One health systems strengthening in countries: Tripartite tools and approaches at the human-animal-environment interface

Abstract

Unexpected pathogen transmission between animals, humans and their shared environments can impact all aspects of society. The Tripartite organisations-the Food and Agriculture Organization of the United Nations (FAO), the World Health Organization (WHO), and the World Organisation for Animal Health (WOAH)-have been collaborating for over two decades. The inclusion of the United Nations Environment Program (UNEP) with the Tripartite, forming the 'Quadripartite' in 2021, creates a new and important avenue to engage environment sectors in the development of additional tools and resources for One Health coordination and improved health security globally. Beginning formally in 2010, the Tripartite set out strategic directions for the coordination of global activities to address health risks at the human-animal-environment interface. This paper highlights the historical background of this collaboration in the specific area of health security, using country examples to demonstrate lessons learnt and the evolution and pairing of Tripartite programmes and processes to jointly develop and deliver capacity strengthening tools to countries and strengthen performance for iterative evaluations. Evaluation frameworks, such as the International Health Regulations (IHR) Monitoring and Evaluation Framework, the WOAH Performance of Veterinary Services (PVS) Pathway and the FAO multisectoral evaluation tools for epidemiology and surveillance, support a shared global vision for health security, ultimately serving to inform decision making and provide a systematic approach for improved One Health capacity strengthening in countries. Supported by the IHR-PVS National Bridging Workshops and the development of the Tripartite Zoonoses Guide and related operational tools, the Tripartite and now Quadripartite, are working alongside countries to address critical gaps at the human-animal-environment interface.

Keywords: COVID-19; Health policy; Health systems; Health systems evaluation; Public Health.

Figure 1

Tripartite pathway for improved health security at the human and animal interface. This pathway enables countries to organise actions and improve capacities in critical technical areas at the human-animal-environment interface. The logical progression allows countries to use IHR-MEF and WOAH PVS Pathway to assess collaborative needs, identify, prioritise and plan corrective measures and then select from various tools and approaches available across the Tripartite and global partners. IHR-MEF, WHO International Health Regulations Monitoring and Evaluation Framework; PVS, Performance of Veterinary Services; WOAH, World Organisation for Animal Health.

Figure 2

Overlap between IHR-MEF indicators and PVS Pathway critical competencies. IHR-MEF, WHO International Health Regulations Monitoring and Evaluation Framework; PVS, Performance of Veterinary Services.

Figure 3

Chronology of tool development associated with the IHR and the PVS Pathway. IHR, WHO International Health Regulations; NBW, National Bridging Workshops; PVS, Performance of Veterinary Services; TZG, Tripartite Zoonoses Guide; WOAH, World Organisation for Animal Health.