 My name is Mark as Victor has introduced me and what I'm going to talk about is just sort of analysis of what we've been trying to do collaboratively locally and in the region and what one health efforts that have been building momentum for the last decade. I am a visiting scientist here at Ilri and I work with Eric Favre under the Horn project, the Horn project in the middle and we have been working with many other organizations so currently we are advising the government of Kenya through the zoonotic disease unit as the effort program to develop policies and guidelines for example what GASA has just talked about, that's one of our outputs but we are going to we know the momentum to go that so the outline of my presentation is that I just want to give a snapshot of the global regional and the local efforts of what has been happening and to show the interconnectedness of how this is an additive way of having a common achievement when you work together as one health you bring together very many disciplines. The focus for this talk is that we want to see how implementation moves to operationalize and finally how you can institutionalize because you need to embed this into national policies as you move forward and why do we need to develop policies or why do we need to develop guidelines. I think apart from the planning financially you need to have sort of arguments where if you want to have an outcome you're looking at specific public health hazards you're looking at specific emerging disease or foodborne diseases as a previous speaker here from I think Richard talked about you need a common way of looking at it and the plans here have been ignored for a very long time but then we are seeing them sneaking in here as part of the one health in a shared environment so that's where we need it to help us to plan better but at the same time also to help us actually just to have a common way of working from the various sectors that are involved in this but it's a long process and this is not a template for for Kenya but this is just a general way that probably how policies will be developed for some of us who have been involved in developing guidelines and strategies for the country this is a common approach that you have to use but the most important thing is after you review the available material and literature that exists is relevant to one health or infectious diseases you need actually to go to the stakeholders and then develop a framework that is now going to have a governance structure whereby it has to have a political bite so apart from having accountability issues that you need partners and people actually to bind into your story there has to be a document that actually guides you and that's why it's very important to do this but M and E is very important in terms of doing this at FAO we have developed the one health monitoring tool that takes account and it takes you a stepwise way actually to understand on are you having investments that are to get realistic or are you just throwing your money into implementing my health programs on December 1st this year the one health expert panel that has been 26 individuals from various countries we are privileged to have our own Kenyan Salome Bukashi actually sitting in this panel and they redefined one health and previously it has been silent on plant health but now we are seeing an ecosystems approach whereby for sustainable way to balance and optimize health not just for human beings you have to actually look at the ecosystems and the animals that exist in this system so this definition is going to create an impetus for us for what this is is going to ignite a lot of collaboration to coordinate this also to focus on issues of one health workforce capacity building and at the same time you want to communicate better to the stakeholders so I mean this December this has been a milestone in terms of just bringing this out very clearly but the most important thing is that the trapezoid which is composed of FAO which shares the trapezoid right now and OINWTO has been very systematic actually in developing tools that is a G is a very good template that actually allows you to understand how collaborations are done how well are probably at what extent can you define as a noted disease is AMR and food safety part of this has AMR or food safety been ignored and I think these are some of the issues that have been and I liked the previous speakers actually who touched on issues to do with food safety that we sometimes we put it on the backdrop and don't really want to bring it on the forefront of this and countries just adopt this as a template but the most important thing is that based on our country experience you have also to have a best practice of way of actually implementing this and that's why it's very important actually to see what the trapezoids have been doing over the years so the TZG will actually focus on a few areas and these operational tools they're the ones actually that help us to focus on some key you know technical areas and one of the areas that probably I'll just highlight is the MCA what you call the multi-sectional one health coordination but we have some technical areas in terms of conducting a joint risk assessment what we call the JRA and the One Health Workforce Development which is being done by many organizations including Afro-Hoon which has championed this curriculum development in terms of One Health Workforce Development and the UC Davis so as we move forward these tools are the ones which actually guide from the global perspective to the national perspective to be able actually to adopt some of these tools and some of the documents probably that we have contributed for over some time is that even the World Bank has an interest actually in funding One Health Research and provides a very good if you go online and look at Redis here you'll see actually what they do and this is like a blueprint which actually they used to to to text talk and maybe prioritize areas that are going to fund and AMR actually is imagined very strongly as we move forward so we move from the global level and then we come to the African Union the African CDC and the auspices of the African Union based in Addis Hababa has for over the years actually championed now by endorsing a One Health approach by creating these frameworks that are actually going to be best practices in tackling what you call zoonotic diseases but the main thing is you have to share your data you have to establish the systems but at the same time actually enable to strengthen One Health coordination collaboration so what we are seeing here is that One Health approach is really taking center stage even at our own African perspective but then this report here has been highly cited and I think it was developed by scientists from Ilri here including Bernard Bert and others and it actually outlines that we are having spillovers all over the place from the environment back to the the ecosystem and we're having you know humans you know coming in as you can clearly see how do we break this chain of transmission if you're looking at COVID-19 of which this report focuses on for the first time the United Nations Romantical Program now becomes the fourth arm of the trapezoid so we had FAO or UNWHO and now UNEP comes in actually to really bringing the environmental aspect which we have been actually missing into this so we can mainstream One Health approaches by building capacity by enhancing actually what you call M and E and focusing on governance and our discussions today are actually going to be on governance how does governance actually be allowed and our first tool of the seven tools is the MCM this is a 10 step you know kind of a process whereby you have to take stock and you have to you know have a team working together and choose the areas of of of collaboration that you're going to focus on but the key elements that guide us in terms of moving forward we we can be focused on leadership and governance and the policies and legal frameworks and this is the whole discussion that you've been having here how do you fund activities what do you base on actually if you want to fund some of these activities you can just come out nowhere probably with a big money of bug and then drop it somewhere else so these they are very many co-elements but the focus for this talk we are going to look at leadership and governance and those frameworks that have been established across the continent or across the whole of Africa and efforts actually to prioritize zoonotic diseases or events so the MCM actually it forms a template that guides us as we move forward and again this work I think it was commissioned by OREKA led by Fasina who we also work with and you look at the the the way they have mapped out all these organizations and come up with many of these activities and these activities keep on varying but the most important thing that you have to look at is that we are narrowing this to only the human and animal issues and this is actually the weakest link that as we move forward this study did a very interesting thing because actually try to look at the powers of interest so you want to see how does actually power influence whether they're decision makers or funders in that and conversely you find that in terms of you can have a very good correlation between the interest and influence in terms of decision making but then you find there's some you know poor correlation and this can be actually influenced by sector specific priorities whereby you have the policies that are segmented to each sector but they are not really merging into the other so I think I like this work that actually OREKA had a lot of input in which is published and it gives us a lot of focus where we can see where activities are done for example the East African region has taken a huge lead over other areas where but you find that over probably a hundred and so initiatives activities are being done in the South African region but what is happening in the western part of Africa and probably the southern part so we need to bring together these continental efforts actually to see land-based practices from other areas of the continent and actually as we move forward understand this and this actually propelled us to understand for example what has been happening in our country as Kenya I'll be a bit biased because I'm Kenyan and just trying to give a story of how you know the Kenyan zoonotic disease unit was established the Kenyan the ZDU is the national one-hearth platform actually which had been just presented by the previous speakers just Augusta and this has been a long journey I think all the way from probably almost 30 years ago when we had the the Kenya Rebis Group that was under you know the South and East African Rebis Group so due to the sporadic emergencies of these cases but this journey actually gained momentum in 1998-1999 when we had the 1997 relief outbreak which was huge in the East African region the the technical committee has been in existence for all these years until even the outbreaks that have happened during the 2021 or 2020 in this African region but the milestones that happened beyond the the HPI task force was in 2012 when they were able actually to develop a strategic plan which actually was endorsed by both Ministers of Health and at that time Ministers of Livestock to come up with a first strategic plan that actually brought to the establishment of the zoonotic disease unit but a very very significant effort happened I think in 2014 when we were able actually to develop the national strategic plan which was being led by the ZDU and a lot of support from other organizations like the WSU led by Dumbi and others and they removed for it very quickly to this year actually to showcase some of the the one health strategic plan the anthrax that she was presenting and also the brucellosis control and prevention strategy so we have this trilogy of documents that we are going to launch very soon that are actually going to put Kenya on the global stage actually as a leading force in terms of actual implementation that so after we look at how the ZDU is structured and I think she had mentioned this I already really want to be labelled this the main emphasis that are on the left side is that do we have a need to co-opt other sectors do we need the environment to bring in the environment actually to provide support for this do we need to bring in wildlife monitoring so while the core functions are being run by vet and medical epidemiologist who run the the the entire unit it also cassettes lower to the county one health units which I'll be talking about in the next slide up the sub county level but the most significant thing is to bring together all these sectors as per defined by the recent definition of one health by the expert panel that probably we need to look beyond just these two displays and expand this for us to institutionalize one health approach we need evidence also from these other sectors and this is what we call the county one health units in 2015 we piloted the county one health units with the with the CDC office in Kenya to actually try to mirror what is happening at the national level and we can bring it down to see if the same thing can be done at the county level and in 2021 with the support from the global implementation solutions we have been able actually to develop the county one health curriculum that are based on tools of surveillance joint response probably AMR communication on risk assessment and so on and so forth but some of these modules were heavily borrowed from Afrohoon and Afrohoon most of you know I think Helen talked about it yesterday and Sam is in the room also here is that their leaders actually in terms of the one health workforce development so from bridging the academic aspect and bringing in together the industry developing these curriculums actually has helped the ZDU that will now go down to put down courses on data sharing information how well can we coordinate this and then finally a big story of policing legislation so the county one health unit again will put Kenya on the global map because we are going to see how you can trickle down actually the way to implement a decisionless one health and I bring this story by this paper from Uganda which actually has also showcased their journey that began way way back I think they began in 1980 when the veterinary public health division was embedded in the minister of health and this probably was a milestone at that time but they have come along a long way tackling african trepanosomiasis and I think in 2017 from this publication by this team they had the national one health platform but there's some uniqueness about the national one health platform that is not in our canyon one you find that they have the high level one health technical working group that has all these director of animal resources director of health services but a key thing they have the environment embedded in and wildlife and so these are some of the lessons that we can learn that while we have ours strongly embedded into only two sectors other countries actually have elevated it and actually brought it and even down to the district level what we call for our case the county one health unit so east african countries or countries across africa can learn from each other actually on how to operationalize and implement most of their one health programs and you need a lot of resources actually to go ahead and do this kind of thing so i'll not really go one by one but for you to plan better to share information very well you need frameworks and some of these frameworks are set for example the hr by the who you have the terrestrial guide by oie and then you have the corvus elementaries but the most important thing is you have to have the expert networks the way there's no technical working groups work in these countries that they are led by the twin directors of health but then they have subject matter experts being led by researchers from ill re kemry and other organizations which provide support for this so we have the national action plan for security in place for example in kenya and all these other documents that actually can guide us to move forward these kind of complicated in any other country because you this is uh what probably uh when you are developing the strategies for wonder we had this kind of approach that we used and what is a joint external evaluation so this is a very systematic way of looking at pandemic preparedness and you have about 19 key steps that you have to go through it is a voluntary process but again it enables you after every five years actually to review now it will tell you if a country has the ability to respond well to infectious disease kenya did its je in 2017 and what we saw after having this and the z due to clean into this that all these 17 areas of capacity we focus for example on the global health security agendas packages which we have this notice package we have the mr package and the other package so in line with the global health security agenda what we are looking at where we as a country and where are we going if you have a score of one then we are doing two but but if we have a score of about four then we are doing very well and in kenya you can see for example mr um and maybe i'll focus on z notic diseases here you find that surveillance systems for for for the z notic decision mechanisms actually to do this and we are three so meaning that we have some capacity going forward but then you find that we have probably an area on antimicrobial resistance we are two so some limited capacity but this was in 2017 so the purpose of the jje which will be tied together to what we call the performance of veterinary services is to try and bridge the gap of what is happening on the side of the human health via the hr guidelines which were developed in 2005 and what is going to happen actually on the on the on the veterinary side and that brings us to this activity that we did last month uh we brought together experts from the whor led by the whor regional office the z du coordinated this with the animal health experts human health experts and it's very important to bridge the gap so if you want to move forward and have a platform of probably establishing how to institutionalize this the one health is a commonality between what happens in the human health and what happens in the in the animal health and what the pvs and ihr bridging workshop does is that it tries to harness those areas of commonality those weaknesses that exist in both systems and this will be what will be prioritized by the country so we were able actually to prioritize key areas that have been listed here we had about 12 but we started with looking at the joint risk assessment will be very key to look at that but those are more technical the most priority that we are looking at as a country right now is that for us to move the z du from where it exists under the directorates to a higher office probably under the presidents so if you you establish that directorate and i'll talk about that at the end is that now you can have more funding and you can actually prioritize that but you have all this continent flowing together between what happens in veterinary aspect and what happens actually in the in the public health aspect so this is the main purpose of the hr and the pvs and this work took us a lot of time under the home project and what we wanted to do is that we went out there and we wanted to understand what has been reported in the home of africa where has it been reported which country has done a lot of work on this and all the publications that have been churned all over the years we were able to synthesize all these publications and this work was led by my colleague Lisa who we work with and we were able actually for example you can see that Uganda Ethiopia and Kenya I've just picked a few we did Somali Djibouti and all that and where you see the red line on that graph is when they had prioritized these noted diseases so at that time you realize that probably the number of publication might start going up because focus is being given to specific diseases that you're going to work with but the most important thing is you want to analyze which domain where are we having the interface if you look at the Venn diagrams that you bring in together you find that as we want to prioritize these diseases rabies takes a huge share probably on the human aspect where the analysis is being done and anthrax brucellosis rift valley fever and all those diseases but then you find that the human the animal aspect actually predominates all these sectors in terms of whether they are doing risk surveys whether they're doing seropidemilogy studies or just probably cup studies this work actually was sort of you know going back and trying to understand what has been happening in the region for the year so we call this paper actually a hundred years of scoping and we are just looking at what is happening in the whole of Africa but the most important thing is based on that paper which came probably much later these efforts have been going on to try and prioritize diseases and why do you want to prioritize diseases you want to prioritize diseases because that's where you're going to put your money that's where your policies are going to focus on and the CDC has designed a tool what we call the OHZP and this tool actually is a semi-quantitative tool whereby you want to understand what happens in a country of autism disease so in 2015 in Kenya on the last map we actually prioritized those diseases we started with anthrax triprosomiasis rabies brucellosis rift valley fever and these were very many about 35 diseases but you only want to focus on the first five and the criteria actually is based on few on few issues we you want to see the social economic impact does this disease actually really cause loss why do you want actually to tackle this disease does this disease actually cause severe illness in humans or does this disease actually does it have an epidemic potential slash pandemic potential what we what we have seen and as you can see many countries as followed the CDC tool to actually operationalize this second martin 2018 and others actually ranked seven diseases in Uganda as you can see but in Nigeria actually this year a paper which was published and actually it had also some Kenya North as Martin Muturi and others helped actually to do this process I mean you can see rabies is very common in these countries if you look at at the four countries that we have used across Africa you find that there's a common out of diseases so it's very important to standardize most of these tools but this is our biggest achievement so far in the 12th year journey that we've worked we have actually been able to revise our old strategy and we have the strategy here which actually the director of veterinary services was talking about we're going to launch it very soon and based on the guidelines that are going to be developed so this this strategy the Kenyan national one health strategy is a blanket of two other strategies that will come down here what Augusta was talking about and also we have a resources strategy that has to be in place but the main thing is that the first objective of this actually really really focuses on implementation issues and this realization the others probably are applied research which will see the importance of being applied to research and probably just to to strengthen surveillance so I think this is a very big step for Kenya as we move into the the next phase to try in the next five years actually to roll out this strategic plan and probably have more impetus to see if we need to summarize into a policy document but based on the two things that I talked earlier the JEE and the PBS which you are now familiar with trying to find those you know areas of convergence or weaknesses both in the human health and animal health Kenya developed a national action plan for health security in 2017 and this when you look at this national action plan for health security it really brings out the strength of capacity building when you're looking at the one health approach these institutional capacities that you want actually to implement issues to do a IHR it's mandatory actually to bring in the one health approach and that's why the contributions of both sectors after undertaking the stock of the PBS and the JEE they came up to develop this document which is now being funded actually it is a costed strategic plan which is actually going to prepare the country for and as I said being a Kenyan I'll be very very systematic so we have the the avian influenza contingence plan and we are recently about to to revise the Rift Valley fever contingence plan which has been worked on for many many years actually by leading researchers in in Rift Valley fever in this country and the purpose of this is that you keep on updating it because you want to create guidelines and SOPs that you're going to use but I mentioned the the rabies plan as earlier in the discussion and then Augusta just talked about the anthrax strategy and then also we also have these brucellosis and the one health strategy that we have launched so I think as we move forward we are seeing the outputs of the efforts that we are putting in as a country and another project that was involved in this we founded by WHO and TDR in in Baringo Kenya and the EDNOM 2 yesterday actually presented part of the findings from this study part of the anthropological work is that you can develop policies or strategies at a much lower level so when you went to Baringo Kenya and we conducted the one health study between malaria and Rift Valley fever in these populations and we were able actually to create policy briefs both for malaria and a policy brief for Rift Valley fever and this policy brief has been used by Baringo County and probably it can be emulated by other neighboring counties which have probably the same ecological drivers of this disease so it's very important actually to see on how you can unpackage all these issues from the much higher level and then you move forward why do you do research you don't do research just for fancy publishing you want to do research that is impactful you want to see these communities actually have these messages that are very simple and they can be able actually to use these messages actually to protect their livestock and at the same time protecting themselves from vector bone diseases like Rift Valley fever and FAO commissioned mapping of the one health activities in Kenya and this was led by the zoonotic disease unit at once again and what we find here that despite that we have some gains in one health our country being covered in a very nice map and you find that most of the one health activities probably are more based in areas that have high livestock populations you see the up north I think in Mars a bit and probably now we are starting to see a shift so sort of an epidemiological shift where but we are seeing now more activities going to areas that are semi intensive and this is what urbanization does so you see actually coming up of most of these diseases from areas that probably were not prevalent to some of these diseases we provide this as a template and in terms to operationalize some of these things that this can be emulated by other countries actually when you map out the activities and you know where you want to go you know where you want to put your money so for you to be able actually to move forward you want to check on the technical areas and what we looked at and I'm not really going into all the areas I'll just look at this one area of institutional policy in the zoonotic frameworks this came out very prominently we talked to experts in one health in medical research and everything and it came out very very clearly that the areas that has have to be given priority in terms of interventions these were areas in creating conducive legislosal frameworks and at the same time actually creating institutional policies that are going to drive one health agenda forward and part of that and we are just discussing this with Harri at the break is that how is one health funded in most of these countries one health is funded being driven by priorities by the donor organizations of donor countries when do we have an aspect of probably understanding the priorities of one health funding are going to be driven by our own courses do we have probably budget lines in our countries for example Kenya and the DVS has also provided some support and now I know the means of health has actually put a division that actually looks at specifically the zoonotic disease unit so in not really becoming biased this is a donor driven agenda that is actually you know supporting most of these activities when you see the CDC the USAID most of the activities what we do 100% in FAO are being funded by the global health security agenda which is a just a USAID project so all the organizations that are coming in we need to have a national agenda and a conversation to see where we can put our money and how we can prioritize where to actually how to control you know emerging infectious disease and more so one health events and some of the policies that have been in the pipeline for a very long time we have the health policy we have the veterinary bill we have the animal health bill it's very very important to see that you can have a bill but also at the same time you can have a policy so we have some acts that are also very active in this country that are actually helping us to move forward so when you look at existence of some of these policies and you look at the instruments instruments are now bills they are not actually policies are such how is Kenya doing this is that for us to intervene better for us to prioritize on how we're going to visualize this we need to strengthen our legal frameworks and actually cassette this to a lower level and this slide is very interesting because um we supported Cameroon actually to do this work and and more recently actually Tanzania has completed its strategic plan what comes out very clearly in this comparative you know outline is that you find in Tanzania the office the nationwide platform in terms of governance is placed at the prime minister's office that's a very high level office and you find in Cameroon it follows the same way a very high office the prime minister's office but in Uganda as I had mentioned earlier you can see those signatures they come from all those health agriculture lifestyle environment and tourism and then you see I think in Nigeria again is also a bit elevated and now the Nigerian CDC which is a very very strong kind of African organization comes in so we're asking ourselves that we need to have these offices elevated to much higher levels in government and this is the story of Kenya so when we are looking at where there's no deceased unit is it looks like it's somewhere down there it's very functional but in our dream actually means to see there's no deceased unit move and be a directorate in the office of the president that gives us more muscle it gives us more power actually to allocate funding as we move forward and this can be replicated actually at the county level and I like using this slide for Rwanda and the question is it's the only country actually in this region that has a win health policy and how have they done it I think they have had the political will if you have the political will and you can summon actually the expertise to bring together actually on an integrated way of implementing this so as they have moved forward actually in March 2021 to have their first one health policy launched they had previously had the strategic plan that was revised ending 20 to 2026 and it's possible even as we move forward as Kenya probably as a case study to move now from what we have as a strategic plan and think on having a very small document that we're going actually to present to policy makers to make decisions on what to prioritize and what to find as a country so we collaborate in a lot of work and and as I said principally honed is what I've been working the project for honed for a very long time now we're coming almost to the to the fusion at the end and I've with Eric Favre at the University of Liverpool and advising FAO and this matters and just to thank the organizers of this conference as OREC I think being a very new be it's not really an old organization but it has been able to pull out this kind of a conference I think that actually gives us an opportunity to share what is going on in the region and probably to hope in future that we're going to have all these things being done in person so thank you very much for giving me an opportunity to speak to you about this. Thank you very much Dr Nningi. I think I don't want to be labor and say anything more because most of that discussion will be carried into the next session but I just want to echo the comments of the Kuala County Veterinary Officer Dr Omlai that says this is light this this light is a spotlight in the tunnel I'm not sure which tunnel is talking about but maybe you can get it but it's it's the beginning of trying to get animal one health into a sort of structured sort of delivery and there's a lot of good reviews coming from the charts that shows that people are really tracking this.