18/07/2016 - After responding to emergency zoonotic outbreaks, the importance of One Health Approach has been emphasized worldwide in effectively preventing and controlling these diseases. In order to discover more about this approach within the Viet Nam country context, a discussion was held with FAO Viet Nam's Emergency Centre for Transboundary Animal Diseases (ECTAD) core One Health technical staff members (Pawin Padungtod – Senior Technical Coordinator, Nguyen Thuy Hang – One Health Advocacy and Communication Coordinator and Nguyen Phuong Oanh – Operations Officer to talk about their recent One Health assessment mission in Ha Giang and Quang Nam provinces.

 (The answer of interviewees are marked as 'P' for Pawin Padungtod, 'H' for Hang Thuy Nguyen and 'O' for Oanh Phuong Nguyen. Questions are indicated as Q.)

Q. Before we talk about the mission, could you explain a bit on One Health?

P. It is an integrated approach that calls for multidisciplinary and inter-sectoral cooperation and communication, among human health, animal health and ecosystem health to address health issues facing our ecosystem. One Health approach has been applied to infectious diseases emerged at the human-animal interface, especially those with the potential to cause pandemic and can seriously impact public health and livelihoods.

H. Experiencing outbreaks originated from different animals, especially like H5N1 and rabies, we have learnt that One Health provides solutions to effectively prevent and control zoonotic and transboundary diseases from the farm level in Viet Nam.

Q. Then how would you define FAO's role in the implementation of One Health initiatives in Viet Nam then?

H. FAO ECTAD Viet Nam has been providing technical assistance to the Ministry of Agriculture and Rural Development (MARD) to control H5N1 outbreaks in poultry, One Health collaboration, surveillance, laboratory diagnosis, biosecurity, value chain analysis and advocacy have been the core areas of work we supported.

P. In order to implement the One Health approach, we have facilitated the conversation between animal health and human health government agencies to identify opportunities for collaboration. Within the UN system, we have been supporting various policy dialogues, multi-stakeholder coordination and consultation between national and international partners with WHO and UNDP. One Health approach can also be extended beyond Viet Nam borders, and together with the Government of Viet Nam, FAO organized animal-public health cross-border talks with neighbouring countries such as China or Cambodia to improve information exchange and build up a quicker response to outbreaks.

Q. So, where in Viet Nam were the One Health activities supported by FAO?

O. Following from last year's One Health mission to Thanh Hoa and Binh Dinh Provinces, this year we went to Quang Nam and Ha Giang Provinces in Viet Nam with officials from six agencies including Department of Animal Health, Regional Animal Health Office 2 (RAHO2), Department of Preventive Medicine (GDPM), National Institute of Hygiene and Epidemiology (NIHE), FAO and WHO. Like a troop of One Health promotors! It was a joint mission with the animal and human health key players from the government and UN.

Q. One Health promotors! What did you do as One Health promotors?

P. We went to the two provinces to see how the one health approach was applied. In Viet Nam, there is an inter-ministerial Circular 16, which was issued by both Ministry of Health and Ministry of Agriculture and Rural Development since 2013. It provides the legal basis for coordination, information sharing and collaboration between the human and animal health sectors in surveillance, risk assessment and response activities. So basically, we were evaluating how the Circular 16 was being implemented by local human and animal health sectors.

O. We interviewed 22 leaders and technical officers from both animal and human health sectors of each province in commune, district and provincial level to ensure we were assessing the full picture of One Health implementation at all levels within the government.

Q. How exactly did you do that? Was there a tool used to get information from commune, district and provincial people?

H. We used a structured questionnaire to interview the people followed by discussions and collecting relevant evidences. For the interview, we focused on the subjects of surveillance, outbreak investigation and response, communications activities, training and study activities and implementation.

O. During direct discussions, we covered the difficulties, advantages and recommendations on implementing Circular 16.

Q. What were your impressions of One Health implementation during the assessment?

O. We could see the substantial effort from both sectors to enhance working relationships but there could be more engagement of local authority's leadership at provincial, district and commune level to support the Circular 16 implementation plan. Capacity building to better understand and properly apply the Circular 16 is critical for One Health implementation at the field.

H. If local government could allocate funds to support the plan, invest in human resources, infrastructure and professional training at the commune level, it would improve the implementation of the Circular 16 a lot. Also capacity development on outbreak response and investigation for the public and animal health professionals at all levels is always needed.

Q. Are there any follow up actions to improve the implementation of circular 16?

P. We have developed several training programs to promote Circular 16 implementation, including response to priority zoonoses such as rabies. These trainings have been piloted in Ha Giang and Quang Nam. We will collaborate with the relevant agencies to organize a training course on Joint outbreak investigation before the end of 2016.

H. Along with the training, FAO ECTAD Viet Nam will cooperate with the Department of Animal Health, General Department of Preventive Medicine to implement the Circular 16 activities and support the provincial public and animal health staff in both Ha Giang and Quang Nam Provinces.

Q. Do you have any thoughts to share on this mission before wrapping up?

P. As a joint mission involving both animal and public health sector, I would say this mission was truly a demonstration of One Health collaboration. By interviewing officials from provincial to commune levels in Ha Giang and Quang Nam Provinces, we could witness their efforts to implement the Circular 16 at all levels despite their limited resources and capacity. On this occasion, we would like to reaffirm our technical assistance to the project in the spirit of One Health.

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