Introduction
Zoonotic diseases such as Rift Valley Fever (RVF) frequently break out in East Africa. For instance, RVF outbreaks are triggered rainfall and the distribution of suitable vector habitat. The disease is transmitted to livestock through mosquitoes and flies, and to humans through contact with or consumption of an infected animal (Africa CDC). Because of its nature, RVF and other zoonotic diseases require a regional/multi-country approach to contain it, and one that embraces human, livestock and environmental health.
East African countries under the leadership of the East African Community (EAC) have been using One Health approach to address RVF outbreaks. One Health is a collaborative, multisectoral, and transdisciplinary approach that works across borders to achieve optimal health outcomes, and which recognizes the interconnection between people, animals, plants, and their shared environment (CDC, u.d1). It was first endorsed in 2012 at a summit in Davos, Switzerland, and approved as a way to manage health threats and improve public health through multi-sectoral and multi-stakeholder cooperation (CDC2). The African Union endorses its use in addressing the shared human, animal and environmental health threats in Africa.3
Implementation
The EAC Council of Ministers endorsed One Health in 2014 as the region’s primary response mechanism to zoonotic epidemics, to be applied in the surveillance, early warning and rapid response system. Once the EAC receives reports about disease outbreak, it issues alerts to member states likely to be affected, to step up surveillance. It also deploys a ready multi-disciplinary team of regional emergency experts to the affected areas to coordinate the response and support the local partners through training and supply of equipment.
For instance, in the 2018 outbreak of RVF in the region, the EAC convened a multi-sectoral Technical Working Group on Transboundary Animal and Zoonotic Diseases, to guide the response across the affected member states. The team included health, veterinary, and environmental specialists, who worked together to manage the outbreak. In collaboration with member states, the EAC also conducted public awareness campaigns in the region to educate communities about the symptoms of RVF and the preventive measures they could take.
To prepare for a rapid response, the EAC One Health multi-disciplinary teams also periodically run simulation exercises in the region to prepare for an actual outbreak. The EAC secretariat also mobilises partners to contribute resources to the regional response during an outbreak. Further, the regional body also conducts training for member states, to increase the capacity of teams in understanding and using the One Health approach as a strategic response to cross-border infectious diseases.
Its secretariat staff also support member countries to regularly review and improve the quality of zoonotic disease inspections conducted at border crossings within the economic community.
The regional multi-disciplinary team is replicated at individual member states. For instance, Kenya has a multi-sectoral Zoonoses Technical Working Group coordinated by the Zoonotic Disease Unit (ZDU), a collaborative platform between the ministries responsible for human and animal health (ZDU, 20214). This working group receives outbreak alerts and mobilises local response, in collaboration with the EAC team.
Policy Framework
The EAC Regional Contingency Plan for Epidemics due to Communicable Diseases, Conditions, and Other Events of Public Health Concern (2018 – 2023) outlines the EAC response to epidemics using the One Health approach. It was launched shortly after the endorsement of the approach by the EAC Council of Ministers in 2014. It outlines the specific processes and activities to be followed by member states in epidemics surveillance, response and post-recovery, including during RVF outbreaks, using the One Health approach. The EAC also has elaborate standard operating procedure guidelines on cross-border surveillance for zoonotic diseases, which outlines the processes, resources and necessary steps to be taken in a multi-disciplinary approach. It also has a regional risk communication strategy based on the One Health approach, and which mobilizes partner states to implement coordinated communications for the prevention of and response to disease outbreaks.
Impact
Applying One Health approach has helped the EAC region to manage RVF outbreaks and minimise its harm. In 2022, Rwanda used the approach to manage a significant countrywide outbreak, employing cross-sectoral task forces for case detection, contact-tracing and reporting, vaccinations, isolation and treatment (Remera et al, 20245). Outbreak-related information was synthesized by the district teams and shared at national level while national strategies were communicated to the affected communities through the district structures.
The campaign also embraced community-led surveillance of signs and symptoms of the illness in livestock. This rapid, multi-faceted response may have contained the outbreak and led to fewer livestock deaths countrywide (516 deaths in 1339 confirmed cases), with 22 deaths reported among humans. It is also believed to have improved case diagnosis through the linkage with advanced public health laboratories. In Uganda where the first One Health strategic plan was launched in 2018, employing One Health approach led to improved surveillance and response, and reduced the number of confirmed livestock cases and deaths in 2019-2021 (Komugisha et al, 20246). In 2024, Kenya quickly controlled an outbreak through quick response to surveillance reports. The response included multi-disciplinary actions led by the local One Health team in the affected counties (ILRI, 20247).
Lessons Learnt
Applying the One Health approach to the prevention and management of infectious diseases such as RVF provides many lessons for other regions in Africa faced with the same challenges. Key lessons include the following:
- The value of political leadership and commitment: EAC member states regularly convene to review and approve plans and strategies for pandemic preparedness. This commitment and leadership have enabled the community secretariat to push ahead with implementation of the regional strategies.
- The value of coordination and joint activities: Establishing a mechanism for coordination and collaboration is critical to the success of the One Health approach. This includes willingness to jointly implement activities, and sometimes to pool resources. For example, the ZDU in Kenya is funded through the budgets of the various ministries involved. This coordination is critical for a multi-sectoral, multi-discipline initiative to succeed.
- Harmonising policies and regulatory frameworks across health, agriculture, environment, and other relevant sectors is critical to facilitate integrated approaches to disease control, food safety, and environmental management.
Conclusion
Embracing the One Health approach is essential for African countries to address interconnected health challenges and promote sustainable development, resilience, and health security. Strengthening One Health initiatives in the region will enhance the continent's capacity to prevent, detect, and respond to emerging zoonotic diseases, contributing to positive health outcomes and economic prosperity for the population.