The interconnections of life and health

By : Michael Gibb

One Health is the embodiment of this paradigm, acknowledging that the health of all creatures is interdependent rather than separate. Because of food systems, interconnected ecologies and mutual reliance, the welfare of a lowly shrimp, for instance, can have important implications for human well-being.

Informing the public

Our decision to make One Health one of the overarching research themes at CityU has been vindicated by recent events around the world. Food security, the dangers posed by zoonotic diseases, and the impact of the Covid-19 pandemic in 2020 are three reasons why One Health deserves to be one of the key research areas cited in our most recent Strategic Plan.

“Our role at CityU is to inform the public, stakeholders, policymakers and those involved in basic research that One Health means everything on our planet is connected,” says Professor Nikolaus Osterrieder, concurrently Dean of the Jockey Club College of Veterinary Medicine and Life Sciences (JCC) and Chair Professor of Virology and One Health.

Antibiotic concerns

Appointed in July 2020, Professor Osterrieder was formerly Department Head and Professor of Virology at Freie Universität Berlin, Germany. He is also an Adjunct Professor of Virology at Cornell University, CityU’s collaborator in establishing JCC.

An expert in virus pathogenesis, i.e. how viruses cause diseases in their target hosts, Professor Osterrieder is keen to get back to researching health issues that affect all life on earth once Covid-19 has passed. One issue in particular on the College’s research and outreach agenda is anti-microbial resistance (AMR).

Professor Nikolaus Osterriede “We need to continue to look at AMR because it poses such a great threat. It could lead to 50 million deaths by 2050 according to WHO figures,” says Professor Osterrieder.

AMR occurs when microbes acquire protection against antimicrobials such as antibiotics leading to potentially lethal cases of multidrug resistant bacteria. One of the causes of AMR is linked to overuse of antibiotics. Professor Osterrieder stresses the need to stop excessive consumption of antibiotics for all animals, including humans.

“We need better antibiotic stewardship. For example, the usual antibiotic regimen of a 5 to 10 day course of treatment is not really based on strong evidence. You don’t actually have to use antibiotics for extended periods of time when you are sick. To do so is harmful since the drugs fight good microbes, while those they can’t reach can outgrow the others,” he warns.

Looking after animals better

Another point the Dean emphasises is animal welfare. “People may think JCC is primarily for animal health but we have great social responsibility, including animal welfare,” he says.

Having grown up on a dairy farm in Germany, Professor Osterrieder believes strongly that all the time animals fall under our care, they must be treated well.

“Animals are my buddies,” he says, and he considers every aspect from farming, husbandry, food and transport to be critical to One Health. “If animals under our care are not looked after properly, I consider we act unethically and the chances of diseases breaking out increase.”

Meanwhile, the reputation of JCC continues to grow. Applications for the 6-year bachelor’s degree in veterinary medicine, the only one of its kind in Hong Kong, were oversubscribed for 2020/21 with over 1,300 candidates targeting 30 places.

“I am confident that, under the umbrella of the One Health paradigm, JCC will evolve into one of the best veterinary schools in the world,” the Dean says. “Our overall goal is to improve quality of life and the health of people, animals and the environment, and to ensure sustainable food production through the promotion of animal welfare.”

Human psychology is as much a factor in One Health as the biomedical field, suggests Professor Dirk Pfeiffer, Chow Tak Fung Chair Professor of One Health and Director of the Centre for Applied One Health Research and Policy Advice.

One Health can be reframed as interdisciplinarity since we need to integrate between different scientific disciplines, including those dealing with human behaviour, he advises.

“In the era of Covid-19, we need to appreciate the psychology of wearing masks – why some societies more than others are more likely to wear masks or choose not to,” says Professor Pfeiffer, who specialises in the translation of science into policy, evidence-based veterinary medicine and analytical epidemiology, among others.

“The social sciences are extremely important to One Health,” he adds.

images: Freepik.com

 

 

Interdisciplinary understandings

An area in which human behaviour plays a role in One Health is connected to infectious disease risks associated with wet markets. 

Professor Dirk Pfeiffer“We need to understand people’s preference for wet markets which, if not kept clean, are ideal environments for pathogens to multiply and therefore pose a threat to human and animal health. The need for fresh meat and the urge to eat more meat is not good for the planet. If this trend continues, we will have to expect an increased risk of zoonotic disease emergence as well as major adverse impacts on the environment,” he says.

Admittedly, he points out, improving the way we look after food animals will increase the cost of meat and other products from food animals, which means it will become less affordable to large sections of society.

“A key issue for a farmer keeping animals for meat or other products is how to balance investments into facilities necessary to provide appropriate animal health and welfare and the price that consumers are prepared to pay,” he says.

As with the Dean of JCC, looking after animals properly is essential for many reasons, including reducing the risk of AMR.

“There is a cycle of dependency. If you don’t look after your own health, or that of animals, diseases occur, which requires more antibiotics, which leads to AMR, which threatens all life,” he says.

Policies are needed to encourage humans and farmers to only use appropriate antibiotics for treatment of correctly diagnosed disease rather than for prevention of disease occurrence or in case of the suspicion of disease.

Rapid action, academic freedom

Our response to these health problems must be innovative, fast and creative and at the global level, Professor Pfeiffer says.

“At the moment, for Covid-19, states are acting according to their own agenda, but we need a globally coordinated response since a virus doesn’t respect country borders,” he says.

Academic freedom in particular is essential if we are to successfully pursue One Health and thwart other major issues such as climate change, which is impacting the health of the planet.

“There are no more safe bets and we have to have the courage to accept the risk of failure when looking for alternative and new ways of dealing with the challenges of the present and the future. This is what universities have to do even more now than in the past: provide an environment where researchers are constantly pushing the envelope of current human knowledge and imagination so that they can test innovative ideas and if appropriate they can translate them into impact,” he argues.

Questions about politics and society are deeply embedded in One Health, says Dr Nicholas Thomas, Associate Professor in the Department of Asian and International Studies and an expert on health security.

“Responses to disease are affected by nationalism, sovereignty, ethics, cultures. As social scientists, we analyse policies and support mechanisms; exploring areas such as behavioural psychology, cognitive bias, trust in public health and how policies are received,” he says.

CLASS contributions

Dr Nicholas ThomasThe range of disciplines included in the research cluster for which Dr Thomas is the convenor highlights this level of interdisciplinarity. Members represent the departments of Asian and International Studies, English, Media and Communication, Public Policy, and Social and Behavioural Sciences in the College of Liberal Arts and Social Sciences (CLASS).

In addition to an uptick in CLASS contributions to One Health particularly in the increase in the number of researchers applying to the Public Policy Research Funding Scheme and Strategic Public Policy Research Funding Scheme, numerous projects are in the pipeline such as seminars and roundtables on risk and communication, public policy, global responses and mental health.

For example, the first One Health seminar in early November 2020 saw three researchers from the Department of Media and Communication cover areas relating to risk perception, health communication strategies, and the role of social media. In February 2021, the cluster will be convening an international panel on global responses to Covid-19, with researchers zooming in from the US, Asia, Europe, and the UK.

Security and outreach

image: Freepik.com As with CityU researchers working in the bio-med fields, Dr Thomas is looking closely at AMR issues, too, since the phenomenon poses an existential threat to all life. By exploring the securitising responses initiated by states and international organisations, he evaluates how regional states respond to the threat in the public and animal health sectors as well as the domestic and international implications of these responses.

Outreach is also an important component of One Health work currently being generated through the social sciences at CityU. An essay writing competition organised by Dr Thomas and aimed at school children in Hong Kong invited contributions that explored reactions to Covid-19.

“Secondary school students have been uniquely affected by the outbreak. Not only have their current studies been significantly disrupted but their future plans have been challenged by the disease. The question is how?” Dr Thomas asks. There were two essay questions. One asked for an oral history on how Covid-19 impacted young people’s lives today; the other asked participants to fast forward 50 years and reflect on how the virus impacted Hong Kong.

“The social sciences, and in particular areas such as health security, are essential components in the construction of the One Health paradigm as evidenced not just by the current pandemic but ongoing challenges such as TB, malaria or AMR,” he says.

Drivers of disease emergence in live animal markets is a key aspect of the One Health research and teaching conducted by Dr Ioannis Magouras, Assistant Professor in the Department of Infectious Diseases and Public Health (PH).

Dr Magouras samples wild birds for ectoparasites and infectious diseases during fieldwork near Ithaca in New York State. “Like many colleagues in PH, I work at the animal–human interface, especially on diseases that can be transmitted from wild and domestic animals to humans, i.e. zoonotic diseases,” says Dr Magouras, a specialist in veterinary public health and food safety.

One of his current projects, of particular interest in debates surrounding the origins of infectious diseases, concerns the consumption and trade of meat sold in live animal markets. Alongside Professor Pfeiffer and an international team of collaborators, he is exploring what specific interventions related to zoonotic risk reduction would be acceptable for consumers and vendors. The results of his study will assist policymakers in minimising the risk of zoonotic disease emergence.

“The overall aim of this project is to address the issue of disease emergence in live animal markets at its source, by improving our understanding on the sociocultural context of meat consumption and trade in the region,” he says.

Dr Magouras is researching how turtles sold in wet markets are potential reservoirs for zoonotic diseases and antimicrobial resistance determinants in Hong Kong. He hopes the study will help to design new, and adapt existing, culturally-tailored (community) interventions that will support sustainable meat consumption without compromising public health, and therefore minimise the risk of future pandemics.

In terms of teaching, PH offers a course titled “One Health”, Dr Magouras explains. The course introduces students to these complex relationships within the One Health paradigm and the role of veterinarians in this context.

“We demonstrate an understanding of the interrelatedness of wild and domestic animals, humans and the environment, analyse veterinary and public health topics using a One Health perspective, and describe the ethical and legal responsibilities of the veterinary surgeon in relation to patients, clients, society and the environment,” he says.

This interrelatedness was the focus of a trip to Kadoorie Farm last November when Dr Magouras’ veterinary students could see animals in the rescue centre, wards and the vet clinic.

“We noticed the negative impacts of the illegal wildlife trade on wild animals in Hong Kong. Wild animals, domestic pets, humans, and the environment are all interconnected,” says Natalie Wong Wai-ki, a Year 1 student. “Each species plays an important role in the ecosystem. We are definitely one!”

Hayley Kwok Wing-nam, also a Year 1 student, was equally positive about the impact of the Kadoorie Farm trip on her outlook on One Health.

“I met veterinarians during the Kadoorie Farm trip who rehabilitate wild animals. Their consideration of human, animal and environmental factors when determining the best course of treatment was thought-provoking. Through this eye-opening experience, I began to understand the relevance of the One Health concept in the field of veterinary medicine,” Hayley says.

It’s an eye-opening experience we all need in order to see the connections that underpin One Health.