Implementing One Health as an integrated approach to health in Rwanda

Nyatanyi, Thierry; Wilkes, Michael; McDermott, Haley; Nzietchueng, Serge; Gafarasi, Isidore; Mudakikwa, Antoine; Kinani, Jean Felix; Rukelibuga, Joseph; Omolo, Jared; Mupfasoni, Denise; Kabeja, Adeline; Nyamusore, Jose; Nziza, Julius; Hakizimana, Jean Leonard; Kamugisha, Julius; Nkunda, Richard; Kibuuka, Robert; Rugigana, Etienne; Farmer, Paul; Cotton, Philip; Binagwaho, Agnes

â–¸ Improve communication and interactions between ministries responsible for animal, human and environmental issues and regional agencies â–¸ Engage in One Health strategic planning focused on systems-thinking that considers the diverse range of complex and inter-related One Health issues impacting on animals, human health and the environment at the local, national and international level â–¸ Collaborate with the East African Community to expand the One Health concept across the region, given that toxins, infections and environmental degradation do not respect political borders â–¸ Provide financial incentive and support for One Health initiatives to incentivise collaborative problem solving 2 (community/NGO level): strengthen surveillance, prevention, early detection, rapid response, and control of zoonosis in both animals and humans â–¸ Improve the capacity within Rwanda to conduct community surveillance, treatment and monitoring of outcomes of One Health problems including emerging and re-emerging zoonotic diseases, neglected diseases, and other public health events of international concern that pose a threat to human health â–¸ Introduce technologies including computers, mobile phone data collection applications, and tele-conferencing to improve detection, monitoring and intervention related to One Health problems at the community level â–¸ Promote timely and goal-directed communication between local communities, ministries, NGOs and neighbouring nations 3 (academic level): build capacity and promote applied research at the human, animal and ecosystem interface â–¸ Improve training capacity of both professionals and mid-level providers to develop skills necessary to identify, monitor and respond to One Health problems that may cross outside of their area of expertise â–¸ Modify health science and environmental training programmes/curriculum to promote graduation competencies related to collaboration and cross-disciplinary problem solving â–¸ Develop training programmes for existing professionals to promote the sharing of knowledge, skills and resources to address current and future One Health needs â–¸ Train, keep current and incentivise One Health problem solvers to stay in Rwanda. Despite the huge investment of national resources, it is not unusual for trained health experts to leave the country for economic gain or even to be pulled away for other national service â–¸ Protect national resources include the gorilla population and other wild animals that could be damaged by exposure to life-threatening human infectious diseases further train animal-human-ecosystem providers in integrated problem solving, leadership and communication skills related to One Health. Finally, a vibrant One Health students' club for undergraduates was established in 2012, the first of its kind in the region, that links virtually with other health sciences schools around the world who share a commitment to learning related to One Health. It consists of students from veterinary medicine, environmental health, nursing, medicine and agriculture. The goal of the club is to bring One Health skills, approaches and attitudes to a new generation of scientists and problem solvers who will embrace the importance of working together to serve the community rather than working in silos.