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      An environmental scan of one health preparedness and response: the case of the Covid-19 pandemic in Rwanda

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          Abstract

          Background

          Over the past decade, 70% of new and re-emerging infectious disease outbreaks in East Africa have originated from the Congo Basin where Rwanda is located. To respond to these increasing risks of disastrous outbreaks, the government began integrating One Health (OH) into its infectious disease response systems in 2011 to strengthen its preparedness and contain outbreaks. The strong performance of Rwanda in responding to the on-going COVID-19 pandemic makes it an excellent example to understand how the structure and principles of OH were applied during this unprecedented situation.

          Methods

          A rapid environmental scan of published and grey literature was conducted between August and December 2020, to assess Rwanda’s OH structure and its response to the COVID-19 pandemic. In total, 132 documents including official government documents, published research, newspaper articles, and policies were analysed using thematic analysis.

          Results

          Rwanda’s OH structure consists of multidisciplinary teams from sectors responsible for human, animal, and environmental health. The country has developed OH strategic plans and policies outlining its response to zoonotic infections, integrated OH into university curricula to develop a OH workforce, developed multidisciplinary rapid response teams, and created decentralized laboratories in the animal and human health sectors to strengthen surveillance. To address COVID-19, the country created a preparedness and response plan before its onset, and a multisectoral joint task force was set up to coordinate the response to the pandemic. By leveraging its OH structure, Rwanda was able to rapidly implement a OH-informed response to COVID-19.

          Conclusion

          Rwanda’s integration of OH into its response systems to infectious diseases and to COVID-19 demonstrates the importance of applying OH principles into the governance of infectious diseases at all levels. Rwanda exemplifies how preparedness and response to outbreaks and pandemics can be strengthened through multisectoral collaboration mechanisms. We do expect limitations in our findings due to the rapid nature of our environmental scan meant to inform the COVID-19 policy response and would encourage a full situational analysis of OH in Rwanda’s Coronavirus response.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s42522-021-00059-2.

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          Most cited references22

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          Global trends in emerging infectious diseases

          The next new disease Emerging infectious diseases are a major threat to health: AIDS, SARS, drug-resistant bacteria and Ebola virus are among the more recent examples. By identifying emerging disease 'hotspots', the thinking goes, it should be possible to spot health risks at an early stage and prepare containment strategies. An analysis of over 300 examples of disease emerging between 1940 and 2004 suggests that these hotspots can be accurately mapped based on socio-economic, environmental and ecological factors. The data show that the surveillance effort, and much current research spending, is concentrated in developed economies, yet the risk maps point to developing countries as the more likely source of new diseases. Supplementary information The online version of this article (doi:10.1038/nature06536) contains supplementary material, which is available to authorized users.
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            Scent dog identification of samples from COVID-19 patients – a pilot study

            Background As the COVID-19 pandemic continues to spread, early, ideally real-time, identification of SARS-CoV-2 infected individuals is pivotal in interrupting infection chains. Volatile organic compounds produced during respiratory infections can cause specific scent imprints, which can be detected by trained dogs with a high rate of precision. Methods Eight detection dogs were trained for 1 week to detect saliva or tracheobronchial secretions of SARS-CoV-2 infected patients in a randomised, double-blinded and controlled study. Results The dogs were able to discriminate between samples of infected (positive) and non-infected (negative) individuals with average diagnostic sensitivity of 82.63% (95% confidence interval [CI]: 82.02–83.24%) and specificity of 96.35% (95% CI: 96.31–96.39%). During the presentation of 1012 randomised samples, the dogs achieved an overall average detection rate of 94% (±3.4%) with 157 correct indications of positive, 792 correct rejections of negative, 33 incorrect indications of negative or incorrect rejections of 30 positive sample presentations. Conclusions These preliminary findings indicate that trained detection dogs can identify respiratory secretion samples from hospitalised and clinically diseased SARS-CoV-2 infected individuals by discriminating between samples from SARS-CoV-2 infected patients and negative controls. This data may form the basis for the reliable screening method of SARS-CoV-2 infected people.
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              Operationalizing the One Health approach: the global governance challenges.

              While there has been wide-ranging commitment to the One Health approach, its operationalisation has so far proven challenging. One Health calls upon the human, animal and environmental health sectors to cross professional, disciplinary and institutional boundaries, and to work in a more integrated fashion. At the global level, this paper argues that this vision is hindered by dysfunctions characterising current forms of global health governance (GHG), namely institutional proliferation, fragmentation, competition for scarce resources, lack of an overarching authority, and donor-driven vertical programmes. This has contributed, in part, to shortcomings in how One Health has been articulated to date. An agreed operational definition of One Health among key global institutions, efforts to build One Health institutions from the ground up, comparative case studies of what works or does not work institutionally, and high-level global support for research, training and career opportunities would all help to enable One Health to help remedy, and not be subsumed by, existing dysfunctions in GHG.
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                Author and article information

                Contributors
                gigihozo@ughe.org
                Journal
                One Health Outlook
                One Health Outlook
                One Health Outlook
                BioMed Central (London )
                2524-4655
                16 January 2022
                16 January 2022
                2022
                : 4
                : 2
                Affiliations
                [1 ]GRID grid.507436.3, Center for One Health, , University of Global Health Equity, ; Kigali, Rwanda
                [2 ]Global 1 Health Network, Ottawa, Canada
                [3 ]GRID grid.28046.38, ISNI 0000 0001 2182 2255, School of Epidemiology and Public Health, , University of Ottawa, ; Ottawa, Canada
                [4 ]Rwanda Food and Drugs Authority, Kigali, Rwanda
                [5 ]GRID grid.14848.31, ISNI 0000 0001 2292 3357, Faculty of Veterinary Medicine, , Université de Montréal, ; Saint Hyacinthe, Canada
                [6 ]Centre de Recherche en Santé Publique (CReSP), Montreal, Canada
                [7 ]Groupe de Recherche en Épidémiologie des Zoonoses et Santé Publique (GREZOSP), Saint-Hyacinthe, Canada
                [8 ]GRID grid.21100.32, ISNI 0000 0004 1936 9430, School of Health Policy and Management, , York University, ; Toronto, Canada
                Author information
                http://orcid.org/0000-0001-9641-2509
                Article
                59
                10.1186/s42522-021-00059-2
                8761094
                35033197
                94f47f07-2c36-44bb-bacd-dd9ddb99eb8a
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 16 November 2021
                : 25 November 2021
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000024, Canadian Institutes of Health Research;
                Award ID: 170388
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2022

                one health,covid-19,rwanda,infectious disease management,emergency preparedness,pandemic response

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