Good Governance of Human and Animal Health Services: On-going collaboration between OIE and WHO
Knowing that more than 60% of animal diseases are transmissible to humans and that 75% of recent emerging diseases are zoonotic, human and animal health systems need to be strong; they also need to work in close partnership to jointly address common issues regarding early detection, assessment and response to events of potential international health concern. Strengthening surveillance, reporting and response capacity are common requirements for both human and animal health services, and form part of international standards developed by the WHO (World Health Organization) in the International Health Regulations (IHR, 2005), the OIE (World Organization for Animal Health) in the Terrestrial and Aquatic Animal Health Codes and Manuals, as well as the international foods standards developed by the Codex Alimentarius Commission.
During the last decade and driven by the emergence of major zoonotic infectious diseases, dialogues and joint initiatives among WHO, the OIE, FAO and the World Bank have continued to grow. In 2010, the Tripartite (WHO, OIE, FAO) developed a joint concept note describing the areas of common interest to “share responsibilities and coordinat(e) global activities to address health risks at the animal-human-ecosystems interfaces”. This increased collaboration has contributed to the development of references for good governance across the animal and human health sectors.
Appropriate material and guidance are needed for individual countries to objectively evaluate their situation, to address deficiencies and to build capacities in order to improve their operational capability and to better comply with international requirements.
Specific tools have been developed in the human and animal health sectors. WHO has established a list of minimum core public health capacities to guide the effective implementation of the IHR, and has provided countries with a Monitoring Framework including a checklist and indicators so that they can assess their degree of compliance with the expected levels of capability described in the IHR.
The OIE has developed the Performance of Veterinary Services (PVS) Pathway, which encompasses in particular the OIE PVS Evaluation (using the PVS Tool, qualitative assessment) and the PVS Gap Analysis (PVS Costing Tool, qualitative and quantitative assessment); these tools are used by countries to objectively assess and address the main weaknesses of their Veterinary Services and determine the scope and costs to improve compliance with international standards. In order to establish the current level of performance, a total of 47 PVS Critical Competencies have been elaborated under the four Fundamental Components of the PVS tool. For each Critical Competency, qualitative levels of advancement are described.
A higher level of advancement implies that the national Veterinary Services is complying with the preceding levels (i.e. level 3 assumes compliance with level 2 criteria; level 5 assumes compliance with level 4 and preceding criteria; etc.). The Critical Competencies are reviewed on a regular basis and new Competencies can be added to reflect changes in the OIE Terrestrial and Aquatic Animal Health Codes.
The joint use of the outputs of the WHO IHR Monitoring Framework and of the OIE PVS Pathway enables Member Countries to obtain a detailed overview of existing national forces, bridges and gaps in human and animal health coordination. It also generates wide ranging benefits for the development of national strategies targeting capacity building in human and animal health sectors.
This vision promotes the concomitant and facilitated use of existing frameworks, rather than the development of new processes and procedures.
In collaboration with the World Bank and with grant funds provided by the European Community, represented by the Commission of the European Communities under the European Commission Avian and Human Influenza Trust Fund (the World Bank acting as administrator of the grant funds through the Avian and Human Influenza Facility) and in the framework of the National Human and Animal Health Systems Assessment Tools and Bridges Project, the WHO and the OIE have developed an operational approach, which aims to promote the concomitant and facilitated use of the OIE and WHO frameworks.
A Guide has been developed to help Member Countries better understand the importance of good governance at the human-animal interface and to present and explain the tools available to help them examine their capacities, including those related to cross-sectoral collaboration. The Guide is structured in two parts: the first part introduces the standards and good governance principles and references; the second part introduces the WHO IHR Monitoring Framework and the OIE PVS Pathway, highlights synergies and complementarities between the two frameworks and also includes results of pilot national workshops conducted in countries. These pilot national workshops provided an opportunity for national human and animal health services to review the outputs of the PVS Pathway and IHR Monitoring Framework and to use the results of this analysis to: firstly, bring benefits to the endeavours of both sectors, and secondly, to identify next steps and activities for the development of a joint national plan of action to strengthen collaboration and coordination. Specific sections in the guide include more in depth analysis of the tools used to assess and monitor national capacities, the costing tools available to quantify the cost required to strengthen national capacities, as well as the complementary tools developed by the OIE and WHO with regard to helping Member Countries analyse their national laboratory situation and identify targeted and strategic improvements.
During the final meeting of the project, held at WHO Headquarters on 17 April 2014, all interested parties satisfactorily reviewed the progress of the work implemented. During this meeting it was agreed that WHO and the OIE should implement more national workshops / regional workshops in order to enhance human and animal health sector dialogue and engagement. They will providing human and animal health services with a forum to share assessment results and is a necessary prerequisite to motivate future intersectoral liaison and to forge permanent national ‘One Health’ collaborative roadmaps.