Ibadan, Nigeria — The COVID-19 pandemic has shown us that global health challenges cannot be solved only by health sector interventions.
Many of the recent epidemics -- Ebola, Zika and even Covid-19 -- are emerging infectious diseases transmissible from wildlife species. In addition, other global health challenges greatly impact people, livestock, wildlife and agriculture which results in adverse effects on local, national, and global economies.
To truly tackle prospective pandemics, Africa's higher education institutions need to promote a more integrated approach to healthcare training that breaks down the silos between doctors, veterinarians, laboratory scientists and other aligned professions to embrace a "one health" approach. In short, every discipline is affected and all must be taken into consideration when applying solutions.
We must begin to coordinate and optimise resources across human, veterinary and environmental sectors for prevention, detection and control of infectious disease outbreaks
The One Health approach refers to the collaboration of multiple disciplines working locally, nationally, and globally towards optimal health for people, animals, plants, and the environment. It brings together different disciplines to tackle issues holistically and is critical for Africa since most of the emerging and re-emerging diseases have been linked to wildlife.
The concept has been already been endorsed by several national and international organisations and is beginning to be implemented in several medical schools in North America.
But not in Africa.
Take, for example, Nigeria where the education model encourages competition and territoriality among professions instead of collaboration in practice.
Currently, only 2% of clinical trials conducted globally occur in Africa, according to Tom Kariuki, director of programmes at the African Academy of Sciences. This could hinder the efficacy of COVID-19 vaccine in terms of gaining an understanding of immune response and safety in African populations.
There are historical challenges that have limited vaccine trials in Africa. In Nigeria, these challenges are exacerbated by professional tussles. Whereas drug and vaccine approval is under the purview of the National Agency for Food and Drug Administration and Control (NAFDAC), the oversight of conduct of clinical trials involving human subjects lie with National Health Research Ethics Committee, Nigeria (NHREC). This at times portends bureaucratic difficulties.
Some African countries do have networks involved in One Health training, research, and outreach. However, most of these are not integrated in approach and practice. For example, the Nigerian Field Epidemiology and Laboratory Training Program (NFELTP) is a service-oriented training program with three different options or tracks: applied epidemiology, public health laboratory practice, or veterinary epidemiology means the different tracks still maintain their traditional professional territory.
Recently, while working at the frontlines during the ongoing Covid-19 pandemic as the leader of the Decontamination and Containment arm of the Covid-19 Taskforce for Oyo State, Nigeria, it became clear that healthcare workers still lacked an understanding of what a One Health approach means in practice. Most requests to decontaminate facilities where Covid-19 patients had been evacuated were either not communicated, were delayed or relayed through wrong channels.
The lack of synergy in information communication has significant implications for the overall efforts to curtail the spread of the virus. A global One Health approach requires individuals who have technical competencies to work across sectors, disciplines, and borders to successfully manage complex health issues and disease outbreaks.
We have already seen examples of this in action on the continent. Through curriculum development workshops the University of Rwanda's School of Veterinary Medicine, in association with Tufts University, revised its curriculum to incorporate collaborative skills across disciplines in order to better prepare graduates for the reality on the ground.
The approach has been endorsed by WHO Director-General Dr Tedros Ghebreyesus who said "we can only prevent future pandemics with an integrated #OneHealth approach to public health, animal health and the environment we share".
While it is not possible to immediately refashion all medical, veterinary and environmental health practitioners transformed into One Health workforce, we can start by organising ongoing in-service professional development in One Health keep practitioners abreast of best practice cross-sectoral responses.
Higher Education institutions must incorporate One Health concepts, skills, and competencies to create enhanced curricula and programmes. Finally, we must strengthen communication among medical, veterinary, and environmental Health practitioners on the field.
COVID-19 has shown that we need to act fast as changes at the interface of humans, livestock and wildlife are driving increased risk of emerging disease threats across the globe. We must begin to coordinate and optimise resources across human, veterinary and environmental sectors for prevention, detection and control of infectious disease outbreaks.
By doing so, we will be better prepared for the next pandemic.
Olanike Adeyemo is a Professor in the Department of Veterinary Public Health and Preventive Medicine, University of Ibadan, Nigeria and a 2021 Aspen New Voices Fellow. She advocates for an integrated one health workforce to support a cohesive approach for a healthier world. Follow her on Twitter @OlanikeAdeyemo1.