John S. Mackenzie, Martyn Jeggo, Peter Daszak and Juergen A. Richt (eds.)Current Topics in Microbiology and ImmunologyOne Health: The Human-Animal-Environment Interfaces in Emerging Infectious Diseases2013Food Safety and Security, and International and National Plans for Implementation of One Health Activities10.1007/82_2012_253
© Springer-Verlag Berlin Heidelberg 2012
One Health in Mongolia
Zayat Batsukh1 , B. Tsolmon1, Dashdavaa Otgonbaatar2 , Baatar Undraa3 , Adyadorj Dolgorkhand4 and Ochirpurev Ariuntuya5
(1)
Government Implementation Agency for Veterinary and Animal Breeding, MoFA and Light Industry, Peace avenue-16a, SPB-IX, Ulaanbaatar, Mongolia
(2)
National Centre for Zoonotic Diseases, Ministry of Health, 20 Khoroo, Songinokhairkhan district, 18131 Ulaanbaatar-211137, Mongolia
(3)
National Center for Infectious Diseases with Natural Foci, Central post office box 582, Ulaanbaatar, Mongolia
(4)
National Center for Infectious Diseases with Natural Foci, 20 Khoroo, Songinokhairkhan district, 18131 Ulaanbaatar, Mongolia
(5)
WHO, P.O. Box 46/78, Ulaanbaatar, Mongolia
Abstract
The Asia Pacific Strategy for Emerging Diseases (APSED) requires collaboration, consensus, and partnership across all the different actors and sectors involved in different aspects of emerging disease. Guided by APSED, Mongolia has established a functional coordination mechanism between the animal and human health sectors. Surveillance, information exchange and risk assessment, risk reduction, and coordinated response capacity and collaborative research have been identified as the four pillars of the zoonoses framework. Intersectoral collaboration has been clearly shown to be a crucial tool in the prevention and control of emerging zoonotic diseases. A “One Health” strategy has been implemented under the concept of ‘Healthy animal-Healthy food-Healthy people’. An intersectoral coordination mechanism established between the veterinary and public health sectors has expanded its function to incorporate more work on food safety, emergency management, and effects of climate change on zoonotic diseases. Its membership includes the human health sector, the veterinary sector, the national emergency management agency, the environment sector, emergency management and inspection authorities, and the World Health Organization (WHO). The main outputs of the coordination mechanism have been strengthened surveillance and response activities and laboratory capacities. The coordination mechanism has also strengthened the surveillance and response capacity of neglected zoonotic diseases, such as brucellosis, anthrax, and tick-borne diseases. Through regular meetings and brainstorming sessions, both sectors have developed joint operational plans, a long-term risk reduction plan 2011–2015, initiated a prioritization exercise and risk assessment for 29 zoonotic diseases, and reviewed and revised standards, procedures, and communication strategies. In 2011, a list of experts on major zoonoses were identified from different sectors and formed into a taskforce to identify the focal points for rabies, brucellosis, and vector-borne diseases. As a result, disease control strategies are now linked to scientific research and epidemiological expertise.
1 Background
1.1 Country Profile
Mongolia is a landlocked country in East and Central Asia, situated between and bordering China and Russia, and with a population of 2.7 million as of 2011. The country has the lowest population density in the world, one person per 1.57 km². Mining and agriculture, and are the two main sectors of the Mongolian economy. For centuries, the Mongolians have been engaged in animal husbandry, raising horses, sheep, goats, cattle, and camels. Agriculture, primarily herding, is the traditional basis of the Mongolian economy, contributing about 20 % of GDP and providing 40 % of national employment. Livestock husbandry is the main economic pillar, vital for public good, and the significant source of export income.
Due to increasing urbanization and socioeconomic development of country in recent years, migration from rural to urban and suburban areas has been increasing. In 2010, only 36.7 % of the population resided in rural areas. Approximately, 30 % of the population is nomadic or seminomadic. Administratively, Mongolia is divided into 21 provinces, and the capital city, Ulaanbaatar.
1.2 Climate
Mongolia has an extreme continental climate with long, cold winters and short summers, during which most precipitation falls. The temperature is as low as −45 to −50° C in the winter and can reach 25° to 30 °C in the summer. Global climate change is believed to have had an influence on the climate; the annual average climate temperature has risen by 1.94 °C over the last 65 years, and in the last 30 years, the temperature has risen faster and the rainfall has decreased in Mongolian forest-steppe regions. Due to environmental and human impacts in the last few years many rivers, streams, and lakes have dried, pasture growth has decreased by 20–30 %, pasture plant species numbers have reduced and it has resulted in an increase in land degradation and desertification. Natural disasters such as drought, heavy snowfall, flood, snowstorms, windstorms, extreme cold and hot temperatures, and earthquakes recurrently occur throughout the year. Mongolia is very dependent on nature and climate due to its traditional nomadic lifestyle throughout four seasons of the year.
The large herder population has a greater chance of zoonotic infections. As the Mongolian economy is heavily reliant on herding and agriculture, the harsh winters and periodic droughts have adverse effects on livestock and agriculture, and also on the health status of the population.
1.3 Situation of Zoonotic Diseases
The livestock population was 36.3 millions as of 2011, down from 44.0 million at the end of 2009. Pig and poultry population are not prominent. Endemic zoonotic diseases such as brucellosis, anthrax, rabies, plague, and tick-borne diseases create important public health problems.
In recent years, endemic zoonoses have expanded and outbreaks of number of transboundary diseases have emerged in both animals and humans. Climate change and extreme weather conditions have had an adverse effect on biodiversity, distribution of animals, and microflora, which can lead to the emergence of zoonotic agents and create favorable conditions for disease outbreaks. Over 20 bacterial and viral and 18 parasitic zoonotic diseases were reported in animals. Six out of 15 diseases listed as transmissible diseases notifiable to the OIE were reported in Mongolia, and four diseases have a potential risk for further spread.
The significance of zoonoses is increasing due to improved animal husbandry practices, climate change, desertification, and developments in the mining sector. In spite of the progress achieved, anthrax, brucellosis, tick-borne diseases, and rabies still constitute a threat to human health and welfare.
2 Coordinating Mechanisms Between Animal and Human Health Sectors
The Asia Pacific Strategy on Emerging Diseases (APSED) recognizes the importance of close multisectoral cooperation for the prevention and control of zoonoses. With the support of World Health Organization (WHO), the Intersectoral Coordination Committee on Zoonoses was officially established in Mongolia in February, 2010, although many collaborative activities had already been undertaken since 2006. The Committee is chaired by either the Vice-Minister of Health or the Vice-Minister of Food and Agriculture and Light Industry, alternating between the two positions annually, and the membership includes representatives from the Ministry of Health (MoH), Veterinary and Animal Breeding Agency of Ministry of Food and Agriculture and Light Industry (MoFALI), National Emergency Management Agency (NEMA), Ministry of Nature and Environment, General Agency for Specialized Inspection, and the WHO.
The overall vision of the Coordination Committee is to have “strong human and animal health sectors, together with emergency response and national inspection agencies working in partnership toward the attainment of a healthier community”. The Coordination Committee has responsibility for developing joint policy on the prevention and control of priority zoonotic diseases; for approving action plans produced by a technical working group; for making recommendations on risk assessment, early warning and response activities during outbreaks; for reviewing and revising zoonotic diseases standard operational procedures (SOPs) and guidelines to reflect intersectoral collaboration; for providing methodological assistance to improve the capacity of professional institutions at the national and subnational level; for coordinating cooperation among different sectors in carrying out early detection and response functions; and for monitoring and evaluating overall zoonotic disease prevention and control. The Director-General of the National Centre for Zoonotic Diseases in the MoH serves as secretariat, and is responsible for routine coordination and management.
Before the establishment of the Coordination Committee, MoH and MoFALI developed a written Memorandum of Understanding (MoU) to conduct joint surveys on zoonotic diseases in 2007–2009. Both sectors exchanged annual statistical reports and conducted joint serological surveys. The results of the survey helped define the distribution of major zoonoses which are important to both animal and human health. The surveys identified new diseases in Mongolia, such as tick-borne encephalitis, West Nile fever, Lyme disease, rickettsia, and Q fever. The joint survey promoted collaboration between two sectors. The new diseases have been added to the list of notifiable diseases to reflect current threats. However, most of the activities were aimed at gathering information about zoonotic pathogens only. Notable changes observed in the two sectors during the survey were transferred by the joint task to surveillance with ongoing and systematic collection of information in order to define the extent of disease problem, and to disseminate this information to improve public health awareness, early warning, diagnosis, prevention, and control.
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