Joint UMA/UVA International One Health Conference Hotel Africana, Kampala, Uganda.

1. BACKGROUND AND CURRENT DISEASE SURVEILLANCE & CONTROL STRATEGIES UNDER ONE HEALTH APPROACH IN UGANDA Joint UMA/UVA International One Health Conference Hotel Africana, Kampala, Uganda. 14-16 February, 2013. Author: Dr. WinyiKaboyo, Veterinary Public Health, MOH Co-authors: Dr. C. Rutebarika, ACDC, MAAIF; Dr. P. Atimnedi , Vet. Coord. UWA and Mr. E. Enyel, Wildlife Officer, UWA.

2. Background • The need for professional/interdiciplinary collaboration between medical & veterinary recognised in the past: • CalvineSchwabe expounded concept of “One Medicine” • WHO -1975 promoted establishment of VPH units in ministries of health and at WHO Hqs. • In Uganda, VPH Unit established in MOH since 1980s.

3. Current Disease Surveillance & Control Strategies under OH • Key sectors mandated in prevention, control & management of zoonoses: • Ministry of Health (MOH); ESD, VPH • Ministry of Agric, Animal Industry & Fisheries (MAAIF) • Uganda Wildlife Authority (UWA) • Local Govt. Authorities; Districts, KCCA • Other Partners: UN agencies, NGO’s, Red Cross, UPDF, etc

4. Mechanisms for collaboration • 1. Joint technical committees • 2. National Task Forces • 3. Field disease investigations & management • 4. Simulation exercises • 5. Project design, appraisal & implementation

5. How do these mechanisms work? • Technical committees (TCs) In the early 1990’s, MOH and MAAIF formed TC for rabies, RVF, lab network for early detection & response to the zoonoses. Regular meetings & sharing information, strategies, lab results and resources, holding joint workshops.

6. INFORMATION, EDUCATION & COMMUNICATION (IEC) ON RABIES

7. Vaccination of pets at one of the centresTECOR

8. Mechanisms contd.. • National Task Forces Due to emerging zoonoses, Anthrax, BSE, VHF, (ebola, marburg), HPAI, pandemic influenza H1N1, National Task Forces were formed. Regular meetings, situation reports, resource mobilization & sharing, joint rapid response teams (RRTs), community mobilization & sensitization, advise policy & training.

9. One Health training on PPEs Mbarara district

10. Mobilization against anthrax • The Republic of Uganda • ANTHRAX ALERT!!! • GUIDELINES ON HOW TO PROTECT YOURSELF FROM ANTRHAX • 1. What is anthrax? • Anthrax is a dangerous disease that affects human beings, domestic and wild animals and can cause death. • 2. How can I tell that an animal has got anthrax? • An animal suffering from anthrax or a carcass can be easily recognized by seeing unclotted blood coming out of the natural openings like the mouth, nose, ears and anus. • 3. What should I do to avoid getting infected? • In case of an outbreak or suspected cases of anthrax in any animal including wild animals, the following measures must be taken immediately:  • Avoid skinning any animal suspected to be sick or to have died from anthrax. • 4. Do not eat meat from such an animal. • 5. Do not remove teeth, horns, hooves or any other body part of that animal.  • 6. Report any suspicious case to the authorities (Local Councils, Park Rangers, Veterinary or Health staff nearest you)  • 7. Seek immediate medical attention if you have been exposed to a suspected case of anthrax.  • Published by: Veterinary Public Health Unit and Health Promotion Education Division Ministry of Health Uganda.

11. Mechanisms contd…. • Field disease investigations & management i) Rabies outbreak investigations and mass vaccination of dogs and cats. ii) Anthrax, iii) Plague, iv) Yellow fever v) HPAI, pandemic H1N1 vi) Ebola & marburg

12. Joint rabies vaccination campaign- Rakai district

13. Animals captured & sampled(L) Vervet monkey & Bat (R)

15. Joint communication & outbreak reporting strategies • Avian Influenza Communication Strategy • Uganda National Disease Outbreaks Portal (www.diseaseoutbreaks.ug)

16. Joint simulations on HPAI • Table top simulation exercises held for districts. • One national field simulation exercise in Mukono District, May/June 2012. • Regional field crossborder simulation exercises for at Busia at Uganda and Kenya border under EAC.

17. Zoonoticdss projects • SPINAP under AU/IBAR funded by EU. 2008/2010 • Avian & Human Influenza Preparedness & Response project (AHIP) • Multi sectoral (MOH, MAAIF, OPM & Local Govt/districts • Funded by World Bank & GOU. • 3 yr project (training, logistics, lab diagnostic, surveillance & civil works)

18. Challenges to One Health • Inadequate funding for the key sectors • Political will yet to be fully mobilised • Lack of enough technical expertise especially at district level among the DRRTs to repond to emerging zoonoses. • One Health concept yet to be explained and appreciated at district level & below: (DHO,DVO, Med Supt, Wildlife/Game Warder, i/c Health Unit).

19. Way forward for One health • Formalise structures; joint MoU, policies, guidelines, strategies between key players at implementation level. • Improved funding for zoonoses; training, disease outbreak response, lab capacity/ infrastructure, • Prompt zoonoticdss outbreak communication and management in human, domestic and wildlife. Thank you