Abstract

Emerging zoonoses with pandemic potential are a stated priority for the global health security agenda, but endemic zoonoses also have a major societal impact in low-resource settings. Although many endemic zoonoses can be treated, timely diagnosis and appropriate clinical management of human cases is often challenging. Preventive ‘One Health’ interventions, e.g. interventions in animal populations that generate human health benefits, may provide a useful approach to overcoming some of these challenges. Effective strategies, such as animal vaccination, already exist for the prevention, control and elimination of many endemic zoonoses, including rabies, and several livestock zoonoses (e.g. brucellosis, leptospirosis, Q fever) that are important causes of human febrile illness and livestock productivity losses in low- and middle-income countries. We make the case that, for these diseases, One Health interventions have the potential to be more effective and generate more equitable benefits for human health and livelihoods, particularly in rural areas, than approaches that rely exclusively on treatment of human cases. We hypothesize that applying One Health interventions to tackle these health challenges will help to build trust, community engagement and cross-sectoral collaboration, which will in turn strengthen the capacity of fragile health systems to respond to the threat of emerging zoonoses and other future health challenges. One Health interventions thus have the potential to align the ongoing needs of disadvantaged communities with the concerns of the broader global community, providing a pragmatic and equitable approach to meeting the global goals for sustainable development and supporting the global health security agenda.This article is part of the themed issue ‘One Health for a changing world: zoonoses, ecosystems and human well-being’.

Highlights

  • While outbreaks of emerging zoonoses, such as Ebola virus disease, galvanize the world’s attention, it is the endemic zoonoses that still inflict the much greater burden of mortality and morbidity

  • The lessons of past disease outbreaks and response efforts show that the adaptation of existing networks and capacities to deal with new threats is crucial. This approach has recently been advocated in the regional meeting of Health and Agriculture Ministries in Latin America on the management of zoonose risks, with emerging, re-emerging and endemic zoonoses considered as linked priorities, and with integrated surveillance and coordinated governance key pillars of strengthening One Health capability [25]

  • We have previously suggested that approaches focused on endemic zoonoses offer a pragmatic approach to overcoming existing barriers that limit global capacity for emerging disease surveillance, and address inequalities in global health by delivering benefits to affected people in lowincome countries [27]

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Summary

Introduction

While outbreaks of emerging zoonoses, such as Ebola virus disease, galvanize the world’s attention, it is the endemic zoonoses that still inflict the much greater burden of mortality and morbidity. Measures for the prevention, treatment and control of endemic zoonoses are often available to protect people and animals in high-income countries and the disease burden is much less substantial than in neglected communities. These factors reduce immediate awareness and concern about disease risk at international level, which in turn impacts on the perceived need to prioritize investments for disease control and prevention in low-income settings. While several endemic zoonoses have been termed ‘neglected’ [13], the issue of neglect arises not as a result of lack of recognition of or research on the pathogens per se Most of these zoonoses have long been recognized in the medical and veterinary literature, are well understood and are often well controlled in high-income countries.

A global rationale for prioritizing endemic zoonoses
Rabies as a case study
Zoonoses causing human febrile illness
Designing One Health interventions: the example of livestock vaccination
Implementation and scaling-up of animal vaccination strategies
Findings
10. Conclusion

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