VN November 2021

Vetnews | November 2021 11 of health determinants to address global issues as evidenced by the 2014-2016 Ebola Virus epidemic inWest Africa. The world response to contain the recent Ebola Virus fell dramatically short of ideal and was deemed by many a failure. 4 When we examine the reasons, we can see that the One Health approach with three interlinking circles was insufficient. The response failure was not due to a lack of understanding of the virus in humans, animals or the environment (while there was still more to learn), but a failure to understand and manage the disease from a political, social, cultural, and economic perspective standpoint. The cultural construct of West African tribes and societies was not well understood. Burial customs that included washing victims’ bodies and bathing in the fluids rapidly added to the transmission of the disease throughout villages. 5 The external medical response teams were often dressed in white personal protective equipment (PPE) gowns representing cleanliness from our Western viewpoint. Still, white signified death to local people and led in part to the killing of medical responders. (personal communication-Macgavin-Skinner). Standard protective procedures such as using gloves when families were providing care to hospitalized patients were not well understood as caregivers wore gloves at the bedside and then kept them on when eating in the dining facilities (personal communication-Noah). The politics and economics of the consequences of transparent reporting of Ebola by West African governments were not well- considered. The institutional culture and procedures of the World Health Organization led to delays in declaring this an emergency and effectively mobilizing international support. A Public Health Emergency of International Concern (PHEIC) was issued under the International Health Regulations (IHR) criteria, and the timing of the determination of PHEIC during the Ebola outbreak was based on the application of the IHR but did not address the potential ongoing impact of the virus and slowed international response. The understanding of West African nations’ economics, surveillance, and response capacities under IHR were not well understood and led to global response failures. 6 The Ebola crisis is just one example of where the traditional three circles of One Health, human health, animal health and environmental health did not provide an adequate framework for an international emerging zoonotic disease response. As we move forward with the evolving One Health framework, we need to broaden our view and include those areas and disciplines critical for the successful resolution of local, national and global issues. Political scientists, sociologists, cultural anthropologists, linguists, economists, organizational design specialists, and others must be included with human medicine, veterinary medical and environmental specialists and be familiarized and trained for these broader aspects of One Health. This will require prior coordination, training, education, organizational structure, and a proper legal foundation for response. The Ebola illustration from global health can be equally applied to clinical veterinary medicine and surgery where the entire context of the client, patient, environment, economic, legal and cultural circumstances impact the scope of practice and the ability to provide and perform veterinary services. This broader view of an effective and efficient One Health framework beyond the traditional three circles is well illustrated by the Canadian Public HealthGraphic for One Health that includes these multi-disciplinary aspects and serves as a valuable construct to view One Health. References: 1. The World Bank publication People, Pathogens and Our Planet Volume 1: Towards a One Health Approach for Controlling Zoonotic Diseases 2010 2. AVMA https://www.avma.org/KB/Resources/Reference/Pages/ One-Health94.aspx (accessed 4 January, 2017) 3. GHRF Commission (Commission on a Global Health Risk Framework for the Future). The neglected dimension of global security: A framework to counter infectious disease crises. http:// nam.edu/GHRFreport (accessed 4 January, 2017) 4. K . Kelland, Global health experts accuse WHO of ‘egregious failure’ on Ebola, (2015) http://www.reuters.com/article/us- health-ebola-response-idUSKBN0TB10K20151122 (accessed 4 January, 2015) 5. A. Maxmen. How the Fight Against Ebola Tested a Culture’s Traditions (2015) http://news.nationalgeographic. com/2015/01/150130-ebola-virus-outbreak-epidemic-sierra- leone-funerals/ (accessed 4 January, 2017) 6. World Health Organization Secretariat response to the Report of the Ebola Interim Assessment Panel August 2015 v Article