Any nation must put strategic disease prevention and control measures in place if it wants to limit the number of new infections, the number of people who already have the disease, and the morbidity and death caused by the disease in the community. For endemic diseases, routine control measures are conducted, while sporadic measures are used in response to sudden epidemic outbreaks. A practical and evidence-based approach to healthcare, infection prevention, and control has an impact on several healthcare-related issues, including hand cleanliness, surgical site infections, injection safety, antimicrobial resistance, and how hospitals run both in emergencies and when they are not. Each country must be self-sufficient in this regard and have access to cutting-edge, high-tech labs to improve capacities for vaccine production and distribution as well as surveillance and knowledge. Additionally, to effectively prevent and control infections, they must design the protocols for providing healthcare and medical hygiene standards. Additionally, the global focus on the idea of "One Health" acknowledges the interdependence of humans, animals, plants, and the environment. This concept promotes a cooperative, multi-sectoral, and transdisciplinary approach and calls for the development of resilient systems at the national level. Even in low- and middle-income countries, where increased population pressure hurts healthcare delivery and medical hygiene standards due to secondary infections, there are differences among the nations in their programs and investments to support disease prevention and control.
A useful strategy to address the issues in several countries is a coordinated cross-country management of public health issues. In the United States, Europe, Africa, and Australia, there are Centers for disease control and Prevention that are already operational and making efforts in this area. The US Centers for Disease Control and Prevention, founded in 1964, is the oldest of these, while the European Center for Disease Prevention and Control (founded in 2005), the Africa Centre for Disease Control and Prevention (founded in 2017), and the Australian Centre for Disease Control (founded in 2023) were all established later. While the US and Australian CDCs have the states within' as Member States, the European and African CDCs have 'nations' as Member States. The COVID management strategies established by these CDCs provide an impenetrable framework for attaining cross-country coordinated disease control and resolving public health issues, successfully overcoming programmatic and infrastructure constraints in various nations. Following is a summary of the One Health (OH) methods and best practices these CDCs have embraced for COVID management.
United States: To solve OH problems, prepare for outbreaks and emergencies, increase surveillance, and inform people about disease prevention from animals, the US CDC's One Health Office works with partners both domestically and internationally. They encourage a multi-sectoral One Health approach, engage specialists from several fields, and support zoonotic outbreak investigations. The Office also created a surveillance infrastructure for SARS-CoV-2 and supports states with One Health investigations into SARS-CoV-2 infections in animals. Through the One Health Federal Interagency COVID-19 Coordination Group, it encourages cooperation and information sharing.
Europe: The European Centre for Disease Prevention and Control (ECDC) oversees two important tasks: behavior modification and health and prevention. Its goal is to improve Europe's defenses against infectious illnesses through communication, public health training, readiness for and support during outbreaks, scientific guidance, and surveillance. To support national laboratories, promote testing procedures, and encourage data reporting, ECDC maintains a strong laboratory capacity with an integrated network of EU reference laboratories. Infection patterns and outbreak sources can be tracked down with the help of molecular monitoring, which enhances epidemiological communicable disease surveillance. The European Surveillance of Antimicrobial Consumption Network, a training program in genomic epidemiology and public health bioinformatics, and support for whole genome sequencing infrastructure are among the areas of concentration for the ECDC. While ECOVID LabNet organizes microbiological efforts, ECOVID-Net integrates epidemiological and virological COVID-19 surveillance to provide information to decision-makers.
Africa: The Regional Coordination Centres are used by the Africa Centre for Disease Control and Prevention (ACDC) for surveillance, readiness, emergency response activities, and collaboration with Member State National Public Health Institutes (NPHIs). ACDC develops quality management systems, executes biosafety and biosecurity efforts, and strengthens laboratory systems through AFCAD (African Collaborative Initiative to Advance Diagnostics). Its surveillance initiatives include the One Health Program, cross-border illness surveillance, digital disease surveillance, and programs for controlling antimicrobial resistance. The Vaccination Bingwa Initiative, which was co-designed by ACDC and the Youth Division of the African Union Commission (AUC) to combat COVID, created a network of youth ambassadors across the continent to advocate for COVID-19 vaccination.
Australia: With a focus on preventing chronic diseases, the recently founded Australian Centre for Disease Control improves pandemic readiness and response. It guarantees constant readiness, response to infectious disease outbreaks, and prevention of contagious and non-contagious diseases. The National Coronavirus Helpline provides 24/7 guidance on COVID-19 and immunizations, and the CDC created the "Living with COVID-19" service to assess and connect positive people to healthcare services.
Coordination of One Health Approach: Asia's Lessons
48 nations make up the Asian continent, which is divided into the East, South-East Asia, Central Asia, South Asia, and West. Low- and middle-income nations (LMICs), which deal with intense population pressure and insufficient disease control infrastructure, methods, and standards, predominate in it. Supporting the nation's ability to effectively plan for and respond to outbreaks and emergencies can be achieved in large part by strategically promoting the One Health strategy. This strategy enhances overall efficacy by utilizing regional technology and experience for multi-sectoral surveillance, which aids in overcoming deficiencies. Given the diversity of the political, economic, social, and cultural fronts, the following elements should be taken into account when building the CDC and a coordinated One Health strategy for Asia:
A. Creating a CDC at the subcontinental level: The goal of creating an integrated system for all Asian nations seems unachievable given the wide range of differences, inequities, and disagreements among Asian nations. In areas where regional cooperation agreements or organizations like the Association of Southeast Asian Nations (ASEAN), South Asian Association for Regional Cooperation (SAARC), Gulf Cooperation Council, Eurasian Economic Union (EEU), and Shangai Cooperation Organization (SCO) already exist, a subcontinental integration may be the potential solution. The development of a South Asian CDC is anticipated to be resilient and fruitful because, among the five areas of Asia, South Asia has created and demonstrated stronger and sustained regional cooperation through the ASEAN and SAARC associations.
B. Partnerships and Collaborations: The sub-continental/regional CDC can benefit from the knowledge of national authorities and public health institutes in the area by forming partnerships and collaborations with them. This will help to promote a coordinated One Health strategy. Additionally, this would support the creation of a regionally connected network of reference laboratories, strengthening both the public and clinical health laboratory systems.
C. Data integration across borders: The coordinated One Health concept and a South Asian CDC need multisectoral data from all of the member nations. For data integration, communication with the external affairs ministries of the member nations is crucial. The coordination with member countries' ministries may be facilitated by the regional cooperation created in the South Asian region.
D. Coordinating surveillance and policy: The regional CDC should support the member nations' efforts to develop their health systems to prevent disease. By establishing an early warning and response platform for health threats, mapping health hazards and risks at regional and national levels, developing public health capacity through targeted training programs, and strengthening the coordinated One Health approach in the region to combat cross-border health threats in the region, including communicable diseases, this strategy can eventually harmonize policies and surveillance systems.
IQVIA is supporting One Health efforts in the UK, India, and many African nations. These initiatives focus on a variety of disease management strategies, such as surveillance, system strengthening, and capacity building. The National Centre for Disease Control (NCDC) in India is currently undergoing a thorough makeover by adapting to absorb and accommodate the One Health approach through a strengthened surveillance infrastructure, skill enhancement among technical officers and grass-roots functionaries, the implementation of robust monitoring mechanisms, and a strengthened Integrated Health Information Platform. The inclusion of the phrase "cross-country coordination" for disease control in South Asia would raise the NCDC to the status of a regional hub for the area.
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