Stone Mountain Workgroups

“Operationalizing ” One Health

In May 2010, the U.S. Centers for Disease Control and Prevention (CDC), in collaboration with the

World Organisation for Animal Health (OIE), the Food and Agriculture Organization of the United

Nations (FAO) and the World Health Organization (WHO), hosted a meeting in Stone Mountain,

Georgia, USA to identify critical action steps needed to attain a defined 3-5 year vision of One Health.

During the Stone Mountain Meeting (SMM), six workgroups were formed to address these activities.

Almost two years after the SMM, all of the workgroups remain active and productive. The workgroups

are on track to achieve their vision of success, recognizing that coordination, not ownership or

institutionalization, will be key to advancing the vision of One Health. All of the workgroups have

dramatically increased in size as new members who did not attend the original SMM join and contribute.

In late February, the workgroup leaders met via conference call to update each other on the status of their

activities. During this call, it became clear that several groups were already aligning objectives and

actions, and that there are increasing opportunities for collaboration. Several of the workgroups are now

in active discussions to pursue more coordinated efforts.

Workgroup Updates

Business Plan Workgroup

Chairs: Jonathan Rushton, Royal Veterinary College, and Katinka de Balogh, Food and Agriculture

Organization of the United Nations

Anticipating the retirement of Jan Slingenbergh, the Business Plan workgroup has

welcomed its new chairs, Dr. Jonathan Rushton from the Royal Veterinary College in

London and Dr. Katinka de Balogh with the Food and Agriculture Organization of the

United Nations in Rome.

During this transitional period, the Business Plan workgroup has continued its collaboration with the University of Georgia (UGA). Through an internship sponsored by the

United States Department of Agriculture, an MBA student has expanded on UGA’s

domestic One Health Business Plan proposal by developing a concept paper for a U.S. Steering Committee. This concept paper defines the purpose of the committee, discusses barriers to acceptance of the

One Health concept, and provides suggestions for utilizing business world concepts to promote One

Health. The student has also developed a set of value propositions for key stakeholders, including

professional organizations, industry partners, and foundations. These value propositions contain a

detailed analysis of how One Health supports the principles of each organization and provide guidance on

approaching and communicating with donor and advocacy entities.

The process of developing a business plan has provided information that is directly useful

and supportive of other SMM workgroups. For example, focus group meetings with

national and international donors have highlighted the importance of an identifiable

portal of entry for One Health, demonstrating the need for the governance discussions

led by the One Health Global Network workgroup. The Business Plan workgroup

continues to communicate with the other SMM workgroups regarding possible

opportunities for collaboration.

Country-Level Needs Assessment Workgroup

Chair: Jean Kamanzi, World Bank

Over the past several months, the Needs Assessment workgroup has continued to develop the One Health SelfAssessment Guide. The first volume of this assessment guide has been completed and focuses on the background, rationale, and approach. The second volume, currently in revision, focuses on intersectoral collaboration. These tools are designed to be country-driven resources and will provide countries with valuable results

that can be used to initiate dialogue surrounding One Health. The self-assessment tool serves to enhance, but not duplicate or

replace, the OIE Performance of Veterinary Services (PVS) assessments and International Health Regulations (IHR) reviews.

The workgroup, in conjunction with the Capacity Building Workgroup, has tentative plans to pilot the tool in Minnesota, USA

this summer. They are also investigating opportunities to pilot the tool in several developing countries, as well as in other more

developed locations, including Manitoba, Canada. The workgroup is exploring the possibility of publishing a report summary in

open literature so that the tool will be accessible to any country interested in using it.

Capacity Building Workgroup

Chairs: Katey Pelican, University of Minnesota, and Purvi Mehta, International Livestock Research Institute

Many of the Capacity Building workgroup’s goals align closely with the activities of other SMM workgroups

and the workgroup’s co-leads are actively investigating potential opportunities for collaboration with the other groups. Specifically, the workgroup plans to assist the Needs Assessment

Workgroup in piloting the One Health Self-Assessment Guide this summer. The workgroup

will use the One Health Self-Assessment Guide to identify opportunities for universities and

other capacity building organizations to work with governmental agencies to meet their One

Health capacity needs. The workgroup will collaborate with the Needs Assessment

workgroup in future pilots to determine what kind of post evaluation meeting would be most locally useful in

building capacity to address the lessons learned from the needs assessment.

As the group identifies additional opportunities for collaborating, they will move forward with their objective of expanding One

Health engagement by leveraging existing programs and building more coordinated One Health efforts on the ground.

One Health Global Network Workgroup

Chairs: Alain Vandersmissen, European External Action Service, and Tracey McNamara, Western University

The One Health Global Network (OHGN) workgroup has been busy over the past several months. The U.S.

Department of State provided funding for the workgroup to convene a group of experts in Atlanta, GA from

October 31-November 1, 2011. Additional funding was contributed by OIE for a facilitator.

The main objectives of the meeting were to develop a proposal for the OHGN and identify a vision for

governance of both the network and the One Health global movement. Meeting participants agreed on the

key objectives of the OHGN, which included ensuring the delivery of coherent messages, creating synergies

through cross-sectoral collaborations, and uniting One Health actors to pursue coordinated actions. The

attendees determined that the OHGN will be a “network of networks”; it will not replace the existing networks and websites,

but will instead provide the linkages between these networks so that information and opportunities can be shared more easily

and rapidly. A task group, led by Dr. Pierre Duplessis, has been assigned to further define the attributes of the network under

the guidance of an expert group. In mid-February, Dr. Vandersmissen attended the Global Risk Forum One Health Summit in

Davos Switzerland to share the workgroup’s vision of the network with meeting participants; his presentation is available at:

http://www.grforum.org/pages_new.php/Plenary-Session-I/1075/1/938/1073/. The OHGN webportal opened to the public in

April and can be accessed at: http://www.onehealthglobal.net/

Participants also developed a vision of governance for One Health to ensure coherence and consistency of the

movement and developed an implementation roadmap for that vision, with actions, timelines, and accountabilities. The group did not envision the formation of a new institution or secretariat, but rather a “One Health

Global Guidance Group” that could act as a facilitator and enabler for the concepts and goals of One Health,

A group is working to further develop the “Guidance Group” concept, including objectives and goals. The

proposal has been circulated to meeting participants and been endorsed.

Development of the OHGN and a global guidance structure

will add legitimacy to the One Health movement. Additionally, the OHGN web portal will help support the agendas of the

other workgroups and could serve as a repository location for

workgroups to share their updates and products with a wider

audience.

Proof of Concept Workgroup

Chairs: Malika Kachani, Western University and Peter Rabinowitz, Yale University

The Proof of Concept workgroup has assembled a systematic literature review of intervention studies that take a One Health

approach, defined to be intervention studies that assessed health outcomes in human, animal, and environmental health. A key finding of the literature review was that few intervention studies to date have assessed

outcomes in human, animal, and environmental health spheres simultaneously. This emphasizes the novelty of

a One Health integrated approach and the need for further proof of concept research. Due to the small number

of intervention studies, the group is considering using an expanded definition of One Health,

focusing on the importance of approaching challenges from a multi-sectoral perspective. An

academic paper, based on the findings from the literature review, is currently in preparation.

In addition to the current literature review on the effectiveness of an integrated human/animal/ecosystem

approach for disease control, the group has identified several other aspects to the One Health proof of concept

issue which require further exploration. These include examining the effectiveness of an integrated human/

animal/ecosystem approach in disease prediction and as an interdisciplinary team model.

The group has continued to work on developing a prospective study design to demonstrate the usefulness of an integrated One

Health approach. Potential contributors have been identified and the group hopes to start the study this summer. These

initiatives will help build a body of evidence, both prospectively and retrospectively, for the One Health concept and will serve

as valuable support for the other SMM workgroups as they share their products and proposals with potential donors.

Training Workgroup

Chairs: Joe Annelli, U.S. Department of Agriculture, and Kira Christian, U.S. Centers for Disease Control and Prevention

The Training workgroup, which added many new members over the past few months, has compiled a catalogue of

existing One Health courses. Along with course descriptions, the catalogue contains information on the type of

training, target audience, and applicable accreditations. Currently, the group is developing a list of One Health

core competencies for different proficiency levels, ranging from individuals working in the field to national policy

leaders. Eventually, the group hopes to crosswalk the course catalogue against the list of competencies in order to

identify training gaps and guide future course development.

The group’s conference calls have revealed that other organizations have been developing their

own lists of core competencies for One Health. In March, Dr. Annelli attended a meeting at

FAO, hosted by the University of Minnesota, to align the various One Health core competency initiatives

currently underway by multiple groups and agencies. Additionally, the group will host a discussion on One

Health core competencies for the One Health Talk website in May and interested participants can join the

conversation at: http://www.onehealthtalk.org/

The workgroup would like to post the course catalogue and competencies on a website in the near future,

possibly the newly released One Health Global Network web portal, accessible at: http://www.onehealthglobal.net/. This will

make the information easily accessible to One Health practitioners and allow the documents to be conveniently updated.

Introductions

Jonathan Rushton, PhD, is an agricultural economist who specializes in the economics of animal

health and livestock production – an interest that grew from living and working on the family dairy

farm. He is involved in research in the UK and Europe, and has extensive international experience in

livestock production and the control of animal diseases in South America, Africa and Asia. During the

global avian influenza response he worked at the Food and Agriculture Organization of the United

Nations (FAO), and continues to provide advice to the World Organisation for Animal Health (OIE)/

FAO/World Bank Working Group on the global control of foot and mouth disease. He is currently a

senior lecturer and researcher in animal health economics at the Royal Veterinary College, a member

of the Leverhulme Centre for Integrative Research on Agriculture and Health and a non-executive

member of the Animal Health and Welfare Board for England.

Katinka de Balogh, DMV, PhD, is of Dutch and Hungarian origins and grew up in Latin-American.

She studied veterinary medicine in Berlin and Munich and graduated and obtained her doctorate in

tropical parasitology from the Tropical Institute of the University of Munich in 1984. Later she specialized in tropical animal production and health in France and in Veterinary Public Health (VPH) in the

Netherlands. After a short career as a zoo veterinarian in the Rotterdam Zoo she moved to Africa where

she lived for a total of 9 years and worked as a district veterinary officer in rural Zambia and as lecturer at

the veterinary faculties of Lusaka, Zambia and Maputo, Mozambique. Thereafter she worked for 5 years

at the Utrecht veterinary faculty in the Netherlands as lecturer and international project coordinator. In

the late 80’s, she spent two years as a young professional at the VPH Unit of the World Health Organization (WHO) in Geneva where her interest in zoonoses and inter-sectoral collaboration started. Presently

she works at the Food and Agriculture Organization of the United Nations (FAO) in Rome, Italy where she leads the VPH

activities of the organization and is actively involved in advancing One Health.

Rebekah Kunkel, MS, MPH, is an ORISE fellow with the One Health Office at the U.S. Centers for

Disease Control and Prevention (CDC). She completed a Bachelor of Science degree in biology from

the University of Illinois, where she first became interested in the intersection of ecology and public

health while studying the role of small mammals in Lyme disease transmission in northern Illinois.

After completing a Master of Public Health in epidemiology at the University of Michigan, Rebekah

worked as a CDC/CSTE Applied Epidemiology Fellow in the Division of Global Migration and

Quarantine at the CDC, where she focused on improving infectious disease surveillance at U.S. ports

of entry. Due to her interest in the role of ecology in infectious disease spread, Rebekah returned to

graduate school in 2009, focusing her studies on infectious disease ecology. She completed a Master of

Science in Ecology from Emory University in August 2011 and joined the One Health Office in September. Rebekah will be

coordinating follow-up with the Stone Mountain Meeting workgroups and is excited about the opportunity to help bring the

concept of One Health from vision to action.

For more information regarding the Stone Mountain Meeting and workgroups, please visit the One Health Office at

www.cdc.gov/onehealth or contact us at onehealth@cdc.gov.

Conclusion

Over the past year, there has been an escalation of One Health activities internationally and it

is evident that this is a period of great opportunity for the One Health movement. Continued

coordination between the human, animal, and environmental sectors will be the key to

maintaining this forward momentum. Over the next several months, the SMM workgroups

will continue to look for collaboration opportunities as they interact via regular conference

calls and through the workgroup chairs listserv hosted by CDC. The individual and

collaborative activities of the workgroups are all helping to advance the SMM vision of One

Health: culture change, increased visibility, designated funding, and improved coordination.