Transcript One Health In Kenya

One Health In Kenya
Ian Njeru, MD
Ministry of Public Health & Sanitation
Kenya
One Health Meeting In The African Region
Libreville, Gabon,
12-14 November 2012
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Presentation Outline
• Background
• Key steps in OH
• Outline of milestones in OH
• Application: One Health in Action
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Background
• Land mass: 580,367 km2
• Human population
– 38,610,097 (2009)
• Livestock Pop (2009)
– Cattle 18 million
– Sheep 17 million
– Goats
28 million
– Camels 3 million
– Poultry 32 million
• Wildlife
– Rich in diversity and
numbers
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Kenya: Key OH Steps
(2006-2012)
• Formation of National Influenza Task force(NIT) 2005
• NIT responded to Rift Valley Fever (RVF) outbreak as
RVF Task force - 2006/7
• Formation of Zoonotic Technical Working Group
(ZTWG)- 2008
• Formation of One Health in Central and Eastern
Africa (OHCEA) Kenyan chapter - 2010
• Development of Kenya’s priority zoonotic diseases
list – 2011
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Kenya: Key OH Steps
(2006-2012)
• Revision of Integrated Disease Surveillance and
Response (IDSR) technical guidelines to incorporate
zoonotic diseases -2011
• Creation of One Health office: Zoonotic Disease Unit
(ZDU) - 2011
• Development of Strategic Plan for Implementing One
Health in Kenya (2012 - 2017) – 2012
• Revision of national policies to incorporate One
Health- ongoing
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OH Milestones in Kenya
(2006-2012)
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1. Formation of Zoonotic Technical Working
Group (ZTWG)
– Formed in 2008
– Multi-sectoral, including
• Government
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–
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–
–
Ministry of Public Health (MoPHS),
Ministry of Livestock Development (MoLD),
Kenya Wildlife Service (KWS)
Kenya Medical Research Institute(KEMRI)
Kenya Agricultural Research Institute (KARI)
• Universities
• WHO, FAO, AU-IBAR, CDC, ILRI, ICIPE etc
– Meets quarterly
– Chaired alternately by Director of Veterinary Services or
Director of Public Health and Sanitation
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Role of ZTWG
• Advise the government on policy issues on
Zoonoses
• Advise government on technical issues on
implementation of One Health
• Monitor and Evaluate One Health
implementation
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2. Creation of One Health
office: Zoonotic Disease Unit (ZDU)
MOU: Signed by MoPHS and MoLD in Aug 2011
Housing: Office constructed on government land and officially
opened by the Minister for MoLD and Minister for MoPHS
– Oct 2012
Staff: Two Epidemiologists deployed by government
Support staff: Admin Assistant and Data Manager (supported
by donor)
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ZDU Formation
Zoonotic Disease Forum: Sept 22-24, 2010
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ZDU Vision and Mission
Vision
A country with reduced burden of zoonotic
diseases and better able to respond to epidemics
of emerging and re-emerging infectious diseases
Mission
To establish and maintain active collaboration at
the animal, human, and ecosystem interface
towards better prevention and control of zoonotic
diseases
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ZDU Organogram
DPHS
DVS
Zoonotic Technical Working Group
DDSR (MoPHS)
Zoonotic Disease Unit
1 Medical Epidemiologist (MoPHS)
1 Veterinary Epidemiologist (MoLD)
1 Data Manager
1 Adminstrative Assistant
DVS- Director of Veterinary Services
DPHS- Director of Public Health and
Sanitation
DDSR- Division of Disease Surveillance and
Response
VEEU- Veterinary Epidemiology and
Economics Unit
MoPHS- Ministry of Public Health and
Sanitation
MoLD- Ministry of Livestock Development
VEEU (MoLD)
Other experts on an as
needed basis
(Epidemiologist, Ecologists,
Microbiologists,
Climatologists,
Environmentalists,
Sociologists, Economists,
Geospatial experts e.t.c.)
Launch of the ZDU – 3rd Oct 2012
Minister, MOLD and PS MoPHS
officially open ZDU office
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3. Development of Kenya Priority
Zoonotic Diseases List –2011*
1.
Viral Hemorrhagic Fevers
i.
ii.
iii.
iv.
v.
vi.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
Crimean Congo Hemorrhagic Fever
Dengue Fever
Rift Valley Fever
Yellow fever
Ebola
Marburg Virus Fever
Avian influenza & influenza A H1N1
Brucellosis
Leishmaniasis
Leptospirosis
Anthrax
Rabies
Bovine TB
Plague
Tularemia (Rabbit Fever)
Protozoa Infections
i.
ii.
12. Salmonellosis
13. Helminths and Ecto parasites
i.
ii.
iii.
iv.
v.
Trichinosis
Cysticercosis
Hydatidosis
Sarcoptic mange
Diphyllobothrium
14. Fungal Diseases
i.
ii.
iii.
iv.
Dermatophilosis
Histoplasmosis
Cryptococcosis
Aspergillosis
15. Schistosomiasis
16.
17.
West Nile Virus
Trypanosomiasis
*Not ranked in any order
Cryptosporidiosis
Toxoplasmosis
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4. Kenya Revised IDSR
Technical Guidelines
Key changes
• Addition of zoonotic diseases in the priority disease list
• Inclusion of Veterinary and Wildlife Officers in both the
district and county Public Health Emergency
Management Committees(PHEMC)
• Section added on coordination with Animal Health and
other relevant Sectors
• Changes were made in consultation with relevant
stakeholders
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5. Strategic Plan for Implementing
OH in Kenya (2012-17) :Highlights
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Goal 1: Strengthen surveillance,
prevention and control of zoonoses
• Conduct risk mapping for 4 priority zoonotic diseases
(RVF, Brucellosis, Anthrax, Rabies,)
• Develop and implement OH plans/SOPs for jointly
responding to zoonotic disease outbreaks
• Strengthen laboratory diagnosis for zoonosis
• Develop and implement prevention and control
strategies for 4 priority zoonotic diseases
• Identify and designate subject matter experts for
each priority disease
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Goal 2: Establish structures
and partnerships to promote OH
• Incorporate OH in existing MOLD and MOPHS
policies
• Develop OH communication strategy
• Cascade OH approach to the county and
district levels
• Lobby line ministries to allocate budget lines
for OH program
• Strengthen partnerships
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Goal 3: Conduct and Promote Applied Research
To better understand the mechanisms of
zoonotic pathogen maintenance and
transmission to humans
• Hold workshops for universities, research
institutions and individual scientists on neglected
zoonotic diseases
• Provide training and mentoring to veterinary,
medical and public health trainees
• Promote applied research collaboration among
human, animal and ecosystem sectors
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Strategic Plan Outcomes
• Greater compliance with WHO/IHR and OIE
guidelines on public health threats
• Risk maps for priority zoonotic diseases
available
• Disease prevention and control strategies for
zoonoses developed and implemented
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Strategic Plan Outcomes…
• Capacity for early epidemic detection,
diagnosis, and rapid response strengthened
• Better understanding of socio-economic
impacts of zoonotic diseases
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6. Revision of National Policies
to Incorporate OH
• The Veterinary Policy – on going
• The National Health Policy Framework, 2011
to 2030 – ongoing
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7. Capacity building activities on OH
• Spearheaded by OHCEA Kenya
• Membership of OHCEA Kenya:
– University of Nairobi
• Faculty of vet medicine
• School of public health
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Moi University School of Public Health
MOLD
MOPHS
KWS
KEMRI
National Environment Management Authority
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Objective of OH capacity building
• Transform future workforce to be OH compliant
– Pre-service curriculum review:
• Being initiated November 2012
• Targets undergraduate and postgraduate curricula in
universities e.g. BVM, MBChB, MPH, wildlife programs
• Transition the current workforce to be OH
compliant
– In-service training: Joint trainings involving staff from
e.g. MOLD, MOPHS, Environment and Nursing
• Needs assessment for training to be done January 2013
• Curriculum development: February and March 2013
• In-service training commences April 2013 at county level
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8. Other OH Steps and Activities in Kenya
• Inclusion of Veterinary students and Veterinary
module in FELTP-since 2008
• Kenya hosted HPAI field simulation exercise in 2010
• OIE Performance of Veterinary Services (PVS) “One
Health” Evaluation Mission in Kenya – 2011
• Research projects incorporating OH approach
– Arbo-viruses Incidence and Diversity (RVF)
– Brucellosis study in three counties
– IDRC Echo-Health Project
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Other OH Activities in Kenya…
• Influenza surveillance
– Avian Influenza surveillance in wild birds and domestic
birds in the market – Ongoing
– Human influenza sentinel surveillance- Ongoing
• Rift Valley Fever (RVF) - sentinel herd and
entomological surveillance - Ongoing
• Establishment of a molecular diagnostic laboratory
at KWS for bush meat identification for public
health and law enforcement - Ongoing
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One Health in Action
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Introduction
• In March 2012, two case reports of Human
African Trypanosomiasis (HAT) reported from
a national reserve
• Joint outbreak investigation conducted
• 3 teams
– Human team
– Animal team
– Entomological team
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Human Investigation
Active surveillance
Setting up sentinel
surveillance sites.
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Animal Investigation
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Entomological Investigation
Ngu trap
Biconical trap
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Findings/Actions
• No human infective forms of Trypanosoma
brucei detected in human, animals or tsetse
flies
• Five human sentinel surveillance sites
established after the study
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Next Steps for OH in Kenya
• Implement the Strategic plan 2012-2017
• Priorities
– Develop guidelines for inter-sectoral collaboration
– Develop communication strategy to guide
communication across sectors
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Thank You
for more information visit
www.zdukenya.org
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