By Karissa Lowe and Elaine Faustman
The STOP Spillover project is committed to implementing the One Health approach and knows that sustainable zoonotic spillover interventions will require a collaborative, multisectoral, and transdisciplinary effort. The One Health approach recognizes that the health of humans, animals, and the environment are inseparably linked and must be considered together to address complex health threats. The recent COVID-19 pandemic has stressed the importance of this interconnectedness.
There have been some growing pains, however, as sectors that have historically been compartmentalized learn to work together effectively. Human, animal, plant, and ecosystem health sectors are often siloed and clear lines of communication or data sharing systems between them do not always exist. In many cases, hurdles to effective collaboration exist on a broader level, and standard frameworks, guidelines, and even shared technical language to enable these sectors to work together effectively is lacking, especially regarding the topic of “risk.”
For example, between different sectors there are countless guidelines on how to define and how to assess risk. This causes difficulty in understanding risks at the shared human–animal–environment interface and difficulty in communication.
For the One Health approach to be successful in preventing future zoonotic spillovers, every sector and stakeholder must use the same risk language so that we are able to understand risks and address them together. The Joint Risk Assessment Operational Tool can help us do that.
The Joint Risk Assessment Operational Tool (JRA OT) was developed by the tripartite organizations, a partnership between the Food and Agriculture Organization of the United Nations (FAO), the World Organisation for Animal Health (OIE), and the World Health Organization (WHO) in response to the need for a broad One Health framework to address zoonotic diseases. The purpose of the JRA OT is to create a framework that “allows all sectors, acting together, to evaluate fully, understand and manage shared risks at the human–animal–environment interface with coordinated responses.” The risk of zoonotic threats is shared by many actors, and risk assessments conducted jointly will be more relevant and provide clearer answers than risk assessments conducted by individual sectors.
The JRA OT provides guidance on the entire Risk Assessment process for zoonotic diseases. The framework begins with a section on “setting up” the Joint Risk Assessment (including making sure that all relevant stakeholders are invited to the table) and gives step-by-step instructions on how to conduct each part of the process. This includes templates to lead discussion and a glossary of risk assessment terms. This tool is of special importance to the STOP Spillover Risk Analysis and Communication (RAC) Resource Hub that works to include risk framing at every step in the multisectoral STOP Spillover project. Building from and applying the JRA OT in our work will be key, and according to our partners on the ground, some health officials in our priority countries are already familiar with this tool. According to Shamilah Namusisi, the STOP Spillover RAC Resource Hub Lead in Uganda, Ugandan health officials have recently used the JRA tool to assess risk for Anthrax and Rift Valley Fever under the support of FAO, and national guidelines in Uganda for zoonotic disease risk assessment have been adopted from the JRA OT.
Dr. Mohammad Enayet Hossain, the RAC Resource Hub contact in Bangladesh, also notes that the JRA OT is an improved version of a previous risk assessment tool used by members of the One Health movement in Bangladesh during the emergence and detection of H7N9 in China in 2013. He also observes that the JRA OT can easily fit into STOP Spillover’s Outcome Mapping process, as identifying stakeholders is an important part of outcome mapping, and from there, we can select members to utilize the JRA OT guidelines to assess risk. The broad, standardized framework of the JRA OT allows experts from all sectors working at the local, regional, national, and global levels to provide input.
Broadly defined and accessible guidelines such as the JRA OT clarify terminology and create transparency in assessing zoonotic risk so that multiple sectors can weigh in. The Joint Risk Assessment Operational Tool also highlights the importance of assessing data gaps and levels of uncertainty in each step of the Risk Assessment process, a critical process throughout the STOP Spillover project.
The tripartite partnership between the FAO, OIE, and WHO leads by example, showing exactly how a One Health collaboration can work and demonstrating the importance of including many sectors’ perspectives. Other projects around the world are also using the approaches from the tripartite partnership as a foundation. In Europe, the One Health Surveillance Codex was established to build from the priority areas the tripartite identified and to create resources that support the One Health approach in areas of surveillance data.
The One Health approach is increasingly recognized as an effective way to fight zoonotic diseases by engaging the entire human-animal-environment interface, but for this approach to succeed we need to utilize the standardized risk language and guidelines that have been made available.
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