The one health landscape in Sub-Saharan African countries

Abstract

Objectives: One Health is transiting from multidisciplinary to transdisciplinary concepts and its viewpoints should move from 'proxy for zoonoses', to include other topics (climate change, nutrition and food safety, policy and planning, welfare and well-being, antimicrobial resistance (AMR), vector-borne diseases, toxicosis and pesticides issues) and thematic fields (social sciences, geography and economics). This work was conducted to map the One Health landscape in Africa.

Methods: An assessment of existing One Health initiatives in Sub-Saharan African (SSA) countries was conducted among selected stakeholders using a multi-method approach. Strengths, weaknesses, opportunities and threats to One Health initiatives were identified, and their influence, interest and impacts were semi-quantitatively evaluated using literature reviews, questionnaire survey and statistical analysis.

Results: One Health Networks and identified initiatives were spatiotemporally spread across SSA and identified stakeholders were classified into four quadrants. It was observed that imbalance in stakeholders' representations led to hesitation in buying-in into One Health approach by stakeholders who are outside the main networks like stakeholders from the policy, budgeting, geography and sometimes, the environment sectors.

Conclusion: Inclusion of theory of change, monitoring and evaluation frameworks, and tools for standardized evaluation of One Health policies are needed for a sustained future of One Health and future engagements should be outputs- and outcomes-driven and not activity-driven. National roadmaps for One Health implementation and institutionalization are necessary, and proofs of concepts in One Health should be validated and scaled-up. Dependence on external funding is unsustainable and must be addressed in the medium to long-term. Necessary policy and legal instruments to support One Health nationally and sub-nationally should be implemented taking cognizance of contemporary issues like urbanization, endemic poverty and other emerging issues. The utilization of current technologies and One Health approach in addressing the ongoing pandemic of COVID-19 and other emerging diseases are desirable. Finally, One Health implementation should be anticipatory and preemptive, and not reactive in containing disease outbreaks, especially those from the animal sources or the environment before the risk of spillover to human.

Keywords: ACDC, Africa Centres for Disease Control and Prevention; AFROHUN, Africa One Health University Network; AMR, Antimicrobial resistance; AMU, Arab Maghreb Union; AU, African Union; AU-IBAR, African Union Inter-African Bureau for Animal Resources; Africa; Animal health; Antimicrobial resistance; BMGF, Bill and Melinda Gates Foundation; BSL-3, Biosafety level 3 laboratory; CEMAC, Economic and Monetary Community of Central Africa; CILSS, Permanent Inter-State Committee for Drought Control in the Sahel; COCTU, Control of Trypanosomiasis in Uganda; COMESA, Common Market for Eastern and Southern Africa; COVID-19, Coronavirus (SARS CoV 2) disease 2019; EAC, East African Community; ECCAS, Economic Community of Central African States; ECOWAS, Economic Community of West African States; Emerging and re-emerging diseases; Environment health; FAO, Food and Agriculture Organization of the United Nations; FELTP, Field Epidemiology & Laboratory Training Program; Food safety; GARC, Global Alliance for Rabies Control; GHSA-ZDAH, Global Health Security Agenda's Zoonotic Diseases and Animal Health in Africa; GIS, Geographic information system; HPAI H5N1, Highly pathogenic avian influenza subtype H5N1; IGAD, Intergovernmental Authority on Development; ILRI, International Livestock Research Institute; IRA, Institute for Resource Assessment; ISAVET, Frontline In-Service Applied Veterinary Epidemiology Training; KEMRI, Kenya Medical Research Institute; M & E, monitoring and evaluation; MALF, Ministry of Agriculture, Livestock, and Fisheries; MRU, Mano River Union; MoH, Ministry of Health; NISCAI, National Inter-Ministerial Steering Committee on Avian Influenza; NTCAI, National Technical Committee on Avian Influenza; OH, One Health; OIE, World Organization for Animal Health; One health (OH); PMP, Progressive Management Pathway; Public health; RECs, regional economic commissions; RVF, Rift Valley fever; SACIDS, Southern African Centre for Infectious Disease Surveillance; SACU, South African Customs Union; SADC, South African Development Community; SSA, Sub-Saharan Africa; SWOT, Strengths, weaknesses, opportunities and threats; Toxicosis; UNICEF, United Nations Children's Fund; UNSIC, United Nations System Influenza Coordination; USAID, United States Agency for International Development; WAEMU, West African Economic and Monetary Union; WHO, World Health Organization; ZDU, Zoonotic Disease Unit.; Zoonosis.

Fig. 1

Map of Sub-Saharan Africa showing numbers of identified One Health initiatives per sub-region. One health initiatives across SSA (n = 145) were grouped into coordination, organization, implementation, capacity building, research, tools/applications and multipurpose initiatives. These are national, regional, continental or global in spheres. Many of the initiatives cut across more than one sub-region and the identified initiatives included 101 from East Africa, 85 from Southern Africa, 65 from Central Africa and 64 from West Africa. Coordination and duplication of platforms appeared to be a major challenge among the different initiatives.

Fig. 2

Quadrant analysis of One Health Stakeholders' Interest and influence matrix in One Health initiatives. National Livestock Marketing Council (LMC), National Livestock Producers Association (LPA), National Associations of Traders and Processors (NATP), Research Support Systems like NRF, COSTECH, ARC, others (RSS), Ministry responsible for Agriculture and Forestry(MoA&F), Ministry responsible for Livestock and Fisheries (MoL&F), Veterinary and livestock field officers working in holding grounds, livestock markets and quarantine station (VLFO), Ministry responsible for Natural Resources and Tourism (MoNR&T), Ministry responsible for Environment (MoE), National Environment Management Authority (NEMA), Ministry responsible for Lands and Physical Planning (MoL&PP), Ministry responsible for Public Health (MoH), Agricultural & veterinary Universities/Faculties/Colleges (Agric & Vet Univ./Fac.), Medical & allied health Universities/Faculties/Colleges,Agency/Directorate responsible for medicine control (MCC), National Medical Research Institute (NMRI), National Plant Health Inspectorate Service (NPHI), National Poultry Farmers & Breeders Association (NPF&BA), National Association of animal Feed Manufacturers (NAFM), African Union-IBAR (AU-IBAR), Regional Livestock Development Agencies/Organization and Regional Economic Communities (RLDA/RECs), Africa Centers for Diseases Control and Prevention(ACDC), National Medical Board (NMB), National Veterinary Board (NVB), Ministry responsible for Policy and Planning (MoP&P), National Bureau of Standards (NBS), Agricultural and Livestock Research Institute (A&LRI), Dairy Board (DB), Livestock Meat & Food Board (LM&FB), Pharmacy Board (PB),Field Epidemiology & Laboratory Training Program (FELTP)/ In-Service Applied Veterinary Epidemiology (ISAVET) Programme (ISAVET), State/Province/County Authorities (SPC Authorities), Local Government/District Authorities (LGD Authorities), World Organization for Animal Health (OIE), Donors, funders & financial institutions like USAID, EU, UKAid, World Bank, others (DFF), International Livestock Research Institute (ILRI), Wildlife Management & Research Institutions and Services (WM&RI), Food and Agriculture organization (FAO),National Centers for Diseases Control and Prevention (NCDC), One Health Central and Eastern Africa (AFROHUN), World Health Organization (WHO), Local NGO, CBO and FBOs (LNGOs), Public and Private public and veterinary laboratories (PPPVL).