Creation of a network of tropical medicine units to implement 'One Health'

Sir,

I went through with interest, the article entitled 'Need for integrated surveillance at human-animal interface for rapid detection & response to emerging coronavirus infections using One Health approach' published recently1. I must appreciate the efforts of the author for bringing to light an important issue in pandemic preparedness. However, what I found missing in this paper was an exploration of possible pathways to implement 'One Health'. To his (author's) credit is his willingness to admit the extreme complexity in the implementation process across countries. As someone who has been interested in 'One Health', I see it as not only implementable across India but also capable of delivering provided there is administrative and political will to do.

The Indian Council of Medical Research (ICMR) has set an excellent example using its network of Virus Research and Diagnostic Laboratories (VRDL) in medical colleges to scale testing of COVID-19 infections2. What is required is a similar creation of leadership in the implementation of One Health. Leadership may necessarily not be identified as having a position of authority nor intended to apply to individuals only but to a capacity willing to demonstrate itself in many ways at multiple levels. In this direction, we had suggested using a systems approach to integrate veterinary, human and environmental medicine (VHEM)3. The VHEM collaboration was supposed to function at three fundamental levels: Academic, Research and Service. For implementation, it was suggested to create departments of Tropical Medicine comprising faculties from VHEM. These departments could be established strategically in medical colleges across India preferably with access to VRDL. While establishing such departments, the local incidence and prevalence of zoonotic diseases need to be accounted for. It has also been suggested that till such departments are opened, an integrated unit of Tropical Medicine can be started in the departments of Community Medicine/Public Health/Family Medicine in selected medical colleges across the country3.

These departments and medical colleges will function as point of contact to ICMR for research related to zoonotic diseases. In addition, these will work with the National Centre for Disease Control (NCDC) to create a platform for interaction among veterinary/medical scientists/researchers through its division of zoonosis.

Further leadership can be provided by the Indian Veterinary Research Institute, Izatnagar; Haffkine Institute for Training, Research, and Testing, Mumbai; National Institute of Virology, Pune; and the National Institute for Research in Environmental Health of the ICMR at Bhopal. The departments thus created will also be a source of strength to existing settings such as the Integrated Disease Surveillance Programme (IDSP) and Epidemic Intelligence Services (EIS) being currently run in the country.

As pointed out by the author, in the last few decades we have seen emergence and spread of several new viral diseases; a large number of these human infectious diseases arise from animals. Therefore, it is time to find ways to implement 'One Health' to not just counter the threat of the current pandemic but also build robust health security.