Discussing response to zoonotic outbreaks in Uganda during a poster presentation. David Mugume (UCSF) and Angella Musewa (AFROHUN Uganda)

UCSF is Advancing Pandemic Preparedness Through a One Health Approach

For over three decades UCSF has been at the forefront of driving innovative public health responses, leveraging unparalleled expertise in pandemic science. In 2020, in response to the COVID-19 pandemic, UCSF established the Center for Pandemic Preparedness and Response (CPPR). CPPR was created to address the pandemic on a local and global scale, aiming to strengthen global readiness, response and resilience in effectively managing the most significant threats to health systems worldwide. In the past four years, UCSF’s CPPR has actively engaged in pandemic response efforts, expanded the utilization of virtual reality in healthcare, worked towards enhancing public health surveillance initiatives in various regions and has recently begun working in the One Health space.

The One Health Approach

The increasing frequency and severity of animal-to-human spillover have heightened global recognition of the One Health approach — the interconnectedness between human, animal, and environmental health — stressing the significance of mobilizing multiple sectors, including human, environmental, animal and agriculture, to collectively mitigate disease threats.

In 2023, CPPR’s Global Health Security project, Prevention Response for Outbreaks, Threats, and Emergencies through Capacitation and Training (PROTECT), started providing technical assistance for multi-sectoral data sharing in the Middle East and North Africa (MENA) region. CPPR’s PROTECT team, in collaboration with the UCSF Health Informatics Hub, launched support to the One Health Technical Working Group in Egypt in February 2023 to enhance data integration in the One Health Platform. Initial discussions focused on assessing existing data collection forms and databases to establish a system for alerts, dissemination, information exchange, and report sharing in departments such as environmental health, communicable diseases, vector-borne diseases (VBD), and the Central Public Health Lab.

CPPR’s PROTECT has been supporting the development of a comprehensive system to capture, manage, analyze, predict, forecast, and report surveillance data on diseases, antimicrobial resistance (AMR), and other health threats. This work builds on PROTECT’s ongoing collaboration with Egypt, where a new Event-Based Surveillance (EBS) data system was successfully developed. This system allows users from the Ministries of Health, Agriculture, and Environment to enter and view information in a single system and includes advanced features for alerts that facilitate timely reporting, risk assessment and response. The EBS system facilitates a multisectoral collaborative approach and informed public health decision-making based on the gathered information.

In Jordan, CPPR’s PROTECT provided training and technical assistance to the Jordan Center for Disease Control (JCDC) to develop a national data warehouse that integrates data across various sectors. These integrated platforms will also facilitate a multisectoral approach to monitoring threats, including human health, zoonotic diseases and environmental health threats. CPPR’s PROTECT plans to expand these efforts once the country is ready to implement One Health activities.

A One Health Hub

In April 2024, CPPR was awarded a small grant to initiate the creation of a UCSF One Health Hub in East Africa focusing on Uganda, Kenya and Tanzania. The goal is to map the current One Health landscape in East Africa, identify gaps and needs, and match those with UCSF’s capabilities. To kickstart the hub, the UCSF team had the opportunity to attend the AFROHUN (Africa One Health University Network) three-day annual conference held in Nairobi, Kenya, from April 24-26, 2024. The conference featured subthemes such as Climate Change and One Health, Workforce Development, Climate Change and AMR (Antimicrobial Resistance) and more. The team gained valuable insights from One Health stakeholders, representatives of National One Health Platforms, UN agencies, refugee agencies, private sector actors and civil society organizations — among others — to bring back to UCSF.

CPPR’s Global Health Security team, in collaboration with CDC’s Division of Global Migration Health, has also recently conducted a mixed methods landscaping analysis of cross-border disease surveillance systems for mobile populations in the MENA region, encompassing a thorough literature review and in-depth interviews (IDIs). Six key themes emerged from the literature, one being the significance of the One Health approach and multisectoral collaboration. Specifically tailored questions during the interviews probed into stakeholders’ perspectives on the One Health approach and multisectoral collaboration within their respective countries. Respondents highlighted existing efforts in collaboration and the identification of gaps impeding successful One Health implementation, as well as the importance of sustainable funding for the animal health sector.

UCSF’s CPPR is committed to expanding efforts in the One Health realm. PROTECT’s work in MENA and the initiation of a One Health Hub in East Africa have provided valuable insights and experience. Building on these successes, CPPR hopes to eventually extend the One Health hub and embed these initiatives into other regions.