Hellen Amugunia, Winnie Bikaakob, Irene Naigagab, William Bazeyo
Tufts University, Cummings School of Veterinary Medicine, 200 Westboro Road, North Grafton, USA
One Health Central and Eastern Africa (OHCEA), P.O. Box 7072, Kampala, Unit 4, Ekobo Avenue, Kololo, Uganda
Finance and Administration, Makerere University and Principal Investigator, One Health Central and Eastern Africa(OHCEA) Network. P.O. Box 7072, Kampala, Unit 4,
Ekobo Avenue, Kololo, Uganda
Introduction
Over the past decade, Africa and the world have faced severe public health threats, ranging from infectious disease outbreaks such as the Ebola outbreak in West Africa to environmental disruptions like the devastating effects of hurricane Matthew in Haiti. Recent outbreaks of emerging infectious diseases have captured global attention with their significant impact on health systems and economies. Boundaries between humans, animals and our environment are undergoing rapid changes [1]. Novel diseases are emerging and not just in humans. It is estimated that three out of four new infectious diseases occurring in humans are of animal origin [2]. The complexity of the issues: global movement of people, animals and disease-causing pathogens, cross border exchanges, increased human population, shrinking wildlife habitats, illegal wildlife trade, rapid globalization, pollution, loss of biodiversity, antimicrobial resistance and changes in environment and land use demand that we apply a systems thinking interdisciplinary approach to solve complex health challenges at the human animal and environmental interface.
Experiences from the fight against Ebola and the highly pathogenic avian influenza demonstrated the effectiveness of multi-sectoral, multi-agency approaches that are not limited by national or regional borders in dealing with public health threats [3]. One of the key approaches to achieve global health security is by building a multidisciplinary public health workforce that is well trained and fully equipped to counter infectious disease threats and that eliminate the current global barriers that exist because of disciplinary silos.
In response to this challenge, the One Health approach is advocated as the global framework for strengthening collaboration and capacities of the sectors and actors involved in health service delivery [4]. The One Health paradigm emerged from the recognition that the well being of humans, animals and ecosystems are interrelated and interdependent, and there is need for more systematic and cross-sectoral approaches to identifying and responding to global public health emergencies and other health threats arising at the human-animal ecosystem interface [3]. The One Health concept is a growing global strategy for expanding interdisciplinary collaborations and communications in all aspects of health care for humans, animals and the environment that calls for a paradigm shift in developing, implementing and sustaining health policies [5].
Key to the implementation of One Health strategies is the redesign of a more integrative and dynamic educational system to better match the public health needs and produce a workforce that can effectively and efficiently respond to complex health challenges. Mismatch between present siloed professional competencies and the requirements of an increasingly multidisciplinary complex world means that overhauling public health education is imperative. In 2010, the commission on education for health professionals for the 21st century was launched. This independent initiative with a global outlook sought to advance health by recommending instructional and institutional innovations to develop a new generation of health professionals who would be better equipped to handle present and future complex health challenges in an era of rapid globalization [6]. Yet many professional training programs are still very traditional, producing graduates who are ill equipped to handle current challenges. One Health is a conceptual challenge to conventional public health training and practice because it addresses public health threats from a multidisciplinary collaborative perspective.
One Health Central and Eastern Africa (OHCEA) is a network of universities in Central, West and Eastern Africa which are collaborating to build One Health capacity and academic partnerships in the region. OHCEA membership includes twenty-four Central, West and Eastern Africa Schools of Public Health, Veterinary Medicine and Environmental Science; and US partner institutions: University of Minnesota (UMN) and Tufts University. The current OHCEA membership spans eight countries: Kenya, Uganda, Tanzania, Rwanda, Ethiopia, Democratic Republic of Congo, Cameroon, and Senegal [7], working together to strengthen public health education, systems, emergency preparedness and response.
OHCEA seeks to expand the human resource base needed to detect and respond to potential pandemic disease outbreaks, and increase integration of animal, wildlife and human disease surveillance and outbreak response systems using a One Health approach [7]. To do this effectively requires engagement of multidisciplinary groups of professionals with the right intellectual competencies and knowledge, capable of collaborating with each other. What type of training and preparation will provide public health professionals with the skills and competencies needed to combat such emerging public health threats?
The OHCEA network and its partner institutions, have developed One Health Core Competencies and modules that are key to delivering knowledge and skills to a multidisciplinary workforce and building a framework on which One Health curricula can be designed and implemented. A total of sixteen modules have been developed including One Health soft skills such communication, collaboration and partnership, culture, leadership, gender, policy and advocacy, systems thinking as well as core technical skills including ecosystem health, risk analysis, infectious disease epidemiology, One Health concepts and outbreak investigation and response. These modules are being used at both preservice and in-service levels. by faculty and students across OHCEA’s eight countries and institutions in East and Central Africa, and by various government and private industry in these countries-deliberately focusing on building cross sectoral collaborative skills and technical competencies that prepare them to efficiently respond to any emerging public health threats. They are designed to fill the cross sectoral and technical skill gap caused by the changes in public health practice. The skills provided combine human and animal health sciences with the principles of ecology and environmental health while at the same time considering the social, economic, cultural and environmental impacts and effects on global health security. In this manuscript, we provide a detailed description of the module development process.