FAO is strengthening One Health preparedness and response capacities in Africa

National One Health platforms discuss lessons learned and best practices on the operationalization of the Joint Risk Assessment tool. 

Health challenges at the human-animal-environment interface, including zoonotic diseases such as avian influenza, rabies, Ebola and Rift Valley fever as well as food-borne diseases and antimicrobial resistance, account for more than three-quarters of emerging and re-emerging infectious diseases and are a serious threat to animal and public health. 

The first step to decreasing zoonotic disease threats is understanding where and why risks exist. Historically, each sector has applied its own specific tools and processes for outbreak investigation, surveillance and risk assessment of zoonotic diseases. Today, multi-sectoral approaches and tools have highlighted the need for multi-disciplinary and multi-sectoral collaboration, coordination and cooperation between the human, animal and environmental sectors to implement the One Health approach. In this context, the Tripartite collaboration between the Food and Agriculture Organization of the United Nations (FAO), the World Health Organization (WHO) and the World Organisation for Animal Health (OIE) are working together to develop global guides, such as the Tripartite Guide to Addressing Zoonotic Diseases in Countries, as well as standard tools to ensure a consistent, harmonized approach throughout the world. Such tools include operational tools for conducting the Joint Risk Assessment (JRA), which enables each sector to have a holistic understanding and integrated analysis of risk, joint identification of solutions and their implementation, with a stronger global commitment.    

Despite the coronavirus disease 2019 (COVID-19) outbreak, across the African continent One Health platforms in several countries have expressed interest in facilitating the JRA training tool before the end of 2021. So far, 18 countries in the region have been trained and the One Health platforms of Cameroon, Ethiopia, Kenya, Liberia, Senegal and the United Republic of Tanzania have used the tool after the training to address health concerns arising at the interface of the environment, animals (domestic and wildlife) and humans. 

To this end, from 8 to 9 July 2021, the six national One Health platforms mentioned above gathered virtually to discuss lessons learned and best practices from the countries’ experiences in the operationalization of the JRA tool, as well as to explore the way forward to improve the use of the JRA tool and to apply best practices. 

Joint Risk Assessment (JRA) tool implementation in Africa 

To adequately assess risk from zoonotic diseases, antimicrobial resistance, food safety or any health threats at the environment-animal-human interface, a variety of information on the hazard – epidemiological, environment, climate-related, human and animal among others – must be considered. Such health event-specific information can then be shared and assessed jointly by the national animal health and public health sectors and other stakeholders. However, to proceed efficiently the sectors must agree on a standard approach and process and be guided by best practices. Historically, since animal health and human health sectors have had different objectives in conducting risk assessments, different approaches, processes and definitions have evolved in each sector. But with successful Tripartite collaboration, the JRA tool represents a compromise between the approaches, processes and terminology generally used for risk assessment by the animal health and public health sectors.  

The JRA approach was first piloted in Indonesia in March 2018, based on zoonotic influenza and other national priority zoonotic diseases (rabies and leptospirosis). To facilitate rolling out the tool widely, Dakar held the first Africa regional facilitator training on the use of the JRA tool in 2019. 

JRA operationalization outputs and recommendations are used by the national One Health platforms to initiate the update of their preparedness and response plans. This joint exercise also contributed to strengthening multi-sectoral collaboration and coordination in national preparedness and response to any public health threat. It has been very well received as an important component in the implementation of One Health approach to address shared health threats at the human-animal-environment interface such as zoonoses and antimicrobial resistance. Following completion of the four-week formal training in Uganda, trainees will return to their duty stations to commence their field projects under mentor supervision. 

During the closing ceremony, Jeff Gilbert, FAO's Emergency Centre for Transboundary Animal Diseases Global Programme Coordinator, encouraged “rolling out this tool in simulations, that is essential in an epidemic emergency situation.” He added: “JRA can be used at high-level decision-making to change and adopt new policies to assess risk at national level. The next pandemic could come from Africa and having this tool could help prevent it.”  

Andrew Hollands, from the United States Defense Threat Reduction Agency (DTRA), stated: “It’s been an outstanding meeting and I would like to thank participating countries and partners for their commitment and their support to make One Health a reality in the continent and for successfully coordinating around this approach.”   

In his remarks, Ricardo Echalar, representative for Global Health Security Agenda East and Central Africa thanked participants and said: “I hope that this session leads to continuous discussions amongst participant countries on best practices and lessons learned.”  

Exploring the way forward 

There are challenges to building integrated structures and systems to address zoonotic diseases, given the wide scope of countries and contexts. In order to make these structures and systems more sustainable and effective, national One Health platforms discussed lessons learned and best practices on the operationalization of the JRA tool during the meeting. They also identified priority areas of focus to improve the use of the JRA tool and to apply best practices. The areas are: (i) advocacy at high level to fast track the use of the JRA tool whenever needed; (ii) domestic resource mobilization for the implementation of JRA recommendations; (iii) monitoring of the implementation of JRA recommendations; and (iv) JRA operationalization at sub-national level. 

This meeting is part of the FAO Sustainable Operationalization of the One Health in the Africa Region project, funded by DTRA, which aims to strengthen One Health preparedness and response capacities of beneficiary countries.