After Ebola: West African ministers discuss public health cooperation

Source: World Health Organisation

At the landmark West African regional conference in Dakar, Senegal, 38 ministers from 16 countries in West Africa endorsed a communiqué, pledging their commitment to implement the One Health approach both within and across countries. This is a critical step forward toward implementing the World Health Organisation's (WHO) Regional Strategy on Health Security and Emergencies 2016-2020, which was agreed upon at the 66th session of the WHO Regional Committee for Africa in Addis Ababa, Ethiopia, in August.

Link between humans and animals

One Health is an approach that calls on policymakers and health practitioners to consider the inextricable link between human, animal and environmental health when designing public health systems, research and programmes. In recent years, 75% of emerging infectious diseases have originated in animals or animal products. It is believed that Ebola spread to a young boy in rural Guinea from an infected animal, sparking an epidemic that infected more than 28,000 people, including in the capital cities of six West African countries. By taking an integrated approach to public health, communities and countries can identify outbreaks in animals before they spread to humans.

"Disease outbreaks and public health crises - many of which began in animals - have taken lives and livelihoods, severely impacted our industries and economies, and taken a serious toll on our already-stretched public health workforces," said Dr Matshidiso Moeti, WHO regional director for Africa. "With so much at stake, the world simply cannot afford to take a crisis-by-crisis approach to health security. Strong systems and coordinated efforts are needed - both within and between countries - to detect, report and control the spread of diseases that affect animals and humans."

West Africa is currently tackling outbreaks of several zoonotic diseases, such as avian influenza in poultry in Cameroon and Nigeria and Rift Valley fever in Niger, as well as vector-borne public health threats, such as the recent emergence of the Zika virus strain from Brazil in Cabo Verde and Guinea-Bissau. These diseases impact not only health, but also food security and economic security. For example, the Ebola outbreak cost Guinea, Liberia and Sierra Leone nearly $600m in lost gross domestic product, and avian influenza has cost the region tens of billions of dollars since 2013.

Antimicrobial resistance

Additionally, the overuse and misuse of antibiotics in animals and crops is resulting in the emergence of antibiotic-resistant disease pathogens - which is rendering common infectious diseases and bacterial infections more difficult and expensive to treat. The approach of incorporating human, animal and environmental health helps to keep these medicines effective by more carefully and diligently managing their use.

The communiqué signed by ministers will help bolster the regional coordination and strong systems that are needed to help prevent and stop disease outbreaks. The agreement also announced the creation of framework that will help countries work together across sectors and borders to ensure effective integration of human, animal and environmental health efforts. Ultimately, this will provide the basis for countries in West Africa to conduct joint preparedness and response planning at the country and sub-regional levels, which will help manage outbreaks before they become national and international crises.

Specifically, member states party to the agreement have pledged to carry out national risk assessments and set up alert mechanisms for both common and emerging disease outbreaks within their territories. Governments will be tasked with integrating laboratories for human and animal samples to improve the timely diagnosis of diseases and track the spread of drug-resistant pathogens at the national level-a crucial step in the fight against antimicrobial resistance (AMR).

Together, these commitments will generate renewed momentum for West African countries to prioritise health security and pandemic preparedness. Ultimately, this will help drive progress towards existing commitments and initiatives, such as WHO's International Health Regulations (IHR), a legal tool that helps to ensure countries are better equipped to prevent, report and respond to public health risks that could cross borders and threaten people worldwide.