One Health: An overview of APHIS VS’ activities at the intersection of animal health, public health, and environmental h

1. One Health: An overview of APHIS VS’ activities at the intersection of animal health, public health, and environmental health Secretary’s Advisory Committee on Animal Health January 21, 2011 Thomas M. Gomez DVM, MS USDA, APHIS, VS Liaison to the CDC

2. APHIS VS’ OH Strategy -- Outline • One Health • Threats, Definition, Solutions • USDA and External activities • VS’ expanded OH mission area • How public and animal health collaboration works at the AHI

3. One Medicine, One Health MAD COW DISEASE

4. What is One Health… • The convergence of people, animals and our environment has created a powerful dynamic through which the health of animals is inextricably linked with the health of people and the viability of ecosystems.

5. What is One Health….. • One Health is not new • AVMA defined One Health as: • the collaborative efforts of multiple disciplines working locally, nationally, and globally to attain optimal health of people, animals, and the environment

6. Challenge of One Health – “Wicked Problems”……… • One Health problems tend to be “wicked” (influenza viruses, antimicrobial resistance, melamine, etc) • So complex that no one individual, group or discipline can completely understand • No single solution

7. “Wicked Problems”……… (cont.) • So compelling that demand action • Most groups/agencies tend to work in silos – not a good strategy for wicked problems • Solutions to these issues require a comprehensive and interdisciplinary strategy • Need to position ourselves to effectively work in a world of wicked problems • How?....

8. Historical View Bovine TB and brucellosis • Dramatic decline in humans and animals, but not eradicated • Changes bring new challenges

9. Examples of OH Policies initiated within USDA • USDA (Secretary Vilsack) has created a One Health Multi-Agency Coordination (MAC) Group at the Undersecretary Level to address OH policy and interdepartmental coordination • USDA One Health Joint Working Group co-chaired by APHIS and FSIS to implement OH principles at the technical level • Both with the goals of helping to ensure synergy of ideas, reduce redundancy, and improve efficiency.

10. Examples of OH Policies initiated within USDA One Health USDA Multi-Agency Coordination (MAC) Group “There are numerous policy groups that have formed and are being formed that focus on one health. It is important the USDA has a voice at these tables and forms sound policy, as the decisions that are made through these groups will have a substantial impact on the work that we do.” Secretary Vilsack 3/31/10

11. External OH Activities • Global Health Initiative • Bio-defense Interagency Policy Committee (IPC) • National Strategy for Countering Biological Threats • International Ministerial 2007; introduced the concept of “One Health” to the international community leading to the creation of: • FAO, OIE, WHO; “Contributing to One World, One Health” – Strategic Framework • Winnipeg Meeting • Stone Mountain Meeting • November 2011 Joint Ministerial Conference • AVMA; “One Health: A New Professional Imperative” • One Health Commission • CDC One Health Office

12. APHIS VS’ OH Strategy -- Outline • One Health • Threats, Definition, Solutions • USDA and External activities • VS’ expanded OH mission area • How public and animal health collaboration works at the AHI

13. VS 2015 Vision One Health Budget Surveillance Synthesis Information Technology M & M Regulatory Authority AEM-PReP

14. One Health Working Group Members VS Management Team Sponsors: Beth Lautner, NVSL Brian McCluskey, Western Region Jere Dick, Assoc DA/Chief of Field Operations • Lynn Creekmore, Western Region • Tom Gomez, NCAHEM • Beth Harris, NVSL • Steve Just, MN Area • Patty Klein,  NAHPP • Katherine Marshall, CEAH • Leslie Tengelsen, ID PHV • Jo Chapman, MD Dept of Ag • Mike McDole, NM Area • Lee Myers, NCAHEM • Sheryl Shaw, MN Area • Jay Srinivas, CVB • Jill Wallace, NCIE • Randy Wilson, Oregon Area • Joseph Annelli, One Health Coordinator Facilitators: Tom Gomez, Ashley Glosson; Bill Macheel, Larry Miller (to April 2010)

15. APHIS VS Business Advantages in One Health National network of experts in veterinary medicine, animal health , epidemiology, emergency preparedness and response, veterinary diagnostics, veterinary biologics AHPA that embraces all species and references public health USDA and APHIS sister agencies with expertise in wildlife biology, companion animals, safety of meat, poultry, and eggs, animal health research Veterinary laboratory infrastructure, including NAHLN for addressing surveillance and emergency situations (proven surge capacity) Fully integrated programs and workforce synergy with State Animal Health Officials

16. APHIS VS Business Advantages in One Health Partnerships with subset of veterinary practitioners through the APHIS VS NVAP, the private sector (industry, commodity groups) and NGOs Access and availability to Federal agency OH partners, e.g. HHS, EPA, DOI, DHS Voting membership in the OIE OIE Collaborating Centers include NVSL, CVB, CEAH APHIS employees embedded in the OIE and FAO VS employees embedded in CDC and DOD NCMI NAHMS Nationally distributed APHIS VS infrastructure On-farm presence, trust, respect, and the ability to communicate with producers

17. Draft “STRATEGIC PLAN FOR IMPLEMENTING ONE HEALTH ACTIVITIES WITHIN USDA APHIS VS”

18. VS One Health Vision APHIS VS will provide U.S. leadership for the animal health component of OH and, as a dedicated OH partner, will contribute toward improving the global health of people, animals, ecosystems and society

19. VS One Health Mission As the Federal government animal health authority, APHIS VS will contribute expertise, infrastructure, networks, and systems to partner effectively in a multi-disciplinary, multi-level (local, state, national and international) collaborative approach to promote healthy animals, people, ecosystems and society  

20. Strategic Plan Goals for Implementing OH Activities within APHIS/VS Align VS policy, programs, and infrastructure with VS 2015 OH vision Build new collaborations and partnerships, and sustain existing relationships in the OH community Spearhead outreach and communication to build credibility, trust, and respect in the OH community Transform the VS culture and workforce, and build new skills sets to support and integrate VS OH principles Apply our unique competencies to support and enhance the OH community

21. 2011 OHWG Strategic Priorities Developed a list of 12 key priorities identified by the OHWG for immediate action. These priorities will assist VS in building the needed foundation for implementing its OH strategy • Establish a One Health Coordination Office – Interim (Task ID:1.1.1.a) • #’s 2-12 • Need to define, by policy for some tasks, our role in incidents involving zoonotic agents, joint investigations at the AHI, support requests for assistance, pre-harvest food safety, establish/enhance engagement with OH partner at all levels, e.g., establish a Federal interagency OHWG, OH communications, OH training and development courses for VS employees, zoonoses surveillance coordination…

22. OHWG Pilot Projects • Short term developmental projects • Veterinary Services Assessment Teams • One Health Coordinating Office

23. Short-term Developmental Assignment Project • VS field employees are encouraged to explore short-term projects with One Health partners. • These are informal learning experiences – goal to promote interdisciplinary approaches and to foster cultural exchange and connections • Include in IDPs

24. Short-term Developmental Assignment Project • VS field employees are encouraged to explore short-term projects with One Health partners. • In Minnesota, a 2 week assignment with the FDA and FSIS based around drug residue testing and slaughter surveillance highlighted an opportunity for better traceability of livestock found with violative drug residues. • A similar project is underway in Nebraska and may be expanded to South Dakota and Wisconsin.

25. Veterinary Services Assessment Teams (VSAT) • Formal mechanism to respond to requests for VS expertise, experience and infrastructure in situations where animals may play a role in impacting public health, animal health, or the environment • Means for response and assessment • Initiated at the request of State and Federal OH partners • Works in collaboration with State and Federal personnel • Flexible and scalable • Assistance may vary from technical evaluation and consultation to site visits and field investigations

26. Pilot One Health Coordination Office (OHCO) • OHCO officially began duties January 1, 2011 • Members of the “virtual” Office – Joe Annelli, Lynn Creekmore, Katherine Marshall, Tom Gomez, Sarah Tomlinson • VSMT champion/lead - Jere Dick • Purpose – forge the implementation of our OH Strategy

27. APHIS VS’ OH Strategy -- Outline • One Health • VS’ expanded OH mission area • How public and animal health collaboration works at the AHI • Highlights the need for a OH approach to address the domestic and global health challenges such as emerging zoonotic diseases and issues at the AHI

28. Reported Human Infections with Swine-Origin Influenza Viruses in the US - 2005-2010 • Increased detections of interspecies transmission of influenza virus between pigs and people have been reported • 19 cases Dec 2005- Dec 2010 • 12 trH1N1, 6 trH3N2, 1 trH1N2 • All recovered from their illness • 12 cases in children (<19); 7 in adults • Exposure to swine IDed in 15 cases • Limited P-to-P is likely to have occurred

29. Algorithm for Notification and Communication Between Human and Animal Health When Novel Influenza A Viruses Identified in Humans

30. 2009 Novel Influenza A (H1N1) Detected • On April 15th and 17th, the first 2 cases of what became the 2009 H1N1 pandemic were initially investigated using the previous algorithm. • Cases’ illness onset late March 2009 • Jointly investigated potential swine exposure as the source of infection for each case and found none -- no common exposures, no pig contact • Uneventful recovery • Tested because part of enhanced influenza surveillance • CDC - both viruses genetically identical • Contain a unique combination of gene segments previously not recognized among known available swine or human influenza viruses in the US or elsewhere • WHO IHR notification on April 17th • MMWR Dispatch April 21st Dawood, et al NEJM 2009

31. Collaborating on Swine Influenza Virus (SIV) Surveillance • Because of the need to better understand the epidemiology and ecology of SIV, APHIS continues to work with Federal and State AH, PH and industry partners on SIV surveillance • August 2008: CDC & USDA entered into an IAA to conduct SIV surveillance • CDC provided USDA funding to initiate a pilot SIV surveillance project • May 2009: USDA expanded surveillance • July 2010: USDA revised national SIV surveillance plan

32. Summary (1) • The ever-changing demands and needs of animal agriculture continue to impact APHIS VS resources and programs • Domestic and global health challenges such as emerging zoonotic diseases and issues at the AHI highlight the need for a OH approach • The OH initiative has gained significant traction throughout the USG (led by the President’s new policies for national security and global development), international and private sector organizations, academia…

33. Summary (2) • Our unique experiences, expertise and core capabilities position VS to take a more active leadership role to fill critical animal health One Health gaps • As part of our vision for 2015, VS will expand our engagement in OH • Includes defining, by policy in some areas, how VS will or can coordinate and support OH activities at the AHI with our OH partners

34. Summary (3) • The implementation of our OH strategy will commit our organization to build upon past successes in safeguarding American agriculture and adopt a new paradigm to address the complex intertwined health relationships between animals, humans, and their shared environment • Reluctance by our agency to take a more active leadership and/or supportive role will result in lost opportunities and critical gaps that will be filled by other groups – resulting in outcomes we may not agree with…

35. Acknowledgements • APHIS/VS 2015 and One Health Working Groups

36. Questions?

41. APHIS/VS-CDC Liaison Officer - Role Establish and enhance coordination, collaboration, and communication between VS (APHIS – IS, AC, WS, PPQ) and CDC on issues of mutual agency interest