The Ebola epidemic continues to rage in West Africa, and while it is very unlikely to reach pandemic scale (see The Economist), the outbreak provides a reminder of the linkages between disrupted ecosystems and human illness.
Back in July, the Op Talk blog of The Times explored how environmental conservation in areas that are reservoirs for Ebola can help cut the odds of outbreaks. In 2012, Jim Robbins wrote a fine overview of “The Ecology of Disease” — everything from Ebola to Lyme disease — accompanied by a superb map of “Hot Spots for Emerging Diseases.”
Now, a very helpful overview of the “one world, one health” concept has been written for the Future Earth blog by by Catherine Machalaba, program coordinator for health and policy at EcoHealth Alliance. The illustration above is part of an info-graphic created by Machalaba and a colleague. Here’s an excerpt:
Ebola and other emerging diseases: losing the trees before we see the forest’s connection to our health
The Ebola crisis has serious impacts on public health, economies, and societies, but crucially, it’s not an isolated incident. Globally, infectious diseases account for a billion human cases per year, leading to millions of deaths. The majority of known human infectious diseases are “zoonotic,” meaning they are shared with animals. Ebola is just one of nearly 1,000 known human diseases that have originated from animals….
[W]hat’s striking about diseases emerging in recent decades, of which over 70 percent have come from wildlife, is that we ourselves are driving their appearance in humans. The more we expand the footprint of human populations, encroaching upon and altering natural habitats in order to extract resources, intensify food production, and move animals and people – and the pathogens they carry – the greater the potential for infection and the spread of pathogens novel to humans. Climate change may also create newly suitable habitats for species and their pathogens. As an example, projections have suggested that warming temperatures could alter the range for Flying Fox bats, which carry the deadly Nipah virus. The drivers of disease emergence and spreading are also the drivers fundamentally changing our environment….
In the devastating Ebola crisis, there may be a silver lining to salvage. While Ebola fortunately is unlikely to become a global pandemic (due to Ebola’s infection pathway, which requires direct contact with bodily fluids, and the risk-minimizing public health advances in many parts of the world), we can harness the concern from the global community about Ebola’s potential spread to have a constructive dialogue about preventing future outbreaks. This is especially timely given other recent animal-origin diseases we’ve seen, including H7N9 and the Middle East Respiratory Syndrome (MERS-CoV), and our challenge in controlling their ongoing spread.
In addition to essential community and policy-oriented actions around strengthening preventive public health infrastructure, science has an important role to play in prevention. Science can yield a better understanding of disease risks and identify ways to prevent pathogens from moving from animals to humans. We can expand our arsenal by targeting the source, as with the USAID Emerging Pandemic Threats PREDICT program, which has conducted novel pathogen surveillance in wildlife in settings of high risk for transmission to humans. Routine surveillance of animals may also directly benefit both wildlife conservation efforts and human health by providing sentinels for diseases of harm to humans. Detection of Ebola infection in wildlife might have prevented transmission to the first Ebola case in the Democratic Republic of the Congo (DRC) a few weeks ago, which occurred from butchering and/or consuming an infected animal, an outbreak believed to be separate from the one in West Africa.
As we look towards the Sustainable Development Goals, health stands out as a ubiquitous concern that communities worldwide will continue to grapple with. A 2012 study found that vector-borne and parasitic diseases (VBPD) can negatively affect economic development and suggested an increased VBPD burden where biodiversity decreases.
The overlapping drivers of disease and environmental change, as well as their development implications, point towards the need for, and benefits, of ‘One Health’, a more integrated view and approach to human, animal and environmental health. We can no longer afford to think of human health as separate from animal health and their environmental determinants. “My biggest concern is the lack of understanding of the biotic and abiotic factors that lead to outbreaks such as Ebola”, says Dr. William B. Karesh from the conservation and health organization EcoHealth Alliance, who has been a leader in One Health initiatives. “Without a broad collaborative approach like Future Earth is taking, we will be severely limited in our ability to prevent future outbreaks”.
Some international groups are helping to foster synergies, including the World Health Organization’s recent conference on Climate and Health, the Convention on Biological Diversity’s initiative on Health and Biodiversity, the Lancet-Rockefeller Commission on Planetary Health, and the DIVERSITAS-Future Earth ecoHEALTH project, which brings together public and animal health, development, ecology, economics, and other sectors to investigate connections between health and environmental change to generate science and policy outputs that can inform sustainability solutions.
Central to dialogues on infectious disease is the number of pathogens that exist. A recent estimate suggests over 320,000 mammalian viruses are still to be discovered but haven’t yet emerged in humans. What we do to our planet will determine whether we can go beyond reactive responses and prevent an increasing health burden. If we don’t rapidly take a broader view of health – moving from beyond our single-species perspective, to ecosystems as a whole – we may lose the trees before we have seen the forest, and the importance it holds for our health.
Further Reading:
Morens DM, Fauci AS (2013) Emerging Infectious Diseases: Threats to Human Health and Global Stability. PLoS Pathog 9(7): e1003467. doi:10.1371/journal.ppat.1003467
Please read the rest of the article here.
There’s more on the science describing the Ebola virus on The Conversation and in a fascinating 2013 news article by Donald McNeil on hints of Ebola’s presence in South Asia.
Disclosure Note | I’m on the Interim Engagement Committee of Future Earth (a voluntary position), which is a new international hub for coordinating interdisciplinary research aimed at fostering sustainable human progress on this finite planet.