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Wildlife is an essential component of biodiversity and provides people with multiple social and economic benefits. However, a resurgence of epidemics over the past two decades has highlighted wildlife's role as a potential source of dangerous pathogens for humans and livestock, with devastating consequences worldwide. Simultaneously, numerous reports have indicated that wildlife populations are declining at an alarming rate due to human and livestock pathogens, predation, and competition. An integrated approach to managing wildlife, human, and domestic animal health is therefore clearly needed. Yet this integration often fails to materialize due to a lack of wildlife health standards and know-how. Here, we present an operational framework that follows a step-by-step approach: i) a holistic definition of human health is adapted to the context of other-than-human animals, including wildlife; then, ii) different categories of wildlife living within a landscape or a country are defined based on the management systems under which they live. For each wildlife category, the type (natural vs. anthropogenic) of habitat, the nature of the interface of wildlife with humans and/or livestock, and the level of sanitary control are defined; and finally, iii) the holistic definition of wildlife health is considered in relation to each wildlife category to define health challenges and the domains of expertise required to address them. This framework can assist national and international agencies, including veterinary and wildlife authorities and policy makers, in defining wildlife health priorities, responsibilities, policies and capacity building strategies. The extensive interdisciplinary collaboration needed to manage the many different aspects of wildlife health calls for a more integrated One Health approach.

To respond to the antimicrobial resistance (AMR) threat, public health entities implement policies aiming to reduce antimicrobial use (AMU) in livestock systems, in which policy success and sustainability might be subject to the social acceptability of the novel regulatory environment. Therefore, consistent methods that gather and synthesize preferences of stakeholder groups are needed during the policy design. The objective of this study was to present a methodology for evaluating the acceptability of potential strategies to reduce AMU using multi-criteria decision analysis (MCDA) using French dairy industry as a model. Preference-ranking organization methods for enrichment evaluations were applied to rank stakeholders' acceptance of four different potential AMU reduction strategies: 1. Baseline AMU regulations in France; 2. Total interdiction of AMU; 3. Interdiction of prophylaxis and metaphylaxis AMU; and 4. Subsidies to reduce AMU by 25%. A total of 15 stakeholders (consumers, n = 10; farmers, n = 2; public health representatives, n = 3) representing the French dairy sector and public health administration participated in the acceptance weighting of the strategies in relation with their impact on environmental, economic, social, and political criteria. We established a MCDA methodology and result-interpretation approach that can assist in prioritizing alternatives to cope with AMR in the French dairy industry or in other livestock systems. Our MCDA framework showed that consumers and public health representatives preferred alternatives that consider the restriction of AMU, whereas farmers preferred to maintain baseline policy.

Senegal has long sought solutions to achieve universal health coverage (UHC). However, in a context dependent on international aid, the country faces multiple external pressures to choose policy instruments. In this commentary, we propose an analysis of this influence. The empirical material comes from our involvement in analysing health reforms for 20 years and from many interviews and observations. While studies have shown that community-based health insurance (CBHI) was not an appropriate solution for UHC, some international actors have influenced their continued application. Another global partner proposed an alternative (professional and departmental CBHI), which was counteracted and delayed. These issues of powers and influences of international and national consultants, established in a neo-liberal approach to health, have lost at least a decade from UHC in Senegal. The alternative now appears to be acquired and is scaling up at the country level, witnessing a change in the current policy paradigm.

La mondialisation de l'économie et des problèmes environnementaux et sanitaires a influencé les modes d'intervention des politiques publiques en matière d'élevage. Cet article explore les bouleversements induits dans ce secteur et en particulier sur le pastoralisme. Il analyse les tenants et les aboutissants de la reconnaissance, de l'institutionnalisation et de la valorisation économique des activités pastorales par les politiques publiques. Il en ressort que les aspects intersectoriels et multifonctionnels du pastoralisme ont, dans la plupart des cas, été négligés alors qu'ils sont déterminants dans les dynamiques des socioécosystèmes considérés. Aussi, explorons-nous comment l'approche par les communs peut permettre aux acteurs eux-mêmes de promouvoir une gestion adaptative du pastoralisme en réifiant, dans les milieux considérés, les interactions homme-animal dans leur complexité.

The decrease in the supply of veterinary healthcare in France adversely affects health of food-producing animals. In a One Health perspective, the health of people, animals and their shared environment are interconnected, and adequate supply of veterinary healthcare is required to ensure public health. Prevention of outbreaks and zoonotic diseases that may impact public health mobilizes a set of public policies, including strengthening veterinary workforce. These policies should be informed by quantification of animal health care accessibility, yet this has not been well characterized. The objective was to quantify the accessibility to veterinary healthcare for cattle, swine, and poultry sectors in France. A Two-Step Floating Catchment Area (2SFCA) approach was used to measure the level of accessibility to veterinary clinics. In the cattle sector, the 2SFCA score indicated relatively high accessibility in the north and south of France, but insufficient accessibility elsewhere. In the swine sector, there was high accessibility in the north east and in north of France, medium accessibility in the south west, and insufficient accessibility elsewhere. Finally, in the poultry sector, all regions had insufficient accessibility. Sensitivity analysis examining the effects of a change in spatial accessibility according to various travel time showed that the optimal threshold to compute 2SFCA score in cattle, swine and poultry sectors were respectively, 45, 60 and 60 min. According to a definition of “underserved area” derived from an official decree and the optimal thresholds to compute 2SFCA, the cattle, swine and poultry sector have on average 75.3, 89.9 and 98.3% underserved area, respectively. We provided evidence that the supply of animal health care was not sufficient and we proposed recommendations on how to assess animal health care accessibility, enabling modelling and visualization of the effects of potential public policies aimed at reducing veterinary shortages.

Background: Access to veterinary drugs for livestock has become a major issue over the last decade. Analysis has tended to focus on the demand for these products, while studies looking at the drivers behind their use generally focus on farmer behavior and interactions between veterinarians and farmers. However, the use of drugs also depends on structural factors that determine the functioning of the drug supply chain and farmers' access to the drugs. This article presents an overview of the factors that limit access to veterinary drugs in sub-Saharan Africa (SSA) as well as the international policy tools and arrangements that claim to improve it. Methods: We have conducted a scoping review of the scientific and grey literature as well as the publicly-available data from both the animal health industry and international organizations. We aimed to gather information on the veterinary drugs market in SSA as well as on the international norms, recommendations, guidelines, and initiatives that impact SSA farmers' access to these drugs. Findings: We highlight numerous barriers to veterinary drug access in SSA. The SSA market is highly dependent on imports, yet the region attracts little attention from the international companies capable of exporting to it. It suffers from a high level of fragmentation and weak distribution infrastructures and services, and is driven by the multiplication of private non-professional actors playing a growing role in the veterinary drug supply chain. The distribution system is increasingly dualized, with on the one hand the public sector (supported by development organizations) supplying small scale farmers in rural areas, but with limited and irregular means; and on the other side a private sector largely unregulated which supplies commercial and industrial farming systems. Different innovations have been developed at the international and regional levels to try to reduce barriers, such as homogenizing national legislations, donations, and

En mars 2021, Montpellier Université d'excellence (MUSE) et Agropolis International ont réuni des décideurs, acteurs opérationnels, représentants d'organisations internationales et scientifiques pour partager leurs expériences des approches intégrées en santé dans le cadre du concept One Health. Ces échanges intersectoriels fructueux ont croisé les points de vue et ont pointé les obstacles et les enjeux de la mise en oeuvre concrète de ces approches. Les participants ont abouti à des propositions pour rendre plus efficace cette mise en oeuvre et faire face aux menaces sanitaires émergentes et aux futures pandémies : coconstruire des projets intégrés avec tous les acteurs concernés (citoyens, décideurs politiques, chercheurs, services locaux) ; développer des méthodes d'évaluation de leurs impacts ; former les acteurs ; institutionnaliser et coordonner les actions du niveau local au niveau mondial.

Background: Anthrax is a zoonotic disease that causes frequent outbreaks in livestock and fatal human cases in Burkina Faso. Effective surveillance of this disease calls for the establishment of an integrated surveillance system, in line with the One Health concept. However, despite a strong technical and financial support from international partners, surveillance is still poorly conducted within an integrated approach. Based on stakeholder perspectives, the study has for objective to deepen our understanding of the anthrax surveillance system and to identify the obstacles and levers towards a more integrated approach to anthrax surveillance in Burkina Faso. Methods: The data was collected from a literature review and interviews with surveillance stakeholders. We first conducted a qualitative descriptive analysis of the data to characterize the surveillance system (programmes, actors, collaboration). In a second step, we conducted a thematic analysis of the informants' discourse in order to identify what represents an obstacle or, conversely, a lever for a more integrated approach to anthrax surveillance. Results: The surveillance system of anthrax in Burkina Faso includes three programmes (in the livestock, wildlife and human sectors), which involves 30 actors. These sectoral programmes operate almost independently from one another, although some collaborations are existing for the governance and implementation of surveillance activities. Analysis of the discourse of key stakeholders led to the identification of four categories of factors that may influence the implementation of an integrated surveillance system in the country: knowledge; technical, organizational and social capacities; motivation; intersectoral governance. Conclusions: This study highlights the difficulty of translating One Health governance to the national level and the need to better articulate the visions of all categories of stakeholders. This study also reveals the need to develop specific ev

In Guadeloupe, a French overseas territory located in the Eastern Caribbean, infectious and non-infectious diseases, loss of biodiversity, natural disasters and global change threaten the health and well-being of animals, plants, and people. Implementing the “One Health” (OH) approach is crucial to reduce the archipelago's vulnerability to these health threats. However, OH remains underdeveloped in Guadeloupe, hampering efficient and effective intersectoral and transdisciplinary collaborations for disease surveillance and control. A multidisciplinary research group of volunteer researchers working in Guadeloupe, with collective expertise in infectious diseases, undertook a study to identify key attributes for OH operationalization by reviewing past and current local collaborative health initiatives and analyzing how much they mobilized the OH framework. The research group developed and applied an operational OH framework to assess critically collaborative initiatives addressing local health issues. Based on a literature review, a set of 13 opinion-based key criteria was defined. The criteria and associated scoring were measured through semi-directed interviews guided by a questionnaire to critically evaluate four initiatives in animal, human, plant, and environmental health research and epidemiological surveillance. Gaps, levers, and prospects were identified that will help health communities in Guadeloupe envision how to implement the OH approach to better address local health challenges. The methodology is simple, generic, and pragmatic and relies on existing resources. It can be transposed and adapted to other contexts to improve effectiveness and efficiency of OH initiatives, based on lessons-learned of local past or current multi-interdisciplinary and intersectoral initiatives.

Background: Post-exposure prophylaxis (PEP) is highly effective at preventing human rabies deaths, however access to PEP is limited in many rabies endemic countries. The 2018 decision by Gavi to add human rabies vaccine to its investment portfolio should expand PEP availability and reduce rabies deaths. We explore how geographic access to PEP impacts the rabies burden in Madagascar and the potential benefits of improved provisioning. Methodology & principal findings: We use spatially resolved data on numbers of bite patients seeking PEP across Madagascar and estimates of travel times to the closest clinic providing PEP (N = 31) in a Bayesian regression framework to estimate how geographic access predicts reported bite incidence. We find that travel times strongly predict reported bite incidence across the country. Using resulting estimates in an adapted decision tree, we extrapolate rabies deaths and reporting and find that geographic access to PEP shapes burden sub-nationally. We estimate 960 human rabies deaths annually (95% Prediction Intervals (PI): 790–1120), with PEP averting an additional 800 deaths (95% PI: 640–970) each year. Under these assumptions, we find that expanding PEP to one clinic per district (83 additional clinics) could reduce deaths by 19%, but even with all major primary clinics provisioning PEP (1733 additional clinics), we still expect substantial rabies mortality. Our quantitative estimates are most sensitive to assumptions of underlying rabies exposure incidence, but qualitative patterns of the impacts of travel times and expanded PEP access are robust. Conclusions & significance: PEP is effective at preventing rabies deaths, and in the absence of strong surveillance, targeting underserved populations may be the most equitable way to provision PEP. Given the potential for countries to use Gavi funding to expand access to PEP in the coming years, this framework could be used as a first step to guide expansion and improve targeting of inter

L'article examine l'histoire, les définitions, les objectifs assignés aux politiques de santé animale. Ces politiques associent des objectifs nombreux et potentiellement contradictoires de santé publique, d'économie agricole, de commerce international, de bien-être animal, et plus récemment, d'en faire une composante du triptyque One Health. Ce dernier objectif est lié à la mobilisation de la communauté internationale (FAO, OMS et OIE [Organisation mondiale de la santé animale]) pour la santé globale. La santé animale devient simultanément un enjeu de biosécurité et un bien public mondial. Ce recadrage permet de mobiliser la communauté internationale sur le registre de la menace et de l'intérêt général. L'exemple de la grippe aviaire au Vietnam montre la nécessité de veiller à ce que ce recadrage ne marginalise pas les enjeux et les apprentissages locaux. Plus généralement, la santé animale est un objet politique qu'il faut dénaturaliser. Les sciences sociales permettent de comprendre les intérêts, les valeurs en concurrence dans le concept de santé animale et de nourrir le débat sur ce que nous voulons en faire pour construire un monde plus sûr mais aussi plus solidaire entre États ainsi qu'entre humains et animaux.

La COVID-19 a pressé les gouvernements à intervenir à l’aide de données partielles sur l’efficacité des moyens. Les femmes sont particulièrement touchées car elles sont plus nombreuses à s’occuper des autres. Cette étude a pour but de comprendre l’influence des décisions politiques sur les conditions de vie et de travail des travailleuses de la santé. Une analyse des interventions gouvernementales de santé publique du Québec et des revendications des travailleuses de la santé retrouvées dans les documents journalistiques et les communiqués de presse officiels du gouvernement (13 avril au 1er juillet 2020) a été effectuée. Les résultats démontrent le manque de reconnaissance des autorités face à certains types de care, ainsi qu’une inadéquation dans les moyens de prise en charge pour prendre soin de la population. Le peu de reconnaissance des conditions de vie et de travail lors de décisions politiques engendre une répartition inéquitable des fardeaux associés à la pandémie. -- Mots-clés : COVID-19 ; equité/Justice sociale ; femmes ; gouvernance ; politiques/politique ; equity/social justice ; women ; governance.

Antimicrobial resistance (AMR) policies, which aim to redefine how antibiotics are used, reshape the veterinary profession's relationships in at least two ways. The policies can give state veterinarians greater power over practising veterinarians and thus change the relationship between the profession and the government supposed to regulate it. The policies also call for coordination with other relevant professionals, mainly in the areas of human medicine and food safety, which can limit the veterinary profession's autonomous decision-making. Based on a survey of veterinarians working at different levels of the administration and their non-veterinary colleagues in Switzerland, it is shown that AMR policies, by strengthening the administration's planning and supervisory functions, do contribute to increased state control of the veterinary profession. However, this shift is limited because implementing the policies requires negotiating with representatives of the profession.

The global lockdown to mitigate COVID-19 pandemic health risks has altered human interactions with nature. Here, we report immediate impacts of changes in human activities on wildlife and environmental threats during the early lockdown months of 2020, based on 877 qualitative reports and 332 quantitative assessments from 89 different studies. Hundreds of reports of unusual species observations from around the world suggest that animals quickly responded to the reductions in human presence. However, negative effects of lockdown on conservation also emerged, as confinement resulted in some park officials being unable to perform conservation, restoration and enforcement tasks, resulting in local increases in illegal activities such as hunting. Overall, there is a complex mixture of positive and negative effects of the pandemic lockdown on nature, all of which have the potential to lead to cascading responses which in turn impact wildlife and nature conservation. While the net effect of the lockdown will need to be assessed over years as data becomes available and persistent effects emerge, immediate responses were detected across the world. Thus, initial qualitative and quantitative data arising from this serendipitous global quasi-experimental perturbation highlights the dual role that humans play in threatening and protecting species and ecosystems. Pathways to favorably tilt this delicate balance include reducing impacts and increasing conservation effectiveness.

The whole human society was caught unprepared by the emergence of SARS-CoV-2 and the related COVID-19 pandemic. This should have not been. We already had on hand all information to organize properly and prevent this emergence. However, this information was never translated into preparedness because the current system of sanitary crises management is not adapted. We keep implementing a medical, symptomatic, post-emergence approach which cannot stop an emerging pandemic. The only preventive action considered is the screening for viruses in the wild but it is not efficient since pandemic viruses do not exist in the wild, and indeed, have never been found. The emergence of a viral pandemic is the result of a double accident: the in-host evolution of the causative virus and its amplification to the epidemic threshold by societal factors. To be prepared the society should target this societal dimension of emerging diseases and organize accordingly. Unfortunately, the society is not organized that way and is still unprepared and vulnerable.

75% des maladies infectieuses chez l'homme sont des zoonoses, c'est-à-dire d'origine animale. La crise sanitaire actuelle liée à la Covid-19 nous rappelle ce risque élevé d'émergence de maladies zoonotiques ainsi que leur impact parfois majeur. Le contrôle de ces maladies est donc un enjeu crucial pour la sécurité sanitaire des populations humaines et animales dans ce monde globalisé. Les virus influenza ont été à l'origine de quatre pandémies majeures au cours du siècle dernier. A partir de 2003, ces virus ont entrainé un grand nombre d'épizootiques catastrophiques pour les élevages avicoles dans de nombreux pays. Si le rôle des oiseaux sauvages est clairement identifié dans la diffusion mondiale de ces virus influenza, les mobilités humaines, matérielles et animales au sein des réseaux de production avicoles interviennent également dans cette diffusion. La vaccination, couplée à la surveillance des foyers et à la biosécurité des élevages, permet de limiter l'impact et la circulation de la maladie dans un élevage et donc dans un réseau de production avicole. Les stratégies de vaccination à mettre en oeuvre doivent prendre en compte le contexte épidémiologique, la structure du réseau, les différents types de vaccins et les ressources disponibles. L'objectif de ce travail de thèse est de comprendre le rôle des mobilités humaines, matérielles et animales entre les élevages dans le risque de diffusion des virus IA au sein des réseaux de production avicole et de proposer un outil d'aide à la décision pour déterminer et évaluer des stratégies de vaccination basées sur ces risques et capables contrôler la diffusion virale au sein de ces réseaux. Pour ce faire, une revue de la littérature a tout d'abord été réalisée pour identifier les différentes mobilités existantes au sein des réseaux de production avicoles. Cette revue montre que le rôle de ces mobilités est rarement pris en compte sur l'ensemble des réseaux de production. Le développement de l'outil d'évaluation s'est