives inter professionally to facilitate the breaking down of silos and improve program continuity and professional services.