Sunday, 8 April 2012

One Health Core Competencies - Building Capacity for Response to Emerging Pandemic Threats

Dr. Felicia Nutter, DVM, PhD, DACZM got an early start in the field of One Health. With role models such as Jane Goodall and Diane Fossey, Dr. Nutter informed her mother that she wanted to be a veterinarian and live with the apes in Africa while she was still in elementary school. She did go on to receive her DVM from Tufts University. It was here that Dr. Nutter had the opportunity to complete a fellowship in Tanzania working with apes and humans in Gombe National Park. After that she had an internship in small animal medicine, a residency in zoological medicine, and she completed her PhD in Comparative Biomedical Science at NC State University. Dr. Nutter worked with the Mountain Gorilla Veterinary Project for five years. The project originally concentrated strongly on conservation, but made a transition to a One Health focus. Dr. Nutter continued to make One Health connections as a Staff Veterinarian at the Marine Mammal Center in Sausalito, CA. 

Dr. Felicia Nutter discusses how the USAID RESPOND project is using a One Health approach to develop the framework necessary to improve disease surveillance and outbreak response at the global "hot spots" for emerging pandemics.


Dr. Nutter now works with the RESPOND project, which was the focus of her presentation. She works with Tufts University and the University of Minnesota and is the liaison to FAO and OIE for the RESPOND project. She provides technical and strategic support to the project headquarters and provides global technical support to the project's offices in a few of the “hot spots” for emerging pandemics. These include the West Congo, East Congo and Southeast Asia.

The Emerging Pandemic Threats Program takes a One Health approach to improve disease surveillance and outbreak response. The program consists of four parts: Predict, Respond, Prevent, and Identify. RESPOND prepares others to respond to pandemic. It uses a multidisciplinary approach to:
    •    Improve training for skills needed to respond to outbreaks
    •    Improve cross-sectional links to support coordinated outbreak response
    •    Improve capacity to conduct investigations of suspected outbreaks
    •    Introduce technologies to improve training, surveillance, and outbreak investigations

 
The project took a year to get underway and when it started it had a strong focus on local training. Unfortunately, due to monetary issues, the project now focuses more on professional development training and graduate training. RESPOND receives funding from USAID, which receives its budget from Congress, so sometimes the funding falls short of expectations. RESPOND also receives funding from two private companies: Development Alternatives Incorporated and Training Research Group. The companies develop techniques for training adults. With more funding the project could continue with local training, which would benefit general populations in immeasurable ways and catch outbreaks at their roots. Funding is one of the larger issues that any project faces and as pioneers for One Health we all need to do our part in making sure that potential supporters realize the importance of our mission.

The RESPOND project has successfully assisted with the establishment of two educational organizations in the pandemic hot spots. These are the One Health Central and East Africa (OHCEA) and the Southeast Asia One Health University Network (SEAOHUN). SEAOHUN has more disciplines and a holistic approach. It is composed of 10 universities from Thailand, Vietnam, Indonesia, and Malaysia. There are 14 faculties and schools of veterinary medicine, tropical medicine, nursing, allied health sciences, public health, and medicine.

Dr. Nutter defined some of the concepts central to One Health. She explained the contrast between multidisciplinarity, interdisciplinarity, and trans-disciplinarity. Multidisciplinarity is an additive approach which does not integrate different disciplines, but rather just brings more disciplines together. The disciplinary perspectives are not changed. Interdisciplinarity is an interactive approach, which synthesizes two or more disciplines. This establishes a new level of discourse or integration of knowledge. The interdisciplinary approach is how One Health currently operates. Trans-disciplinarity is a holistic approach that shares conceptual framework with no disciplinary boundaries. This is ideally what One Health will become.

Dr. Nutter defined “competency” as measurable knowledge, skills, attitudes, and behaviors used as a basis for training and education.  The “One Health core competencies” are skills that everyone involved with RESPOND need to have to constitute a common baseline. Some core competencies under discussion are values, ethics, cultural competency, team development, leadership, communication, responsibilities, analysis and assessment from a systems perspective, joint planning and management resources, and governance. RESPOND is developing core competencies for One Health with working groups, such as EPT projects, the CDC and the USDA. RESPOND is also combining expert opinion, literature review, and participatory approaches. Furthermore, SEAOHUN is working on regional input and curriculum mapping.

Most discussions during the forum were inquiries as to how long the program would operate and about the movement away from training locals. Dr. Nutter explained that these were budget issues and that the program was a five year project that has two years of funding left. It was also mentioned that this One Health approach to responding to pandemics is actually partitioned into different parts, which is the opposite of One Health. Dr. Nutter and Dr. Whittier explained that this project is new and that ultimately the program will achieve a more holistic organization and that for now, they are serving as liaisons between the different parts.

The presentation by Dr. Nutter was, in my opinion, one of the most interesting of the semester so far. It demonstrated how the One Health Concept is being implemented in real world situations with pandemic outbreak response. With the success of this project and other studies that Dr. Nutter said will soon be underway, hopefully One Health will gain more notoriety and we can all work together to make this world a healthier, safer place.


Post authored by Christon Wiles, NCSU Zoology Major

Up Next (10 April):
From Four Legs to Two - Translating Research Findings to Therapy of Spinal Cord Injury

Dogs and Spinal Cord Injury - Another Role for Man's Best Friend
Natasha Olby, VetMB, PhD, DACVIM, Professor, Neurology at NCSU CVM

The Dalfampridine Story - The Making of a Medicine
Andrew Blight, PhD, Chief Scientific Officer Acorda Therapeutics