REFERATE GENERALE

6
Review of Institute of Medicine
and National Research Council
Recommendations for
One Health Initiative
Carol Rubin, Tanya Myers, William Stokes, Bernadette Dunham, Stic Harris,
Beth Lautner, and Joseph Annelli

Human health is inextricably linked to the health of ,QLWLDWLYH7DVN)RUFHGH¿QHG2QH+HDOWKDVWKHFROODERUD-

animals and the viability of ecosystems; this is a concept
commonly known as One Health. Over the last 2 decades,
the Institute of Medicine (IOM) and the National Research
Council (NRC) have published consensus reports and
workshop summaries addressing a variety of threats to ani-
mal, human, and ecosystem health. We reviewed a selec-
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from NRC and IOM/NRC consensus reports and from opin-
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sociation, and other interested parties should “plan a study
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ions expressed in workshop summaries that are relevant WKLV HIIRUW´ 1 ,Q  WKH ,QVWLWXWH RI 0HGLFLQH ,20
to implementation of the One Health paradigm shift. We
grouped these recommendations and opinions into themat-
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given to various aspects of One Health. We conclude that
although One Health themes have been included through-
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and initiatives that will, in turn, be instrumental in shaping
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remain that may warrant targeted studies related to the One FDOO\DQGLQWHUQDWLRQDOO\´27KHVWXG\ZDVVODWHGWREHJLQ
Health approach.
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O ver the past decade, animal and human health leaders
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prompted by recognition that highly specialized practices opinions is a critical step in assessing whether to move
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links between human health, animal health, and the viabil- FRPSOHPHQW WKH H[LVWLQJ ERG\ RI ,2015& UHSRUWV :H
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Atlanta, Georgia, USA (C. Rubin, T. Myers), National Institutes of
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Carolina, USA (W. Stokes), US Food and Drug Administration,
Rockville, Maryland, USA (B. Dunham), Department of Homeland The National Academies and Their Reports
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culture, Des Moines, Iowa, USA (Lautner); and US Department of SURYLGHXQELDVHGDQGWLPHO\H[SHUWDGYLFHWRSROLF\PDN-
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the weight ascribed to consensus committee recommenda-
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were judged most likely to contain multiple recommenda-
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concepts, this review was constructed to provide a starting
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lationships between humans, animals, and the ecosystems
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policy improvement, to general statements encouraging
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interactions among humans, animals, and the environ- ongoing activities or programs that appear to address gaps
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Date Title 7\SH
1991 Animals as sentinels of environmental health Report
1992 Emerging infectious diseases: Microbial threats to health in the United States Report
1999 The use of drugs in food animals: Benefits and risks Report
 (PHUJLQJLQIHFWLRXVGLVHDVHV)URPWKHJOREDOWRWKHORFDOSHUVSHFWLYH WS
 7KHHPHUJHQFHRI]RRQRWLFGLVHDVHV8QGHUVWDQGLQJWKHLPSDFWRQDQLPDODQGKXPDQhealth WS
2003 Microbial threats to health: Emergence, detection and response Report
2005 Animal health at the crossroads: Preventing, detecting, and diagnosing animal diseases Report
2005 Critical needs for research in veterinary science Report
 $GGUHVVLQJIRRGERUQHWKUHDWVWRKHDOWK3ROLFLHVSUDFWLFHVDQGJOREDOFRRUGLQDWLRQ WS
 7KHLPSDFWRIJOREDOL]DWLRQRQLQIHFWLRXVGLVHDVHHPHUJHQFHDQGFRQWURO WS
 *OREDOLQIHFWLRXVGLVHDVHVXUYHLOODQFHDQGGHWHFWLRQ$VVHVVLQJWKHFKDOOHQJHV– finding solutions WS
 9HFWRU-ERUQHGLVHDVHV8QGHUVWDQGLQJWKHHQYLURQPHQWKXPDQKHDOWKDQGHFRORJLFFRQVHTXHQFHV WS
2009 Sustaining global surveillance and response to emerging zoonotic diseases Report
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 ,QIHFWLRXVGLVHDVHPRYHPHQWLQDERUGHUOHVVZRUOG WS
2011 Climate change, the indoor environment, and health Report
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ERUQHGLVHDVHV WS
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strategies WS
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Appendix Table 2 lists all of the recommendations, the LQWRVXI¿FLHQWFRQVLGHUDWLRQRIDOODVSHFWVRID2QH+HDOWK

exact references that support each recommendation, and approach, nor does it indicate adequate consideration of
H[DPSOHV RI DFWLYLWLHV WKDW DSSHDU WR UHVSRQG WR VSHFL¿Fcurrent understandings of One Health concepts. Appor-
recommendations. WLRQLQJRXU¿QGLQJVLQWRWKHPDWLFFDWHJRULHVOHWXVFUHDWHD
framework for evaluation of breadth of coverage. We found
Discussion that some categories have received more attention than oth-
On the basis of the list compiled from the 20 reviewed ers. For example, the Surveillance and Response category
reports, we found that the principles of One Health have, had 16 recommendations or opinions that originated from
to varying extents, been included in many of the NRC/ 14 individual reports; and the Governance and Policy cat-
IOM recommendations and IOM workshop summaries. egory had 10 recommendations or opinions from 8 reports.
All of the reviewed reports had at least 1 recommenda- By contrast, 4 recommendations or opinions were identi-
tion related to an aspect of One Health. This sample was, ¿HGLQWKH3DUWQHUVKLSFDWHJRU\DQGZHUHLGHQWL¿HGLQWKH
admittedly, skewed toward those reports most likely to in- category of Communication Needs.
clude recommendations, but we were impressed with the Most of the examples of implementation of One
TXDQWLW\LGHQWL¿HGLQWKLVUHYLHZ$OWKRXJKHYHQWKHHDU- Health concepts that are described in the Technical Ap-
liest (1991) consensus report reviewed contained recom- SHQGL[ DUH QRW GLUHFWO\ DVVRFLDWHG ZLWK VSHFL¿F ,20 RU
mendations, a deeper review including reports from ear- NRC recommendation. In contrast, recommendations from
OLHU GDWHV ZRXOG OLNHO\ ¿QG DGGLWLRQDO UHFRPPHQGDWLRQV the United States Agency for International Development
linked to One Health concepts. As might be expected, One (USAID)-supported IOM report “Sustaining Global Sur-
Health (or a related term) was not used in all instances veillance and Response to Emerging Zoonotic Diseases”
DV D GHVFULSWRU IRU UHFRPPHQGDWLRQV RU RSLQLRQV WKDW ¿W (2009) were translated into One Health activities under
ZLWKLQWKHGH¿QLWLRQRI2QH+HDOWKDFWLYLWLHVXVHGIRUWKLV USAID’s Emerging Pandemic Threats (EPT) Program.
review; in fact, many recommendations that by today’s Progress in One Health activities may be a result of ex-
understanding are clearly related to One Health were not plicit recommendations from IOM and NRC reports, or
tagged as such. simply be occurring because of increasing awareness of
The quantity of recommendations and workshop opin- One Health concepts.
ions related to One Health concepts suggests that a reason-
able level of attention has been given to the One Health Examples of Progress
movement in the past 2 decades of IOM/NRC publications. In the Surveillance and Response category, there is
However, level of coverage does not necessarily translate good evidence that progress has been made in addressing
94 REVISTA ROMÂNÅ DE BOLI INFECºIOASE – VOLUMUL XVII, NR. 2, AN 2014

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Sursa: Emerging Infectious Diseases  www.cdc.gov/eid  Vol. 19, No. 12, December 2013
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