Tripartite partnership of FAO, WHO, and OIE highlights the importance for strengthened work at the human–animal–ecosystem interface
Health threats at the human–animal–ecosystem interface have increased over the past decades, as pathogens continue to evolve and adapt to new hosts and environments, imposing a burden on human and animal health systems. The increase in health threats to humans and animals is driven by multiple, inter-related global factors generally related to human behaviour and environmental changes and also reflects the complexities of the ecosystems in which humans and animals coexist. Because reducing these risks cannot be achieved by one sector alone, there is increasing convergence toward a One Health approach that incorporates a collaborative, cross-sectoral, multidisciplinary mode of addressing these threats and reducing health risks. Building upon the principles and areas of joint work captured in the FAO–OIE–WHO Tripartite Concept Note, ‘The FAO–OIE–WHO Collaboration – Sharing responsibilities and coordinating global activities to address health risks at the animal–human–ecosystems interfaces,’ the Tripartite partnership of FAO, WHO, and OIE has made a commitment to jointly address the risks at the interface. In the Concept Note, the Tripartite recognizes the need to establish an environment in which ministers representing the various sectors within countries can voice their expectations and come to a consensus on future activities, particularly collaborative ones. Ensuring a high-level technical perspective on the issues was seen by the Tripartite and global partners to be critical to formulating the rationale and arguments that would effectively engage ministers in such a discussion.
ORGANIZATION AND APPROACH TO THE HIGH-LEVEL TECHNICAL MEETING TO ADDRESS HEALTH RISKS AT THE HUMAN-ANIMAL-ECOSYSTEM INTERFACE (HLTM)
In conceiving the HLTM, the Tripartite and Mexico, supported by the United Nations System Influenza Coordination (UNSIC), provided a venue for stakeholders from the national health, agriculture, and environmental sectors and from technical, regional, and donor organizations to contribute their perspectives and expertise to discussions of mutual priority health issues at the human–animal–ecosystem interface – especially those that would be of interest to ministers. Participants from the different sectors considered and came to agreement on cross-sectoral technical and policy approaches to address the mutual priorities and on the next steps for moving forward to implement these approaches. (vi) Three topics – zoonotic influenza, rabies, and antimicrobial resistance (AMR) – were used as ‘entry points’ for participant discussions, as each offers successful and beneficial examples of cross-sectoral collaboration, and the themes of risk assessment and risk mitigation were the lens through which the topics were examined. The HLTM was organized into opening and plenary sessions, facilitated working group sessions, and panel discussions from which came the major HLTM outcomes – key elements of effective cross-sectoral collaboration – along with specific actions and concrete next steps. These key elements could be used by countries when considering the establishment of national cross-sectoral approaches, and are described in detail in this report.
KEY ELEMENTS OF EFFECTIVE CROSS-SECTORAL COLLABORATION
Key supporting elements
- Political will and high-level commitment
- Common objectives and priorities
- Shared benefits
- Strong governance structures, aligned legal frameworks, and recognition of existing international standards
- Adequate and equitably distributed resources
- Identification and involvement of all relevant partners
- Coordinated planning of activities
- Guidance on implementation of cross-sectoral collaborations
- Capacity development
- Strong and effective health systems within the individual sectors
Key operational elements
- Joint cross-sectoral coordination mechanisms
- Routine communication
- Joint simulation exercises
- Data sharing
- Joint risk assessment
- Active cooperation on disease control programmes
WHAT’S NEXT? A STRATEGIC VISION FOR POST-HLTM ACTIONS
The HLTM was partly envisioned to provide a technical basis for a joint Ministerial Conference, described in the Tripartite Concept Note, but there was overall agreement that certain interim activities would need to take place before such an inter-ministerial meeting could be most useful. Potential priorities, approaches, and next steps identified at the HLTM by the Tripartite and the Steering Committee members fell under three interconnected headings:
1. Develop and deliver clear messages
During the HLTM it emerged that exactly what the global community hopes to achieve by taking cross-sectoral approaches to collaborative work at the human–animal–ecosystem interface was at times unclear, even among some of the meeting participants. It was agreed that the outcomes of the HLTM would be translated into standard cross-sectoral tools and that clear policy messages would be developed and widely distributed.
2. Develop a clear plan for building cross-sectoral approaches into existing standards and tools and investing in existing systems
Identifying practical cross-sectoral actions was a main theme of the HLTM. Plans to apply cross-sectoral approaches – specifically those described in the key operational elements – could be developed at all administrative levels. Further, it was agreed that incorporating cross-sectoral approaches into existing mechanisms and structures was more efficient than creating new ones.
3. Define and describe costs and benefits of cross-sectoral approaches
During the HLTM, it was clearly noted that coordinated, cross-sectoral approaches and interventions could offer increased efficiency and effectiveness – and at the same time it was noted that, while intuitively obvious and backed up with some strong examples, further economic efficiency analyses are needed. Partners noted the importance of evaluating the economic impact of adopting cross-sectoral approaches to address health issues to ensure that evidence is provided to policy-makers to make appropriate decisions.
As presented within the objectives for this meeting, FAO, OIE, and WHO sought to conduct a the HLTM to advance the implementation of One Health approaches in countries and complement the other meetings that have taken place on this subject. A main outcome was the identification of key supporting and operational elements of effective cross-sectoral collaboration to address health risks at the human–animal–ecosystem interface. The HLTM provided an important contribution in advancing our ability to address risks at the interface. The full achievement of the meeting objectives was, and will continue to be, interlinked with the continued collaboration between the Tripartite organizations and their partners in these efforts – partners that include other international actors, regional and national governments, and non-governmental and academic partners, including in some cases establishing public– private partnerships. Each entity has an important role to play and often has a slightly different group of stakeholders or methods of reaching common stakeholders. Harnessed, the combined roles of these various partners should be adequate to ensure fundamental progress toward broadly implementing cross-sectoral approaches to health issues at the human–animal–ecosystem interface.