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Collaboration in Covid-19: a lesson for NTDs

9 April 2020

In the face of this unfolding pandemic, a positive headline is welcome news for many.

“Covid-19 self-test could allow return to work”, say health officials

Vets and virologists from three UK universities have been developing an on-farm test for viral diseases of chickens for use in developing countries, where poor laboratory infrastructure makes testing impossible. The team are now seeking manufacturers to allow their hand-held device to be used in the current Covid-19 outbreak. Another report praised the swift repurposing of a veterinary laboratory in the Faroe Islands to allow immediate testing for Covid-19 to be established.

The pandemic has seen unprecedented worldwide collaboration, with WHO praising Chinese scientists acting early to sequence the coronavirus and releasing genome data for others to build on. Knowledge of the genome is essential for development of diagnostic tests and vaccines, a challenge taken on by scientists around the world.

This spirit of collaboration doesn’t have to end when a crisis ends – sharing resources and knowledge across sectors can achieve more than working alone.

In the Neglected Tropical Diseases (NTD) sphere, we know that there are many neglected zoonotic diseases in which animals play a crucial role in continuing disease transmission. Veterinary public health expertise is therefore essential for the long-term sustainability of efforts to control these potentially devastating diseases.

One Health is a collaborative approach to health that recognises that humans and animals live in a shared environment and there is added value to be gained by working together on issues at the interface of different sectors.

Schistosomiasis is a good example, as the parasite needs to live some of its life cycle in snails. Currently the mainstay of control is targeted mass drug administration using praziquantel for at-risk children. However, the WHO has last week reaffirmed its commitment to control the disease in snails to reduce the disease in people. They recommend careful use of molluscicides to kill snails, but acknowledge this can have impacts on the wider ecosystem, such as toxicity to other water-based species.

Finding a solution to often complex disease transmission cycles mean it is necessary to consider a multitude of control strategies to come together. For schistosomiasis, this includes water, sanitation and hygiene (WASH) and mass drug administration alongside control of snail populations.

But how do we ensure we ‘do no harm’ to the wider ecosystem? This is where One Health evaluation can be useful.

One Health evaluation uses a systems-based approach, first mapping out all the stakeholders that may be directly or indirectly involved. For example, the system relating to schistosomiasis can span from the behaviour scientists designing school health education programmes to occupational health experts advising on molluscicide application; from the patients themselves to the fish in lakes in which they might swim or bathe.

Evaluating and measuring all these things with one metric is challenging but demonstrating and accommodating all the complex interactions of the different stakeholders in a system can mean we avoid any unintended negative consequences of disease control interventions.

Dr Gabrielle Laing BVSc PhD MRCVS

One Health Policy Adviser