Operationalisation of one health approach

Patients in the emergency unit at Kamuli General Hospital. Health experts in Uganda have warned that the country is registering worrying increases in death and cost of healthcare because of drug-resistant infections.
 PHOTO/ SAM CALEB OPIO

What you need to know:

  • The consequences of having no explicit legislation on OH are extremely serious.

Uganda has a history of a series of zoonotic disease outbreaks ranging from anthrax, zoonotic influenza viruses, viral hemorrhagic fevers, brucellosis, African trypanosomiasis, plague, and rabies. If there is one thing that is absolutely clear about these outbreaks, it is that they severely disrupt all aspects of the socio-economic fabric of the affected communities.

As such, managing a crisis is not a pro-active strategy and may not be the best approach to address complex global health threats. It is increasingly clear that to address complex global health threats requires deliberate concerted multi-sectoral and transdisciplinary efforts from all stakeholders.

Uganda has been forward thinking on matters concerning global health security since 2014 when she signed to be a member of the Global Health Security Agenda (GHSA). The agenda aims to accelerate the implementation of the World Health Organisation (WHO) International Health Regulations (2005) by building countries’ capacities to prevent, detect and respond to global health threats posed by infectious diseases.

It is from this Agenda that a One Health (OH) approach is based. OH is a collaborative, multi-sectoral and transdisciplinary approach, primarily intended to counter global health threats through disease surveillance, outbreak investigation and response, and to achieve optimal health outcomes between people, animals, plants, and their shared environment. Owing to its collaborative, multi-sectoral and transdisciplinary nature, OH, offers an opportunity to acknowledge shared interests and appreciate teamwork to achieve optimal health outcomes.

In an effort to operationalize OH, on November 3, 2016, Uganda, launched a National One Health Platform (NOHP) by formalizing the One Health Framework (OHFW) and signing of a Memorandum of Association (MoU) amongst all partners. This was aimed to spearhead collaborative efforts among four government entities, that is, the Ministry of Health, Ministry of Agriculture, Animal Industry and Fisheries, Ministry of Water and Environment, and Ministry of Tourism Wildlife and Antiquities, to prevent, detect and respond to zoonotic diseases and emerging public health threats.  

The Office of the Prime Minister provides oversight and monitoring of the four-line ministries and other ministries departments and agencies (MDAs) contributing to health security.  The NOHP also established two structures, that is, the One Health Technical Working Group (OHTWG) and the Zoonotic Diseases Coordination Office (ZDCO) which are both mandated to provide oversight and direction on OH activities in Uganda.  The OHTWG provides technical leadership to implementation of the One Health activities. The ZDCO transitioned to the NOHP which provides coordination of partners and the private sector.

Despite these efforts made and the considerable progress in the operationalization of OH approach in Uganda, there is no explicit legislation guiding the operationalization of the OH approach.  As a result, coordination and communication among MDAs, development partners and the private sector responsible for health, animal health and environment remains a challenge; ; with poor resourcing and uncertain financing of OH activities which are currently largely dependent on donor funding.

The fact that no legislation has explicitly given attention to the OH approach not only discloses how casual government is about this critical area, but also undermines effective implementation of OH. The consequences of having no explicit legislation on OH are extremely serious. There is an urgent need for legislation on OH, providing for: the definition, concept and scope of OH; administrative structures and their roles; communication or reporting structures; financing; and other OH specific provisions.

Thus, prioritizing an OH legislation would provide room for effective addressing of the persistent OH stakeholders in coordination, administrative and financing challenges and act as a proactive response to the ever increasing global health threats.

Micheal Bwambale Asiimwe, Lawyer, and Global Health Security enthusiast        [email protected]

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