The following is a guest post by Scott Moreland, PhD of MEASURE Evaluation
Recent experience with the threat of Ebola Virus Disease in West Africa, specifically Guinea, has rung a few bells in neighboring Senegal.
Approximately 75 percent of new infectious diseases that threaten people have been shown to be zoonotic—that is, originating from animals or animal by-products. The “One Health” approach—which considers animal, human, and environmental health as a unit—has gained momentum in response to the emergence of new infectious diseases at the human-animal-ecosystem interface.
The government of Senegal has shown its commitment to the One Health approach by moving stewardship of that effort to the Office of the Prime Minister — ensuring its visibility. The full backing of the government demonstrates Senegal’s foresight in setting up the information and data structure to be ready for any disease outbreak.
One of the main challenges to implementing a One Health approach, however, is a lack of data, especially for zoonotic diseases. Unlike infectious human diseases, the reporting of zoonotic disease is sparse and spotty and data are poor. Knowledge of the prevalence rates for zoonotic diseases among animals or in humans is limited. In developing countries, the data infrastructure for animal diseases is poor at best and often nonexistent, despite the importance of livestock in those economies.
For that reason, Senegal supported the launch of an activity implemented by MEASURE Evaluation, with Ebola funds from the United States government for its first phase (April 2016–March 2018), which was designed to improve human surveillance in two pilot districts in Senegal. The United States, through Global Health Security Agenda — a 50-nation consortium — is funding the second phase (October 2017–March 2019) to build off phase one to include diseases in animals and extend surveillance to a wider geographic area.
The first phase aims to improve a community event-based surveillance system set up in the two pilot regions, Tambacounda and Saint Louis. Community event-based surveillance is a priority area for the country because if it can be integrated at all levels of a national health surveillance system, it can be an effective mechanism for early detection and response — the keys to control of disease outbreak events.
Challenges observed in the first phase included difficulty accessing some areas, poor Internet connectivity at health centers and scant mobile connectivity in remote areas. Logistics were a barrier for nurses to investigate disease alerts, and continued motivation of community volunteers was a challenge. The second phase will build on those findings and address the identified gaps.
Adding diseases among animals to the surveillance in the second phase, the project will look for rabies, zoonotic influenza, tuberculosis, hemorrhagic fevers (such as Ebola and Marburg), and anthrax.
For this phase, MEASURE Evaluation is working with Senegal to provide additional training for community health workers and community-based animal workers in the two phase one regions with plans to extend into Ziguinchor and Sedhiou regions. Strengthening multisectoral coordination to exchange alerts on outbreaks of diseases in animals and in humans facilitates early detection of outbreaks in one that may affect the other. This activity, along with a parallel one in Burkina Faso under the USAID-funded MEASURE Evaluation project, is globally unique, from what we know — truly a world first. In addition to Senegal, partners include the United Nations Food and Agriculture Organization, the World Health Organization, and the World Bank.
As the African continent makes strides in economic growth — and may become one of the fastest growing regions in coming decades — some of these desired changes will inevitably give rise to conditions that could become threats to human health. As incomes grow and the population increases, we may see dramatic intensification and expansion of demand for livestock and livestock products. And this rapid growth will pose health risks from diseases among animals and people, antimicrobial resistance, and environmental degradation.
But Senegal is laying the foundation for high-quality data, trained responders, and strong government backing to be ready for such potentially dangerous outcomes.