PowerPoint Presentation
Actualization of an interdisciplinary curriculum for One-Health
in West Africa - (Lessons from the PENAPH, ProMED and NFELTP
examples)
An invited plenary session Lead Speaker presentation at the 2nd
Centre for Control and Prevention of Zoonoses CCPZ Annual
Conference and One-Health exposition Improving Zoonoses
Surveillance in West Africa: The One-Health Approach. 30th June to
4th July 2013
2nd CCPZ ConferenceActualization of an interdisciplinary
curriculum for One-Health in West Africa (Lessons from the PENAPH,
ProMED and NFELTP examples)An invited plenary session Lead Speaker
presentation at the 2nd Centre for Control and Prevention of
Zoonoses CCPZ Annual Conference and One-Health exposition Improving
Zoonoses Surveillance in West Africa: The One-Health Approach. 30th
June to 4th July 2013
2nd CCPZ ConferencePresenterDr Olutayo O. Babalobi (DVM, MPVM,
PhD; FCVSN). Department of Veterinary Public Health and Preventive
Medicine, Faculty of Veterinary Medicine, University of Ibadan,
Ibadan, Nigeria GSM Nos. : +234-816-753-8536; +234-805-530-1991.
E-mail: [email protected]; [email protected] Key
Terms:Actualization: making real or giving the appearance of
reality. Actualizing: To describe or portray realistically.
Definition of termsHealthInterdisciplinary: Of, relating to, or
involving two or more academic disciplines that are usually
considered distinct
culminating in death at the other end.A condition of physical,
mental, and social well-being and the absence of disease or other
abnormal condition.
http://medical-dictionary.thefreedictionary.com/Human+healthThe
opposite of Health isDis-ease: Dis ease: anything that makes a
living being not to be at ease Ease:.The condition of being
comfortable or relieved.Un-ease: 1.Lacking a sense of security;
anxious or apprehensiveStress: Stressis a person's response to a
stressor such as an environmental condition or a stimulus.Stressis
a body's way to react to a challenge. Distress: Distressmay refer
to:Distress(medicine), occurring when an individual cannot adapt to
stress; Suffering Current views of health and illness recognize
health as more than the absence of disease. The need for a more
realistic definition of the word Health was expressed by stn &
Jakob in 2005 in an article titled: Re-Defining Health which
appeared in the Bulletin of the WHO 83:802.
(http://www.who.int/bulletin/bulletin_board/83/ustun11051/en/) in
which they quoted Australian Aboriginal people who generally define
health thus Health does not just mean the physical well-being of
the individual but refers to the social, emotional, spiritual and
cultural well-being of the whole community. This is a whole of life
view and includes the cyclical concept of life-death-life (National
Health and Medical Research Council. Promoting the health of
Indigenous Australians. A review of infrastructure support for
Aboriginal and Torres Strait Islander health advancement. Final
report and recommendations. Canberra: NHMRC, 1996: part
2:).5Definition of terms
Health:"A state of complete physical, mental, and social
well-being and not merely the absence of disease or infirmity."
(WHO 1946)Health does not just mean the physical well-being of the
individual but refers to the social, emotional, spiritual and
cultural well-being of the whole community.
The word health was derived from the old English word hoelth,
which meant a state of being sound, and was generally used to infer
a soundness of the body (Dolfman M. The concept of health: an
historic and analytic examination. Journal of School Health 1973;
43:491-7.)Health[hoelth] is a relative state in which one is able
to function well physically, mentally, socially, and spiritually in
order to express the full range of one's unique potentialities
within the environment in which one is living. In the words of Ren
Dubos, health is primarily a measure of each person's ability to do
and become what he wants to become.
Realizing that humans are dynamic beings whose state of health
can change from day to day or even from hour to hour, leaders in
the health field suggest that it is better to think of each person
as being located on a graduated scale or continuous spectrum
(continuum) ranging from obvious dire illness through the absence
of discernible disease to a state of optimal functioning in every
aspect of one's life. High-levelwellnessis described as a dynamic
process in which the individual is actively engaged in moving
toward fulfillment of his or her potential.A common concept of
health as a continuum ranging from optimal wellness at one end to
illness 6
Existing terms in Health
Global health:Global Health is thehealthof populations in a
global context and transcends the perspectives and concerns of
individual nations It is the area of study, research and practice
that places a priority on improving health and achieving equity
inhealth for allpeople worldwide'Global health is typified by the
international activities of the World Health Organization
International HealthInternational Health: International health
is defined as a well-established branch of public health, with
origins in the health situation of developing nations and the
efforts of industrialized countries to assist themUS-CDC started as
International Health
Public Health:Public Health: Interdisciplinary an d
multidisciplinary preventive education, research and extension ion
measures against health problems and threats at local and foreign
communities to improve human well-being involving professionals
mainly epidemiologists,biostatisticians,community health and
environmental health officers but also physicians public health
nurses,medical microbiologists, Ecologists, environmental health
officers/public health inspectors,pharmacists,dental
hygienists,dietitiansandnutritionists,veterinarians, public health
engineers, public health lawyers,sociologists, community
development workers, communications experts, and others
Veterinary Public Health (VPH)Veterinary Public Health (VPH) is
defined as The contributions to the physical, mental and social
well-being of humans through an understanding and application of
veterinary science [WHO/FAO/OIE definition 1999]. Human health,
animal husbandry and animal health are closely connected and VPH is
a fundamental part of public health whereby human health and
well-being are the main objectives.Veterinary Public Health
(VPH)VPH is multidisciplinary and contributes to many areas of
public health that are not always related to animals. In order to
integrate veterinary public health into the goals of public health,
it is essential to improve collaboration between human and
veterinary medical science, environmental science and other related
fields in accordance with one health principles.
ONE HEALTH
ONE HEALTHIt is a multidisciplinary strategy to prevent, control
and eliminate the challenge of diseases, where possible, within a
larger ecological context that includes humans, animals and plants
interacting in a complex ever-changing natural environment
recognizing that 60% of all human pathogens are zoonotic
(http://nigeria-feltp.net/prog_desc.php)
Definition of terms
One Health:"the collaborative effort of multiple disciplines
working locally, nationally, and globally to attain optimal health
for people, animals and the environment"
The One Health concept arose from the realization that human
health and animal health are inextricably linked and that a
holistic approach is needed to understand, protect, and promote the
health of all species. One Health seeks to improve communication
and encourage collaboration between veterinarians, physicians,
environmental scientists and public health professionals to find
multidisciplinary solutions to the shared challenge of public and
environmental health. It is a multidisciplinary strategy to
prevent, control and eliminate the challenge of diseases, where
possible, within a larger ecological context that includes humans,
animals and plants interacting in a complex ever-changing natural
environment recognizing that 60% of all human pathogens are
zoonotic (http://nigeria-feltp.net/prog_desc.php)
15Definition of terms
My comprehensive definition:All collaborating efforts of various
human activities, occupations and professions; labouring as
companions, working together, united to achieve a common mandate,
purpose and responsibility of making man to be at ease with other
biological and non-biological components of the earth and its
environment.DisciplinesAdiscipline(orspecialism) is knowledge or
wisdom associated with one academic field of study or profession. A
discipline incorporates types of knowledge, expertise, skills,
people, projects, communities, problems, challenges, studies,
inquiry, approaches, and research areas that are strongly
associated withacademic areas of studyor areas ofprofessional
practice. Multidisciplinary Multidisciplinary: of, relating to
using several disciples at the same time multidisciplinary (m l t
-d s -pl -n r , -t -). adj. Of, relating to, or making use of
several disciplines at once: amultidisciplinaryapproach to
teaching. A multidisciplinary community or project is made up of
people from different disciplines and professions who are engaged
in working together as equal stakeholders in addressing a common
challenge.Interdisciplinary:
Interdisciplinaryknowledge is the knowledge extensions that
exist between or beyond existing academic disciplines or
professions. The new knowledge may be claimed by members of none,
one, both, or an emerging new academic discipline or profession.An
interdisciplinary community or project is made up of people from
multiple disciplines and professions who are engaged in creating
and applying new knowledge as they work together as equal
stakeholders in addressing a common challenge.InterdisciplinaryThe
key question is what new knowledge (of an academic discipline
nature), which is outside the existing disciplines, is required to
address the challenge. Aspects of the challenge cannot be addressed
easily with existingdistributed knowledge, and new knowledge
becomes a primary sub goal of addressing the common
challenge.Difference between multidisciplinary and
interdisciplinaryMultidisciplinarityis a non-integrative mixture of
disciplines in that each discipline retains its methodologies and
assumptions without change or development from other disciplines
within the multidisciplinary relationship.
Aninterdisciplinaryfield is a field of study that crosses
traditional boundaries between academic disciplines or schools of
thought, as new needs and professions have emerged.
One Health: Inter or MultiIs One Health multidisciplinary or
interdisciplinary or both?
Disciplines involved in OH Disciplines involved in OH
include:Professions : Agricultural, Biomedical health,
Ecological/Environmental, Laboratory, Medical and Veterinary Health
Academic and Research Institutions: University
Faculties/Schools/Colleges of Agriculture, Animal health and
Production; Environmental Sciences; Biomedical, Medical, Nursing,
Public Health, Community and Social Medicine; Veterinary
Biomedical, Clinical and Pathological Medicine, Public Health and
Preventive Medicine; Biomedical, Environmental and Veterinary
Research Institutes) Relevant professional students/trainees:
(agricultural, biomedical, environmental health, laboratory,
medical, nursing, public health, veterinary etc.Other
non-professional/ occupational traineesConservation medicineis an
emerging, interdisciplinary field that studies the relationship
betweenhumanandanimalhealth, andenvironmentalconditions. Also known
asecological medicine,environmental medicine, ormedical
geology.
CURRICULUM : WHAT IS CURRICULUM?
A curriculum is a planned guided learning experience of a
student. From Latin, literally running, course, it is the subjects
taught at an educational institution, or the elements taught in a
particular subject. The curriculum is really the entire program of
the schools' work. It is the essential means of education. It is
everything that the students and their teachers do.
Curriculum ComponentsEssentially, the curriculum should contain
four main components or elements: the objectives or purpose, the
content or subject-matter, the method or ways of passing on
knowledge, and evaluation or assessment (i.e. the procedure for
testing whether or not the pupils or students have benefited from
the instructions given).
CurriculumThe knowledge of the environments in which the
trainees will work and the task they will face as well as getting
the appropriate training strategies including the field exposure
are factors highly influential in designing a curriculum.
ONE HEALTH CURRICULUM COURSES
A typical One Health Curriculum (OHC) should involve the
following courses:Basic One Health Concept: Definition, Concepts,
History , General Introduction to the One Health
/Collaborative/Comparative Medicine conceptBasic Epidemiology: -
Host-Agent-Environment interactions and Disease Transmission.
Outbreak Investigation and Disease Reporting. Ecology/Environment
Health. Wildlife / Zoo MedicineDisease Surveillance, Monitoring,
Prevention and Control. Disease Emergency Preparedness ResponseONE
HEALTH CURRICULUM COURSES
Epidemiology of Zoonotic diseases. Emerging, Infectious,
Neglected and Re-occurring Zoonoses Diseases. Animal: Human
Interface in a Pathogenic EnvironmentNon-Zoonotic/Non-communicable
Animal and Human Public Health Issues e.g. Food Hygiene and Food
Safety; Transboundary/Exotic/Foreign/Tropical Diseases. Livestock
Livelihood and Socio-Cultural/ Traditional and Socio-Economic
factorsLaboratory Clinical Diagnostic issues in One Health-
biochemical, immunological, microbiological and molecular
medicine.
Examples of One Health CurriculumNFELTP-OHCCCIn 2011, African
Field Epidemiology Network (AFENET), Kampala, Uganda engaged the
presenter as a Veterinary Academics Consultant during his
sabbatical leave. Working in conjunction with Dr Lora Davis, the
Chief Veterinary Medical Officer of the Animal-Human Interface
Project, AHIP Nigeria, Centers for Disease Prevention and Control
CDC- Atlanta One Health Office
NFELTP-OHCCCThe presenter assumed the lead role in organizing a
collaborative working group to review existing NFELTP curricula and
course content and recommend a One Health curriculum and
standardized course content OHCCC template that may be used by
AFENET for establishing additional One Health training programs in
Africa.
NFELTP-OHCCCThe report of has since being submitted in 2012 as a
55 page Technical Report and Recommendation for a One Health
standardized curriculum and course content in Field Epidemiology
Training Programs July 2012. 55pp.
ProMED-mailA more efficient and effective disease reporting/
surveillance systems for diseases is one of the envisage benefit of
One Health. A One Health activity needed to be promoted to permit a
rapid response to disease outbreak, control and surveillance is
operating a joint collaborative outbreak reporting list along the
lines of Program for Monitoring Emerging Diseases (ProMED-mail)
ProMED-mail since its inception, has espoused the One Health
concept. (See PROMED AND ONE HEALTH
http://www.onehealthinitiative.com/publications/ProMED%20article2.pdf)
EPIDEMIOLOGY
Epidemiology/Epizootiology, the branch of medicine that deals
with the incidence, distribution, and control of diseases (in human
populations), is a major vehicle for One Health. Though used for
animal populations, Epizootiology orveterinary epidemiology, is the
study ofdiseasepatterns within animal populations.
EPIDEMIOLOGY/PARTICIPATORY EPIDEMIOLOGYParticipatory
epidemiology is the application of participatory methods to
epidemiological research and disease surveillance. It is a proven
technique which overcomes many of the limitations of conventional
epidemiological methods, and has been used to solve a number of
animal health surveillance and research problems (Jost CC,Mariner
JC,Roeder PL,Sawitri E,Macgregor-Skinner GJ (2007): Participatory
epidemiology in disease surveillance and research. Rev Sci
Tech.2007 Dec; 26(3):537-549).
Participatory EpidemiologyParticipatory Epidemiology (PE)
integrates human and veterinary medicine into a common approach and
is a powerful tool in international public healthPARTICIPATORY
EPIDEMIOLOGYInitiated in 2007, the Participatory Epidemiology
Network for Animal and Public Health (PENAPH) connects groups and
individuals who apply PE methods in controlling emerging and
existing diseases. The concept arose as a result of applying
participatory epidemiology to some of ILRIs projects which bridge
human and livestock health.
CONCLUSION
What are some challenges to creating One Health partnerships and
collaborations?CoordinationLeadershipIndividualityProfessional
suspicion/ Mutual mistrustProfessional arroganceProfessional
ignorance
WHAT IS THE ROLE OF UNIVERSITIES IN INSTUTIONALIZING ONE HEALTH
IN NIGERIA
University roles from pre-degree to preclinical to postgraduate
levels: Training, Research and community and social extension
servicesOne Health general studies courses for 100L undergraduate
agricultural, biomedical, environmental health, medical, science
and veterinary studentsJoint pre-clinical -200L One Health course
for biomedical, medical and veterinary studentsJoint teaching of
zoonosis courses by medical and veterinary lecturers Recognition
and adequate respect of the role of technologists and biomedical
professionals in public health training
One Health postgraduate degrees for students of diverse
professional backgroundAdmission of qualified students of various
professional backgrounds to courses such as MPH, MSc
Epidemiology/Epizootiology, MSc Immunology, MSc Virology and other
clinical and field- based postgraduate degreesOne Health extension
and community services to clients, patients and livestock farmers
level at rural, suburban and urban levelsCreation of University One
Health Continuous Education, Distant Learning, E-Learning and
Research Centres or Units One Health extension and community
services to clients, patients and livestock farmers level at rural,
suburban and urban levels
Joint comparative research (e.g. on Avian/ Swine Influenzas,
Brucellosis, Lassa fever, Rabies, Rift valley fever, Tuberculosis
and other zoonosis and environmental diseases) at undergraduate and
postgraduate levels involving agricultural, biomedical,
environmental health, medical and veterinary students and
lecturers; and across universities at local, national and
international links levels
ConclusionThe issue of One Health is more and beyond just
Zoonosis, even though zoonosis is a major itemThe history of One
Health in Nigeria shows it began from the University of Ibadan, the
first University in NigeriaEfforts to have a National OH
Coordinating Center at the Dr Nasidi headed Nigeria CDC have been
frustratingStill the first and the best, there is need for One
Health National Coordinating Center which UI should be readyto
host
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