Report Submitted to the One Health Initiative Autonomous pro bono team December 16, 2013 – Posted OHI website December 19, 2013
One Health Sweden steering committee visit to Florida (USA) December 2013
Björn Olsen, MD, senior physician, professor in infectious diseases, Uppsala University, Uppsala
Lotta Berg, VMD, senior lecturer, associate professor in animal hygiene, Swedish university of Agricultural Sciences, Skara.
Karin Artursson, VMD, associate professor in bacteriology, research coordinator, the National Veterinary Institute, Uppsala
Josef Järhult, MD, Specialized physician in infectious diseases, Uppsala University, Uppsala
“More similarities than differences in how One Health is approached in Europe and North America”
The Swedish One Health Network (OHS) was initiated in 2010, under the name Infection Ecology and Epidemiology Network. The network has four core partners: Uppsala University, the Swedish University of Agricultural Sciences, the Swedish Veterinary Institute and the Linnaeus University, and welcomes individual members from all universities, institutes and health related organisations nationwide. The main focus is on zoonotic diseases and antimicrobial resistance issues. The members are mainly physicians, veterinarians, biologists, ecologists, microbiologists, health economists and other health professionals interested in such topics and interdisciplinary research. For more information, please see www.onehealth.se/ohs .
Since the start almost four years ago, OHS regularly arranges a large annual scientific meeting, smaller research pubs with more informal presentations, and seminars targeting health professionals, research funding councils, politicians, policymakers and the general public. OHS has also launched an open access electronic journal, the Infection Ecology and Epidemiology Journal (IEE Journal, please see http://journals.co-action.net/index.php/iee/index) to facilitate publication of multi- and interdisciplinary One Health related scientific papers from all over the world. Furthermore, OHS has supported the development of cooperation between the veterinary medicine and human medicine graduate programmes in Uppsala.
One Health is by definition a global initiative, and hence it is of profound importance to actively participate in international networks as well. Colleagues from the original One Health Initiative (Laura Kahn and Jack Woodall) and CDC (Carol Rubin) have, together with European researchers, been invited to give presentations at the annual scientific meetings, and members of the OHS steering committee and also other network members have attended the international One Health Congresses in Melbourne and Bangkok respectively. Furthermore, a study visit has been made to Immuno Valley in the Netherlands.
As the OHS steering committee is continuously aiming at developing and strengthening the national network and its international contacts, we made a decision to contact colleagues with a strong interest in One Health issues in the US, for further exchange of ideas and inspiration. Hence a group of four persons – two physicians and two veterinarians, all involved in One Health research activities - (Karin Artursson, Björn Olsen and Lotta Berg from the steering committee, and Josef Järhult who is one of the most active members of the network) went to North Carolina and Florida in the end of November - beginning of December 2013. The main aims were to strengthen our international network, investigate the possibilities for future research cooperation, obtain information on various ways of designing undergraduate training and graduate programmes to integrate physicians, veterinarians, public health officials and others working with a One Health focus, to discuss the context and contents of the One Health concept, and also to discuss methods for informing and influencing policy makers and politicians about One Health in an efficient and transparent way.
We were fortunate to meet with several well-renowned One Health profiles in the South-Eastern U.S. First, Karin Artursson visited the Research Triangle Park region of central North Carolina to meet Cheryl Stroud and Suzanne Kennedy-Stoskopf, Chair and Co-Chair of the North Carolina One Health Collaborative (NC OHC). Karin also shared information about One Health Sweden with Betsy Hilborn, Janice Dye and Whitney Krueger who work with the EPA (U.S. Environmental Protection Agency) and enjoyed a tour of the NCSU College of Veterinary Medicine. Being part of the Research Triangle Park region, the four year old NC OHC has been able to engage representatives from local universities, state and federal government agencies, and companies in One Health conversations and endeavors. A course, ´One Health: From Philosophy to Practical Integration of Human, Animal, and Environmental Health' , cross-listed among Duke University, the University of North Carolina, and North Carolina State University is offered within the public discussion forum. Cheryl Stroud has recently also been appointed Executive Director of the One Health Commission, a non-profit organization founded in the U.S. just a few years ago. The Commission seeks to connect One Health leaders to work collaboratively on One Health projects and promotion.
The entire group then met with the One Health Initiative profile Bruce Kaplan in Sarasota, where we discussed how the One Health concept has evolved in the US and in other parts of the world, ongoing activities and initiatives, various definitions of One Health and their implications. In research, One Health doesn’t mean that all projects will need to involve researchers from all possible disciplines, but that there should be an awareness of the importance of linking the results from different projects together to paint a bigger picture. Furthermore, there is a need to define each research project in its own context, not just as a “One Health project” (e.g. antibiotic resistance, zoonotic infections etc.). Other aspects mentioned were the importance of individuals, both when it comes to active researchers being able to continuously push One Health aspects, and when it comes to the significance of having individual faces to illustrate the consequences of failure to apply a relevant One Health approach in public health, to bring the concept to a personal level that will make the public and hence the politicians more aware of these issues.
We then continued to Gainesville and the University of Florida (UF), where our host Greg Gray at the Emerging Pathogens Institute and his colleagues and co-workers there and at the College of Veterinary Medicine (including Paul Gibbs, Glenn Morris, James Lloyd and more) informed us about how the university is working on One Health issues, including emerging and re-emerging diseases, food safety and antibiotic resistance, nationally in the US and also internationally also in rather remote parts of the world. It became quite obvious that regardless of country of origin, we share experiences both in relation to successful research projects and in relation to a certain amount of frustration linked to the challenges in communicating the results to achieve impact at the central authority and policy-making level. The possibilities of formalising future cooperation between the Emerging Pathogens Institute and the institutions forming OHS were further discussed. Concrete projects were mentioned as well, especially in relation to influenza viruses and antibiotic resistance respectively, and Björn Olsen and Josef Järhult were given the opportunity to present some OHS-related projects at a seminar at UF. We also enjoyed a tour of the top-modern animal hospital facilities at UF.
Finally, Björn Olsen, Lotta Berg and Josef Järhult continued to Tallahassee, to meet with Carina Blackmore at the Florida Department of Health and with Lisa Conti at the Florida Department of Agriculture & Consumer Services, both being veterinarians with a strong interest in and vast experience from One Health related work at competent authorities. We found the discussions about how politics may influence One Health legislation, policy making and priorities highly interesting and very relevant also from a European perspective, although current policies – for examples on the use of antibiotics in animal and plant production – may be different. Risk communication, ‘story-telling’ (e.g. about cases of zoonotic diseases) and the involvement of veterinarians, infectious disease physicians and ecologists together in outbreak prevention and response work were other topics discussed. Also at this meeting various possibilities of future research cooperation were mentioned, especially with a focus on water sampling and antiviral residues in waste water effluents.
In summary, we found this intensive trip to be very well invested time and money, with excellent and quite concrete outcomes in terms of knowledge exchange and plans for future contacts and cooperation. We would like to express our sincere gratitude to everybody who took their time to meet us and make our stay valuable, both in terms of professional knowledge and in terms of hospitality and introduction to the beautiful state of Florida, and to the Swedish Civil Contingencies Agency for financially supporting this trip.
Reported by Dr. Lotta Berg for the OHS Steering Committee