Operationalizing the One Health Approach: Nexus of Science, Indigenous Knowledge, Policy

Panelists:

Chair: Dr. VK Paul, Hon'ble Member (Health), NITI Aayog
•    Dr. Richard Hatchett, CEO, CEPI, UK
•    Dr. Samit Hirawat, Executive Vice President, Chief Medical Officer, Global Drug Development, Bristol Myers Squibb, USA
•    Ms. Cynthia McCaffrey, UNICEF Representative to India
•    Dr. Mahender Nayak, Head of Asia Pacific, Takeda Pharmaceuticals, Singapore
•    Dr. Sai D. Prasad, Executive Director, Bharat Biotech International Ltd.

Antimicrobial resistance a key area, environment management and sustainability that are a key part. 

Richard Hatchett: 

There are organizational challenge and problem of logistic connectivity. Sharing the necessary science information between the ecology of animal species overcoming climatic triggers and linked with patterns of circulation and patterns of outbreak. All these domains are linked. That science is still in its infancy. Animal and Human vaccine industry have been segregated for ages. There must be more stringent regulations and overcome economic barriers. 

VK Paul:

Information and data are shared across the world. It is one world. WE need to be timely in sharing data. Be preemptive and proactive and comprehensive for data share. Know about the genesis of the disease. Fasted possible interpretation required. Agree pathways to be created across nations and bi or multilateral agencies/ across sectors / and across food chain. Data safeguards with key principles should be in place. But first, create those networks. 

We must organize resources, rise to the occasion. During Covid 19, one major source of funding was Covid Suraksha. The Govt. of India will rise to the occasion through the corpus money for sure. Rapid clearances took place and pathbreaking changes happened in drug cosmetics and biomedical devices. 

Communication with people is very important – a task that vests with the Govt. and scientific community. Democratic communication. Readiness to take the technologies and solutions to the people must happen ahead of time while playing a stewardship role. 

The One Health Mission has been crafted as a roadmap for a full rollout. Deals with pandemic preparedness, integrated surveillance, ensuring strong routine preventive practice, and joint outbreak response. Enablers are data and database integration, streamlining regulatory and approval processes for solutions, targeted R&D for solutions across platforms. The core is humans, livestock and wildlife. The stakeholders will have 11 central organisations including Minstry of Health/ Agriculture/ Animal Husbandry/ BT/ Council of India Medical Research/ Disaster Management etc. In terms of stepping up capabilities – we are moving to 3-4 labs including public health labs, clinical care unit (AYUSHMAN Bharat mission) with building up capacity to be able to respond. 

For animal world, a unique ID called Pashu Aadhar for livestock mission has been launched. Private players can also take part in R&D on the livestock. There will be a digital backbone linked and focus on integrated surveillance. Diseases surveillance for wildlife is being proposed – monitoring activities and threats of wildlife. The initial building blocks are place and consultations are moving forward. 

What is India offering on One Health Mission? Antimicrobial resistance domain, drugs, diagnostics, AI solutions coming from this room. Digital solutions that are generic and can be adapted to other countries and make them available to other parts of the world as an open source. Telemedicine solutions – India has demonstrated huge capacity as a great pillar of response. Programme implementation as skill is a strength of India. 97.5% covid vaccines were delivered through public healthy system. Moblisation of required resources in case of uncertain agenda. 

As per the Govt. mandate, we will screen 17 million tribal people for sickle cell disease and treat them. If required we will even go for BMT. New-born screening and provisioning for pneumococcal vaccine for older people, provision for penicillin, and counselling to prevent the disease from recurring in the family. 
Kala Azar, leprosy, Cancer-surveillance – we want to eradicate these and more diseases through efficient rapid diagnostics are in progress. We need a robust pathway. We would like to ensure that screening for liver disease on chip. These technologies on primary platforms. We need to revolutionize diagnostics in the country. 

Mahender Nayak – Takeda Pharma

Provide the data in a timely manner and moving forward in making vaccine real goal – having a clear political will, a clear opportunity for sustainable financing in terms of clear matrix and implement, making use of tools such as digital technologies, along with sharing of scientific data are necessary. The investment behind R&D, $200 bn spent every year. We are all chasing the same disease therapeutics. We need to look at the yield of new molecules, listen to the needs in the country from the markets. We need to look at collaboration beyond the prescriptions, go through the entire value changing through the stakeholders. Provide equitable access is very critical. 

Samit Hirawat:

As the acuteness of diseases pass, the society moves on to the next. Preditive science/ power of AI ML – if these you have central databases – one can predict where the next acuteness can happen. Pay close attention diseases may originate but if we don’t give the infrastructure – we need to invest more in understanding those disease areas. Science needs to transcend the borders; we need to evolve from a thinking perspective.

Prequalify facilities ready to deliver when we need them. Have a better understanding what it is we need to preplan to continue the supply chain for the development of vaccines and medicines. Prevention is better than cure as the basic mantra applies when you think about cattle to human transmission. There are three points to remember. 1. Education – spread the word to the community. 2. Quick development of vaccines or other methods to prevent transmission. 3. Limiting the transmission to smaller areas as soon as they are identified and limit it to one species or one herd. It has to be a multifactorial approach. 

Sai D Prasad: Bharat Biotech:

We are looking at Immunology in veterinary vaccines and take these concepts not developed for human vaccines so that it can be brought in for knowledge agenda. Rabies vaccines must be taken in full speed. 

We are also working on food processing and adding value to farmers. What if the next pandemic impacts animas as Richard said – we need to preserve the germplasms from plants and we are working on those concepts. 

We need help from global agencies to recalibrate our thinking and perspective on the health challenges. We are also looking at the impact on the food chain/ security/ economics when a herd of goats is infected. 

Cynthia:

We need real time data in terms of drugs being rolled out and the logistics. Community science must be paid attention to. During the measles outbreak in Indonesia, it was the wealthiest neighbourhoods refused the measles campaign unlike the poorer sections of the society. UNICEF took the campaign ahead in explaining the need through community science. 

What to keep in mind in what types of things should be in labs during R&D considering it is an incredible investment when we focus on children’s lives. UNICEF procures more vaccines than anyone else in the world. Let’s look at the incredible marshalling of response to a pandemic like India did. Equitable access to the measures develop and how we route it. 

The issue of One Health – bringing and breaking down the silos. Grab the lessons from Covid 19. The data, the science and different expertise. Information sharing not only among scientists but among the communities including farmers and families to avoid panic. The fundamental hygiene messages are powerful. Distilling information into decision-making abilities among deciders.