BANGLADESH

Fighting against wide-ranging contagious viruses, the authorities are finally strategising on a unique platform — taking all living creatures into equation to wage a common war.

As part of the design, experts have assembled in Dhaka to draft a 'one health' strategy for Bangladesh. This comes against a backdrop of emerging infectious diseases, such as avian and pandemic influenza, SARS, anthrax and nipah that threaten both human and animal health.

Once adopted, the strategy would be the first of its kind in the world.

"It (one-health approach) is an understanding that the health of humans, animals and of the environment is inextricably linked," said Prof Nitish C Debnath, coordinator of 'One Health Bangladesh' project.

He said the strategy would find ways to promote health safety of all species, and can be achieved "only through collaboration, cooperation and coordination across disciplines, professions and sectors".

"Our mission is changing from a focus on individual diseases and disciplines to looking at health across the lifetime," he said.

Bangladesh has experienced repeated outbreaks of avian influenza (commonly known as bird flu), nipah and anthrax of late.

With its devastating effect on the poultry industry, bird flu is even now hurting 52 of the country's 64 districts.

In 2010, an outbreak of anthrax from cows afflicted more than 600 people, apart from 100-plus livestock, in 15 districts.

And returning like an annual haunting spectacle, the ongoing nipah virus infection has killed all infected patients in Joypurhat.

A NEW DISEASE EVERY EIGHTH MONTH

Prof Nitish Debnath said: "We got 35 new diseases over the last 25 years, and 75 percent of them are zoonotic, meaning they are transmissible across species. Based on this pattern, we can say we are getting a new disease every eight months."

Globally, Bangladesh witnessed the onset of avian influenza in 1997, nipah virus infection in 1999, hantavirus in 1993, SARS in 2002, and Prion and HIV in the 1980s, he said.

Prof Debnath said they are even more "intriguing" in terms of their cross-species transmissibility. "And here lies the importance of one-health approach," he stressed.

BRAINSTORMING UNDERWAY

Besides the ministries of health, fisheries and livestock and environment, the five-day brainstorming effort to draft the national strategy has representation from UN agencies FAO, WHO and Unicef as well.

UNICEF chief of health Dr Lianne Kuppens said a strong collaboration is needed to contain the spread of emerging and re-emerging infectious diseases. "Emerging infectious diseases pose enormous challenge as the threat is invisible because (these) diseases are still evolving, or exist in limited pockets of wildlife or livestock," she said.

With this framework of one health, she said, Bangladesh reaffirms the need to shift off crisis response to focusing on building systems to combat emerging infectious diseases.

Health secretary Md Humayun Kabir told that activities of different ministries would be pinpointed as part of the strategy. "There will be clear instructions on which ministry would do what work during any situation of disease outbreak," he said.

At the inauguration of the workshop on Sunday night, fisheries and livestock minister Abdul Latif Biswas said the strategy is vital to expand and institutionalise existing inter-ministerial collaboration. He also asked experts to consider the context of Bangladesh while drafting the strategic paper.

"The strategy should be practical and actionable, and I hope you will consider this while drafting the strategy framework," the minister said, addressing experts assembled for the session.

NEED TO OVERCOME BARRIERS

Prof Debnath said there are challenges to adopt the one-health concept, the most important being the need for "key leadership" to embrace the concept and execute programmes on a national and international basis.

"Its success also depends on overcoming many barriers, including changing the mindset of healthcare providers from disease care to preventive medicine," he pointed out.

He said research should be undertaken by pooling insight and expertise of professionals from the fields of health, veterinary, agriculture and environmental. "The main emphasis is on working to enhance the quality of life, and to respond to change occurring around the globe at large, and specifically in Bangladesh," he said.