Wspólnotowy Serwis Informacyjny Badan i Rozwoju - CORDIS

FP7

OH-NEXTGEN Streszczenie raportu

Project ID: 289412
Źródło dofinansowania: FP7-KBBE
Kraj: Belgium

Final Report Summary - OH-NEXTGEN (Training of the One Health Next Scientific Generation in the Sahel and Maghreb)

Executive Summary:
Executive summary
Humans and animals living in poor communities in the developing world often suffer from health problems arising from neglected zoonoses. Control options for these diseases are perceived as either too expensive or to be beyond the mandate of either the human or animal health systems. There is evidence that zoonoses in humans can be suppressed or even eliminated through interventions in animals. Moreover, joining human and animal health services can provide access to care that would otherwise not be affordable or not be available. The close collaboration between the public and animal health sectors, also called One Health, with clearly defined roles for each sector, offers a formidable potential for creative and cost-effective solutions in disease control.

OH NEXTGEN develops a web-based modular training course designed to empower a new generation of scientists to address One Health issues faced by communities in Africa. While this programme is targeted to the Maghreb and the Sahel, the course will be accessible worldwide by offering training modules through the European Tropical Health Education Network (tropED) and other existing networks.

The course includes selected neglected zoonoses and generic themes such as integrated methods of joint human and animal disease surveillance and epidemiology, health economic assessments, animal-human modelling of infectious disease, trans-disciplinary approaches to connect science and society and address issues of culture, gender and contextualized extension and health education. In each module the added value of One Health is demonstrated. The project will complement the existing EU FP7 ICONZ project, which builds up the evidence base for integrated control approaches to neglected zoonoses across 7 African countries.

A group of 29 Francophone and 15 Anglophone online tutors were trained during two face-to-face sessions, organised respectively at the Institut Agronomique et Vétérinaire (IAV) Hassan II at Rabat (Morocco) and the School of Public Health, College of Health Sciences, University of Ghana Legon at Accra (Ghana). They were evaluated and received certificates enabling them to act as online trainers of the next generation of One-Health scientists. A first online course was organized by IAV. It is currently being run by nine online tutors, training 23 participants.

Project Context and Objectives:
Project context and objectives
Brucellosis, bovine tuberculosis, echinococcosis, leishmaniasis and rabies comprise five of the neglected zoonoses, as classified by WHO that are largely prevalent in the Sahel and Maghreb regions (World Animal Health Information Database Interface - www.oie.int/wahid). For the past decades, theses zoonoses have received little attention from local governments and international health agencies because it was erroneously assumed that their impact on human health could be mitigated using cheap control tools and methods applied in industrialized countries. The lack of human and financial resources and the implementation of structural adjustment programmes in the developing South over the past decade have severely impacted on government and state veterinary service provision. The resulting absence of any disease control in the animal reservoir combined with the close co-existence of animals and humans that prevails in low-resource communities has served to increase the risk of transmission of these pathogens to the poor.
ICONZ (Integrated Control Of Neglected Zoonoses – www.iconzafrica.com), an EU FP7 funded project, was specifically designed to evaluate the need to control seven neglected zoonoses in Africa and to propose integrated control strategies that are adapted to the local socio-economical conditions. Strong progress is reported for cooperation and control for cysticercosis and tsetse transmitted zoonotic trypanosomiasis or sleeping sickness but for the diseases that affect large pastoralist communities, the diseases recognised by this call, greater “One Health” integration is needed in approach to their control. Pastoral communities have been identified in several studies as facing the greatest exposure to brucellosis and bovine tuberculosis These communities -nowadays largely transhumant towards and settling in peri-urban areas- and communities in mixed livestock-crop systems are dependent on livestock for income, food, manure, draught power, as financial instrument and to enhance social status. Reduced livestock fertility caused by brucellosis and the increased morbidity and mortality of cattle caused by bovine tuberculosis seriously affects the local economy. In addition, zoonoses such as brucellosis have a significant and negative effect on human health. Humans are assumed to predominantly be infected by both Brucella spp. and Mycobacterium bovis via consumption of uncooked milk. Contamination can also occur by direct contact with afterbirth and abortion material or by aerosol, respectively. Theoretically transmission of these two bacterial zoonoses diseases to humans could be easily reduced through implementation of an effective vaccination strategy against bovine brucellosis and the testing and removal of TB infected cattle augmented by implementation of basic hygienic measures (milk pasteurisation, contacts with livestock). However, in the partial or complete absence of these control measures in the majority of African countries, coupled with a lack in disease awareness and knowledge, the impact of those diseases on human livelihoods is poorly understood and not unaccounted for. Wildlife species are also sensitive to bacterial pathogens as either spill-over or true reservoir hosts and surveillance and control further requires engagement from Wildlife Services. The importance of these bacterial zoonoses with regard to extinction of threatened species, ecotourism and reservoir role should not be underestimated.
Echinococcosis and rabies are zoonoses that are associated with dogs (domestic and wild canines). Dogs play important roles in herding and have significant societal value in the Sahelian pastoral and Maghreb sheep breeding communities. While rabies can be easily prevented through dog vaccination, this requires significant levels of compliance and inputs (in particular to treat stray and wild animals). Echinococcosis is more difficult to control given the very close contact between sheep and dogs in these communities. These dog-associated diseases cause, locally, severe morbidity and mortality in humans. ICONZ is treating these diseases as a group in terms of assessment and burden of control in the case studies. It may be advantageous to include leishmaniasis (vector borne) in the same group and to develop disease control strategies specifically oriented on dogs to make use of synergies in service provision instead of addressing each disease individually. Local public health measures enforced by scientists who understand the epidemiology of the diseases and the communities’ expectations should play a very important role in disease control policy development.
The “One Health” approach conceptualizes the view that some animal and public health issues are best served within the framework of collaboration between medical, veterinary and where appropriate environmental and wildlife professions. The reason some endemic zoonoses remain neglected in Africa has been attributed to the difficulty of taking a societal perspective to assess their impact, the difficulty in implementing control across at least two vertical systems and the fact that costs for control are equated separately. This means that the large benefits for control, given the combined expected impact on human or animal health is not translated to policy level. The benefit becomes even more significant if the effect on both public health and animal production is considered. “One Health” is the added value of a closer cooperation of human health, animal health and other sectors. This concept is supported by a number of recent reports from international organisations. The report of the joint WHO and DFID UK Animal Health Programme meeting held in Geneva in September 2005 ( www.who.int/zoonoses/Report_Sept06.pdf ), Nairobi in 2008 and Geneva in 2010 focused on endemic zoonoses. WHO has drawn attention to the relationship between poverty and the emergence or re-emergence of zoonotic diseases, which remain largely neglected. The European Technology Platform for Global Animal Health (ETPGAH) also recognised the importance of neglected zoonoses and identified the need to facilitate and accelerate the development and distribution of effective tools for controlling animal diseases of major importance to both Europe and the rest of the world (http://cordis.europa.eu/technology-platforms/pdf/gah.pdf). Finally, the World Bank, in a document published in 2010, promotes the “One Health” approach for controlling zoonoses worldwide (http://siteresources.worldbank.org/INTARD/Resources/PPP_Web.pdf).
Professional organizations have declared their adhesion, governments have created joint public and animal health working groups, and numerous research and surveillance programs have been initiated. Notwithstanding these beneficial developments, we should not forget that there remains a huge gap between human and veterinary medicine from unprecedented (over)specialization of disciplines and increasingly reductionist approaches to scientific questions. A radical paradigm shift in our approach to global public health is needed - drawing on practical approaches and hands on examples to facilitate application of the “One Health” approach. This approach has been successfully applied to zoonotic trypanosomiasis in Uganda where the Ministries of Health and Livestock Food and Fisheries come together to deliver an integrated approach to disease control (see www//stampoutsleepingsickness.org) targeting the animal reservoir of infection for control. The experience in Mongolia and Chad in the control of Brucellosis and rabies, respectively, also demonstrates the relevance of this approach.
Lack of interaction and shared perspective between the actors often leads to collaboration failures. It is crucial to expose veterinarians to public health practices such as disease diagnosis and surveillance, disease burden assessment and disease control strategies. Similarly, medical scientists should be aware of the reservoir role played by animals for a number of neglected and emerging human diseases, the epidemiology and the impact (sometimes very low) of zoonotic pathogens which can cause severe disease in people but are unapparent, mild or chronic in livestock such as many food-borne diseases. Some zoonotic pathogens cause different diseases in animals and humans, which can be confusing. For instance, brucellosis causes abortion in ruminants but not in humans and yet communities faced with abortion losses in sheep are fearful of impacts on the health of their families. The neglected zoonoses share complex bacterial and parasitic life cycles, some involving multiple hosts and vectors and these serve to complicate the health education messages to be delivered to the communities. Ultimately, the medical and the veterinary sectors are expected to overcome these difficulties and develop joint control strategies to efficiently address zoonoses in Africa with limited support to deliver the vision of healthy people, healthy livestock and healthy wildlife.
The poor in least developed countries bear a disproportionately high burden of disease through reasons of access to and affordability of healthcare, and vulnerability. The burden of zoonoses falls especially heavily on poor people because (i) they are at greater risk of contracting these diseases for the strong association between poverty and living closely with the animal reservoirs of disease, (ii) they are less likely to receive effective treatment, given the difficulties in diagnosis, and (iii) they suffer from the dual burden of disease both in humans and the animals on which they depend for their livelihoods.
Northern Africa occupies a key geographical position, between sub-Saharan Africa and Europe and touching the Middle-East. Increased mobility of both people and animals in the continent of Africa and the importance of trade across the Mediterranean Sea increases risk of disease transmission. The impacts of global climate changes increase the risk of pathogen introduction to the European continent and this will require more stringent approaches to surveillance and disease control in Northern Africa. These threats include the endemic and epidemic zoonoses (rabies, leishmaniasis, Rift Valley fever, tuberculosis and brucellosis) and also the emerging diseases (H5N1 flu, hemorrhagic fevers). Improving the surveillance and the control of zoonoses in the Maghreb and Sahel is therefore expected to have an important impact on the spread of animal and human diseases from Africa to the rest of the world and vice-versa.

Objectives
In view of developing cost-effective control strategies for the neglected zoonoses of Africa there is need to quantify the impact and burden of zoonoses, to evaluate and prioritise control needs and approaches and to improve the national and local capacity to prioritise disease control interventions. This includes training for the adaptation of zoonotic diseases control strategies to local sociological and economic conditions. Local medical and veterinary scientists should develop their capacity to adapt disease control to specific circumstances (i.e. poverty, knowledge gap), taking into account the changing environment (e.g. urbanisation, climate change, changing livestock production systems). Through shared training and identification of potential synergies and added value of closer collaboration in aspects of “One Health” the actors from the relevant professions should be able to optimise the utilisation of local resources available for health and veterinary interventions and in so doing achieve locally relevant solutions to high priority health risks.
The overall strategic objective of OH-NEXTGEN is to improve the knowledge on human and animal health, to alleviate poverty and to contribute to the millennium development goals (MDG - www.un.org/millenniumgoals). To achieve this, a number of actions are required to ensure that the current position regarding neglected zoonoses in terms of the burdens on communities and relevant research are understood. Building on this knowledge, new technologies and research outcomes should be utilised to develop innovative and more appropriate strategies to control neglected zoonoses. All research and intervention results must be communicated to stakeholder, and particularly policy advisors of affected countries.
The knowledge gap for education and training in zoonoses impact and burden assessments will be addressed through provision of knowledge development in general and disease specific epidemiology, surveillance principles and techniques to assess disease risk, economic impact and burden tailored to individual settings. Scientists from International Co-operation Partner Countries (ICPC) will be invited to reflect on the development of genuine locally acceptable and sustainable control policies for their region. Using “One Health” principles, medical and veterinary scientists will become aware of the need to review and adapt current zoonotic diseases surveillance and control policies. They will have the opportunity of a new form of participatory, collaborative training of medical and veterinary professions in the field by studying the detailed biology and epidemiology of the listed specific diseases, understanding the sociological and economical demands and constraints and considering different surveillance and control strategies.
OH-NEXTGEN’s main output will be a unique and sustainable web-based training programme that would equate to diploma level in neglected zoonotic diseases based on the “One Health” concept to contribute to research development and improved control of zoonoses in Africa as initiated by ICONZ. Its target audience are the post-graduate and post-doctorate communities of medical and veterinary scientists in the Maghreb and Sahel regions. The course will be delivered in modular form and will be made available in both French and English. The dynamic nature of the programme and delivery modes will permit inclusion of other zoonotic diseases and enable expansion to other regions in Africa or beyond. The course will be integrated in the tropED platform (http://www.troped.org) and credits will be quality assured so that they will be valid for inclusion in other MSc, PhD and continuing professional development (CPD) purposes. OH-NEXTGEN is a four-year project that will develop, implement, evaluate and disseminate the course. Thereafter the course is expected to be sustainable, co-funded by the participants, implemented by local training institutions and tutors and scientifically supported by international institutions and subject experts that have developed the materials.
There is much demand for capacity building in the developing world, which is widely recognised by international organisations. This proposal aims to help meet this demand by building on existing networks and linkages. Research establishments in Europe and the developing ICPCs will be involved in the project. The mapping of infrastructure, facilities and activities generated by ICONZ has generated a better understanding of the resources available to the partnership and more broadly.
The specific objectives of the project include the development of curriculum and course content, production of a web platform and virtual learning environment, identification, recruitment and training of local tutors, course advocacy, delivery and evaluation of the training programme. The curriculum will focus on “One Health” principles in the various modules that will be offered. Modules will include intersectoral collaboration, epidemiology (including disease mapping and surveillance and risk assessment), socio-economics (including livestock and health economics, disease burden assessment and socio-economic understanding of zoonoses in households and communities), specific disease epidemiology and control, policy development and, lastly, health education and communication. Local tutors will be recruited and trained using the course material that will be developed for the web-based course and through contact sessions in Rabat and Accra. They will also be trained in distance learning techniques. It is envisaged that ICONZ trainees will represent an important fraction of the first cohorts of students. .
The objectives will be achieved through intensive collaboration with the FP7 ICONZ project. Expertise and scientific results will be made available by ICONZ for educational purposes in this collaborating action. Duplications and waste of resources will therefore be avoided. Vice versa, ICONZ research activities are expected to benefit from the training of local scientists in animal and public health issues. This is particularly true in the Sahel and the Maghreb where there is an urgent need for Veterinary Public Health capacity building.

Project Results:
Achievements
The first output of OH-NextGen consists of the study guide (Francophone and Anglophone versions), which (apart from outlining the proposed course content) provides background information, explains the importance of One Health, the target audience, the overall learning outcomes, quality assurance measures, prerequisites. The actual modules, currently available (listed below) are the result of numerous meetings and other discussions with various stakeholders.

Module Title Module ECTS Learning goals of modules
OH One Health in the Sahel and Maghreb 3 ECTS This module gives first an historical overview on One Health and the ecology of zoonoses. It sets the stage for subsequent modules displaying different kinds of added values of One Health in the Maghreb and the Sahel with examples from various regions.
EPI1 Concepts of Epidemiology in One Health 3 ECTS This module provides an overview of basic definitions, diagnostic concepts and statistical tools used in epidemiology, with special reference to a One Health framework.
EPI2 One Health Survey Methodology 6 ECTS This module provides instructions for the design of surveys and offers advanced statistical techniques for the analysis of complex data generated in surveys and longitudinal studies.
EPI3 Risk Analysis in a One-Health Framework 9 ECTS This module provides a theoretical and practical overview of risk analysis including quantitative risk assessment and risk modelling.
EPI4 Geographical Information System in One Health 6 ECTS This module provides an overview of the use of geographical information systems (GIS) for One Health epidemiological studies and provides the framework to understand spatio-temporal processes. It also shows how decision-support systems for One Health can be strengthened.
HALE Health and Livestock Economics 6 ECTS This module introduces the student to the application of economics in assessing the benefits and costs of zoonoses control.
ZOON Specific Diseases and Integrated Control 3 ECTS This module provides an overview of five selected neglected diseases, namely brucellosis, bovine tuberculosis, echinococcosis / hydatid disease, leishmaniasis and rabies that prevail in the Maghreb and Sahel regions. The module covers biological, clinical and epidemiological aspects, diagnosis, surveillance and control methods in human, livestock and wildlife, taking into account disease characteristics in the target regions.
POLICY One Health Policy Development 6 ECTS This course examines the evolution of the concept of One Health. Evidence of the close relationship between humans, animals and the natural, political and socioeconomic environs throughout history has evolved over the past few decades into what has become known as One Health.
EDU Health Education and Communication in a One Health framework 3 ECTS This module provides an overview of strategies for promoting health by culturally appropriate methods that lead to sustained behaviouralr change at the individual, household and community levels.
CULT Socio-cultural and Ethical Aspects in One Health 3 ECTS This module provides an introduction to the assessment of context-specific zoonotic illness at household and community levels using qualitative research methods. It also gives an overview of ethical aspects in One Health.
ECTS: European Credit Transfer and Accumulation System

A more detailed description of the various module contents follows. The reader is referred to the full study guide for further information on specific learning outcomes and suggested module formats.

Chapters of the Module OH: One Health in the Sahel and Maghreb
1. History and concepts
2. Complex disease ecology: people, animals, and the ecosystem
3. The added value of One Health
4. Transdisciplinarity
5. Global human and animal health governance
6. Integrated surveillance and control
7. Resilience and global partnership
Chapters of the Module EPI1: Concepts of epidemiology focusing on the One Health approach
1. Introduction and objectives of the module
2. Definitions of epidemiology
3. Descriptive statistics
4. Measures of disease frequency
5. Measures of association
6. Interpretation of a measure
7. Observational studies
8. Evaluation studies
9. Statistical tests
10. Probability theory and probability distributions
11. Simple and multiple linear regression
12. Logistic regression
13. Poisson, negative binomial, and zero-inflated regressions
Chapters of the Module EPI2: Survey methodologies focusing on the One Health approach
1. Definitions and chronology of surveys
2. Design phase
3. Adjustment and analysis phase: Conditional and marginal models
4. Adjustment and analysis phase: Models specifying complex sampling plan
5. Adjustment and analysis phase: Decision trees
6. Adjustment and analysis phase: Survival analysis
Chapters of the Module EPI3: Risk Analysis in a One-Health Framework
1. Risk analysis
2. Probability theory
3. Quantification of information
4. Risk modelling
Chapters of the Module EPI4: Geographical Information System in One Health
1. Components of a GIS, data types, cartography and GPS
2. Data Resources
3. GIS in epidemiology
4. Advanced GIS modelling
Chapters of the Module HALE: Health and Livestock Economics
1. Introduction to the economics of zoonoses control
2. Livestock Production Economics
3. Animal Health Economics
4. Human Health Economics
5. The Cost of Controlling Disease
6. Discounting and benefit-cost analysis
7. Economic analyses of zoonoses control programmes
Chapters of the Module ZOON: Specific Zoonoses and Integrated Control
1. Brucellosis
2. Rabies
3. Leishmaniasis
4. Bovine tuberculosis
5. Echinococcosis / hydatidosis
Chapters of the Module POLICY: One Health Policy
1. Introduction to Policy and its Role in One Health
2. Undertaking Policy Research
3. International Health Policy and Mechanisms for Global Health Governance
4. Disease Prioritisation for Health Policy
5. One Health Case Study
Chapters of the Module EDU: Health Education and Communication in a One Health framework
1. Introduction to Health Education and Communication
2. Evidence-based methods of health education and promotion
3. Assessing and adapting to local knowledge
4. Developing and evaluation health communication activities
5. Political and ethical issues in health promotion
6. Final assignment
Chapters of the Module CULT: Socio-cultural and Ethical Aspects in One Health
1. Socio-cultural aspects of dealing with zoonoses – what do we know, where do we go?
2. Introduction to medical anthropology and its linkages to One Health
3. Introduction into qualitative research design and methods
4. Introduction to qualitative data management and analysis
5. Ethical issues and animal welfare in One Health
6. Final assignment

Teaching materials for the above modules were prepared in both French and English versions. Course notes, supplementary material (e.g. example datasets), exercises and quizzes are deposited on the project website (http://www.oh-nextgen.eu) and the web-based course platform (http://oh-nextgen.avia-gis.com) and are freely available upon request to the project administrator (hsy@itg.be): instructions on whom to contact and details of IP rights will be provided upon request.

The principal aim of OH-NextGen was to train the trainers for the next generation of One Health scientists, again both Francophone and Anglophone, in the Maghreb and Sahel regions. The aim was to produce a corps of fully trained online tutors, who were to be available for interested universities and other institutes to actually run or assist in the running of online course in the various fields of One Health.

Two face-to-face training workshops were organised to this effect, a Francophone training session at the Institut Agronomique et Vétérinaire Hassan II at Rabat (IAV, 6 January – 28 February 2014) and an Anglophone training session at School of Public Health, College of Health Science, University of Ghana (UG, 8 January – 6 February 2015)

IAV made the necessary local organizational and logistic arrangements to assure appropriate conditions for the Francophone face-to-face training of tutors: negotiation with IAV administration, reservation of classrooms, access to laboratory and field visits, purchase of computers and internet facilities. Student’s accommodation and meals were also arranged.

The Management Board decided, in Dakar, to propose the candidates to follow a common trunk of 3 weeks (including an introduction to One Health, distance education principles and an introduction to epidemiology) and then to split to follow one of the three following options: (1) Epidemiology, (2) Policy and Health and Livestock Economy and (3) Specific Diseases, Health Education and Socio-Cultural issues and Ethics. A call for candidates with launched July 2013. All partners used their respective networks to assure the dissemination of the call among their respective alumni and projects. A total of 167 valid applications were received. Candidates had various origins and background (See below).

Rabat course applicants according to professional background and nationality
Vets Medics Other med sc Other life sc Socio Other Total
Algeria 7 7
Mauritania 6 1 1 8
Morocco 2 4 1 7
Tunisia 4 4

Chad 4 2 6
Mali 4 16 1 1 22
Niger 9 5 1 4 1 20
Senegal 7 2 1 3 3 16

Benin 3 1 11 1 16
Burkina Faso 5 7 5 7 2 26
Cameroun 5 5 1 4 2 17
Guinea 1 1 2
Ivory Coast 7 2 2 1 12
Togo 4 4
Total 68 38 11 39 1 10 167

The editorial boards of the three options selected their respective candidates among the applicants to reach the proposed total of twenty. In the end, a total of 29 participants followed the course, divided as follows over the three options:

(1) Epidemiology: 9 participants
(2) Human and animal health economics and policy: 10 participants
(3) Specific zoonoses: 10 participants

The origin of the participants was:

Country Number
Algeria 1
Benin 5
Burkina Faso 1
Côte d’Ivoire 2
Guinea Conakry 1
Mali 2
Morocco 10
Mauritania 1
Senegal 5
Togo 1

All participants passed the tests and exams set in the different modules and were issued with a certificate attesting the successful completion of the face-to-face training. The training programme was evaluated in several ways: tutors by trainers, trainers by tutors and the overall programme by an external evaluation.

The One Health Training the Trainers (Tutors) Programme workshop was organized for fifteen health staff, made up of medical doctors, veterinarians and scientists from Ghana (ten participants), Nigeria (four participants) and Burkina Faso (one participant) from 8th January to 6th February, 2015 at the Aknac Hotel adjacent Trasacco Valley, Accra. This workshop was organized by the School of Public Health, College of Health Sciences, University of Ghana Legon. The fifteen participants were selected from 32 applicants from five countries, following the same procedure as for the Rabat training (i.e. editorial board leaders for each package made the final selection, following beforehand agreed upon selection criteria). The same modules were offered. The only difference between the Rabat training and the Accra training was that for the latter the actual face-to-face period had been shortened. The final training was given during a further, extended online training period. This also called for a different evaluation of the trainees and trainers.

The course evaluation has contributed to the quality assurance of the course, by establishing protocols and providing feedback reports on the virtual learning environment (VLE) platform, the tutor training (Anglophone and Francophone). The reports produced in the process highlighted the key strengths of the course/platform as well as pointing out gaps and suggesting corrective measures to improve its quality. These were grounded within the context of the courses, taking account of factors that externally influenced the training and capacity building activities of the consortium. These reports will provide valuable information for the sustainability, uptake and extension of the web-based course by the African institutions in the future.

The final major output of the project was the initiation of the first Francophone online course organised by IAV. Online access to the platform of the first Francophone online course was implemented on 2 March 2015 and the course is currently offered as a two-year Master in One Health addressed to French speaking participants involved in research, medical practice, education and health policy development in Maghreb and Sahel countries. Twenty-three candidates are currently being trained. A preliminary report covering the period to 30 September 2015 is available.

In accordance with the project terms of reference, and the decisions made at the consortium level of OH-Nextgen, the IAV Hassan II, has addressed a formal application call for a Master online on "One Health" using the IAV website and other communication ways such us posting announcement in different training establishments and universities in relation with biological and medical sciences. To ensure wide distribution, the same announcement was sent to partner institutions in the Maghreb and the Sahel region. Tutors, who have benefited from face to face the training in Rabat, have been asked to contribute to the announcement dissemination in their respective countries (see fact sheet in Appendix 1, and announcement in attached file).

More than 100 applications were received by the IAV team who is responsible for the preparation and management of this training. A first selection based on documents examination was undertaken in order to cheek for admissibility of each participant file. A short list of forty candidates with complete and consistent file was sent to the consortium partners for information and advice.

On this basis, 23 candidates were selected since the course is accredited for a maximum of 25. To ensure maximum rigor in controlling the documents authenticity, candidates were asked to submit, by normal mail, certified copies of their diplomas and administrative documents.

The work was completed by performing interviews with some candidates via Skype before taking a final decision on their application. Direct interviews were organized for Moroccan candidates. This procedure has contributed partly to the delay in starting up of online Master.

As selection criteria for candidates, we relied primarily on the following:
• Motivation of candidate supported by motivation letter and at least two recommendation letters.
• Degrees obtained by the candidate justifying the prerequisites of this online training.
• Ability to easy use of computing tools and easy access to internet.
• Good level of French language.

Of the 23 candidates selected for the online training, 21 (91%) have been registered and followed full training. Thirteen candidates are from Morocco, six from Benin, and one each from Guinea and Japan. The characteristics of the registered candidates are as follows:
• 60% are Moroccan, including a Japanese resident in Morocco and working on health aspects in North Africa who has an acceptable French speaking level.
• 40% are from countries of sub-Saharan Africa.
• Among the registered, 66% are employees and 34% are students.
• 76% are aged less than 40 years.

According to their respective profiles, the registered participants are distributed as follows:
• Veterinarians ( 42.85 %)
• Biologists ( 38.11 %)
• Physicians (9.52 %)
• Engineers in Animal Production (9.52 %)

With regard to the available marks and appreciations allocated to tutors who have attended the "face-to-face" training in Rabat, given by different courses animators and the project team members, tutors were classified in order to facilitate the selection of tutors who are able to provide supervisory of participants to this online Master. For this matter, confidential list containing the proposed names of nine tutors was established and sent to Avia-GIS. Three tutors per option were selected, two as main tutors and a third as substitute. They were to be contacted by Avia-GIS to ensure the support participants during the Master training period as planed in the project.

The Master start up was scheduled for early January 2015 but delayed for various reasons independently to the organizers. The main reasons are related to the delayed reaction of some selected candidates and to the reception of authentic documents. In agreement with the AVIA-GIS partners, the course access to the online courses platform was implemented by as 2nd March 2015.
The training content is recorded in the following table with respect to chronological order and logical steps.

Module Module title Nb. credits (ECTS) Suggested assessment period
OH One Health in the Sahel and Maghreb 3 ECTS 17 - 21 August 2015
EPI1 Concepts of Epidemiology in One Health 3 ECTS 17 - 21 August 2015
EPI2 One Health Survey Methodology 6 ECTS 14 au- 18 September 2015
EPI3 Risk Analysis in a One-Health Framework 9 ECTS 28 September - 02 October 2015
EPI4 Geographical Information System in One Health 6 ECTS 19 - 23 October 2015
SAnEE Health and Livestock Economics 6 ECTS 02 - 06 November 2015
ZOON Specific Diseases and Integrated Control 3 ECTS 16 au 20 November 2015
POLICY One Health Policy Development 6 ECTS 30 November au 04 December 2015
EDU Health Education and Communication in a One Health framework 3 ECTS 04 - 08 January 2016
CULT Socio-cultural and Ethical Aspects in One Health 3 ECTS 04 - 08 January 2016
Catch up sessions will be organized in the period from 18th January to 19th February 2016

It was agreed to allow participants the freedom to follow the course modules at their own preferences and convenience. This was a collective choice of the IAV team after consulting a number of participants and the Direction of post-graduate studies. Among the reasons for this choice comes the profiles diversity of participants. Some of them were able to easily assimilate some modules than others. Other candidates prefer to follow a different order of modules.

Potential Impact:
Potential impact

Introduction
Whilst the number of tertiary institutions currently offering formal post-graduate training specifically in One Health – as defined by the course title – remain small, a growing number of institutes worldwide are bringing One Health principles into pre-existing courses such as veterinary public health, epidemiology and wildlife and/or ecosystem health (Table 1). In addition, several donor-funded programmes have assisted in the development of OH training in low- and middle-income countries (LMICs); besides OH-NEXTGEN, examples include a One Health course development project in the current INNOVATE programme funded by the European Commission’s Europe Aid Development and Cooperation (DEVCO) (http://www.onehealthnetwork.asia/node/500), and a recent World Bankfunded One Health MSc programme in Asia (Vink et al 2012).

Despite this growing momentum of formal One Health training opportunities, particularly in United States and European institutes, to date there has been little critical analysis of the potential mid- to long-term global health impacts of this emerging cohort of international One Health practitioners. Moreover, individual, institutional assessments of the successes and challenges of offering One Health postgraduate interdisciplinary training – as opposed to the more traditional methods of streamlining tertiary courses according to subject and/or discipline – are also difficult to obtain in the public domain.

Nevertheless, there is a growing requirement to critically address the current impact - and future potential - of the various forms of One Health training increasingly offered in tertiary institutions worldwide. Whilst the need for interdisciplinary, more holistic approaches to issues at the human-animal-ecosystem interface in the 21st century cannot be denied, questions remain as to whether specific ‘One Health” post-graduate qualifications are necessary to ensure the required pool of expertise is created globally. Alternatively, does the development of this type of ‘joined-up’ thinking require action at an earlier point; for example at undergraduate or even secondary levels of schooling? The requirement to first acknowledge – and subsequently address – the inherent challenges in moving from disciplinary/sectoral thinking towards a more ‘systems-based’ approach to health is one of the objectives of this short term impact evaluation of the OH-NEXTGEN approach to One Health training.

Example of postgraduate courses with a One Health focus
Country Institution Course Title Level Delivery
Denmark University of Copenhagen Masters Veterinary Public Health MSC Online
Australia University of Sydney Diploma/Masters Veterinary Public Health Management Diploma/MSc Online
Scotland University of Edinburgh International Animal Health PG cert/PG dip/MSc Online
Scotland University of Edinburgh Global Health and infectious diseases PG cert/PG dip/MSc Online
Scotland University of Edinburgh One Health MSc Online
Scotland University of Edinburgh One Health PG cert/PG dip/MSc Online
Northern Ireland University of Ulster Food regulatory affairs (Veterinary Public Health) PG dip/MSc Online
England University of London (Royal Vet College) Vet epidemiology and Public Health PG cert/PG dip/MSc Online
England University of London (Royal Vet College) One Health MSc Face to face
England London School of Hygiene Tropical Medicine Veterinary epidemiology MSc Face to face
England University of London (Royal Vet College) Wild animal biology/ecosystem health MSc Face to Face
South Africa University of Pretoria Master in biotechnology and management of animal and zoonotic disease MSc Face to face
Belgium Institute of Tropical Medicine PG dip/MSc en Santé Animale Tropicale PG dip/MSc Face to face
Scotland University of Glasgow MSc Veterinary Public Health MSc Face to face
Senegal

Ecole Inter Etats des Sciences et Médecine Vétérinaires de Dakar
Master Santé Publique Vétérinaire
MSc Face to face
New Zealand Massey University One Health postgraduate fellowship programme MSc Face to Face
USA University of Florida Master of Health Sciences (One Health) MHS Face to face

Direct short term impact of OH-NEXTGEN on tutors, students and institutions involved in development and delivery of the courses: Results of a Ketso assessment [http://www.ketso.com/]:
This qualitative participatory exercise was undertaken at the final OH-NEXTGEN stakeholders meeting in Brussels, 25th September 2015. Participants were requested to discuss and convey their thoughts on the impact of OH-NEXTGEN on various topics surrounding the future development of One Health Training in their institutes, and the impact to date of the project on the tutors that were trained, and the students that have since been taught.

1: Institutional attitudes of OH-NEXTGEN stakeholders towards One Health Training
Participants felt that OH-NEXTGEN has provided an innovative platform for tertiary training more generally in North/West Africa, given that both One Health and distance learning are new approaches in this region. Participants felt that the facilities, teaching methodologies and mentoring provided by the OH-NEXTGEN project has furthered the development of One Health approaches in North and West Africa, in particular by demonstrating to the medics the potential capacity of the veterinary sector to assist in public health issues in the region.

Despite this, participants felt there were still some major institutional issues surrounding the practical implementation of One Health, particularly regarding the goal of OH-NEXTGEN to promote synergy and/or integration between institutions. One main concern raised was that since zoonoses are not the main problem for either vets or medics, it was difficult to pinpoint motivations for institutional synergy; participants felt that perhaps ‘collaboration’ was a more appropriate and attainable terminology, particularly because medics are still regarded as too often absent in One Health initiatives.

Regarding the more technical aspects of course delivery, participants were positive that OH-NEXTGEN provided the support and impetus for the development of several well-rounded, informative and professional modules that can be utilised and adapted to the various institutional, cultural and geographical contexts of the region in the future. Participants however felt that better integration of these modules, both between the teaching institutes and the individuals who developed them, would have improved their cohesion and ultimate impact on the tutors. There was also a recognised need to better standardise/align content delivery tools and assessment, and the level of ongoing input expected from experts who delivered the original materials. For example, given that course assessment had not been discussed prior to its inaugural delivery in Morocco, it was assumed that host institutions would deal with this themselves, resulting in some confusion and controversy between the host institutes and tutors. Intellectual property and acknowledgements for the original materials were also unclear, especially once the materials became further altered and disseminated by the tutors. Participants also felt that as a stand-alone course, the OH-NEXTGEN materials were probably not sufficient for students that had no previous background of core subjects such as epidemiology, economics and social research. The OH post-graduate courses were therefore ideal for those who already had a Masters in a relevant core topic, or as a type of ‘continuing professional development’ for those professionals with previous field experience who would find it easier to integrate their existing knowledge into the topics covered. Participants also felt that apart from content, sustainable delivery to the end users will be critical for uptake and value, and as such the technologies for delivery mechanisms in the various contexts require more thought.

2: Current and potential impact of OH-NEXTGEN on the tutors trained in Morocco and Ghana
Participants were very positive on this aspect, reporting that tutors had received a well- rounded knowledge-base in both natural science subjects such as epidemiology (including expansion of their knowledge of specific diseases), and socio-political and economic concepts and disciplines that were new for many. OH-NEXTGEN also provided tutors with an opportunity to learn about the principles of distance learning, resulting in some tutors now having direct experience of online teaching. It also provided tutors with a valuable occasion for both regional and north-south networking with colleagues from a broad range of interdisciplinary backgrounds, and an opportunity to build / expand CVs to reflect their new career role in teaching. Whilst the tutors no doubt improved their appreciation of the broader concepts of One Health, and the various contributions of other disciplines in achieving an integrated approach for disease control, it was felt that there was still an overarching focus/participation from the veterinary sector, and that greater efforts should be made to motivate and recruit tutors from medical and other fields in future. There was also a recognised need for tutors to further tailor the materials to even better reflect local One Health problems and solutions that were not necessarily known – or captured – by those who developed the original materials.

In terms of potential future impact, stakeholder feedback revealed that whilst OH-NEXTEGN provided a real opportunity to develop tutors into long-term mentors for others within their institutes, this would be dependent on their continued institutional investment and support, which was subsequently advised. For this to occur, there must be an ongoing effort to involve professors and other high-level individuals from the various universities involved in the project, as well as post-course networking between tutors and their lecturers. Moreover, given the potential for these materials to be taught and accredited by other universities in the Sahel-Maghreb, it is important that tutors maintain the contacts they developed during course delivery, and look to other opportunities to promote the materials/concepts in the region through various networks and platforms. Some felt the materials/delivery platform were not currently being utilised to their full benefit; for example whilst many students appeared to be accessing the content, the discussion boards did not show a lot of activity at present.

3: Current and potential impact of OH-NEXTGEN on the students subsequently taught by the tutors trained in Morocco and Ghana
Participants uniformly agreed that OH-NEXTGEN had enabled a new cohort of students in the Sahel and Maghreb to gain access to specific professional information that was of a high quality. These materials, and the broader platform/networks created through their delivery, enables students to interact and network with colleagues from a broad range of disciplines and backgrounds, providing an opportunity for self-learning and continued professional development. OH-NEXTGEN has provided a cost-effective means of further education in the area of One Health; the focus now should be on student evaluation of the course materials/delivery and greater contextualisation and tailoring to meet individual institutional/national requirements.

List of Websites:
www.oh-nextgen.eu

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Kontakt

Dirk Berkvens, (Head of Unit " Veterinary epidemiology")
Tel.: +32 3 247 63 93
Adres e-mail
Numer rekordu: 182100 / Ostatnia aktualizacja: 2016-05-17
Źródło informacji: SESAM