Expert Q&A: Preventing climate-driven disease outbreaks

Approximately 75 percent of emerging or re-emerging infectious diseases in humans come from animals. As humans push further into animal habitats and as climate change destabilizes weather patterns, outbreaks of zoonotic diseases—meaning diseases that can spread between animals and humans—are expected to increase. Working holistically across sectors is not only innovative but necessary.

The US Agency for International Development’s (USAID) Infectious Disease Detection and Surveillance (IDDS) project, implemented by PATH in Uganda, is using a One Health approach to protect local communities from infectious zoonotic diseases.

We spoke with Derrick Mimbe, PATH’s technical leader for the IDDS project in Uganda, and Dr. Laura Lydia Adong, a local veterinarian and lab manager employed by the Mbale District government, to hear their reflections on the USAID-funded infectious disease work in Uganda and why it’s important for human, animal, and environmental health.

Derrick: One Health is a holistic approach to infectious disease prevention that incorporates multiple sectors that affect health security, including human, animal, agricultural, and environmental health. This approach is officially recognized by governments and international bodies—it is most notably being worked on by the Quadripartite, which consists of the Food and Agriculture Organization of the United Nations, United Nations Environment Programme, World Health Organization, and World Organization for Animal Health—for addressing threats from zoonotic disease.

At the core of the One Health approach is the fact that diseases don’t happen in isolation. Recognizing the connection across sectors is critical to a timely and effective response against infectious disease.

Lydia: Resources are saved by the One Health approach, because when you have different sectors coming together, they are better able to use limited resources than if we were to handle the issue on our own.

It also helps share expertise. If there was an outbreak within my subcounty, I might not be able to address that challenge alone as a vet. I would need support from the human and environmental health sides. I believe One Health is the only way that issues related to diseases or conditions that affect humans and animals can be addressed.

Derrick: PATH is working with the Ugandan government and other IDDS implementing partners to improve global health security by focusing on the prevention of infectious diseases, including seven priority zoonotic diseases, and related threats like antimicrobial resistance (AMR).

In implementing the IDDS project, PATH supports the government in strengthening surveillance, testing, and reporting activities. This allows diseases to be detected early on, informing clinicians and community members about what’s circulating in their community so that they can quickly put in place the right interventions to keep disease from spreading and reduce economic losses, disabilities, and deaths.

Our IDDS project team in Uganda supports the National One Health Platform to address challenges in the human resources infrastructure that impact laboratories and their technical teams, including by working across ministries and health sectors to come up with national standard guidelines for the seven priority zoonotic diseases. This tiered system will standardize testing of these diseases across all sectors at the national, regional, and district levels.

Additionally, USAID’s IDDS project is helping the government strengthen the animal health sector. As project implementers, PATH built an electronic system for the animal health sector, improving the integration and interoperability between the animal and human health sectors. We are also contributing to the development of a quality management system based on international standards intended to help regional animal health labs—like the Mbale Veterinary Lab where Dr. Adong works—get accredited to perform certain diagnostic tests.

Derrick: Climate change has caused an increase in the spread of zoonotic diseases. When climate change begins impacting communities, communities tend to venture into forested areas and reserved national parks to get more resources, and that increases human contact with animals, exposing them to zoonotic diseases.

Climate change also leads to natural disasters like flooding, which can bring spores of infectious diseases, like anthrax, from natural areas into communities. This poses a big challenge for hilly, mountainous regions, including eastern Uganda.

For example, when floods come, runoff from mountains can bring anthrax spores from those mountains into the valleys. As farmers move in search of pastures to feed their animals, it puts them at risk of exposure from the environment. When animals graze in pastures in these valleys, they are at risk of picking up infectious disease bacteria and getting sick, which then puts farmers at risk.

Lydia: If an animal is not in good health condition, a farmer will not be able to get a good income out of it. Many families out there depend on these animals as a source of living and food. To see families thrive through these animals drives me.

Although Mbale has not had an outbreak of anthrax, we are at risk due to recent flooding and outbreaks in nearby regions. Because most of the households in rural Mbale are farming households, an anthrax outbreak would cause significant loss to the community.

AMR emergence is also linked to anthrax. We’ve had incidents of farmers indiscriminately using antibiotics to prevent their animals from falling sick, and we know this practice results in the resistance of microbes to the very medicine that can help.

For example, if these same antibiotics are later used in an outbreak of anthrax, then we may see treatment failure due to resistance. This can result in death, increased expenses of prolonged treatment, and of course, production losses for the farmers—all of this translating into devastating impacts on the farmers’ livelihoods.

This is why one of the things we have done as a district is to sensitize farmers about diseases and the misuse of antibiotics. We have trained communities about how to identify animal diseases and zoonosis and when to notify the area vet or district veterinary officer. Our district has also offered free vaccinations for farm animals as prevention.

Lydia: If issues to do with the environment are well managed, we shall have healthy human beings and healthy animals. Why? Because the infectious organisms come from the environment.

Working together with environmental specialists is very important. As One Health, our sectors work together as specialists so we can help to address these issues. Once we make sure the environment is safe, that is when we shall see the results of having healthy animals and healthy human beings.

Derrick: We know climate change does not only affect the environment. It also affects health, gender, and education, which means all of these ministries must come together to manage a holistic response, similar to the One Health approach. We need to work at two fronts, not just with top-down policy from the national to district levels, but also bottom-up, sensitizing communities and moving local realities up to the national level.

While interventions from the government and implementing partners add important value, long-term and sustainable change comes from the community, as most public health events and outbreaks happen at the community level. By engaging the community from the onset of the intervention and developing policies, then you have more ownership, you have more sensitization, you have them be part of the solution, and I think this is really key.