One Health: Water, Animals, Food and Society
The One Health Center (OHC) will engage in action-based research on reducing morbidity and mortality arising from malnutrition, unsafe water, and animal- and vector-borne diseases. The Center, which already has expertise in most of the required disciplines, will utilize the transformational One Health approach to design, implement and evaluate practical, cost-effective health interventions at the national, regional, community and household levels. As examples, we discuss below seven types of interventions in which the OHC will engage.
- Improved water management in underserved areas of the world to conserve water, increase its quantity and quality, and utilize it more effectively to specifically improve health outcomes: By some estimates, nearly two-thirds of the rural population in sub-Saharan Africa lacks access to adequate water supply. This water scarcity increases work stress, especially in women and children, and brings animals and people together more frequently, increasing the likelihood of water contamination and transmission of infectious diseases. Likewise, the manner in which water is used for agricultural and animal production affects worker health, food safety, and the health of those who drink or bathe in water. Better water management encompasses more rational water pricing as well as improved irrigation techniques that result in more efficient use of water in agriculture, which is inextricably linked to agricultural production and better nutrition. The OHC will engage in research on superior water distribution and irrigation systems and more rational water-pricing mechanisms to increase the availability and quality of water. The advantage of the One Health approach is that these model systems will consider multiple facets of water distribution and utilization, including sanitation and pathogen surveillance, proper drainage to control insect vector populations and prevent downstream contamination, and irrigation to improve agricultural productivity and food availability.
- Enhanced vector-control and disease-surveillance strategies: In addition to water management, reduction of morbidity and mortality from infectious diseases requires improved surveillance and management of pathogens and their vectors. Interventions designed by the OHC will include: development of effective low-cost methods for field-based detection of pathogens in water, food, vectors and hosts; measurement of dispersal and gene flow among pathogen, host, and vector populations through the application of massive genome sequencing; improved strategies for disruption of transmission of disease agents by arthropod vectors; collection of remotely-sensed environmental data that influence population dynamics and pathogen transmission to inform evidence-based policy making; and development of more effective and ecologically-sustainable bio-pesticidal larvicides and adulticides for vector control. Escalating rates of pesticide resistance to pyrethroids and other chemical insecticides worldwide makes it necessary to explore other non-chemical control tactics for the future.
- Superior food safety through water and ecosystem management: Recently, more than 200 people in 26 states in the U.S. became ill after eating spinach contaminated by E.coli O157:H7; over 50% needed hospitalization and a significant number developed hemolytic uremic syndrome (three of whom died), resulting in a collapse of public trust in food safety and loss of income to California farmers. The same bacteria were found in cattle grazing near the contaminated spinach fields in the Salinas Valley in California and in wild hogs running through them. Working together, hydrologists, microbiologists, epidemiologists, and ecologists traced the problem to pathogen pollution resulting from drought followed by heavy rains. The OHC will bring together physicians, public health and food safety experts, veterinarians, molecular biologists, ecologists, economists, agricultural scientists, nutritionists, environmental engineers, and hydrologists to work with each other and with resource managers, food producers and local communities to address pathogen and contaminant pollution problems in water and food supplies. We will provide rapid screening tests for enteric pathogens that can be used at the local level, as well as improved water engineering plans to reduce transmission of pathogens both in drainage and through vectors. These complex issues involve land use, water rights, regulatory responsibilities, and constituent needs, and are best addressed at the community level where local stakeholder priorities and possible solutions can be evaluated for shared resource problems.
- Promotion of low-cost and sustainable approaches to combat malnutrition: The OHC will evaluate the cumulative effects of nutritional interventions, including improved local foods, in the context of high prevalence of infectious disease and unsafe and scarce water and food. The use of fortified lipid-based nutrient supplements (such as “plumpy nut”) has proven very effective in treating severe malnutrition. Our faculty and international partners are currently assessing the impact of adding much smaller amounts of more concentrated lipid-based nutrient supplements to local foods to prevent chronic infant and child under-nutrition in Sub-Saharan Africa and elsewhere. Likewise, improving poultry and egg production at the village level has great potential to provide a critical source of food and income for extremely poor households. However, this production has been severely limited by Newcastle and other poultry diseases. In test villages in Tanzania, our collaborative team is training the primary keepers of village chickens to vaccinate using cheap, simple technology, resulting in an increase in nutrient-rich foods available for consumption and sale. The ripple effects may include increased income for other high-quality foods, education, and health care, as well as reduced risk of bush meat consumption — a high-risk food for zoonotic disease transmission and a problem for wildlife conservation.
- Use of agricultural biotechnology for improved nutrition and food security: There are many situations in which nutrition can be improved through the introduction of new varieties of crops that are richer in certain nutrients and that produce higher and more stable yields than currently-produced crops. Researchers at UC Davis have produced new wheat varieties that contain markedly higher protein, iron and zinc content. Genetic improvement of cowpea varieties with significantly enhanced resistance to drought and disease by UCR researchers has been implemented in West Africa to enhance agricultural productivity under conditions of climate change and improve protein content of local diets. UCR and UCD plant geneticists have developed a flood-tolerant rice variety that can provide increased food security in flood-prone areas worldwide. The OHC will bring together nutritionists, plant scientists, water experts, and economists to develop, test and disseminate crop varieties that will improve food security and nutrition around the world.
- Better household practices to prevent the spread of water-related diseases: In regions where water is scarce, the same water body that is used for bathing, watering animals, and disposal of human waste is also used as a source of drinking and irrigation water and may provide habitat for insect vectors that spread disease. In just the human waste, there are numerous types of enteric pathogens including Vibrio cholerae, Shigella, Giardia, rotavirus, and hepatitis A virus, which can contaminate the environment and foods, causing diarrheal diseases. In animal waste, these and zoonotic pathogens such as Crypto-sporidium, Brucella, and Mycobacterium bovis/tuberculosis may be present and contribute to the disease burden among human and animal populations. The OHC will develop and promote point-of-use water purification technologies ranging from low-tech solar water treatment to high-tech processes, depending on household needs and resources. Toward this end, active research programs at UCR and UCD will join forces to further develop and promote novel technologies such as thin film nano-composite reverse osmosis and biosand filters that can produce water free of pathogen and chemical contaminants and be used to generate income through microfinance programs. In addition, hydrologists, engineers, and sociologists will work to develop scalable and sustainable best management practices for disposal of household wastes, irrigation, and vector control.
- Research and education to promote health, nutrition and hygiene: The OHC will partner with international and local institutions to evaluate household behaviors that should be targeted for health education interventions. These interventions will focus on nutrition and transmission of disease from un- and under-recognized sources, such as animals in and around the home and municipally-supplied water, and will include information on personal hygiene, food and water safety, nutritional value of locally available foods, and the special nutritional needs of pregnant and lactating women and children under two. While such messages are typically delivered through information, education, and communication (IEC) campaigns for adults, the OHC will partner with the core and other centers of expertise in the SGH to explore novel methods to deliver health information, such as electronic media and mobile phone technology. The OHC will also develop public health messages to deliver to children via school-based curricula to facilitate long-term behavioral changes.
Juxtaposed across these interventions are five cross-cutting themes, to which the OHC research agenda will be particularly sensitive. First, individuals and households — not governments or NGOs — are the ultimate agents of change in society. For instance, removal of standing water in and around dwellings can reduce considerably the incidence of vector-borne diseases, but only if households actually adopt this practice. Thus, behavioral change and public acceptance are necessary conditions for any new scientific method or technology to succeed and should be considered in the design of interventions. Likewise, regardless of their efficacy, new techniques and methods that are not sensitive to local cultural and social practices are unlikely to be adopted. Second, since public budgets are necessarily limited, it is important to prioritize different health interventions. In the past, scientists have tended to ignore the use of cost-benefit and cost-effectiveness criteria to rank alternative interventions, but this will be necessary if societies wish to obtain the maximum health impact out of their limited health budgets. Third, an essential component of cost-benefit analysis is the assessment of benefits of different interventions. In turn, this requires that impact evaluation be an integral part of any project intervention. Monitoring and evaluation are also critical for recognizing the weaknesses of an intervention approach and allowing for adaptive management. Fourth, for bringing about lasting health improvements, interventions need to be sustainable in the long term and not dependent on the whims, largesse, and technical expertise of external actors. This means that the communities that are served by OHC projects should be true stakeholders in, and take full ownership of, the interventions at every stage of the process-design, implementation, and evaluation. Fifth and finally, understanding who is likely to benefit from an intervention is critical in designing and implementing interventions. For example, since girls and women are largely responsible for water collection among rural households in developing countries, enhanced water systems that bring clean water to rural areas are especially likely to improve female health and well-being. On the other hand, new point-of-use water filtration methods that require large upfront investments are less likely to be adopted by poor households. Thus, some interventions are likely to exacerbate existing disparities in health outcomes while others are likely to narrow them.
The OHC approach to research and training will be innovative and transformational in three distinct ways. First, it will be transdisciplinary, bringing researchers from the health sciences, agricultural and environmental sciences, social sciences, and engineering to work together to understand the social-biological-cultural determinants of health. Historians of science have suggested that real breakthroughs occur when scientists representing different disciplines engage deeply enough with each other’s work to grasp the presuppositions and logic on which they rest. The goal of the OHC will not be to simply juxtapose different perspectives but instead to bring them into rapprochement through a process of creative, cross-disciplinary engagement focused on a shared object of scrutiny. This will be achieved by intentionally designing research workshops, proposals, and projects in ways that promote cross-divisional dialogue and “creative tension’ among the social and natural science disciplines. Second, the research and training conducted by the OHC will be holistic and systems-oriented. The One Health approach emphasizes the inextricable linkages among food, water, and plants as they affect human health. The OHC will strive to develop and promote interventions that integrate agricultural, water-related and zoonotic solutions to health problems. Third, the work done by the OHC will be transformational in that it will integrate cutting-edge research in ways that increase its applicability and relevance to real-world health issues. The OHC will bring this about by organizing multi-disciplinary teams to work on specific health problems. The teams will consider all aspects of the problem, including technology, cost effectiveness, social and cultural acceptability, and sustainability. Further, the same teams will extend their research projects into the field in ways that integrate communities into the interventions in sustainable ways.
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Related UC Programs
- UCD Center for Vector-borne Disease
- UCD Foods for Health Institute
- UCD One Health Institute
- UCD Program in International and Community Nutrition
- UCR Building Bridge across Riverside through Water Quality Research
- UCR Center for Disease Vector Research
- UCR Edward J. Blakely Center for Sustainable Suburban Development
- UCR Water Science and Policy Center