Sri Lanka completes the One Health Zoonotic Diseases Prioritization Exercise

From 21 to 23 August 2024, the One Health Zoonotic Disease Prioritization (OHZDP) workshop took place in Sri Lanka.  This workshop was a collaborative effort of Ministry of Health with WHO, Department of Animal Production and Health, Quadripartite and United States Centres for Disease Control and Prevention (CDC USA).  The overall objective was to conduct the zoonotic disease prioritization exercise, rank the diseases of greatest concern and facilitate collaborative efforts across human, animal, and environmental health sectors.  

Sri Lanka’s diverse ecosystems, rich biodiversity, and close human-animal interactions create an environment conducive to the transmission of zoonotic pathogens. As in many other regions, a substantial number of infectious diseases affecting humans in the country have origins in animal populations. The country with its unique environmental and agricultural practices, faces particular challenges in managing zoonotic diseases.

The OHZDP process developed by US CDC has been utilized in 51 countries globally, while Sri Lanka is the fifth country in the South-East Asia region to use this tool. The exercise employs mixed methods and approaches, allowing for flexibility and adaptability to suit to the country context. The initial phase of the exercise was to conduct a comprehensive literature review and collect data on zoonotic diseases of concern, including their burden, severity, and socio-economic impact, as well as identify the capacity of multiple sectors to respond to zoonotic infections in Sri Lanka.  Prior to the workshop, the core technical facilitators from each sector and external facilitators identified the most important 49 diseases as per the CDC guidelines.

The three-day workshop identified 12 voting members and over 60 technical experts from the public health, animal health, environment, wildlife, agriculture, fisheries, and food safety sectors and academia.  On day one, these technical experts scrutinised the initial list of 49 zoonotic diseases, and later expanded the list and reached the consensus on  a final priority list of 52 diseases to be used for the workshop. Once the finalization was done, the group was divided into five sub-groups where the criteria for the prioritization exercise were discussed. Subsequently, five most important criteria were selected and the prioritization questions for each of the criteria were developed and agreed for scoring of the diseases. On day two, the voting members ranked the criteria for relative importance, and all 52 diseases were scored using the multi-criteria decision analysis (MCDA) tool.  

During day three, the US CDC online software was used for weighting the criteria, calculating the scores for diseases, and generating the ranked list of the diseases. The list was reviewed, and critical changes were made based on justification and consensus. The groups later crafted the key multisectoral actions required for surveillance and control of the top 10 diseases/groups, namely Leptospirosis, Rabies, COVID-19 and other high-threat respiratory pathogens, Zoonotic Tuberculosis, Japanese Encephalitis, Zoonotic Avian Influenza, Listeriosis and other food-borne pathogens, Melioidosis, Brucellosis and Leishmaniasis.  Roles and responsibilities of stakeholders, and timelines for activities to address the prioritized diseases have been identified during the discussions.

The Zoonotic Disease Prioritization Workshop represents a crucial step towards improving public health through a comprehensive One Health approach. By prioritizing zoonotic diseases and developing collaborative action plans, the workshop will contribute to improving preparedness and response capacities for zoonotic disease threats, ultimately protecting human, animal, and environmental health.

The priority diseases identified during the workshop will need to go through more detailed discussions in the future and a costed operational plan needs to be developed for each of the 10 priority diseases/groups. These operational plans will be included to the National Action Plan for Health Security (NAPHS) Operational Plan 2026-2027 and progress in their implementations will be monitored via the e-NAPHS tool.

WR Sri Lanka addressing the participants during the Zoonotic Diseases Prioritization Exercise

Participants engaging in group activities during the Zoonotic Diseases Prioritization Exercise