A World in Change - The Rising Threat of “Zoonotic” Diseases

1. A World in Change - The Rising Threat of “Zoonotic” Diseases

2. The Rise of Zoonotic Diseases

3. If a New “HIV” were to emerge today….would it be another 40 years before we recognize it • Do we have the ability to monitor for new HIV-like threat just as it is “emerging” and before it has become established in human populations • Are our surveillance strategies better able to identify its early spread among humans before it’s a global pandemic?

4. Emerging threats to humans often start as zoonotic diseases Pathogens often started as zoonoses Locus of human disease in geographic hot spots Human and economic Impact can be enormous • Many long-standing diseases in humans (e.g. hepatitis, malaria, measles) caused by microbes originally from animals • In last 70 years, many new diseases (HIV, Nipah , SARS, H5N1, H1N1) have “jumped” from animals to humans • Nearly three-quarters of new zoonotic diseases were caused by pathogens originating in wildlife • New diseases tend to emerge in geographic “hot spots” • “Drivers” for emergence are closely linked to factors that intensify animal-human interactions • Climate changes • Food security • Economic growth • Population pressures • Behaviors • The rate of pathogen emergence is projected to increase 5 fold over between 2000 - 2030 as animal-human interactions intensify • HIV/AIDS has killed >25 million people , continues to infect 33 million more • Cost of SARS estimated at $40-50 billion • Many other examples

5. The “Drivers” Behind The Rising Threat • Accelerated incursions into previously isolated “wildlife” domains: – population growth – 7 billion and counting – search for arable land • Increased wealth – demand for animal protein – economic growth and extraction of natural resources • Globalization – “nothing stays local anymore”

6. Specific challenges associated with early detection of emerging threats require a new approach

7. The standard model for outbreak detection and response does not work well for zoonotic diseases Response Lab Confirmation Detection First Case CASES TIME

8. An alternative approach sees public health as part of the “ecosystem” -- One Health SPILL OVER SPILL OVER SPILL OVER Human Cases Wild Animal Domestic Animal Animal Amplification CASES Human Amplification TIME

9. An alternative approach sees public health as part of the “ecosystem” -- One Health SPILL OVER SPILL OVER SPILL OVER Human Cases Wild Animal Domestic Animal Animal Amplification CASES Wildlife Surveillance/ Forecasting Early Detection and Control Opportunities Human Amplification TIME

10. EPT: Targeting “Hot Spots” Southeast Asia Cambodia China Indonesia Laos Malaysia Philippines Thailand Vietnam Congo region Angola Burundi Cameroon CAR Congo DR Congo Amazon Bolivia Brazil Colombia Ecuador Mexico Peru South Asia Bangladesh India Nepal Eq. Guinea Gabon Rwanda Tanzania Uganda

11. EPT builds on USAID’s broad cross-sectoral development platforms • Maternal and child health programming • Infectious diseases control (HIV/AIDS, TB …) • Disease surveillance • Communications/behavior change Health • University linkages • Curriculum development • Education reform Education Disaster Response • Wildlife resources • Forestry • Conservation • Climate change Environment • Food security • Natural resource management • Livestock/animal husbandry programs • Vaccines and immunization • Global food security • Pharmaceuticals Public Private Partnership Agriculture

12. EPT also includes partners from the private, public and social sectors Pathogen Detection, Risk (biological) Determination USAID EPT grantees PREDICT Univ. California-Davis; Wildlife Conservation Society; Global Viral Forecasting (GVF); Smithsonian; EcoHealth Alliance RESPOND Development Alternatives Inc.; Tufts Univ.; Univ. of Minnesota; Training Resources Group; Ecology & Environment PREVENT Academy for Educational Development – Now FHI 360, GVF IDENTIFY World Health Organization; Food and Agriculture Organization; World Organization for Animal Health Outbreak response capacity Risk (behavioral) Determination, Risk Reduction Laboratories

14. The EPT partnership is building critical “One Health” human and institutional capacities Partner Description Example activities • Strengthen animal and human disease surveillance capacities, • Build and link laboratory networks, and • Enhance response capacities – for disease outbreaks, including those “public health emergencies of international concern” (IHRs) Ministries • Partnering with ministries of health, agriculture and “wildlife” to address structural and operational capacities for coordinated action • Pairing U.S. schools of public health, veterinary medicine, nursing, and wildlife management with counterpart schools and institutions in hot-spot countries • Co-develop pre-service and in-service curricula tailored to the emerging disease, epidemiology and outbreak response needs of each country and program. • Strengthen faculty teaching abilities and methodologies through targeted professional development programs. • Build cadres of trained professionals to lead “the way forward” Educational institutions • Partner with the “extractive industry” to characterize “risky practices” • Formulate appropriate interventions to reduce “risk” • Investing in public-private and community partnerships • Identify/mitigate practices that contribute to the risk of new emergent diseases Private Sector • Characterize “highest risk” areas for focused operations • Partner with provincial and district authorities from MOH/MOA/MOE to build local outbreak response capacities • Supporting the technical and operational capacities of provincial and district responders Community