ONE HEALTH LEADERSHIP EXPERIENCE Dr. Mark Raizenne Director General, Centre for Food-Borne, Environmental and Zoonotic Infectious Diseases, Public Health.

ONE HEALTH LEADERSHIP EXPERIENCEDr. Mark Raizenne

Director General, Centre for Food-Borne, Environmental and Zoonotic Infectious Diseases, Public Health Agency of Canada

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One Health Activities• PHAC’s One Health activities

» One Health approach being applied to:• AMR policy development • Canadian Integrated Program for Antimicrobial Resistance

Surveillance (CIPARS)• National Enteric surveillance - C-EnterNet• Vectorborne disease surveillance - West Nile, Lyme disease

» Science-Policy Integration Projects - One Health approach to food safety (led by PHAC) and One Health approach to emerging infectious diseases (led by CFIA)

• Provinces and Territories » Manitoba, Ontario, Alberta, Saskatchewan, Quebec

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International One Health Activities

• United States:

» CDC – One Health Office

» USDA-APHIS

» Multiple Universities

• European Union:

» Animal Health Strategy (2007 – 2013)

• Australia

• World Health Organization (WHO), World Organization for Animal Health (OIE), Food and Agriculture Organization (FAO), the World Bank

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One Health Education

• One Health curriculum needs to address the effects of climate on ecosystem health, wildlife, and the movement of plant, animal, and human diseases

• There is an opportunity for veterinary medicine to leverage its expertise in One Health and lead advances in food-animal husbandry and welfare, water safety and security, and the health of wildlife and ecosystems

• Need to integrate the key disciplines of human medicine, veterinary medicine, conservation biology, public health, basic sciences, agriculture, economics, social sciences and environmental sciences

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Education Recommendations

• One Health is an “… opportunity to connect and educate health professionals at an early stage, when they are naturally learning together. As undergraduates, these students are excited about integrating new ideas, and their academic schedule may be more accommodating to a variety of classes. Presenting One Health concepts to students at this stage of their education could have a positive impact on their awareness of and attitudes toward public health.”

» Farone TS. Incorporating the one-health concept into undergraduate education.J Am Vet Med Assoc. 2011 Dec 1;239(11):1406-7.

• “Introducing this concept to students early in their academic careers is important to ensure that they are still open to broad-based, interdisciplinary ways of thinking.

» Kahn LH. Educating undergraduates on one health. J Am Vet Med Assoc. 2012 Jan 15;240(2):144.

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Challenges for One Health Leaders

• Labelled as a non-expert

• Issues with common language when mixing disciplines

• Lack of funding – public, private and industry, competing priorities

• Small number of One Health mentors and senior faculty

• No unifying vision for One Health in Canada and abroad - poor coordination among Canadian health actors, “siloes”

• Career paths in One Health are often unclear and few well-paying job opportunities are advertised for graduates

• Limited opportunities to mobilize interest in One Health outside of academia in Canada

• Will require changing behaviours and mindsets

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An Uphill Battle

• “…a shortage of collaborative student programs, insufficient environmental training for health professionals, and a lack of institutional support impede progress” » Meredith A Barrett, Timothy A Bouley, Aaron H Stoertz, and

Rosemary W Stoertz. 2010. Integrating a One Health approach in education to address global health and sustainability challenges. Frontiers in Ecology and the Environment (e-View)

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“If you always do what you've always done, you'll always get what you've always got.”

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The Benefits of One Health (AVMA 2008)

• Improving animal and human health globally through collaboration among all the health sciences, especially between the veterinary and human medical professions to address critical needs

• Meeting new global challenges head-on through collaboration among multiple professions—veterinary medicine, human medicine, environmental, wildlife and public health

• Developing centers of excellence for education and training in specific areas through enhanced collaboration among colleges and schools of veterinary medicine, human medicine, and public health

• Increasing professional opportunities for veterinarians

• Adding to our scientific knowledge to create innovative programs to improve health

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Advantages for One Health Leaders

• Marketable

• Nimble, adaptable

• Responsive to disease outbreaks, challenges

• Broader perspective, see the commonalities

• Chance to show leadership nationally and globally

• Canada has recognized leaders in One Health – available for mentoring and support

• Help to bridge the educational and research gap between the human, veterinary and environmental science fields

• Potential employers – government, educational institutions, NGOs

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The Next Generation of One Health Practitioners

Physical Environments

Humans Animals

Social Environments

Psychological

Sociological

Historical

Anthropological

Economic

Political

Public Policy

Communication StudiesBiomedical

Governance

Public Population Health

Public and Population Health

Veterinary Medical

Evolutionary and Comparative

Animal Science

Medical

Environmental and Ecological

Source: Rock et al., 2009

…leading in public health challenges

• Competencies in Public Health Leadership

» Leading Transformation» Legislation and Politics» Transorganization» Team and Group Dynamics

Determinants of Health

• Income and Social Status

• Social support networks

• Education and Literacy

• Employment – Work Conditions

• Social Environments

• Physical Environments

• Personal Health Practices – Coping Skills

• Healthy Child Development

• Biology – Genetic endowment

• Gender

• Culture

• Health Services