Co-production of knowledge as part of a OneHealth approach to better control zoonotic diseases

Abstract

There is increased global and national attention on the need for effective strategies to control zoonotic diseases. Quick, effective action is, however, hampered by poor evidence-bases and limited coordination between stakeholders from relevant sectors such as public and animal health, wildlife and forestry sectors at different scales, who may not usually work together. The OneHealth approach recognises the value of cross-sectoral evaluation of human, animal and environmental health questions in an integrated, holistic and transdisciplinary manner to reduce disease impacts and/or mitigate risks. Co-production of knowledge is also widely advocated to improve the quality and acceptability of decision-making across sectors and may be particularly important when it comes to zoonoses. This paper brings together OneHealth and knowledge co-production and reflects on lessons learned for future OneHealth co-production processes by describing a process implemented to understand spill-over and identify disease control and mitigation strategies for a zoonotic disease in Southern India (Kyasanur Forest Disease). The co-production process aimed to develop a joint decision-support tool with stakeholders, and we complemented our approach with a simple retrospective theory of change on researcher expectations of the system-level outcomes of the co-production process. Our results highlight that while co-production in OneHealth is a difficult and resource intensive process, requiring regular iterative adjustments and flexibility, the beneficial outcomes justify its adoption. A key future aim should be to improve and evaluate the degree of inter-sectoral collaboration required to achieve the aims of OneHealth. We conclude by providing guidelines based on our experience to help funders and decision-makers support future co-production processes.

Fig 1. A simplified illustration of the sectors and the politico-administrative actors of the KFD management in India including actors from each sector that are impinging on the system or are impacted by KFD in each sector.

Fig 2. Graphical representation of the retrospective theory of change on researcher expectations and the system-level outcomes of the co-production process adopted in the MonkeyFeverRisk project.

The key components of the theory of change framework were as follows: (i) planned activities which included joint problem-framing with cross-sectoral actors to better understand the contextual risk factors and knowledge gaps, (ii) intermediate outputs comprising the social and ecological fieldwork, design and experimentation of a decision-support tool, and (iii) anticipated outcomes which ultimately contributes to fostering inter-sectoral collaboration and increased disease preparedness.

Fig 3. Snapshot of the KFDExplorer Tool showing south India overlaid with the human cases reported in 2019 to the Department of Health and Family Welfare Services, Karnataka.

The areas predicted to be highly suitable for spill-over of KFD to humans are highlighted in red versus areas predicted to be unsuitable for spill-over in blue. The right hand menus in green indicate how data on environmental risk factors, on KFDV-positive dead monkeys and KFDV-positive ticks, can be visualised alongside human case locations, whilst the use of a detailed base map depicts landscape contextual features that guide management such as villages and roads. Source data: Map base layer is from the OpenStreetMap (https://wiki.openstreetmap.org/wiki/Standard_tile_layer). This dataset is available under a CC0 1.0 Universal (CC0 1.0) Public Domain Dedication license (https://creativecommons.org/publicdomain/zero/1.0/) and any copy of or work based on this dataset requires the following attribution: This dataset is based on the dataset produced by the OpenStreetMap Foundation (https://osmfoundation.org/). The administrative boundary dataset used in this figure is from HindudstanTimesLabs (https://github.com/HindustanTimesLabs/shapefiles/), reproduced under the MIT License. Human case data are from the Department of Health and Family Welfare Services, Government of Karnataka.