A consultation on One Health: Collaboration transgressing land and oceans, what next?

In a recent consultation on One Health hosted by the Sydney Infectious Disease Institute, University of Sydney [Sydney ID], and Public Health Foundation of India [PHFI], one priority area that the group identified for the application of One Health approach was in addressing Antimicrobial Resistance (AMR).  

There are four aspects to addressing AMR with a One Health approach. One is research and surveillance for evidence generation. Two, Translating the evidence to action – policies, programs, and planning. Three, Building capacity of the human workforce engaged in human, animal, and environmental health workstreams. Fourth, measurement, learning, and evaluation.

If we were to pinpoint one critical gap in the One Health approach to addressing AMR, we would focus on data management. Data – ‘digitally accessible timely actionable’ information.

In those days when we learned basic disease surveillance in classrooms, our teacher presented us this simple uncluttered definition of disease surveillance ‘Disease Surveillance is the determination of the frequency with which a disease occurs in the community by collection, consolidation, analysis, and dissemination of relevant data.’ After he wrote the definition on the blackboard, he would take an orange chalk and triple underline the word dissemination and relevant in the sentence. We understood what he emphasized and never forgot.

In the application of the One Health approach to AMR management, the most important element is data. The collective collection, collation, analysis, and interpretation of data for timely action. With the advancement of technology, this is possible. As is demonstrated in the Danish Integrated Antimicrobial Monitoring and Research Programme (DANMAP) model. We need to develop such locally relevant models for our local needs. For example, a SAINMAP (South Asia Integrated Antimicrobial Monitoring and Research Programme) where relevant data from human, veterinary, and environmental surveillance is collated and disseminated to relevant stakeholders across countries.

The problem of AMR in its entirety is humongous. The One Health approach in its application has its inherent challenges that are easy to solve on paper and extremely challenging in practice. Coordination, dialogue, and the practice of dissemination are easier said than done.

But we have a model here and we can advocate within our ecosystems and countries to emphasize the need for a SAINMAP model for the Region that will benefit our countries.