In October 2023, Cambodia’s Ministry of Health confirmed two human cases of a highly pathogenic avian influenza (A/H5N1). With technical support from the World Health Organization Cambodia − and in coordination with the Food and Agriculture Organization of the United Nations (FAO) in Cambodia − the Ministry of Health and the Ministry of Agriculture, Forestry and Fisheries conducted an outbreak investigation as part of a public health outbreak response to assess the magnitude of the outbreak, identify the source of infection and understand the mode of transmission.
Cambodia’s avian influenza outbreak is an example of the interdependencies between the health of humans, animals and the environment. Disease outbreaks require all sectors – animal health, agriculture, environment, food safety and human health – to collaborate, share information and work together to respond effectively.
Shared threats require shared solutions
Vannda Kab, a Technical Officer in WHO Cambodia, describes how WHO played a crucial role during the recent avian influenza outbreak to facilitate a multisectoral response and bring all stakeholders to the table. “During the avian influenza outbreak, the Ministry of Agriculture, Forestry and Fisheries was grappling with different consequences of response measures – such as culling poultry – than the Ministry of Health,” he said. “Yet, it was vital that they shared accurate information with each other and collaborated to implement response measures."
Through WHO’s facilitation, informal communication channels emerged between the two ministries, particularly between their respective field investigation teams on the ground. As a result of this collaboration, joint standard operating procedures were reviewed and updated to meet requirements from the avian influenza outbreak investigation and response.
Interdependencies between human, animal and environmental health demand close collaboration, communication and coordination among all relevant sectors. The One Health approach enables this by going beyond silos. It is predicated on a systemic understanding of disease threats at the human, animal and environment interface and the close collaboration, communication and coordination required between all relevant sectors. One Health facilitates better understanding of the root causes and drivers of disease emergence, spread and persistence – and accelerates the development of appropriate prevention and management strategies.
Coordinating country-level engagement for One Health
Vannda shared insights from this experience with other WHO representatives from country and regional offices across the Asia Pacific Region at a bi-regional One Health coordination meeting held in Manila, Philippines, in early December 2023. Other country-level examples of One Health implementation from Bangladesh, Mongolia and Vanuatu underscored WHO’s unique convening power to bring all sectors to the table. The bi-regional meeting served to address One Health implementation challenges and empower country-level staff with the information and tools they need to implement One Health initiatives.
In his opening remarks at the meeting, Dr Babatunde Olowokure, WHO Regional Emergency Director for the Western Pacific, noted “the vital role that WHO has played as a member of the One Health Quadripartite to promote and coordinate multisectoral collaboration on One Health issues. One Health partners – including representatives from the Quadripartite which includes the FAO, United Nations Environment Programme (UNEP) and World Organisation for Animal Health (WOAH) – contributed to the bi-regional coordination meeting and shared strategies for collaboration.
WHO has been at the forefront of addressing the challenges associated with One Health and will leverage the bi-regional Asia Pacific Health Security Action Framework (APHSAF) to support countries to develop comprehensive action plans to drive the One Health agenda forward.