The International Health Regulation and Performance of Veterinary Services (IHR-PVS) National Bridging Workshop was successfully concluded recently, with the participation of key stakeholders from the animal health, human health and environment sectors of the country.

The participants of the three-day workshop comprised of a wide group of stakeholders including officials from the Ministry of Health and Department of Animal Production and Health, and those representing diverse sectors including wildlife, fisheries, environment, media, and the police, reiterating the true spirit of intersectoral partnerships as the way forward to One Health.

Background

A majority of emerging, re-emerging, and endemic human diseases have their origins in animals, and diseases of animals have additional implications for human health through food safety and food security.  It is estimated that, globally about one billion cases of illness and millions of deaths occur every year from zoonoses (diseases that can be transmitted between animals and humans via direct or indirect contacts).  Out of over 30 new human pathogens detected in the last three decades, 75% have originated in animals. 

The recent experiences from COVID-19 and several zoonotic diseases in the past including Ebola virus and zoonotic and pandemic influenza viruses have all increased awareness of the critical need to focus on the interface between human health and animal health. 

World Health Organization (WHO) and World Organization for Animal Health (WOAH), are the two main bodies responsible for proposing references and guidance for public health and animal health sectors, respectively. Working in close collaboration with Food and Agriculture Organization (FAO), WHO and WOAH have been active promoters and implementers of an intersectoral collaborative approach among institutions and systems to prevent, detect, and control diseases among animals and humans. They have developed various frameworks, tools and guidance material to strengthen capacities of personnel engaged in these sectors at the national, regional and global levels. 

WOAH and its PVS Pathway

World Organisation for Animal Health (WOAH) is the intergovernmental organization responsible for developing standards, guidelines and recommendations for animal health and zoonoses. These are mainly laid down in the WOAH Terrestrial and Aquatic Animal Codes and Manuals. To achieve a sustainable improvement the national Veterinary Services’ compliance with those standards, in particular, on the quality of veterinary services, WOAH has developed the Performance of Veterinary Services (PVS) Pathway, which is composed of different tools to assist countries objectively assess and address the main weaknesses in their veterinary services. 

IHR and  WHO

WHO Member States adopted the International Health Regulations (IHR) - a legally binding instrument, for the prevention and control of events that may constitute a public health emergency of international concern. Through these regulations, state parties are required to develop, strengthen, and maintain minimum national core public health capacities to detect, assess, notify and respond to public health threats and as such, should implement plans of action to develop and ensure that the core capacities required by the IHR are present and functioning throughout their territories. Various assessment and monitoring tools have been developed by WHO such as the IHR Monitoring and Evaluation Framework (MEF), IHR State Party Self-Assessment Annual Report (SPAR), Annual Reporting Questionnaire for Monitoring Progress, Simulation Exercises, After-Action Review and the Joint External Evaluation (JEE) Tool. 

WHO and WOAH consider that at country level, the joint use of the IHR Monitoring and Evaluation Framework (IHR MEF) developed by WHO and the WOAH Performance of Veterinary Services (PVS) Pathway would result in better alignment of capacity building approaches and strategies between human and animal health sectors. Using their comparative advantages, they have jointly defined an operational approach to propose capacity building activities to strengthen interactions between professionals and policymakers from both sectors.

FAO and One Health

FAO’s approach to One Health is to consider the concept as part of agri-food system transformation for the health of people, animals, plants and the environment. This includes working with a broad range of stakeholders including the government of Sri Lanka as well as undertaking collaborative work on sustainable agriculture, animal, plant, forest, and aquaculture health, food safety, antimicrobial resistance (AMR), food security, nutrition and livelihoods. 

FAO serves as a knowledge hub in promoting the One Health concept locally, regionally and internationally. The tasks and responsibilities undertaken include projects implemented to protect human, animal, plant and environment health, support for the management and conservation of natural resources,  facilitating access to safe food, advancing climate change adaptation and mitigation and promoting sustainable practises in the fisheries and agricultural sectors. 

Globally and nationally, FAO supports members to build and implement effective, collaborative One Health strategies. FAO undertakes a range of engagements to promote the One Health approach, including improving early warning systems on animal and plant pests and diseases, boosting biosecurity for pest and disease management in animals and plants, facilitating effective emergency preparedness and response relating to any health event at the human, animal, plant and environment interface and heightening AMR risk management at national, regional, and global level. 

In Sri Lanka, FAO works with multiple agencies including the Ministry of Health, the Department of Animal Production and Health, WHO and the WOAH to promote the One Health concept. Strengthening and working together to consolidate the One Health approach is essential for progress and to combat a diverse range of threats and challenges including environment-related human and animal health threats.

The IHR-PVS Workshop Structure and Sessions

The IHR-PVS National Bridging Workshops (NBW) born out of the tripartite collaboration between WHO, WOAH and FAO, enabled Sri Lanka to further explore possible overlapping areas addressed in the human and animal health sectors, in the WOAH and IHR capacity frameworks and develop, where relevant, appropriate bridges to facilitate coordination. The structured approach with user-friendly material, case studies and group exercises enabled in the identification of synergies, review gaps and bring new meaning to the definition of operational strategies. These will be used by policy makers for concerted, corrective measures and strategic investments in national action plans for improved health security.                  

The IHR-PVS Workshop is divided into seven interconnected sessions that build successively on the group exercises and discussions that develop within each step. From the first session that sets the scene and introduces the One Health concept, we move to the second and third sessions where 16 key technical areas of current collaboration are discussed, its strengths and weaknesses identified and mapped into the IHR-PVS matrix. In session four, divided into technical working groups, participants extract relevant information which are then brought under one umbrella, as key joint objectives and activities that strengthen the collaboration between the sectors of human and animal health. Session six finalizes this joint roadmap through an exercise and a prioritization vote,  as the final session discusses the implementation of the joint roadmap, while defining the way forward.

Proceedings and Outcome

The workshop diagnosed the current strengths and weaknesses in the collaboration between animal and human health services for 16 technical areas that are key for the prevention, detection and response to health events. Among the technical areas addressed were, coordination and communication at all levels, legislation/ regulation, finance, emergency funding, field investigation, response operations, risk assessment, joint surveillance, laboratory, education and training, human resources, and logistics. 

Led by local subject matter experts and facilitated by WHO and WOAH experts, the ministries and other government bodies as well as local partners took ownership in devising a roadmap, with gaps, needs and corrective measures being identified with local expertise, leading to home-grown solutions. 

Having completed this workshop, Sri Lanka joins the seven countries (out of eleven) in the WHO South-East Asia Region and the 45^th country out of the 194 member states to have concluded the IHR-PVS bridging workshops and to have subsequently developed roadmaps aimed at the prevention, detection and response to zoonotic diseases and other health events at the animal-human interface.