Martyn Jeggo on behalf of the former Chief Veterinary Officers (CVOs) Group.
The present government has committed to the establishment of a national Centre for Disease Control (CDC) or Centres for Disease Control (CDCs). However, it has not yet determined the level of commitment, the timelines, the exact nature of this centre, or who will determine these.
A recent dialogue with Australia’s Chief Medical Officer, Professor Paul Kelly, discussed but gave no firm direction on any of these issues. What was clear however, was the lack of an inclusive One Health approach in formulating and discussing an Australian CDC.
Yet nationally and internationally, the One Health approach has been repeatedly argued as fundamental for addressing current and emerging health issues. The process for establishing the Australian CDC must have a broad dialogue that goes beyond consulting just the primarily human-health focused professions. At a bare minimum, key players from the veterinary profession must be consulted.
Veterinarians’ role in epidemic management
There are about 15,000 veterinarians in Australia who work for the health (including welfare, production, and biodiversity) of all animals (pets, livestock, and wildlife). We are used to working in multidisciplinary teams to protect the health of animals, ecosystems, and humans, which is termed a One Health approach. We are writing as a group of 33 former Chief Veterinary Officers and Senior Government Veterinarians who have been collaborating in recent years on issues we consider to be of national importance.
Epidemics of disease, whether in humans or animals (including pets, livestock, and wildlife) are not new to Australia. Until the COVID-19 pandemic, Australia had an enviable and proven track record in managing epidemic disease outbreaks and in many cases, maintaining freedom from such diseases that occurred or continue to occur in other parts of the world. Robust management systems exist at both federal and state level to prevent, provide early detection, and to respond effectively to a potential epidemic, whether in humans or animals.
Recent examples of this include our management of the global SARS outbreak, Hendra virus outbreaks, equine influenza, incursions of highly pathogenic avian influenza (HPAI), and our risk reduction processes associated with an incursion of foot-and-mouth disease in ruminants. These achievements were based on a strong research record linked to the maintenance of institutes and expertise working on epidemic diseases. They were also based on a range of national and state policies that underpin Australia’s capacity in epidemic disease management.
It is important to recognise that at both national and state/territory level, many capabilities and processes have been developed over many years to recognise and reduce the risks from epidemic diseases. For livestock it has long been recognised that the risks are as much to do with trade and economics as they are about the health (including welfare) of individual animals. In appreciation of this, the governments of Australia, in conjunction with peak industry bodies, formed Animal Health Australia, which has developed a wide range of policies and procedures to manage the risks from known livestock epidemics.
In part due to the recognition of these capabilities across different disciplines, the past decade has seen a strong global drive to consider a multidisciplinary and holistic approach to address the health of humans, animals, and the environment. The need for a ‘one health’ approach reflects the fact that human, animal, and environmental health are intrinsically linked.
This approach has been used successfully in response to the global HPAI epidemic, SARS, MERS, Hendra/Nipah virus, Q fever and anthrax. It uses multidisciplinary teams — including specialists such as human medical professionals, veterinarians, epidemiologists, ecologists, virologists, bacteriologists, public health experts, risk analysts, economists, sociologists, policy experts, community representatives and communications experts — to address epidemics that have impacts across multiple sectors.
Several factors continue to increase the global risks of newly identified and emerging epidemic disease. These include an ever-increasing global population, urbanisation, global movements of people and goods, destruction of natural ecosystems and habitats (including deforestation) and, significantly, climate change. The COVID-19 pandemic not only highlighted the outcome of some of these risks but also some of the gaps in our current systems. The impact was not only global but at all levels of society.
Our detection systems were found wanting, our health care systems under-resourced, the economic response haphazard, and our scientific underpinning for response and recovery variable at best. By most measures Australia has coped better than most countries, but the COVID-19 epidemic illustrates that we are ill-prepared to deal with such epidemics.
Experts agree we shall see similar epidemics occurring with increasing frequency. Based on experience, the majority of these will originate from animals, hence veterinarians will play a key role in disease prevention and control. Many argue that, to effectively manage these risks, we will need to adopt a One Health systems-based approach.
To better prepare Australia for the next emerging disease there has been a strong call to revisit the concept of an Australian CDC. Such a concept has been discussed on a number of occasions over the past 30 years but without the establishment of a lasting entity. It is clearly early days in this current dialogue, with issues such as scope, funding, location and even the name to be considered. The CDC could also be either entirely new or based on a network of established institutes and organisations. Clearly, there are many issues that will need to be ironed out.
Yet, with the COVID-19 pandemic driving this latest push for a CDC, it should be an easy decision for governments to broaden the dialogue to include those across One Health. Particularly, the veterinary profession in Australia that has an enviable track record in managing epidemics of livestock.
This is a plea to ensure that an inclusive approach is undertaken in considering a CDC, and that governments and the medical profession genuinely engage with the range of disciplines mentioned. The veterinary profession and others working across One Health need to be involved in the planning, governance, scope, and structure of the proposed CDC.
Professor Martyn Jeggo is a former Director of the Australian Animal Health Laboratory and a member of the former CVOs (Chief Veterinary Officers) group.