One Health contributions towards more effective and equitable approaches to health in low- and middle-income countries.
One Health contributions towards more effective and equitable approaches to health in low- and middle-income countries.
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DOI：
10.1098/rstb.2016.0168
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发表时间：
2017-07-19
期刊：
影响因子：
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通讯作者：
Halliday JEB
中科院分区：
文献类型：
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作者：
Cleaveland S;Sharp J;Abela-Ridder B;Allan KJ;Buza J;Crump JA;Davis A;Del Rio Vilas VJ;de Glanville WA;Kazwala RR;Kibona T;Lankester FJ;Lugelo A;Mmbaga BT;Rubach MP;Swai ES;Waldman L;Haydon DT;Hampson K;Halliday JEB
具有大流行潜力的新出现的人畜共患病是全球卫生安全议程的既定优先事项，但地方性人畜共患病在资源匮乏的环境中也会产生重大的社会影响。虽然许多地方性人畜共患病是可以治疗的，但对人类病例的及时诊断和适当的临床处理往往是具有挑战性的。预防性的“同一健康”干预措施，例如对动物种群的干预，产生对人类健康的益处，可能为克服其中一些挑战提供一种有用的方法。已经存在有效的战略，如动物疫苗接种，以预防、控制和消除许多地方性人畜共患病，包括狂犬病和几种家畜人畜共患病(例如布鲁氏菌病、钩端螺旋体病、Q热)，这些疾病是低收入和中等收入国家人类发热病和牲畜生产力损失的重要原因。我们认为，对于这些疾病，与完全依赖人间病例治疗的方法相比，一种卫生干预措施有可能更有效，为人类健康和生计带来更公平的惠益，特别是在农村地区。我们假设，应用单一卫生干预措施应对这些卫生挑战将有助于建立信任、社区参与和跨部门合作，这反过来将加强脆弱的卫生系统应对新出现的人畜共患病威胁和其他未来卫生挑战的能力。因此，一项卫生干预措施有可能使弱势社区的持续需求与更广泛的全球社会的关切保持一致，为实现全球可持续发展目标和支持全球卫生安全议程提供务实和公平的办法。本文是主题为《同一个健康应对不断变化的世界：人畜共患病、生态系统和人类福祉》的一部分。
Emerging zoonoses with pandemic potential are a stated priority for the global health security agenda, but endemic zoonoses also have a major societal impact in low-resource settings. Although many endemic zoonoses can be treated, timely diagnosis and appropriate clinical management of human cases is often challenging. Preventive ‘One Health’ interventions, e.g. interventions in animal populations that generate human health benefits, may provide a useful approach to overcoming some of these challenges. Effective strategies, such as animal vaccination, already exist for the prevention, control and elimination of many endemic zoonoses, including rabies, and several livestock zoonoses (e.g. brucellosis, leptospirosis, Q fever) that are important causes of human febrile illness and livestock productivity losses in low- and middle-income countries. We make the case that, for these diseases, One Health interventions have the potential to be more effective and generate more equitable benefits for human health and livelihoods, particularly in rural areas, than approaches that rely exclusively on treatment of human cases. We hypothesize that applying One Health interventions to tackle these health challenges will help to build trust, community engagement and cross-sectoral collaboration, which will in turn strengthen the capacity of fragile health systems to respond to the threat of emerging zoonoses and other future health challenges. One Health interventions thus have the potential to align the ongoing needs of disadvantaged communities with the concerns of the broader global community, providing a pragmatic and equitable approach to meeting the global goals for sustainable development and supporting the global health security agenda. This article is part of the themed issue ‘One Health for a changing world: zoonoses, ecosystems and human well-being’.