1              Thus far in the conference, we have had some excellent presentations and discussions on the emergence of new diseases and the challenges that we face to prevent, prepare for, detect and respond to them. We have also discussed some of the drivers for disease emergence. Several presenters have told us how the One Health approach differs from the approach of zoonotic diseases.

2              In this presentation, and in the subsequent panel, we will bring these different elements together and explore their potential implications – in particular, for food and nutrition security, for food safety and for marketing practices and trade. My main point is that one health thinking, outcomes, policies, research and action are important for

(A) Increasing the number of people who enjoy food security – ie the availability of, stable access to, and utilization of necessary nutrients (and food) for both long– and short-term development needs;

(b) Ensuring bio-secure, ecologically sustainable and humane livestock production of safe food for people to eat;

(c) Encouraging accessible local markets and fair international trade in livestock products,.

3              The risk of disease emergence at the interface between animals, humans and ecosystems is at the current core of one health thinking. But one health thinking can go further to include illnesses that affect human life and health directly (including, but not limited to, infectious diseases), as well as those with an indirect effect on human health through their impact on people’s livelihoods. It can also include the drivers that increase the risk of emerging diseases (climate change, resource depletion, land degradation, demand, lack of biosecurity, contamination).

4              It would not be appropriate at this stage to rigidly define one health thinking and action. Better to see how different stakeholders – in government, among farmers and food processors, within consumer groups and civil society – use the concepts in practice and see whether a definition of the core and peripheral elements of one health can be established. Just one specific point – whatever framework we use should not only relate to emerging diseases: we also need to deal with existing foodborne or animal-related diseases – at this time they cause significantly higher disease burdens than any emerging problems we have seen to date.

5              One health policies require a joined up approach that unites professional expertise, epidemiological analysis, systems and services for human health, animal health and healthy ecosystems.

6              In September 2005, in the midst of growing global concerns about Highly Pathogenic Avian Influenza – and the potential for it to cause a catastrophic pandemic – I was appointed by the then-UN Secretary General Koji Annan to serve as the Senior UN System Influenza Coordinator.

7              In this role, which I continue today, I was tasked with helping to make the UN system work to its best effect in support of national, regional and global efforts to address the threats posed by avian and pandemic influenza.

8              While work is still underway, I believe that since that time much progress has been made in the efforts to prevent, prepare for, and respond to animal and pandemic influenzas.  [slide 2 – as this chart from FAO-EMPRES indicates, there has been an general downward trend in outbreaks in birds/poultry since 2003 – though there was a jump in 2010, perhaps partially linked to improved surveillance. The downward trend has similarly been the case with WHO statistics on human cases]

9              Building on that coordination effort – which has required much out-of-the-box activity by several great people who are here today – UN Secretary General Ban Ki-Moon asked in 2008 that a similar approach be used to coordinate the UN System’s response to the global food insecurity. I became Coordinator of the UN Secretary General’s High-Level Task Force for the Global Food Security Crisis (HLTF) and Special Representative of the Secretary General (SRSG) for Food Security and Nutrition.

10           I will now look at some of the issues on which one health thinking and policies are relevant.

11           We face a global situation where an estimated 925 million people go hungry. The effects of most recent food price increase are likely to deepen the vulnerability of those who spend between 50% and 80% of their family budget on food, mostly basic staples. [Slide 3– According to the 2009 Global Health Index, there are 29 countries facing “alarming“ or “extremely alarming” levels of hunger.] 

12           The world is witnessing enormous spikes in food prices in 2008 and again more recently in late 2010 and beginning of this year [slide 4], withfood prices remaining high and increasingly more volatile [slide 5]. Whatever the cause (energy/food integration; demographic and dietary changes, low investments in agriculture, inefficient or inexistent safety nets, speculation if food markets etc.), extreme volatility in food prices deters producers from making the necessary investments for increasing productivity and production. This applies to both crops and livestock investment decisions by small scale food producers who already fight with changing climate patterns.

13           Trade plays a fundamental part in the food security equation: improving the stability of food supplies to ensure food security requires both local and international food markets to work well for the most vulnerable. Locally, well-functioning food markets and trade have huge potential to increase small farmers’ integration into value chains so as to increase the benefits they can capture from the trade in their products (capacity building for their umbrella/apex organizations will be needed to fully exploit the potential).At international level, well-functioning food markets can help trade benefit LDCs and their farmers and breeders if they are assisted with proper policy measures on research, infrastructures, extension services, nutritional food security just to mention a few (all of which in the green box of WTO >Non-distorting). Again capacities will have to be built for LDCs to realize increasing benefits from trade. Regional integration offers interesting opportunities to have such issues tabled. The DDA can be another source of progress in that respect.

14           [slide 6] Efforts to respond to food insecurity, food safety and food trade challenges have addressed all four dimensions of food security: availability, access, utilization and stability. Progress was made at the level of

·         countries affected by food insecurity (national budgets, national plans, 1000 days, Flu plans etc.),

·         investors in countries’ efforts to improve food security (GASFP, EUFF, REACH, SUN, IMF new food facilities, WEF)

·         the organizations that support both countries and investors (including the UN system High Level Task Force, regional bodies like CAADP, CGIAR institutions and the like), and

·         (d) the system for governance of international arrangements to assist affected countries (CFS, GASFPN, G20, ASEAN and APEC for Asia and the Pacific etc.)

15           Growing demands from increasingly affluent populations have been identified as drivers for increasing livestock production which can heighten the likelihood of infectious disease emergence at the human-animal-ecosystem interface. [slide 7, from Nature – shows estimates on population rise coupled with increase in caloric availability].

16           The livestock sector is an area in which one health thinking and action can make a difference to lives and livelihoods. The need is great: livestock represents 40 percent of the value of world agricultural output: it is one of the fastest growing sub-sectors of the agricultural economy especially within developing countries. FAO indicated that the number of food animals (including poultry) being produced is growing annually, and will continue to increase from approximately 21 billion today to about 28 billion by 2030. [slide 8] Much livestock is locally grown and marketed. Estimates from the World Bank on the projection for the increase in meat production over the next 40 years also indicate that this will occur in the developing world [slide 9] in particular.Improving livestock production in a sustainable and humane manner that balances both carbon and water footprints is a major challenge facing the One Health community.

17           This increased livestock production – while necessary for a growing population — enhances the potential for disease spread – through the increasing concentration of livestock (and the risks that accompany that) as well as increasing proximity of people and livestock in many urban and peri-urban areas. [slide 10 – map of risk areas for infectious diseases transmissible between animals and humans]

18           Disease risks at the human, animal and ecosystem interface can have major implications for human health. Livestock are often present in large numbers close to human habitations. This can result in increasing disease emergence and outbreaks amongst animals, and then people.

19           For the 75% of the world’s poor that are rural and dependent on agriculture, disease outbreaks in livestock not only put at risk their immediate food source, but it also puts at risk their livelihoods and resilience capacity – that is their long-term food security.

20           Disease outbreaks which reduce the availability of live animals and livestock products can reduce household income, undermine the diets of household members, impair nutritional status AND INCREASE RISKS TO HEALTH, especially of women and children. Outbreaks can also impair the wider market availability for those products. Chronic food insecurity also drives risky behaviours: no one who is well-fed would consider consuming the carcass of an animal that has died from disease.

21           Effects of animal disease extend to people who work in production and processing – including livestock and agri-food workers, transporters and sellers, to name a few. There have been several careful studies of this direct impact on livelihoods in relation to the destruction of poultry flocks in an attempt to control Highly Pandemic Avian Influenza H5N1. Governments, UN agencies and other partners have worked hard to mitigate these consequences. For instance, FAO developed a livelihood toolkit to help address the social and economic impacts of HPAI outbreaks and control measures at all levels. The importance of supporting resilient livelihoods cannot be stressed enough.

22           The intertwining of these elements reinforces the need for developing and utilizing One Health thinking, results and policies and of communication around them.   Given the potential impacts that disease outbreaks can – and as history has shown, sometimes do – have on trade, food safety and food security, there needs to be much greater investment in investing in preventive measures now, in order to avoid future outbreaks.

23           Agricultural intensification and lack of biosecurity can also result in food-borne disease: WHO estimates that in 1997, food contamination cost up to USD 35 billion in the USA alone due to medical costs and lost productivity. Clearly, the societal and economic implications of food-borne disease are major issues that need consideration.

24           Local and international trade are core features of livestock production systems. The global trade of animal-sourced products now constitutes about 13 percent of all food exports, reaching US$37 billion in fresh and frozen meat and US$20 billion in live food animals[1] . The huge growth in the export of animal source products not only creates an avenue for potential disease spread, but it also make it clear that potential disruptions in the global food trade can have significant financial implications.   Increased attention to the risk of pathogens in traded food is inevitable in response to ever widening implementation of rules designed to protect health. The risk assessments stipulated in the SPS/WTO agreements will result in barriers to trade when the risk is deemed to be too high. Poorer countries need to be able to export their food produce into international markets: they need their own capacity to undertake risk assessments and implement risk mitigation. Otherwise they will lose out on trading opportunities to others better able to do this.

25           Fear of losing business can also result in further disease spread in a clandestine way. The potential negative economic impacts of restricting the movement and sale of diseased animals or animal products (a common response to disease emergence) may unfortunately drive some linked to the industry to try to work around bans on sales and trade in order to maintain their income – and in the process, potentially extends a disease outbreak and makes it harder to control.

26           In its paper ‘People, Pathogens and Our Planet,’ the World Bank notes “The emergence of BSE, SARS, H5N1, and influenza A(H1N1) have caused over US$20 billion in direct economic losses over the last decade and much more than US$200 billion in indirect losses.”

27           A disease outbreak can greatly impact on trade. The World Bank found that the 2009 outbreak of the pandemic (H1N1) influenza in Mexico had a significant, though temporary, impact on the Mexican economy, particularly on service-related sectors such as tourism and recreational activities. Their rough estimates are of a 0.3-0.5 percent of GDP, or between US$2.7 and US$4.5 billion, reduction of economic activity in Mexico due to the outbreak.

28           [slide13 Economic Impact of SARS in Hong Kong, Singapore and Taiwan – effects on GDP 2002-2003] An outbreak can also impact on health seeking behaviour which has major economic consequences. The major impacts of the February 2003 SARS outbreak included large, though short-lived negative demand shocks induced by individuals seeking to avoid becoming infected, leading to sharp reductions in foreign and domestic tourism, and reduced domestic demand for service sectors (retail stores, hotels, restaurants, transportation).

G             BETTER FOOD SECURITY AND FOOD SAFETY THROUGH ONE HEALTH PRINCIPLES:  [slide 14, 15]

29           In my capacity as UN system Food Security Coordinator, I work to facilitate UN system contribution to this wider response through engaging in the development and implementation of strategic frameworks such as the Comprehensive Framework for Action (CFA) and its subsequent 2010 update (UCFA), the Road Map for Scaling up Nutrition (SUN). They are within the spirit of sustaining coordinated responses by a wider movement of actors: we seek to encourage a range of stakeholders to work in synergy – in pursuit of immediate and longer term food security outcomes – under the leadership of national authorities. They also encourage multi-stakeholder platforms that synergize and simplify the coordination of support for smallholder-based food security initiatives, nutrition-sensitive development and specific nutrition interventions. [slide 16 on SUN]   They are multi-stakeholder movements, anchored to institutional processes but not controlled by them.

30           What have we learnt over the past few years in applying one health thinking to food and nutrition security, food safety, markets and trade?

·         First, the need for country leadership. Effective action to ensure food security and safe food for all happens if led from within countries – if it is a central political goal, pursued through comprehensive approaches from within a range of sectors, with coordination that involves a range of stakeholders from within and outside government, a strong role for multilateral system and increased national and international investments with transparent tracking and mapping.

·         Second, the need for clarity on results. In our work the emphasis has been on equitable and sustained improvements in people’s lives, long-term health and resilient livelihoods. Given the important contribution of livestock rearing, animal products and environmental health to these outcomes, one health policies have been critically important.

·         Third, the need for joint working by institutions which tend to function separately. These include government services – and their ministries – with separate responsibilities for animal and human health, the environment, as well as for agriculture and trade   My direct responsibility is to work in and among international organizations that serve as a point of reference for these different ministries, encouraging joint working around an action oriented strategy.

·         Fourth, the importance of working with and responding to stakeholders outside government –  particularly organizations of smallholder farmers and those who work in the livestock value chain, businesses, agriculture unions, consumers’ organizations, local food producers, (they encourage the emergence of a movement)they encourage multiple stakeholders to stay engaged as they work through multi-stakeholders and multi-level partnerships , and

31           Within the context of International Ministerial Conferences on Avian and Pandemic Influenza, Ministers have been advocating for one health for more than three years. Can we – bureaucrats and professionals – demonstrate progress when Ministers call us to account? Can we provide them with useful material that they can report on to their electorates? I think we have made real progress in the area of H5N1 Highly Pathogenic Avian Influenza, and in relation to SARS and spongiform encephalopathy. We have much more to do with regard to sustainable livelihoods of pastoral communities, rabies, or what some refer to as the forgotten zoonoses.

32           Political momentum has been built over the last few years and it is now up to us to deliver, to help ensure that the one health approach becomes a lasting reality. This means

FIRST: Working together for sensible and realistic policies to improve food and nutrition security, sustainable and bio-secure production, safe livestock products, functioning markets and fair trade.

SECOND: looking seriously at our tendency to work in our professional niches and bureaucratic silos, and finding sustainable ways to come out of them – sharing data and analyses, developing joint policies, doing research together, implementing joint investigations and being accountable for delivering results.

THIRD: Focusing on outcomes that have meaning to the business community, to human health, animal welfare and wildlife advocates, to politicians and to the media and then working hard to demonstrate and communicate our results .

FOURTH: never forgetting that our primary clients are those most at risk of food insecurity or most likely to be affected by unsafe food or market failure.

33           None of this is easy.   All of us must be ready to advocate for comprehensive, partnership-based, results-focused and increasingly integrated responses to the current challenges we face in the health, food and agriculture, climate change and trade interface.   Are we, as bureaucrats and professionals,  from governments, international organizations, development agencies, private companies and civil society, ready to do this? What about our colleagues who are not here? We can point to progress in some countries and in some agencies. We can take heart from the emergence of multi-disciplinary networks of professionals dedicated to supporting equity, reducing poverty and encouraging resilient livelihoods. They are taking responsibility for working effectively at these interfaces in ways that build trust and respect between people and professionals, between different professional disciplines and between departments and organizations. They focus on results. They will also listen to the people they serve, to each other, to politicians and other stakeholders and to their own instincts as they take this important work forward. They will seek to work in synergy rather than stovepipes: to appreciate what matters to people rather than to tell them what they should do – or feel. It is important that these special characteristics, so evident among participants in this conference, are retained as one health work becomes institutionalized. They will look for opportunities to advocate for one health – in national parliaments, regional assemblies and globally; in the G8, the G20 and other political for a, as well as with farmers’ organizations, labour unions and civil society groups.

34           This conference – and follow up action after it – will be a success if it inspires wider and stronger networks of people who are not scared by the complexity of effective one-health working that empowers communities to act in ways that improve health and livelihoods, and result in better food security, food safety and opportunities for trade.

35           Only a critical mass of committed people who are prepared to resolve problems in ways that reflect people’s interests, rather than those of professional disciplines or organizations, can take this forward: hence the importance of a movement for one health.  The movement must be seen to be inclusive – men and women, social and physical scientists, from all nations.

36           I trust you will all stay engaged in this process and become the core of the movement, working to transform lives and livelihoods for millions who depend on livestock and animals for their livelihoods. Your support in the progressive synchronization of different agendas and debates will be crucial. Allow me to congratulate you for where you have come in the last two days. An event such as this conference represents an important milestone on the path to real change.

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