Three out of four emerging infectious diseases originate in animals – Sars, H5N1/H1N1 influenza, Mers, Ebola, Zika and now COVID-19 are just some recent examples. The accelerated human encroachment into wild habitats has increased the risk of animals transmitting novel infectious viruses to human beings. COVID-19 shows how the local outbreak of a disease emerging from an animal source quickly turned into a global threat to human health and economic stability.
The current pandemic, however, may also provide a political impetus for change. The so-called One Health approach offers an opportunity to address the root causes of pandemics and prevent future ones. This approach links human, animal and environmental health and combines knowledge and insights from the corresponding disciples. Yet a shared understanding of the concept is needed. Despite the challenges posed by weak investments in healthcare systems in West Africa, the pandemic could represent an opportunity to build on West Africa’s experience in dealing with COVID-19 or Ebola and strengthen health systems by making use of the One Health approach. But will we be able to keep up the momentum once the crisis recedes?
In December 2020, ECDPM and DIE, two members of the European Think Tanks Group (ETTG), organised an expert seminar on EU-West Africa cooperation on the One Health approach. The webinar was part of a series of events and policy briefs in the run-up to the (now postponed) AU-EU Summit – the result of a collaboration between DIE, ECDPM and ACET, which received financial support from the German Federal Ministry for Economic Cooperation and Development (BMZ).
The webinar brought together high-level speakers from BMZ (Birgit Pickel); WAHO, the West Africa Health Organisation (Professor Stanley Okolo); NCDC, the Nigeria Centre for Disease Control (Dr Oyeladun Okunromade); OIE, the World Organisation for Animal Health (Dr Karim Tounkara); DG INTPA, the European Commission’s Directorate-General for International Partnerships (Jan Paehler); and DIE (Prof Dr Imme Scholz). They shared valuable insights on challenges and opportunities related to One Health in the West African context.
Here are four takeaways from the seminar, with some key lessons for health cooperation between West Africa and the EU.
- Local expertise and structures are key
Existing structures in West Africa have played a pivotal role in managing the COVID-19 pandemic. The Ebola outbreak in 2014 and 2015 bolstered political will to institutionalise the One Health approach and build functioning national and regional health institutions, such as WAHO. This facilitated a regional collective response to the current threat, and countries in the region have shown remarkable levels of preparedness, leadership, innovation and timely government responses in the face of COVID-19, building on past experiences.
In Europe there is limited awareness of the One Health approach, and the West African resilience and expertise could serve as an example. The EU and West African countries should learn from one another, building on what is already working well (including successful regional cooperation and cross-sectoral capacity building) and complementing existing approaches.
- Cross-sectoral cooperation needs to be fostered at all levels
Speakers repeatedly highlighted the need for collaboration across sectors and disciplines at local, national, regional, continental and global levels. Also here the West African experience can serve as an example, as the regional response to COVID-19, coordinated by WAHO, is characterised by multi-sectoral leadership.
At the national level, institutions such as the NCDC have also promoted collaboration across sectors for One Health at every level. Although silos remain, considerable efforts have been made. Emergency Operations Centers were set up across West Africa to strengthen governments’ capacities to respond to public health emergencies and ensure effective coordination at different levels. Intergovernmental One Health collaborations have been formed, such as the WHO-OIE-FAO tripartite partnership in 2010, which has specific priorities for Africa and works closely with WAHO.
Going forward, multidisciplinary research that is sensitive to African national research agendas will also be paramount. As illustrated by COVID-19, an integrated approach to health security needs to be promoted at all levels. The EU, through its Team Europe approach – which should lead to more complementarity and coherence – and its support to research and health systems, plays an important role in this regard.
- Prevention is better than cure
West Africa’s handling of the pandemic has shown how important existing structures are when a disease breaks out. Capacities and institutions must be built in between emergencies to reduce the risk of new infectious diseases and increase resilience when they emerge. Accordingly, a long-term and preventive application of the One Health approach is required. It’s always a challenge to justify spending money for something that has not yet happened, and, as a result, most efforts remain reactive. A chronic underinvestment in prevention will be hard to reverse. Yet, previous outbreaks of infectious diseases of animal origin could have been avoided if lessons had been learned.
It is now time for the EU and West Africa to draw lessons from the current pandemic to accelerate ongoing reforms and put prevention at the top of the political agenda at all levels, not least for the economic benefits of prevention and preparedness. The World Economic Forum COVID-19 Action Platform estimates that fighting COVID-19 costs 500 times as much as pandemic prevention measures.
- Use this political momentum to increase and sustain investments in One Health
Speakers repeatedly stressed that sustained political leadership is indispensable to implement the One Health approach. When crises recede, financial investments and the institutionalisation of long-term approaches tend to wane (the so-called cycle of panic and neglect). In the aftermath of COVID-19, the world cannot afford to go back to business as usual. Policymakers, civil society organisations and global health experts should ensure that there is continued focus on global health and stronger health systems. Collaborative structures should also be maintained and One Health should be institutionalised at national, regional and global levels. This will be the only way to prevent future health crises in a sustainable way.
Germany can lead the way in this regard, as it recently strengthened its efforts in favour of One Health. For instance, it has created a new One Health Directorate at BMZ, launched a new global health strategy and demonstrated a strong political commitment to the approach. It is also encouraging that the recent EU Council Conclusions on the role of the EU in strengthening the World Health Organization highlighted the importance of the One Health approach for preventing and addressing health emergencies, and that they encouraged reflection on the institutional and organisational anchoring of the One Health approach at the global level. Yet, since health is currently competing with many other strategic priorities, including the green and digital transitions and migration, the EU should make sure that health is strongly integrated in the programming of the next EU multiannual financial framework for 2021-2027 and its Team Europe initiatives.
The webinar made clear that the EU and West Africa must work together to seek long-term solutions to transform health systems, the way they collaborate and the way they approach health. The AU-EU Summit in 2021 will be an important platform for testing this engagement, on the basis of shared interests and priorities.
Author: Pauline Veron, ECDPM
The author is grateful for the feedback and support provided by Paul Marschall and Christine Hackenesch, DIE; Nina Thijssen and Virginia Mucchi, ECDPM; and Vera Mazzara, ETTG.
Image courtesy of Victor Balaban, CDC Global via Flickr.
The views are those of the author and not necessarily those of ETTG.