 I'm so glad to see so many of you back for day three of the Kenya One Health Conference. We've had a great couple of days. We're going to do a full recap a little bit later on today. But so all I want to say today right now is that, you know, for those of you who were here yesterday, I hope that you came away really inspired about incorporating gender into your work and about how we're going to educate and train the next generation of One Health health workers. So it was it was a really inspirational day. Today we're now really moving on into the policy space. So we've talked about research. We've talked about the concepts that we need to consider when we're doing One Health. Now we're really going to think about how do we get One Health into our policies and into the implementation on the ground. So this will be another exciting day. Really glad that we've got everybody here with us. I've got a couple of just housekeeping reminders. So to those of you who are online, please make sure you mute your mics when you're joining. And for those of you who are joining us and participating with presentations online, make sure you switch on your video so that we can pin you. Everybody who is online, your opinions, your thoughts are really, really valuable. Please use the chat function to let us know what you think, as well as interact with the Mentimeter. So we're going to be going to Menti next. So everybody remember the website, www.menti.com, and Nick will come in a moment and give you the code. This session is being recorded. It's being live streamed. And by the end of the week, we will have the edited videos up on the website. They can already be found on YouTube under the Ilri YouTube site. Remember, all of you who are on social media, please join in the conversation, tweet using the hashtag KOHC2021 and follow us on Twitter. So with that, I would like to pass to Nicholas Paul for our first Menti of the day. Thank you very much, Dr. Leon, and welcome again, our online participants. So as usual, we'd love to gather your views on Menti. We have the code 33519760. So our first question would be, want to know any new knowledge that you've been gathering from the past two days? What is changing? Are you still there since you joined or are there some evolving thoughts along? Somebody says one health is the way. Gender is one health. It's a core competency. Let's see, let's see. Yeah, we need gender inclusion. Yeah, somebody also is saying that we need social scientists on board, which is true. We need to mainstream gender. We need to include the environment. We need a framework for one health implementation. Yeah, those are some of the thoughts that we'll be capturing today. Yeah, so keep them coming, keep them coming. How many responses so far? 27. We can go up to 50. How many people do you have online? 315, yeah. So we are at 10th or let's get to 50 or so. Yeah, collaboration is key. Gender. Nobody's talking about one health education. Oh, yeah, good. I think we need more gender involvement. All right. Yeah, somebody says one health is new to them. So I guess one health education is coming in. Social component, that's true. Let's see. Yeah, all right. So keep them coming, keep them coming. We are 55. So we can go to the next question. And now that we've learned about the issue of collaboration, which discipline would you like to include? Maybe you've been working alone or in silos. Which discipline would you want to move on? Maybe one discipline that you'd love to include, which would be your ideal one health or journalism, environmental scientists, social sciences, social sciences, animal health, gender, the ministry of women and youth, yeah, gender experts, yeah, gender economists, interesting. I hope you are not kicking out the vets and the medics. We're just including more. There is at this point, then after gathering the view, we'll still come back to Menti later on. It's now my joy and pleasure to welcome Dr. Victor Yamo, who will be taking us through the One Health Policy and Implementation. He'll be assisted by Dr. Martin Baraza, who will also be joining later their co-chairing decision. So over to you, Dr. Victor Caribo. Yeah, thank you, Nick. Good afternoon, good morning, wherever you are, especially for the online participants. I want to welcome you to this third day of the Kenya One Health Conference. And today we'll be tackling One Health Policy and Implementation. And essentially, how we want to do it is we'll start with the implementation bits, where we'll have a series of presentations for about 90 minutes. And then we will have some highlights on what has transpired this far. And then we will have the policy session, which is going to be a high-level panel constituted by various government officials, Fao and Yusaid, some of our donors. And so without much ado, I'd like to start with the first presentation. Essentially, what I will be requesting the presenters to do, if you're here, is to try and take about 10 minutes or max 12 minutes, and then allow us opportunity to ask one or two questions. And since I'm not conversant with all of them, what I'll do is when the presenter comes, they will quickly introduce themselves, maybe in a minute, and then make the presentation. So our first presentation will be on brucellosis control among agro-pastories in Tanzania, how to communicate risks effectively by Miss Caroline Mihaki. So if Caroline is around, she can come. Or if she's online. Okay, all right. My name is Caroline Mihaki, and I'm going to be talking to you about brucellosis control among agro-pastories in Tanzania. My focus will be on how to communicate risks effectively. To begin with, brucellosis has been determined to be endemic in sub-Saharan Africa, and it is a high priority disease in Tanzania. So there are many efforts to control brucellosis in Tanzania. On the other hand, brucellosis is the incidence of brucellosis higher in pastoralist and agro-pastoralist contexts, and this is related to their consumption of raw animal source foods, as well as the way they handle their animals, and they interact very closely with their livestock. And therefore, they have to be involved as key stakeholders in the control of brucellosis. On the other hand, there's the aspect of risk perception. What people make of a certain risk for disease, for example, in terms of its prevalence, in terms of its severity, in terms of how common that risk occurs, will determine the kind of preventive and control efforts they are willing to take or not willing to take up. And sometimes you might find that the risk perception of professionals will be different from the risk perception of communities, and this will affect community sensitization and whether people are willing to take up those control strategies or not. The objective of this study therefore, what the objectives of this study therefore, what to identify the risk perceptions of the agro-pastoralist communities in relation to animal handling and consumption of raw animal products, as well as to determine the effective community engagement strategies. So first, we wanted to understand what their perceptions about animal source foods, raw animal source foods, as well as animal handling is concerned in terms of disease, in this case, brucellosis. And secondly, to identify what would be the best way to communicate to them in a way that is likely to lead to long-term behavior change. This study was conducted in three villages in Kilombero District in Tanzania. These three villages neighbor each other. It was an ethnography, so I lived in this community for six months. And through these six months, I was able to conduct a survey with almost all the agro-pastoralist households in the three villages. And I was also able to do focus group discussions, in-depth interviews, key informant interviews, and also many informal interviews as well as a lot of observation. So I not only just heard from what they told me in the interviews, but also observed their actual behavior. And this study was conducted in 2019 between March and August. The results of this study show, first of all, that brucellosis is largely unknown. Many of the pastoralist and agro-pastoralist had never heard of brucellosis. And only 7.2 percent of them had ever heard of brucellosis in livestock. On the other hand, when we asked them whether they had observed symptoms of brucellosis in their animals, including abortions, detained placenta, infertility, tailbars, many or some of them had actually observed those symptoms, but they did not consider them to be a big problem. First of all, this was related to the other livestock diseases in their context, which they felt were a much bigger priority than these other symptoms that they had with Nest or brucellosis. On the other hand, even when they observed the symptoms, they did not know what caused them. And sometimes they thought that some of them thought that they attributed them to supernatural factors. And this is because many of these symptoms were reproductive health challenges, which they compared to what happens in humans. So they said, even for humans, you will find tailbars, you will find infertility. And so it was attributed to God that God decides who gives birth, God decides which animals live and which ones die. So it wasn't really considered to be a big issue. When it comes to the issue of retained placenta, they had ways that they felt that they were able to extract the placenta. And so it wasn't really a difficult challenge for them. On the other hand, in this particular context, having owning a large herd of animals was more important than the individual productivity of each animal. So they were willing to retain animals that were not necessarily productive just to have a large herd and for sentimental value. For example, for infertile animals, they would say that those animals became very big and they were beautiful to look at. So for that reason, they were willing to retain them in the herd and maybe sell them at a much later date or slaughter them in the home when there was a function. So they still retain those kinds of animals for other value, not necessarily monetary value or productive value. On the other hand, even for those who had had above brucellosis or new even brucellosis risk factors, they did not change their behavior. And they were willing to continue taking raw milk, consuming raw milk or assisting animals in petitions with bare hands or handling aborted material with bare hands because it wasn't really a big, it wasn't really a risk factor for disease. So they had had about it, but they didn't believe that you can actually get sick from consuming raw milk or from assisting your animal or staying very close to your animal. On the other hand, sensitization activities were usually conducted. So they said, for example, when they went to a health facility for women, child welfare clinic, they would be told don't give raw milk to your child or when somebody had TB, they would be told do not take raw milk because that is how you get TB. But they did not feel that these kinds of sensitization activities were actually addressing their questions, their doubts and their uncertainties. So for example, they would say, we know many people who do not take raw milk, but they are getting many diseases. Or we know some people who are never consumed raw milk or communities that don't take raw milk, but they are still getting TB. So they had those kinds of questions which they felt that they never had, they didn't often have an opportunity to ask. Like when women went to the clinic, they were not able to ask this question to nurses or when there was a community barraza, they were not able to ask this question to the practitioners in a way that they felt that their questions were being responded to. And that was a big challenge for them in terms of adopting new practices or beginning to change their behavior, for example, beginning to boil milk. In this regard, therefore, we found that there was a disparity in the risk perception of professionals and that of the community. So for the professionals, they of course already knew that consumption of raw animal source foods residing with livestock and many of these other risk factors was a big challenge in terms of controlling brucellosis. But for the community, they did not believe that those practices could actually make you sick from brucellosis or any other disease for that matter. And the reason is because these practices were rooted in tradition, this was their culture. It was actually part of who they are. And there were many other benefits that they attributed to these practices, especially to raw milk consumption. For example, they said raw milk is more nutritious. They said raw milk is more beneficial for children, especially when they are young because of that nutritional value. They also said that raw milk helps to counteract any poisonous substances so that if you ingest anything that is not good for you, then intake raw milk, then it will counteract that action and you will be okay. They also said that there were also practical reasons why that prevented them from boiling milk. For example, women say that they were overworked and so boiling milk was an extra chore that they were not willing to take up. Men said consuming raw milk when they're in the forest had looking at the animals is much more effective and more time saving. So they do not want to go through that whole process of boiling milk and waiting for it to cool down before they can drink it and start their journey. On the other hand, there is a need for focus and long-term community engagement. So the way this kind of engagement was done, it was often done in a very haphazard manner. So it wasn't focused in the sense that it was not addressing the real issues in the community. And on the other hand, it was not targeting specific problems or specific questions that the communities had. On the other hand, this kind of engagement also was not long-term. It was usually erratic, so once in a while. So like they would say, when we had a relatively fever outbreak, we had on the radio that it should not be taking raw milk. But it was not a long-term kind of thing that would make them think about it and begin to process this information and to begin to question the kind of behavior that they were engaging in. So it wasn't, in that case, therefore they didn't feel that it was so effective in their context. In conclusion, therefore these are the things that they proposed. First of all, they felt that for community engagement to be very relevant and to be very accepted by them, it needs to be culturally sensitive. They felt that in many cases, people who came to communicate to them used a very patronizing attitude, or they did not understand their culture and they were not willing to listen to that this is part of who we are. So the way the message came across to them was not respectful and therefore they were not willing to listen to it. So like for women they would say, when we go to a health facility and the nurses talk to us this way, we will just nod in agreement, but you're not planning to do, to change our behavior or to even consider what they are telling us. But if they were more culturally sensitive, like listening to us, trying to understand our rationale behind this behavior, then there might be dialogue and we might be more willing to listen to them. Secondly, they proposed that this information needs to be targeted. It needs to be very targeted to their specific questions or specific doubts. So instead of this information being very general and broad, it needs to be specific. Like I said, they are questions that they have and these are the questions they want answered. And so when professionals come to them, not just talking down to them and telling them you need to do this and stop doing that, but asking them what is it about raw milk that you value? Or why is it that you're having challenges with boiling milk? Then that way they will be more willing to consider taking up those new behavior and taking up those new practices. On the other hand, it needs to be dynamic. The way it has been done in the past, it's usually like call a community browser, in which case in this context it is men who will attend. But they were proposing it needs to be dynamic so that you are involving children in schools. This education is being passed to children in schools. It's being passed to women, to harders, to men. And that when it is so broadly done and when it is catering for many people, then everybody will hear this message and maybe now the community can begin to examine it and to start thinking of a long-term behavior change. Even if they don't change now, it can lead to long-term behavior change. And lastly, it needs to be continuous. So that is not just a one-off kind of thing, but it needs to be done repeatedly over and over and over again because that way when they say that the more they keep hearing this message, the more they are likely to consider it. But if they hear it once in a while, then to them it communicates that it's not really that important. But if they hear it more and more, like they gave the example of HIV, the way the messaging has been done, it's done so many times that people are now willing to consider it and start thinking about it. And that is what they propose would eventually lead to long-term behavior change and that might start to help some of the Brussels control strategies that are being employed in this particular context. Because even if we want to start doing vaccination or anything else like that, the community still needs to own it and to still accept this kind of control. Lastly, these are the two publications so far from this work and you can look at them and they would give further insights. And lastly, I want to acknowledge the following individuals for supporting this study. Thank you and have a good afternoon. Yeah, thank you very much Carol for keeping time and also for a very interesting and engaging presentation. For me, it was very interesting to see the footer of your slides that said involve communities, information is not enough. And I think you highlighted the facts that we need to be looking at when we are engaging communities and how it needs to be done, being cultural sensitive at certain levels, ensuring that we are not condescending or looking down on them, but addressing the real and felt issues. For those of us who are online, kindly send your questions on the chat box so that we can ask as I looked at it, there was none. So I'd like to propose that we move to the next presentation that will be done by Dr. Donald Otieno on foot bone disease outbreak in Kericho County, Karibu Daktari, and try to match Caroline's 15, 12 minutes presentation. Thank you. Good afternoon everyone. My name is Donald Otieno. I work from the government. I work as a veterinarian in the county government of Kericho and also an affiliate of the Kenya field epidemiology and laboratory training units, training units, intermediate class of 2018. My presentation today is about foot bone disease outbreak in Kericho County. Background globally, foot bone disease are important cause of illness, and death among human populations, and they also impair on socioeconomic development of the entire population. As we speak now, there's not sufficient data or information to actually put a quantity figure on the global burden due to foot bone disease outbreaks. Bacteria is said to be responsible for almost two thirds of human foot bone disease outbreaks worldwide. Annually, the CDC has estimated that foot bone diseases are responsible for 76 million human illnesses, 25,000 hospitalizations, and 5,000 deaths in the USA. In Kenya, he said that under reporting inadequate investigation of disease outbreaks, and inadequate diagnostic facilities suggest that foot bone diseases are more than what's recorded by the Ministry of Health. In this presentation, I will try to relay the findings about a foot bone disease outbreak investigation, and also how interdisciplinary partnership played along to bring out this investigation into perspective. On Monday of the 23rd, August 2021, the County Disease Surveillance Response Team notified by the hospital clinician that there were 35 patients who had been reported to the hospital with symptoms of diarrhea, vomiting, and headache. A total of 35 patients were admitted with these symptoms, and later on, because of the day, a 38-year-old man passed away. Five patients were immediately admitted, and 29 were treated at the casualty and released to go home. On the same evening, the story was carried on the national media, and now it was a big news. The following day, that is on 24th, on Tuesday, the Department of Health constituted an interdisciplinary team that was having a task of establishing the existence of a possible outbreak of a zoonotic foot bone disease, and the team was given a mandate to go to the ground and establish existence of a foot bone disease outbreak, and also come with the ways of managing it, bring it under control. When the team went to the ground, we found from the key informants that a sick goat had been slaughtered in that village on Friday, and meat was sold out locally, and people ate it. On further questions, we found that the goat was sick previously, maybe on Tuesday, the owner sold it to a butcher, then the butcher stayed with it on Wednesday, and brought it back to the owner, because he realized that the goat was sick and never science was blotted and had a funny behavior. So he brought back the goat then on Friday, that's when the owner slaughtered it to recover his cost. So the team that went to the ground to do, to establish disease, if there was a disease outbreak and find out reasons as to why, had the following composition. We had a human clinical and laboratory staff, public health team, veterinary public health and place of disease surveillance, and also people from the region of veterinary investigation laboratory in Carichon. Also in the team, we had the community health workers, as well as the Mijikumi, and the provision on the national administration. The main objective of this team was just to describe the foodborne disease outbreak in person, place and time, and also characterize the risk factors that resulted to people getting in contact with the unsafe food. So this study was done in Solyatu Ward, since Great Sub-County of Carichon County. It lasted from the 23rd when the outbreak was detected at the 31st when symptoms had resolved. Then we did a retrospective course, clinical study. So we had a case definition because we were doing a line list of people who were exposed. So we were line listing anybody, not any person of any age, who ate the goat that was slaughtered on Friday on the 20th of August 2021 at the same village, at the same ward, Solyatu Ward. Then we commenced to do an active case search the following day. We did a structured questionnaire that was multidisciplinary supported. Also we had a knowledge attitude and practice questions in it so that we could get prongs into all areas where we could generate data. So socio-demographic variables, clinical exposure factors were considered. After that, there were samples that were considered for laboratory analysis. There were human samples that are collected in the hospital. And also the RVIL Carichon went ahead and took the environmental samples and screened a few animals within the homesteads. The samples were, the human samples were analyzed using certain culture and molecular typing for pathogenic enterics. This was done at the Walter Reed Human Laboratory diagnostics in Carichon. Data was collected by training numerators. We got a training numerators. This was disciplinary. It was one setting and that was entered and cleaned in Microsoft Office Excel. Continuous data was analyzed by measures of center tendency and dispersion. We reported the mass mean and median. This data was analyzed by frequency of counts and proportions and presented in tables and graphs. Where we analyzed for hypotheses, we calculated the relative risks that in areas where the risk factors are the epidemiological significance results. In the descriptive findings, a lot of the free cases online is listed actively on the ground during the case search. The median age was 27 years. 29 of them were female. That was 54 or 70 percent. Then we find that the median incubation period of the disease was 15 hours. A total of 58 percent of symptomatic cases sought medical care within 24 hours of onset of clinical signs. A symptom situation period had a median of 5.5 days. So it means the convalescence period was around one week. The table below shows the proportion of foodborne disease mobility characterized in times of age and sex. If you look at the between age six and 15, those are children that bought the brands of these foodborne disease outbreaks. And most of them were young children of female gender. When we describe symptoms among the outbreak cases, so that we could know which ones were more predominant, of the 53 cases that were listed, 24 of them came down with clinical disease. And these were the predominant symptoms that they complained about. Headache was number one at 87 percent, food by the fever 79, abdomen opens, diarrhea, nausea, fatigue, and vomiting. So these ones we saw them as quite characteristics of a foodborne, a bacterial foodborne disease outbreak that we are going to describe here. Then we did a bivariate analysis. We conducted a hypothesis testing, a lot of it, and now we found significant relationship on these independent variables. We found that in terms of gender and the residents of a particular village called Kipselton where the animal was slaughtered, this particular group had the higher relative risk of developing disease. So we thought it was a group problem and maybe the particular behavior of these groups could have predisposed them to a risky public health behavior, that is gender in terms of the male or more at risk in developing disease than female, and also the rest days of that particular village. I think their consumption and the utilization of the meat in greater quantities could have come to that end. Then we analyzed those who eat at the roast meat, the method of cooking, category of yes or no, because they were eating roasted, some ate it raw, some ate it boiled, so those who ate it roasted were more likely to develop disease than the other methods of cooking. Then eating tribes, that is the so-called matumbo, they were more at higher risk of coming down with the disease. So laboratory results from human samples went as follows. We isolated five pathogenic microorganisms of which two were stereotypes of E. coli and one was Salamonella, as shown in the table above. So enterotoxidinic E. coli, we had two isolates, Shiga toxin producing E. coli, we had two isolates, enterotoxidinic E. coli, we had two isolates, Salamonella II, and enterotoxidinic E. coli, there was one isolate. So it seems like there was a mixed, like kind of infection of pathogenic bacteria in this population, discussion. After analyzing the data presented before us, we could say that this disease was an outbreak of a bacteriosis disease caused by pathogenic E. coli and Salamonella organisms. In primary transmission, because people ate it directly, there was no vehicle involved. Then progression of clinical symptoms, as we described them, like incubation periods of 15, of a median of 15 hours, for an analysis period lasting for almost a week, 5.5 days in the median, and the presently clinical enzymes of headache, fever, diarrhea, and stomach aches, these are now consistent with the isolates that were confirmed in the laboratory from the human samples. Then children are the greatest, but the greatest burden of clinical disease. We perceived it maybe due to the low immunity or lack of exposure to such kind of pathogenic organisms. Males and residents of that particular village, we perceived that they were a high risk group, maybe due to a behavior that could put them to a public health risk. I don't know whether this is gender like it was discussed yesterday, that males tend to behave in a particular manner that could endanger them or make them risky to succumb to disease. In this community, it is an agro-pastoral community, and people believe that maybe eating raw parts of a goat is more traditional or more healthier than eating the cooked ones. Because it was this, the old guys tend to get some organs and eat them raw first, is when the women can go and cook. So we thought that is a risky behavior that was being practiced by a particular group of these populations. The people having eaten the roasted meat, the tribes, that is the matumbu, are high disease risk due to, if you look at the kind of cooking, maybe for the roast meat, there's insufficient heat penetration and also there's a lot of handling. So that if there was a contamination, it could easily be passed from a person to the food and to the consumer who is likely more to get ill. And also the tribes, we perceive them to be, to have had a high dose of the pathogens. Because these pathogens, the E. coli and the salamonera, most of them are enterics, and they are found as number of flora within the fecal material of animals. Then we found that health-seeking duration was very short. That is, within 12, 24 hours of development of clinical science. So we could say that this was due to the severity of this foodborne disease outbreak. Because the health-seeking pattern of most people in the society, people tend to stay with the disease waiting resolution before they seek medical help. But these ones, everybody just, all of a sudden, sought medical intervention. Then the limitations to our study was that there was an availability of samples from the slaughtered animals so that we could take it also for bacteriology. The slaughtered animals, you could not get even the fecal material, even the hives, the schemes, even the bones. Everything was not there. I think this one we attributed to, maybe there was a kind of a destruction of evidence because people are now apprehensive. A person had died in this village. The person who slaughtered the animal is a pastor. And also has got a lot of influence. Then he was also under arrest by the police. But the time we are going there, he was already arrested. So we thought that the villagers were now trying to conceal so that we don't break through with any investigation that could put him at the center of this whole thing. So that was a limitation. We could not directly link the animal slaughtered the food to the pathogens found or isolated within the human population. So what are the public health actions and the importance of the disney team response that we played? From 23rd when the case, the first cases, the outbreak was detected and the disney team was constituted. That was veterinary, public health, medical, laboratory, and all of us. We came together and we played a very pivotal role in the detection of disease heartbreak, verification of diagnosis and confirmation of disease in the laboratory. The case definition, we worked on it as a team. We designed and structured questionnaires. This also included knowledge and practice about animal health, about public health, and health-seeking behavior of people in the population. So it was a very big study, some of the findings we have not reported here. So we also did the tabulation and the orientation of that in time place at the person so that we could describe actually what was going on. Then there was formulation and test of hypothesis. This one we did it because the interdisciplinary approach was very important in case of epidemiologic consultation. The medical side was the one that was leading this team, but now the veterinary side also came in to bring out epidemiological information that could help develop hypotheses actually to determine risk factors that could have led to the development of the food-borne disease heartbreak. Then as a team, we conducted the implementation of control measures and we communicated and distributed the findings about the food-borne disease heartbreak. In conclusion, I can say that the food-borne disease heartbreak was caused by podionic ecoli and salamonella bacteria, and this was rapidly managed. Check the importance of having a coordinated county to display one health team. Public health risk behaviors in gender and geographical defined groups. Increase food handling, inadequate cooking time, play the middle role in the food-borne disease heartbreak. Then we can say that children bore the greatest health burden of the food-borne disease heartbreak. In recommendation, we are recommending continuous public health education on food hygiene practices and change of attitudes regarding public health risk behaviors. This may be attributed to particular groups, like men or particular groups in the village. Then we also recommend that there should be anchoring the county-one health inter-business teams on disease control policy in each and every county so that thereby giving it a formal institutional platform for efficient communication, coordination, and leadership. Because without leadership, an interdisciplinary team cannot work harmoniously, like the one we did, because we did not have a formal platform to carry out this work. I want to work knowledge in the county government of Kirisho, Department of Health, led by our epidemiologist Dr. Kegan Tabu, who coordinated this work, our director of veterinary services, Dr. Kirui. We also want to thank Wolder-Reed Project Medical Research Institute in Kirisho for having done the laboratory work, isolation and the characterization of the various isolates, the molecular work. Then we also want to thank the RRL Kirisho, because they try to look at the environmental samples, to screen some elements of this same population to see the spread of the pathogenic organisms in the environment. And last but not least, the Kenyumal Health Conference for having given this platform to further disseminate this information to general populace. So those are some of my references. In the picture form, this is a we are doing key informant interview as a lead one, the specific grounds, and this is the RRL team. We are trying to pick some environmental samples for laboratory work. I say thank you. Thank you very much, Dr. Ari. There are several questions that have come through from the chat. I can see Dr. Kisiru has tried to help you address some of them. But if you can, just go through the chat and address those questions because we are pressed for time. I think the important thing is the fact that you have elucidated that anchoring the County One Health teams in the county is critical and important. And I think it's a discussion that we'll be having with the panelists at the policy level when Dr. Baraza will be leading. And so without much ado, I would like to welcome the next presenter, Dr. Christian Odinga, who's going to be talking about assessing the importance of rabies vaccination campaigns in influencing community knowledge and prevention of rabies in Laikipia, Kenya. Thank you so much. My name is Christian Odinga, and currently I'm undertaking my master's in veterinary epidemiology and economics at the University of Nairobi. So today, I'm here to present to you on some work that you did as part of my MSc, that is to assess the importance of a rabies vaccination campaign at influencing community knowledge and prevention of this disease. A rabies is a disease that affects both animals and humans. It has a domestic cycle and also a wild cycle. In the domestic cycle, the dog has been cited as the major source of infection in humans. But then the wild cycle is equally important because studies have shown that the disease has a potential of wiping out entire population, such as the African wild dog, with a detrimental effect to the ecosystem. And so currently, 59,000 people die of rabies in the world every year. And this is because of poor surveillance and also limited resources allocated for the control and prevention of this disease. And due to that, the World Health Organization set a target to eliminate human rabies by the year 2030. And these are seen increased collaborations across health sectors. And the number of rabies vaccination campaigns have also increased. In Kenya, it accounts for about 2,000 deaths per year. And I can say we are not in a bad place because under the stewardship of the zoonotic disease unit, we have a strategy to eliminate this disease as per the World Health Organization target. And mass dog vaccination is the main part of these among other preventive efforts. So why Lycopia? In Lycopia, we have the Lycopia rabies vaccination campaign, which was started in 2015 by the gentlemen on the right of your slide. They've done this work. Actually, they started it to increase vaccination coverage in pastoral and smallholder settlements that dominate that region. And also, they also have limited access to veterinary services. There's a photo of the paper that they developed from the work. If you want to know more about what they've done, you can look into it. But then the map just below shows the polygons represents the communities that have been visited since this vaccination campaign was started in 2015. And I'd just like to point out that the northern part is predominantly made of pastoral communities, while the southern parts are made of agro-pastoral settlements. So our objective for this study was to evaluate the impact of this vaccination campaign towards improving community knowledge and also prevention practices on rabies. So how did you go about it? We conducted a cross-sectional survey for six months. We visited households in Lycopia region as shown on the map below. The polygons represent the communities that have been visited by the vaccination campaign that we are assessing. And also, on the right, there's a region where they've never visited. So we also conducted a survey in that community. And the right part of my slide shows some of the questions that we were asking them on a mobile-based device provided by the World Wide Veterinary Service and deposited to a common database. The image is just me conducting one of the questionnaires to a respondent. We were interested in three variables. That is the knowledge about the disease, the practices around it, and also the dog vaccination status. And for this, we scored rabies knowledge based on a number of questions as shown on the block on the right side, mainly transmission of the disease and the species affected. But we also teased out the practices of these communities around this disease based on the questions shown on the lower part. That is the health-seeking behavior for humans and also if they wash their wounds after dog bites. One of our key predictor variables, among others, was vaccination years. That is the years that this vaccination campaign covered in these communities that we visited. And we found that the range of years that these communities have been visited by this vaccination campaign was from zero to six years with an average of five years. The demographics of our participants was that 59% of them were female, 26% of them had no formal education, while 34% had studied from a secondary level and beyond. And their ages range from 13 years to 83 years with an average of 35 years of age. What did you find? We found that 60% of our respondents scored our work considered to have inadequate knowledge about this disease. And this was based on an aggregate score on the questions like how is rabies transmitted, the typical signs, and also whether it's fatal or not. So 75% of our respondents will be able to identify that this disease is fatal. 69% identified at least one typical sign in dogs. We were focusing on nervous signs, change of behavior, bites, hypersalivation. And 54% of our respondents stated that they knew this disease is transmitted by animal bites. On asking about the species that can be affected, the ones that knew that this disease can affect both humans and animals were 37%. 24% of our respondents that had adequate knowledge about this disease could identify the dog as the main reservoir. And 2.3% could identify other mammals that can be infected by this disease. And so on further going deep into this analysis, we found that the number of years visited by this vaccination campaign was not significantly associated with or did not influence knowledge about rabies. But then education of the dog owners actually influenced knowledge about rabies as shown on the plot there that represents the odds ratios. The main source of information about rabies as for our respondents was informal word of mouth, either hearing about rabies from their neighbors or friends or just any person that they meet. While the vaccination effort, mainly the L.I.K.P.A. rabies vaccination campaign accounted for 5% as the source of information. It's also important to note that about 17% which is a good number did not know about rabies at all. On further looking into the sources of information, we found that respondents who knew about this disease through informal word of mouth actually was called to have inadequate knowledge about rabies. But then just to note, sources such as school and books provided adequate knowledge about this disease based on our aggregate score. On looking at the dog vaccination status, which was the main aim of this vaccination campaign, 63% of our respondents had their dogs vaccinated against rabies. But then 87% of the respondents that had their dogs vaccinated were up to date with their vaccination. That is, they had vaccinated their dogs not more than one year before we conducted our study. And again, there was no significant association between the number of years covered by the vaccination campaign and the probability of the owners to vaccinate their dogs or there was no influence in the number of years to dog vaccination by the owners. But then, on the other hand, owner education and knowledge about rabies actually influenced the vaccination status. When we looked at some of the reasons, and this is just preliminary because when we looked at some of the reasons that the dog owners presented for not vaccinating their dogs, 14% of the respondents say that they did not believe their dogs needed to be vaccinated. Also, it's important to note that a good percentage say that they didn't know that their dogs should be vaccinated, and another good percentage did not know where to get the vaccines for rabies for their dogs. Looking at health seeking behavior, 95% of our respondents said that they will visit the hospital after a dog bite. But then, we all know that it's not enough to visit the hospital. There are other practices that determine the outcome of a dog bite. So, for example, we have practices such as wound hygiene, agency of going to the hospital, and also knowing that you need to get vaccinated or post-exposure treatment. And 4% of our respondents that said they will go to the hospital stated that they will practice wound hygiene. 5% showed agency in going to the hospital by using terms such as going there immediately before 24 hours elapses or the same day. And 2% of them knew exactly what they were going to get in the hospital, that is, anti-rabies vaccine. So, what can we conclude so far from what we have? The number of vaccination years by this vaccination campaign was not a significant predictor of rabies knowledge and dog vaccination. But then, education of the dog owners was, and we can also say that more efforts are needed to improve on the human health seeking behavior as a key practice in preventing human rabies. So, what are our recommendations? We recommend that the Likipa-Rabies vaccination campaign should incorporate more education efforts in tandem with their vaccination. And they can do this by involving local elders during the planning process so that people know, you know, conducting focus group discussions to educate their locals about the importance of vaccinating their dogs so that they don't just bring their dogs to have them vaccinated for free while they don't know the importance of having their dogs vaccinated. And this has been shown by a previous experience where we had a kind of distemper outbreak just after the 2017 vaccination, which led to detrimental effects. I mean, the communities were, again, doubting the relevance of vaccinating their dogs. The other recommendation is that the vaccination campaign needs to train local representatives so that they can act as a quick response team to constantly monitor the situation of this disease and also other welfare practices in the dogs and the humans. So, what are the next steps? We plan to educate the communities by conducting, you know, educating local representatives and also looking at the ethnic differences so that we can determine if we need to carry out more education efforts in other communities compared to others. And also we plan to estimate the burden of rabies by conducting intensive bite care management. And all these steps will be working towards improving the one health aspects of this vaccination campaign, as I can quote Henry Forda, if everyone else is moving forward together then success takes care of itself. I finally, I'd like to acknowledge all the study participants, Andrew Le Surmatt, who was my field assistant and my university's provisers, and also all the other organizations that made this work possible in one way or the other. Thank you. Yeah, thank you very much, Dr. Harry, for keeping it short and brief and to the point. There are several questions that are coming through which you might need to look at the chat and discuss or respond to. But the interesting ones, which I think I'd like to throw out there, is a question by AU, I don't know whether that's African Union, but they call themselves AU, is elimination of rabies achievable? I think something that we need to be thinking through. One from a good friend of mine says, dealing with stray dogs, do we need a dog protection policy? Well, and then maybe for Dr. Christian, did you use any, was there the use of local language? That's one. And then which other species, Dr. Agakuea of KWS is asking, which other species or animals were affected or did you look at? Maybe you can answer those two then we can proceed to the next one. So first I'll ask, I'll answer the question. The first one was about, do you want to deal with elimination of rabies achievable? I can say elimination of human rabies is achievable. Then the second one. And that is based on the current trajectory. But then also for the other cycles, it's also achievable if we can do a good vaccination coverage. So it's about policy and implementing it because the strategy is in place is just ensuring the right actors are put in place and drives that process for us. Yes. Okay. Then the last two, which are critical and important is in your discussion, one of the things you said is use of local representatives. Somebody asked whether the engagement was in local language or it was in English or the international, the other languages. And then Agakuea wants to know whether there were any other species of animals affected by the rabies other than dogs? Yes. So first of all, about the language, we had a field assistant who is a local and he assisted in translating the questionnaires and also formulating the questionnaires we did it together. And then about other species, I can say we have, I mean, what we've seen from literature is that rabies has been incriminated in almost wiping out the entire African wild dog population in certain settings. Okay. Yes. All right. Thank you, Dr. I think you can engage the rest on the chat box. I want to, and my good friend Baraza will be picking up whether we need to have a dog protection policy or whether it's something that we can look at at another level. I want to move us on to the next presenter, which will be done by pre-recorded video by Dr. Valentina Ndolo. The topic is spatial predictive model of antarax across Kenya using a Bayesian approach. So over to the team for the video. Hello, everyone. My name is Valentina Ndolo. I'm a PhD student from the University of Cambridge studying at the Department of Veterinary Medicine. And today I'm going to present to you a spatial predictive model of antarax disease across Kenya using a Bayesian approach implemented by R. Inla. So to begin with, antarax is a zoonotic disease caused by bacillus and thrases. And prior to infection, the bacteria exists in the form of dominant spores in the soil that are resistant to extreme environmental pressure, often surviving for decades and contributing to the persistence of antarax outbreaks. Now, animals can get antarax when they graze on contaminated soils. And upon ingestion of the spores, they change into the vegetative form, multiply within the host and cause disease or sometimes death, insusceptible animals. Humans can get antarax from direct contact with infected animals. They exhibit four forms of the disease. Cutaneous form, gastrointestinal form and the inhalational form. A fourth and rare form of human disease injection antarax was recently added to account for the infections observed among heroin drug users. Now, antarax causes environmental contamination, massive economic losses in the agricultural sector, and it's also a public health burden in several countries and threatens biodiversity. Although antarax cases have been documented globally, Africa has been reported to have the highest prevalence of antarax disease in livestock. Now, antarax remains a huge burden in Kenya with a sharp increase in cases reported from the year 2005. And this could most likely be due to improved surveillance following the inception of frameworks such as the Zoonotic Diseases Unit in Kenya. Now, some of the ecological drivers of antarax are well known and include precipitation, temperature, soil amongst others. And although these drivers have been used to model the geographic extent of antarax risk, recent studies have applied classical algorithms that cannot capture the underlying spatial dependencies observed in the antarax surveillance data. Here, we apply a Bayesian approach to analyze a long-term spatial data set spanning 30 years of livestock antarax case data to investigate the drivers of the geographical distribution of antarax risk across Kenya. We recorded 582 cases of livestock antarax from 1991 to 2020, and we obtained this data from the Kenya Directorate of Veterinary Services in Nairobi, and five regional veterinary investigation laboratories in Karatina, Nakuru, Eldoret, Kerrich and Maria Kani. We also recorded 20 wildlife outbreaks from the Kenya Wildlife Service, and these cases were confirmed through clinical and laboratory diagnosis. Statistical analysis was done using RINLA package, which stands for Integrated Nested Laplace Approximation. The map on the extreme left shows the livestock cases in red and the wildlife cases in yellow, and what we did was for the livestock cases, we designed a 10 kilometer by 10 kilometer grid cell structure as shown in the middle, and calculated the number of antarax cases within each grid cell. So in the end, we had a total of 184 grid cells measuring 10 kilometer by 10 kilometer with at least one case of antarax within each cell after grouping all the 582 case locations. So the image on the right is showing an example of this where you have several cases, group them into grid cells, and then you obtain the centroid coordinate of each grid cell, which now represents the number of case counts per location. So these were our new presence locations. We used a zero truncated Poisson likelihood to model the counts of antarax outbreaks per location, because we only had presence data without zeros. The equation for the model is as shown above, where CI represents the antarax case counts per location. So these are the 184 grid cells, which had at least one antarax case. The ECI represents the posterior mean of the expected values. Alpha here is the intercept, Alpha here is the intercept, X is a matrix of the covariates, Betas here represents the linear coefficients, while the Delta K represents the non-linear effects, and the U represents the spatial random effects. And the spatial random effects were obtained using a mesh, as shown on the right, and this mesh was used to calculate the spatial random field, and the effects were then added to the model. The covariates used were Bio2, mean-denote temperature range, Bio18, precipitation of the warmest quarter, elevation, distance to water, soil culture, and soil water. The images above are showing the results of the model. The gray graphs on the right are showing the non-linear effects of four covariates, Bio18 and Bio2 on top, and soil calcium and soil water below. These are obtained using cubic regression splines with five knots. The red aerobats on the right are showing the intercept on top, the fixed effect for elevation in the middle, and the fixed effect for distance to water in the bottom. The results of the Bayesian model showed that distance to water bodies was significantly associated with the reduced incidence of anthrax outbreaks. Past studies have demonstrated a significant negative link between distance to water bodies and the suitability of an area for the occurrence of anthrax. This is most likely linked to the fact that most animals use communal watering points, thus there's an increased likelihood of observing anthrax outbreaks close to water bodies than farther away. Elevation had a positive effect on the incidence of anthrax outbreaks. The remaining four variables had non-linear effects. Possibly better explained by looking at the effect on the fitted values. The graph on the right shows the covariate values against the fitted values. The table on the left shows the DIC values of the full model and the various versions of the model where a single covariate was removed each time. We also calculated the difference in DIC between the full model and the models missing various covariates. The mean general temperature range Bio 2 had the strongest effect on the model and removing it increased the DIC by a magnitude of 83. Bio 18, precipitation of the warmest quarter also had a strong effect and the incidence of anthrax cases increased with increasing precipitation up to about 400 mils then reduced. Soil calcium also had a positive effect on anthrax incidents initially but this effect wore off as the values increased beyond 10 and soil water had mostly a negative effect on the incidence of anthrax. These are the results of the spatial random field showing the spatially correlated random effects and these were added to the final model to calculate the fitted values. The maps above show the mean predicted anthrax risk in the middle and the lower credible interval on the left and the upper credible interval on the right. Blue areas are those with lower risk while the warmer colors moving towards red are those with increasing risk. The model predictions showed that most parts of central western and coastal Kenya were at risk of anthrax. However the small pockets of anthrax risk areas in the northern parts of the country specifically in Turkana county were alarming. Now Turkana is classified as an arid and semi arid land with mostly pastoralist communities who rely on mobility to get access to water and grazing resources. These pastoralists are often economically and politically marginalized lacking access to both veterinary and public health services usually available to the rest of the population. As such there are greater risk of zoonotic diseases like anthrax and the capacity of recorded outbreaks in this region could reflect the limited surveillance practices and not necessarily the absence of livestock cases. Thus more effort could be put in place to improve anthrax surveillance across this region. By accounting for spatial dynamics we demonstrate an approach that is easy to interpret and replicate for other diseases and this approach is particularly useful for studies that have patchy surveillance data and underlying structural dependencies. This risk model can support the planning of surveillance and prevention campaigns particularly in marginalized pastoralist communities which are disproportionately affected. With that I would like to acknowledge the following my supervisors the Gates Cambridge Trust, the Royal Geographical Society and the Kenya One Health online conference for organizing this amazing event. Thank you. Thank you very much we can give her a clap and I'm not sure whether we can take questions but I can see there was a question asking where there are no cases of anthrax in northern Kenya but as you want to say something those I saw you trying to answer. She did make a reference to precipitation as a factor and northern Kenya being usually very dry most of the time that can be an explanation. Okay thank you. Thank you. I think without much ado I'd like to welcome the next presenter which will be Dr. Augusta Kivunzia. We'll be talking about national strategy for prevention and control of anthrax in humans and animals in Kenya and I think it then links to the next session which is about policy and so maybe an opportunity to highlight what we're trying to do in terms of strategy and policy. Thank you. Good afternoon. My name is Augusta Kivunzia. I work for the county government of Kittwee and today I'm presenting national strategy for prevention and control of anthrax in humans and animals in Kenya 2021 to 2036 and bring this on behalf of zoonotic disease unit. Anthrax is a zoonotic disease caused by bacillus anthracis sub-bacterial disease and in Kenya it is ranked the top most zoonotic disease. This is based on systematic analysis of the burden of the disease, socioeconomic impact, severity of the disease and the potential to cause outbreak. Based on a records review from the veterinary department and public health from the national level it has indicated that more than 10 outbreaks occur every year in Kenya with the spillover to humans and this data is based on passive surveillance. However, it is considered to be under estimating the outbreaks because of this nature of surveillance some of the outbreaks may go unreported or they are detected very late. Lack of one-year strategy for control of anthrax has been noted in a number of reports. The OIE performance veterinary service report 2018 and the WHO joint external evaluation 2017 have noted the lack of one-year strategy in control of anthrax and therefore recommendation we are meant to develop and implement one-year to implement anthrax strategy. The objective of this strategy is to eliminate human anthrax and reduce the incidence of anthrax in animals to less than 1% of the baseline of 2021 by the year 2036. This strategy was developed through a consultative meeting drawing stakeholders from the academia, from the relevant ministries and from non-governmental organization. A series of meetings were held, drafts were developed, were reviewed and validated through workshops. The strategy is based on guided principles that anthrax prevention and control requires a multilateral and multidisciplinary collaborative approach and effectively it effectively reduces the negative impact on public health and national economy and it involves breaking the cycle of infection and that community is key in prevention and control of anthrax. Committee, national committees will be developed at the national level, at the sub-count level and the county levels and these committees will involve various stakeholders from the government ministries, from the county government, the national government, also involve professional bodies such as KVA and KMA, farmers and community-based organization. Other stakeholders will involve to be the regional and international stakeholders and all these will work to guided by certain thematic areas as we discussed to go on. The anthrax and prevention control strategy will have seven pillars on which its implementation will be based. One, coordination, collaboration and partnership and the objective of this is to enhance collaboration between ministries and other partners and NGOs to ensure that anthrax is well-prevented and controlled. Two is surveillance reporting, systems and outbreak response. During implementation of this strategy, this existing surveillance system will be announced is to ensure that we receive timely reporting of outbreaks and also response to an outbreak before it spills to the humans. That will be prevention and control anthrax is both in animals, wildlife and in human. The objective will be to ensure that vaccines are available, quality vaccines that are available and affordable to the communities and also that guidelines on ensuring that any cases confirmed of anthrax are well handled to prevent contamination of the environment and also infection of humans. Resource mobilization, this will be done through advocacy, holding meetings, seeking to get funds which will be very key in implementation and control of this strategy. Recommunication will be key and the main objective is to increase awareness across the communities which will be very important while controlling anthrax. Sex will be conduct, promote operational and applied research. These studies will be very important as they will help us to get data and inform on the progress on the implementation of this strategy. Then the seventh one will be anthrax diagnostics, laboratory capacity. The objective of this pillar is to ensure that the capacity of the laboratories, both regional and national, they were announced such that they can confirm in anthrax cases as well as promote networking of labs both in the human and the public such that they can share information on anthrax. The implementation of anthrax elimination strategy will follow four phases. These phases will systematically eliminate or reduce the cases in animals aiming at elimination of the disease in humans and in each phase will have a set of activities which will be synchronized to ensure synergy and leverage. In stage one which will run from 2021 to 2023 to involve the preparation and option phase which will be phase one and in this phase it is assumed that anthrax is present but the socio-economic impact is not known. The burden of the disease is not known. Then stage two it will involve the implementation of the strategy in the iris zones which will run from 2024 to 2027. In this phase the situation is that we know the disease impact, the burden. We have implementation plan in place and from that implementation plan we'll have identified areas where anthrax is more causing more burden and this will be the iris areas and this where the implementation of the strategy will start to eliminate human anthrax in these areas as we move to stage three where the implementation of the strategy will be done across the country from 2028 to 2032. In this stage we'll sustain the efforts we have done in phase two and apply the lessons we have learned in the iris zones and now control this disease across the whole country. Then phase four this is the stage where anthrax will be eliminated in humans such that we have zero cases of human cases and rare cases in livestock. In phase one this where most of the activities will be done because we do not know exactly the burden of the disease and a number of things have to be put in place to implement to operationalize the strategy and one will start with developing guidelines and standard operating procedures which will enable us to operationalize this strategy. Guidelines such as vaccination guidelines treatment guidelines among others. Then we'll strengthen surveillance to ensure that we receive all the data or the outbreak on timely and also response to an outbreak. We'll also have a resource mapping a resource mobilization where in this we have to develop resource mobilization plans have meetings and anti-focus meetings international account national and the county governments and others decoders to source for funds to implement the strategy. Prevention and control measures in both human animals and wildlife to ensure that there is no spillover of the the disease to humans and also contamination of the environment. We'll also develop communication plans. I identify the audience and also the communication channel will be identified at this stage and also conduct research so that we may identify the high risk and the low risk areas and also know and understand the economic burden of anthrax in the country. It is at this stage that we'll also form the elimination committees. At the national level we'll have the national prevention and control committee which will be a subcommittee of the zoonotic technical working group and zoonotic decision unit will be the secretariat. This committee will coordinate and oversee anthrax prevention control across the country. This committee will also have members from the international regional and other national partners. At the county level a similar committee will be formed which consists of which will be called the county zoonotic committee and the county one earth units will be the secretariat. They will be reporting direct to the national prevention committee which in turn will report to zoonotic technical working group and this group will now report to the ministries of agriculture, livestock and fisheries, the minister of earth. At the sub county level similar committee will be formed which will be direct to the communities where the implementation will be taking place and the information will flow now from the community to the sub county level, to the county level, to the national level. High risk areas will be identified but from the review of records although this anthrax is endemic in the country it has been reported in some counties more often than others. And it's from that review that this map was developed that Narok, Kiambo, Meru, Nyeri had reported more anthrax cases in the past five years than other counties and these were identified as the high risk areas where the pilot of this anthrax strategy will be developed will start being implemented. However in the first phase through the operational research the risk map of anthrax will be developed and now it will be updated in the strategy which will be the real risk map for anthrax and it will be used for implementation of this strategy. Within these areas where anthrax will be occurring there will be odd spots and this will range from one to fifty kilometers based on production systems. Roar risk areas will are those areas where anthrax outbreaks has not occurred in the last five years. However if anthrax outbreaks occurs in these areas it will be now classified as high risk areas and activities taking place of the high risk areas will now be done in that area. Phase two it is assumed that all infrastructures will be put in place and now we are ready to start implementation of the strategy and this implementation will start in the high risk zones where advocacy communication social mobilization will be done vaccines will be procured distributed anthrax cases will be collected data on outbreaks will be collected and fed to national anthrax database assessment of economic cost analysis intervention will be done outbreak investigation and response will be done as well as communication across the counties that cross the border and impact of the vaccination will also be assessed as well as vaccination survey and also training of the human and the veterinary personnel to ensure that they understand the control of anthrax. To move from this phase to the next phase we'll ensure that some indicators will be used to show that we need to move to the next step and this will include vaccination of 80 percent of the livestock in the high risk areas and three rounds of vaccination will be key during that period that any outbreaks which will be reported in that phase at least 80 percent of these outbreaks are laboratory confirmed and reduce the incidence of anthrax in both human and livestock by 50 percent of the baseline also reduce the anthrax case of human livestock wildlife interface by 50 percent of the baseline. At phase three it will aim to sustain the achievement of stage two and this where will be implemented the anthrax prevention control strategy across the country and here we'll apply the lessons which have been learned in the high risk areas and the activities will include advocacy communication and social mobilization, item surveillance to make sure we get information on time of end outbreaks, vaccination figures, sustained livestock vaccination. We'll review and update the national anthrax risk map and evaluate the effectiveness of programs or the intervention which will be applied as well as communication across the counties. To move from this phase to the last phase the incidence of anthrax is in animals and livestock will have reduced by 80 percent of the baseline as well as reduction of human livestock wildlife interface by 80 percent and the country will have at least vaccinated left 80 percent of the susceptible animals against anthrax. Elimination of anthrax in humans will be the last phase and this will be defined by having no human anthrax in a certain region and in this region there will be surveillance going on to make sure that there is no human case which is missed. At the same time there will be sustained elimination activities in areas where the anthrax cases will be reported. These areas which have not reported anthrax cases at least for two consecutive years will be declared as anthrax free. This implementation will monitor and evaluated both internally and externally and for the internal rotary it will be led by a zoonotic disease unit whereby they have developed very viable indicators. They will measure the progress and assess the achievement of the program in line with the strategy while external evaluation will be independent to assess the program and identify any modifications. We want to acknowledge this organization for financial support while developing this strategy. Thank you and this is the strategy. Thank you very much Dr. I am sure that my good friend Dr. Nanyingi was happy to see the strategy. All right now just a few questions for you. I think which might be critical for you to address before we move on to the next session. One, a former DVS Dr. Kisan Gewa is asking the strategy has moved to 2021 to 2036. What has shifted? Maybe you might not be the competent authority to answer but there's a DVS representative who might help you. The second bit of it is we are in the preparatory adoption phase which should run from 2021 to 2023. 2021 is over, 2022 might be lost due to elections. How far have you done the preparations? Again you can pick those together and the last bit of it is is there any role for private sector in the strategy and have they been sensitized and engaged because I think a lot of strategies have been developed internally as a government but maybe to drive PPP's private sector that might need to play an important role need to also be engaged and is that part of the process and lastly there was a question by Maureen and Edda the challenges in getting vaccines and essentially the the strategy is hinged on vaccinating a certain number of the population so would you have any comments around the vaccines and vaccination bits of it? I'm sure Dr. Ayas might be able to put in one or two but we'll start with Augusta then Dr. Ayas can put in one or two then we can close the session. Thank you for the questions. We are in phase one and we have undertaken some of the activities we have developed guidelines and we are developing the risk map as well as preparing to undertake other activities in the near future. We have been involved in the private sector during the development of the strategy and is also one of the key stakeholders which will be involved in implementation of this strategy. We aim at vaccinating at least 80 percent of the population and we believe that this will build the ideal and such that this will be 70 to 80 percent vaccination coverage is always said to be effective in control of a disease. Thank you. Can you request Dr. Ayas to chip in? Thank you Dr. Kibunzia for the good presentation on the anthrax strategy. Mine is to react to the comments that have come in. One was the question of when will it start. I would say it has already started in the sense that for us to come up with a strategy there's a lot of epidemiological work that had already been undertaken. So the first phase of knowing the extent of the threat of anthrax in the country, the risk factors and all that has been undertaken and from there is when we now moved to developing the strategy itself. So it's evidence-based. The various tillers that have come up are based on evidence that has been collected over a long time. The strategy itself has not been officially launched but we are planning to have it done within the next coming one month. With the launch of the document we'll now go full steam ahead to do the rollout with our country. The challenge is that we have 47 governments. This control is devolved. The money to do the control is out there in the counties. So we have to convince them that this is a priority and that they need to now work on it as one of the key deliverables in the coming years. The private sector roll again with the launch we expect that we will bring them on board. They will be part of the people who will be invited to the launch, key private sector people so that they can contribute. They can take it home and look for their niche within the programs that are there. I must admit vaccines can be a challenge but we do expect that once the counties take it up and they put it in their CIDP as one of the activities we can then work with them to access the vaccines. The OIE has made a good offer that they can supply vaccines at a very good cost if we go as a country. So we can take the various requirements of the counties and approach the OIE and get the vaccine at a very reasonable cost. Yeah thank you Dr. Sari. I think you can be engaged on the chat for more and I'm sure your office is accessible so those of us who are interested can easily also get to that space. I want to bring this session to a conclusion by thanking you all for actively participating. There's very good discussions going on on chat including the fact that Valentina and Olo who did a special presentation is available and I can see she's responding to questions that are there so please continue the chat and the discussions at that level. I'm sure all these things are available. Liam tells me they will be circulated so any presentation any questions can be picked up following this and with those few remarks I want you to give yourself an applause for being a good participant for this session and then I'll call Nick to come and do the reflective section and reactions to mentee before the tea or coffee break. So Nick over to you. Thank you. All right thank you very much Dr. Victor Yamo for moderating that session. Maybe you can give him another round of applause. So today we've had on the policy we've had a lot of talks. We've had a lot of talks on One Health and we're lucky today to have the our policy makers with us. So on mentee we'd love to hear some of your comments on how we can engage our policy makers to make things better. So the mentee code is 33519760. We'd love to hear what you'd like to say to the policy makers in terms of one health can be implemented in Kenya and even around. Dr. Weyer's earlier had mentioned that we do have 47 counties so do people want a unified or they don't want funding most of the funding for these activities. Here people are asking for maybe more policy makers engagement with the donors, more policies to be created that will involve multidisciplinary teams, more evidence based from the policy makers or from the practitioners. Yeah we need to they're asking to break silos especially by the government sectors. I think they're proposing to have more One Health fora, more involvement of private sectors. Yeah more dissemination of this I think they're asking for more conferences by government, organized by government and non-governmental organization. Yeah institutionalization of One Health. So I think this swings back to you as the policy makers on how we can incorporate One Health more and more. So keep your comments coming with this will be captured as we move along. Right now we're going to break for coffee then we resume at 3.40 pm where we look at some of the books that Ilria have created then we'll move to our keynote speakers. Thank you everyone and let's keep giving in our comments center. All right I think we can go on to the next session. Coffee is still there you can pick it up when you need and for our online participants I hope you've gotten a cup of tea or something and we'll start the next session by inviting my namesake Michael Victor to make a presentation on highlights of Ilria's impact book. Good afternoon everybody my name is Michael Victor Head of Communications and Knowledge Management at Ilri. I'm unfortunately a poor substitute for the person who is supposed to speak for this Delia Grace who is really one of the the leading figures as you guys know in zoonotic disease and in food safety and we just wanted to quickly kind of talk about a new book that came out early this year on the impacts of you know Ilria's and partner's research on kind of livestock and zoonotic disease and whatnot. So the impact of International Livestock Research Institute is a book that spans about 40 years of research at Ilria. You know Ilri was comprised of the ILRAD and ILCA the two institutions one based in Ethiopia and one based in Nairobi which combined and I think it was about 1992 so it's it's both those research how they combined in about 1990 and moved on and this is really the the first evidence-based global estimate of many of the the work that had been done by Ilri and its partners and it really kind of documents and not just an institutional history so it just doesn't tell the story of Ilri and how it evolved but really tells you know gives the first evidence base for some of the major developments that happened within Ilri and the impacts of its research and here's the book it's really good for doing curls if you need to do because it's very heavy and I you know I've read it you know it doesn't put me to sleep too much I had to read it and I've had to use it for certain things and if you are a researcher in livestock and you know that spans all these four areas you know animal genetics production and human health primary production tropical livestock systems and policies in the future of livestock research but it spans a whole range of disciplines around livestock production from the animal and human health side all the way to the genetic side and yeah if you're interested in this it's really a good read in terms of how a lot of the the issues have evolved over the years and we'll take you through some of those but there's a lot of related to one health there's a lot of chapters and uh there's something on the control of pasture pathogens and particularly in uh trepanomyces did I say that right trepano yeah okay that it's kind of sound like Trump or something you know what's trying to pronounce that one uh yeah uh but you know there's there's that on the ctc on the impact assessment of immunology and immunoparasitology transboundary animal disease zoonosis and food safety and I think this really shows the antecedents of one health and how kind of one health has emerged and you know that was the story that I read when we started talking particularly about zoonosis and food safety and nutrition you really see how we move from a more of a kind of a sectoral approach to a one health approach so that was quite interesting so you know the chapter on zoonosis really kind of provides the you know you know kind of the antecedents where we did the first kind of global synthesis on the impacts of zoonotic disease uh we look at the global burden of animal disease uh and really outlines kind of the issues of how you know moving from zoonotic disease towards zoonotic research and then into veterinary and one health approaches so again it really that that section is quite interesting and uh and it's something that you could really see the kind of trajectory evolution of zoonotic disease research and how that has moved into one health approaches next slide and again the other one that you know is really interesting is food safety and nutrition and where we've had a lot of impacts you know and you know a lot of stuff there as well looking at foodborne disease and the global burden of animal disease as well so I'm not going to go into this too much because I'm not a specialist in this next slide so if you want to find it it's you know we have selected number of copies of this and you could find it online as well so you just go to the go to illry.org and illry research impact and we can put that into the chat I think Christina has and you can download the book for free the whole book or different chapters you can find it on twitter if you follow illry or 45 years of impact and again if you want to get further information on different chapters you can contact the people on this list so that's it thank you very much yeah thank you very much I think now we can move on to the next session and to begin us in the next session I would like to invite a good friend of mine we use the same route when we are going to the village to make a presentation on experiences and lessons from development and implementation of one health policies in Africa this is our keynote that will be made by Dr. Mark Naningi from Faw and University of Liverpool Dr. Mark Naningi is an infectious disease epidemiologist and a one health expert with a broader interest in zoonotic viral hemorrhagic fevers he holds a phd in epidemiology and a master's in pharmacology and toxicology he trained as a vet surgeon and progressively trained in spatial epidemiology of emerging infectious diseases at john hopkins and Yale and in 2007 he established the spatial data infrastructure for health research at kemry welcome trust kilifi he has extensive training in one health biosecurity biosafety and pandemic preparedness he has previously consulted for world bank in development of guidelines for public health preparedness on climate sensitive infectious diseases and european union directorate of health in public health responses to foodborne infections in the last decade he has been involved in collaborative research with kemry cdc isipe and usamra water read in in coordination of national above virus vector surveillance and risk mapping in kenya he has been the lead epidemiologist for world health organization t rd project on climate change and early warning systems for vector bone diseases in kenya and his his experience in government public administration one health policy advocacy and communication where he collaborates with zoonotic disease unit by provision of scientific and technical guidance of the kenyan government on one health and zoonotic diseases we that that introduction i am sure you are ready and waiting to hear from these experts so caribou dr nanying the floor is yours for the next 15 or so minutes my name is mark as as vixas introduced me and what i'm going to talk about is is just a sort of analysis of what we've been trying to do collaboratively locally and in the region and what one health one health efforts that have been building momentum for the last decade i am a visiting scientist here at hillary and i work with eric farm under the horn project the horn project in the middle and we have been working with many other organizations so currently we are visiting the government of kenya through the zoonotic disease unit as the effort at program to develop policies and guidelines for example what i guess i has just talked about this one of our outputs that we are we're going to we know the momentum to go that so the outline of my presentation is that i i just want to give a snapshot of the global regional and the local efforts of what has been happening and and to show the interconnectedness of how this is an additive way of having a common achievement when you work together is one health you bring together very many these displays 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 diseases 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 plants 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 it will help us actually just to have a common way of working from the the various sectors that are involved in this but it's a long process and this is not a template for 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 buy 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 but 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 one 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 ecosystem's 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 forward 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 OINWHO 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 or way of actually implementing this and that's why it's very important actually to see what the trapezoid been doing over the year so that is a G 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 the MCM what you call the multi-central 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 are 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 ready say you'll see actually what they do and this is like a blueprint which actually they used to to take stock and maybe prioritize areas that are going to fund and AMR actually is emerging 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 of the African Union based in Addis Hababa has over the years actually championed now by endorsing our One Health approach by creating these frameworks that are actually going to be best practices in tackling what we 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 every 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 look at COVID-19 of which this report focuses on for the first time the United Nations environmental program now becomes the fourth arm of the trapezoid so we had FAO or UNWHO and now UNEP comes in actually to really bring in 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 we call M&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 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't just come out nowhere probably with a big money bug and then drop it somewhere else so these there are very many core 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 was 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 whereby 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 parts 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 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 Decision Unit was established the Kenyan the ZDU is the national one health 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 Rift fallacy 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 the East 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 fast strategic plan that actually brought the establishment of the Zoonotic Decision 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's so after we look at how the ZDU is structured and I think she had mentioned this I already really want to be labelled on 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 epidemiologists 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 to the sub county level but the most significant thing is to bring together all these sectors as per defined by the reason 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 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 here 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 academia 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 decision as 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 Ministry of Health and this probably was a milestone at that time but they have come along a long way tackling African trepanosal biases and I think in 2017 from this publication by this team they had their national one health platform but there's some uniqueness about their national one health platform that is not in our Kenyan 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 EHR by the WHO you have the terrestrial guide by OIE and then you have the CODIS 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 Illry, Camry and other organizations actually 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 replicated in any other country because you this is what probably when you were developing the strategies for Wanda 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 JEE in 2017 and what we saw after having this and the ZDU took lead 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 AMR package and 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 if we have a score of about four then we are doing very well and in Kenya you can see for example AMR and maybe I'll focus on zoonotic diseases here you find that surveillance systems for the zoonotic 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 JEE 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 we brought together experts from the WHO led by the WHO regional office the ZDU 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 would 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 ZDU 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 the 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 some Mali 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're bringing together you find that as we want to prioritize these diseases Rebis takes a huge share probably on the human aspects 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 are doing seropidimelogy 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 over the years 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 is a is a semi quantitative tool whereby you want to understand what happens in a country of what this is so in 2015 in Kenya on the last map we actually prioritized those diseases we started with anthrax triprosomiasis rebis 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 socioeconomic impact does this disease actually really cause loss why do you want actually to tackle this disease does this disease actually cause VLness 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 has 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 Kenyan authors Matthew Muturi and others helped actually to do this process I mean you can see rebis 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 coming 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 had 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 PVS which you are now familiar with trying to find those you know areas of convergence weaknesses both in the human health and animal health Kenya developed a national action plan for health security um in 2017 and this when you look at this uh national action 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 PVS 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 uh being a Kenyan I'll be very very systematic so we have the the avian influenza contingent's plan and we are recently about to to revise the rift valley fever contingent's plan which has been worked on for many many years actually by leading researchers in 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 uh these uh brucellosis and the one health strategy that we have 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 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 marsabit and probably now we are starting to see a shift 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 to some of these diseases we provide this as a template and in terms to operationalize some of these things that this can be emitted 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 and legislative 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 have to be given priority in terms of interventions these were areas in creating conducive legislative frameworks and 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 Harry 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 the there's not disease unit so and in not really becoming biased this is a donor driven agenda that is actually you know supporting most of these activities where you see the CDC the USAID most of the activities what we do a hundred percent 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 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 as 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 we supported Cameroon actually to do this work 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 this office as elevated to much higher levels in government and this is the story of Kenya so when we are looking at where the zoonotic disease unit is it looks like it's somewhere down there it's very functional but then our dream actually means to see the zoonotic disease 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 WN 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 and in 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 policymakers to make decisions on what to prioritize and what to find as a country so we collaborate in a lot of work and as I said principally HON is what I've been working with the project for HON for a very long time now we're coming almost to the fusion at the end and I'm 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 it's not really an old organization but it has been able to pull up 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 the opportunity to speak to you about this thank you very much Dr Nyingi 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 lights a spotlight in the tunnel I'm not sure which tunnel is talking about but maybe yeah you you can get it that 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 and so without much I do I'd like to welcome Lian to then make the next recap thank you thank you so much Victor and thank you Mark it's a difficult act to follow there but I'd really like to firstly thank everyone who's remained online we've still got some exciting an exciting session to close and I'd just like to spend a few minutes recapping over the last few days so we've spent the best part of three days on a journey through the One Health landscape in Kenya and during that time we've so far welcomed over 1300 unique online participants into our event which is really exciting and we hope that this that everyone's found this a great opportunity to get to know more about One Health in general and within the Kenyan context specifically so we embarked upon this journey to both showcase what was going on in the country and also to understand how we could improve our practice and I think we can be quite confident that we have succeeded on those on those two objectives we really are a bit more clear not that the journey has ended but we're more clear on our destination and what are the next milestones that we have to have to hit so in day one we got a flavor of the many and varied One Health activities going on specifically in research and we were able to identify through those some best practice this was really strongly drawn out as the ability to work in multi-disciplinary teams to draw in new disciplines who have previously been maybe underrepresented in the One Health space and ensuring community engagement throughout the research process we were reminded of the importance of undertaking world-leading cutting-edge research and this you know I think it was it's good to reflect we were very privileged to be joined for a keynote by the Royal Society Africa Prize winner Professor George Waringway he has built on his veterinary background in the field of vaccinology and uses the One Health One Medicine approach to work on multi-species vaccines for RVF the high degree of scientific rigor and endeavor that he brings to this is a really clear indication of the need for us to maintain our disciplinary depth we're not talking about producing One Health generalists here we're talking about producing specialists who are able to reach out and cross boundaries and talk to each other this came that was uh uh uh sorry that was a theme that was echoed again and again and so we saw from our audience participation on mentee people see the defining feature of One Health as being collaborative being transdisciplinary multidisciplinary integrative this came up in our speakers from our audience and was reflected in many sessions so our panel yesterday on education really sort of spoke to this clearly so they gave some examples of different programs which are teaching people to be able to work in this multidisciplinary way our colleague Margaret Karembu from ISA talked about the need for us to learn each other's language to have a One Health glossary to allow us to collaborate better and it came up very clearly that the soft so-called soft skills of communication are actually a One Health core competency so talking of core competencies it was really fabulous to hear from our gender specialists yesterday and I think everyone will agree that Professor Helen Amaguni was really inspirational in the way she talked us through the need to acknowledge, address and transform the inequities we see around us and her keynote was followed up by two really clear examples of how gender was brought practically into One Health research using a food safety and an RVF example so I think we can take from this some really great ideas about how we incorporate that going forward so from the opening remarks of Illry DG Director General Jimmy Smith onwards another reoccurring thing was the lack of appropriate resource to One Health this is a real a very real challenge and Mark Nunyungi has just alluded to it as well and we hope that we'll come back to that in our policy session later this afternoon but it speaks also to the comment that was made by Professor Dele yesterday he remarked that we need to find new ways of rewarding collaborative work so we understand how to reward sort of maybe the faster pace of work that happens when you're working in one discipline but acknowledging that building collaborations building networks of trusting individuals takes longer we need our funding cycle to acknowledge that length of process and it was nice to see yesterday again the the african proverb go first go alone if you want to go far go together and that's a guiding principle and we need to make sure that our funders acknowledge that the importance of this communication and collaboration was reflected again today in our presentations so we had presentations that talk to the need to communicate with communities so that was brought up in the control of brucellosis and rabies and we've also seen today a great example of one health in practice at the county level with our veterinary and our public health colleagues working together on a foodborne disease outbreak we're really happy again I'm going to allude to Mark Neningi to have him here today to give us that overview of the of the policy landscape here and he also brought in some really exciting messages about bringing in new disciplines into the zoonotic disease unit and the county one health units in Kenya and it was great to look at the Ugandan example about how many disciplines have really been brought in there for the one health platform we also I also noted Mark that you spoke to the importance of needing those subject matter experts to be guiding again reflecting that need for us to retain the depth in what we do whilst we build our bridges and our audience have told us consistently that they are on a one health journey with us and they want to become what better one health practitioners I think we've seen consistently through the comments the conversations in the chat a lot of passion a lot of persistence and a desire to do to better so I really hope that the last few days have given everybody the energy and the inspiration to take these messages forward into their work and I certainly will be hoping to do better in in one health from now on so I think for for at that point it's now for me to pass to our director general of Illry Dr Jimmy Smith for some remarks and reflections on the conference thank you so much thank you Leanne colleagues here and online it sounds like the job is done and the light in the tunnel is not a train but really enlightenment from Leanne's summer I'm unfortunately couldn't be here the whole time or most of the time I wasn't but from Leanne's summary it seems like participation was good the learning was extensive the diagnosis was sound and the understanding of what we need to do going forward is very clear from the CG standpoint of course Erika would continue to be an important part of how we take this forward but Erika is not a government it's a facilitator it's a supporter the real action is how do we as CG support governments to do all the things that our colleague from FAO just spoke about and in Leanne's notes I was very pleased to see that you said that the focus on one health must be on proactive prevention and preparedness plans developed and tested I think this is the holy grail proactive prevention and preparedness song simple but this is really loaded prevention would mean early detection for example or even finding things before they come to light now most of us know how to investigate looking for things that we know exist but many of the emerging diseases we have not seen before so how are we going to be able using our great scientific expertise from the world over to be able to detect things before they actually become a problem that's part of the prevention prevention also means widespread surveillance that you can detect things early as I discussed on the first day the cost of control is strongly correlated with time the more time the higher the cost to control so early prevention is of course important and of course this big challenge here of preparedness preparedness this for HPA I each country had to prepare a preparedness plan and so we need this sort of thing at all levels but note that from our colleague at FAO who just presented a notice called to elevate where one health sits in the government's architecture to put as high as in the prime minister president's office well that was almost what had to happen for HPA I preparedness plan because no ministry had the authority to commandeer the others the only place you can commandeer all the ministries is at the super ministry level which is the president's prime minister's office but I don't know if the prime minister president prime minister president has sufficient time to deal with matters like these so we need certainly the authority but somehow we need to also I think develop a an approach to one health which changes the institutional perspective from when there's a problem each ministry says what do you want from me so we contribute in relation to what we think is needed rather than how can I tackle this problem so not just what my ministry do tell me what I'm doing get on with it and get out but what is it needs to be done and I think if we bring that sort of new thinking and combine that with changes in the institutional architecture we go far so I'm here to say that from a CG standpoint this is really urgent and important but the CG is not a government the CG support governments and that's what we aim to do I have spoken almost entirely and a good bit of the discussions I listen to had a slant of from a pandemic standpoint to not a disease with pandemic potential and I can understand why that has been the focus it is strategic of course but we should not forget that we must deal with also the endemic diseases that places a heavy burden on the farmers we're supposed to be supporting and of course consumers as well through food safety and so on but it doesn't sell endemic diseases going to donors asking money for endemic diseases doesn't sell very well what sells is pandemic so our approach needs to be selling pandemic and if you get funding for pandemic diseases you certainly also have funding for endemic diseases so a bit of strategies to how we go about this I want to thank all of you my colleagues at Illry and all our partners who facilitated this and to say that our CGIR we are committed to this we will seek to get support for it we will work with all of you to make this a mainstream effort but we must commit ourselves to what you said already that we must have a focus on proactive prevention and preparedness we must contribute something that is usable that governments can implement just analyzing the problems and talking about the problems doesn't vary help doesn't help governments so let's make sure we do what you said here you do and I take the promise as a serious one that it will not be just us talking to ourselves that you have identified some new skills which need to be brought in public health city planners and others but let's get also the medics in and the environmentalists in and so on so I hope that with this diagnosis and potential treatment that you've offered we have a way forward that we can implement in an actionable way that is of real benefit to the people who can use it so thank you for these contributions it has certainly will set us an ORECA and the CG on a clearer path and we look forward to continuing to work in this area and to keep this forefront hopefully and I would look to our colleagues here to ensure that this is not a conference and then we write the proceedings and we put them away this is a conference which will help us to be more forceful to mainstream one health in in not only the CG but in the countries in which we work so thank you very much I look forward to learning from Bernard and Lien and the rest of the team here about what concrete we must do we can do to take this forward thank you everybody thanks a lot Jimmy thanks a lot Lien I think we are coming close to the end of our conference but we still have an important session which Martin will lead so I would like to welcome you Martin to come and of course introduce yourself but also introduce the panel so that we can start that session so over to you Martin okay thank you very much Bernard I hope that cutting razor by the center director did not signify that we are winding up it was just a cutting razor for the closing ceremony which is coming up shortly but we also do acknowledge that being the last session for the last day of the conference the energy could be low but we still have in store for you a very exciting panel discussion to do here you will recall that in the last three days we have consumed a lot of material relating to scientific outputs from a number of experts researchers and one health practitioners and I think that we have lost account on the number of times that the word policy was actually mentioned in the as many presentations that we had and to wrap up this I would like to now transition you to this last session that now focuses on the topic of how one health research can be translated into policy and practice in Kenya but of course not only in Kenya because from the presentations that you have heard on the floor there is a lot of lessons and examples that have been drawn from a number of countries in the region now the planning committee while thinking about how best to deal with this session did identify experts and specialists from institutions that we believed are critical in the promotion of the one health agenda in Kenya and in the region and invited the director of veterinary services from Kenya the director general of ministry of health from Kenya the director general of NEMA the national environmental management authority and also a representative from NGO CCM medical collaboration committee of Italy and also a representative from FAO so in a very quick way I would like to introduce the panelists I do recognize we have lost quite some time so I'll be briefed with their introductions but in the panel we shall have Dr. Harris Hoyas Dr. Harris Hoyas today represents the BVS Kenya he's a holder of the bachelor of veterinary medicine from the University of Nairobi a masters of science from the University of London he is currently working at the ministry of agriculture livestock fisheries and cooperatives the director of veterinary services in the capacity of the national veterinary epidemiologist he's a senior deputy director of veterinary services and he heads the disease surveillance vector regulatory and zoonological services division he has over 30 years of experience working in the public sector and as the national epidemiologist he has been ahead of the development and rollout of various disease control strategies including rabies anthrax brucellosis foot and mouth disease ppr he has also been instrumental in the development of contingency plans for it validiva and a highly pathogenic avian influencer he has participated in the development of national one health strategy and has been at the forefront of capacity building of country veterinary services in preparedness and the response to outbreaks of transboundary animal diseases Dr. Yasi has also been instrumental in the development of several cross border memorandum of understanding with the neighboring countries to guide the harmonization of surveillance and control of activities of tards at the border interface with our neighbors he's a member of the east african regional epidemiology network and the national focal point for ppr disease eradication process in kenya welcome to the panel dr. yasi uh next uh we have dr. yon mumo dr. yon mumo uh is here today to represent the director general of nema uh kenya he's an environmental committee working for the national environment management authority nema in kenya as a principal compliance and enforcement officer in this capacity is the head of the environment laboratory in in environmental management and research compliance inspections enforcement environmental monitoring and police information and development of environmental regulations uh next we have a dr. philip engere dr. engere today presents the director general in the ministry of health uh kenya is a public health practitioner with interest in epidemiology currently is the national coordinator events based surveillance and the public health emergency operation center ministry of health uh we have dr. sorry dr. odimbo antony from ccm odimbo antony is a public health and health system management professional with over 12 years of experience in the human health sector in the last four years he has uh worked implementing a one health project uh in a low limited resource context and uh in marsabit uh north whore in kenya and currently he's also leading the implementation of uh the irelia the hill project uh odimbo also has experience in uh formulating one health programs planning implementation and ensuring the alignment with existing strategic plans policies and procedures within the relevant departments lastly but not least we have dr. mark neningi whose introduction will not be labor because he was already introduced and is privileged once again to join the panelists in this uh discussion to the panelists welcome on board and i would like to clarify for you that uh while i do know some of you had presentations already prepared we have tweaked a bit with the format of presentation and what we are going to do is to engage in our panel discussion where we shall be asking to you specific questions separately and individually to discuss as a general overview so if you had any presentations they can only help you for reference to have a quick overview on the points of discussions that we shall rest with the participants are encouraged to engage with you in the chat box dropping in uh questions if they are so with that introduction now uh let me just go now straight to the issue uh and my first question will be directed to dr. oyasi dr. philip ngeri and dr. mumo specifically in your capacities as custodians of policies and the regulatory frameworks in the implementation of one health in your respective dockets in the national government and the question is what do you see as major impediments to the effective implementation of the existing policies we have already heard that as many policies do exist uh so let's start with dr. oyasi and please in your presentation be very focused and spend as much a little time as you can uh so that we can catch up dr. oyasi uh thank you um our facilitator um i'll try to answer the question isn't as short a time as you have uh indicated my from my point of view the major impediments with our current policies has been the ownership and the the fact that a lot of the stakeholders who should be playing a key role in um cutting out these uh policies at all the levels of implementation uh may not be either familiar with the policy or may lack the resources to to conduct these because as we all know policies are just a set of guidelines that uh help us um to move forward and achieve certain objectives that we have spelled out in the end so ownership is very key and this calls for a lot of uh collaboration and uh dealing with the various stakeholders so that they they see at what point does the policy affect them and uh what is their role in carrying it out so we need to start with them while at the development stage while we're developing these policies thank you thank you dr. oyasi we do underline uh uh ownership and uh a lack of dissemination of the existing policies to the main stakeholders as a key impediment from your perspective uh dr. philip engere kindly turn on your video and while doing so could i ask dr. mumo in your perspective what could you suggest are the major impediments to the effective implementation of the existing policies okay good afternoon and uh thank you hope i can be heard well i'll be straight to the point um one is actually we have a actually a poor link between research and policy for example uh you know i've been following these presentations since monday up to today much of it is research research research but you find that there's no working relation between them you know the researchers and the policy makers such that now when we have these recommendations that are coming out of these research outputs you know they look like high-ended subject or scientific material that cannot be you know consumed by policy by by policy makers so these needs to be worked for example they like the strategy which has just been launched here the industry strategy you know there was very little information about um on environment what i could just relate on environment was a only climate and uh you know so that link should actually be enhanced i don't i need to i don't need to overemphasize the issue of the resources as you know harry or yasas mentioned that uh for example in the in the environmental sector looking at even what uh dr. mattingeninge um presented you find that um very little focus has really been put on uh environmental uh you know and uh i think uh this is uh because of maybe you know a poor understanding or maybe there was a when the the conceptual framework when this one else was being crafted it was not actually you know environment was not really understood as to whether it's an institution or whether it's a repository or a sync of these anti you know microbials you know yeah so that has to come out clearly about um and then the aspect of this silo mentality you we have um you know sectors within the one health um you know just working alone and coming up with uh you know findings you know we need to get an integrated approach for example we have the environmental management at the coordination which actually promotes um coordination of these institutions that need to come to work together towards this common end but um you know the challenge comes in it's like uh when uh you know like if i may say following the discussions we've had since money you know much of it has been on veterinary veterinary medicine curative but very little on the preventive so we really need to improve on that uh uh significant at the under lastly but not least um you know the the language and we need to find a way of how to communicate this language when you talk about one health you know sometimes you know uh to a layman you may actually be wondering what are you talking about one health and then when you talk about one length you wonder is it one health and then of course when you start talking about the components within one health animals of course and then you bring the other jag on anti microbial resistance you know we need to find a language that uh you can be able to communicate we need to get communication and information you know especially still can be able to package this information in such a you know language that can be understood by the local person and the uh you know the policy makers but when it comes to crafting regulations guidelines and policies it's actually something that's uh not uh typical for them to work on thank you thank you doctor mumo i think you reflect on very salient points there first of all is about linkages between the researchers and the policy makers i think it's not lost on us on the question of resources resource allocation appropriations and this could be speaking to the observation made by dr nyingi on the placement of the national one health platforms within the relevant line ministries perhaps for better decision making on the resource allocation we take note of the issue of coordination of institutions that are primarily irresponsible to promote or push the one health agenda and you have spoken to the impediment on the issue of communication our topic which was very well covered yesterday in a presentation and communication on one health or science and uh that's quite well noted doctor philip you are turn please thank you thank you uh when a moderator uh good afternoon fellow panelists present and the presenters and participants both physically present and online like me um at my personal level uh i think i've learned a lot the few moments i've been able to join the conference as we strive to build a case for a more proactive deliberate and structured way of undertaking one health activities uh back to the question i think uh quite a number of impediments exist in as far as you know utilization of these policies that we talk about is concerned one of them i think we normally have inadequate involvement of you know the policy level actors in terms of not just endorsement and development of these policies but in terms of the real meaning and understanding of these policies that we develop i guess we need to think through how we can undertake you know serious advocacy through probable policy briefs highlighting you know the success stories behind that needs to be driven by these policies uh the other thing that uh comes to mind comes to my mind is uh inadequate you know use of the research information some of these could be contained in this political documents you could be using some of these to actually develop the documents however um as far as dissemination is concerned we need to be more uh need to adopt a more structured way of dissemination of this uh uh the information that used to guide the formulation and contained in these policies by by by targeting various you know groups of people including the communities you know the program level the policy level and the peers like we sit here we could be resonating well with the information that we are sharing here as peers but i'm not too sure if we be able to package this information in a way that the communities are also able to benefit or appreciate the good information that we are sharing together uh as much as a lot has been done in developing development of this one health policy documents i think we are still uh we are still you know held in held back by our various sectoral silos and i think deliberate efforts need to be done so that um as we as we you know adopt these documents we need to reach out we need to reach out to the colleagues the colleagues you are hands on need to reach out to to to to program officers and and to make sure that they are also on the same page as the technical people that are working on these documents um we also need to think through how we can you know in in mainstream one health issues into our routine training programs so that when these policies are developed you know the documents we are able to understand these documents and we resonate with them well i want to concur with other panelists that there's still a lot to be done about ownership and support uh much is being done but i think a lot more needs to be done so that these documents that you're talking about are appreciated by all all of us these documents that you're talking about are being support in terms of resources from not just the partners uh and this and collaborate collaborating stakeholders but also the mainstream um uh government agencies and ministries thank you thank you doctor philip nguere i think that the participants do acknowledge that uh there is quite some concurrence on the key impediments there is concurrence on the issue of poor or weak dissemination and ownership but i think you also bring out a very uh significant point on the feedback loop that there is a lot of research generated from research work done at community levels that feed into the policy development processes and which result in policy instruments that are domiciled in your dockets but how this gets then fed back to the communities seems to be the challenge from your perspective and it then remains a question from you as custodians for policies uh how or what mechanisms then can be developed to ensure that a feedback mechanism is well anchored and integrated in the uh one health agenda all right now uh i would like to uh transit to uh ask specifically now to antony before i will come to dr mark nanyingi now uh antony uh from ccm as an NGO implementing one health activities what could you say are the major impediments in the implementation of one health activities uh thank you very much uh first of all i would want to thank the organizers for this forum and also the participant uh i think one of the impediment in terms of policies that are existing uh i would say in my view that we lack a common policy especially that bring especially that supports the integrated services for instance in our implementation process we've been trying to implement uh integrated one health unit or integrated uh one health services and in this kind of one health services we integrate both uh animal and human health services including environmental health services however you find the different departments have different structure for instance veterinary or animal health have different structure public health have different structure and if you bring all these veterinary health services and you bring human or public health services together without any framework that supports them that will spell out how they'll be funded that will spell out who will be exactly involved in this kind of service provision it becomes a bit difficult and as we do it as at the moment we are doing it as a partner to the government but supported by the donor funding but we expect this kind of new model because i would say it is a new model that we have introduced is a new model of service provision that integrate the both human animal and human health services we had piloted it and we have seen it working well and now we are we are going on with it in both isiolo and and and and marsabit county but the question is beyond the project how will the county government continue with this so we see that if there is no strong framework that will support this kind of new model of service provision then we may have a problem the other thing that i may allude to also is a conceptualization of the policies i think or i feel that we really need a policy that can consider or cover the all kenya as you can see through the zdu we've already prioritized different zoonotic diseases and even if you come to the public health and different region you will find that they have different endemic diseases both for animals and human and different region they have different environmental needs and with this if we have a robust kind of policy if we don't have the robust kind of policy that will address every contact every part of kenya with their different needs or different one health need and i think this is one of the things also that somehow impairs the implementation of the current or the existing policy also we have seen for instance from the previous prevention on which we have seen kenya has done a lot in the past decade in developing different strategic plan that addresses different zoonotic diseases and addresses different i mean areas but if we don't have we we are still i feel that we are still lacking a common kind of policies that bring all this together because to me one health entails coordination and having everything implemented as i mean coordinated way but if you don't have a good or a strong policy that support how all this can be packaged together and implemented together then to me that's one thing that also impairs some of the milestone that we are trying to make thank you thank you and to me i think you underscore the issue of the need for a framework that facilitates the multidisciplinary integration or operationalizes the integration of the multiple disciplines in one health implementation i think you also speak to the contextual disparities for example if you are implementing in the drier or can we say assault parts of kenya vis-a-vis other ecological zones if there could be some peculiarities that need a specific policy or regulatory framework specific to those regions thank you very much for those observations i ask participants if you have any observations questions please drop them in the chat box i may have a chance to pick one or two to feed back to the panelists for further discussions now to dr mark nyaningi as a representative of an international organization of course you are affiliated to fao any of them a lot of work also in this area and having been highly involved in the creation of one health policies in the region and given the disparities you alluded to in the regional countries in terms of one health policy efforts what do you see as the main impediments and are these impediments reflected in other countries other than what we speak to in kenya thank you very much martin i think the scenarios are not unique to a specific country our governance and political structures across say the home of africa and to a far extent to the wider sub-saharan africa are similar and the challenges that we encounter probably in ijeria would be almost the same that we will encounter in africa and this has to do with convincing the people who have the money these are the politicians so to summon political goodwill there'll be need actually for extending these collaborative efforts beyond borders if you have a network of one health across the region being brought together by for example the trapeitide and then there'll be lessons learned there'll be best practices for example you can convince your government that this can be done because it has been done in your neighboring country so i think the whole thing is having those policy documents in place that will be able actually to provide evidence for political will and commitment from our respective governments thank you very much okay thank you doctor and yingi there is a question on the chat box do we have a one health regional platform so regional one health platform if you may want to speak to that yes so we have both formal and we have also both i'll not call them formal as such but probably social media kind of interactions now in terms of the east african community based in arusha it has a well-structured kind of platform in pandemic preparedness that coordinates activities across the region for example in the east african region we have common simulation exercises at the trans boundary which are conducted between the business of livestock in kenya and and tazania and ukanda so there's a high likelihood that we just need actually to strengthen these platforms and the trapezoid uh wh o i and now being joined by you uh unip uh it has actually spread this gospel across the region now the informal ones which i was talking about is that we have networks created by individuals or universities for example we have the afro net this is a whatsapp group that probably shares real-time information on what is happening it's led by leading scientists in africa both in the animal and public health industry so there's a need to have local level platforms that can cater for local needs let's say you can have your own county actually having a county you know one health uh a kind of framework and then you can have the national one and this can actually you know snowball into regional efforts and even have probably online you know kind of platform so the way to go forward is just to break those barriers and actually embrace each other across the borders and actually try to preach this gospel of one health more widely thank you okay thank you very much uh for that remark and for the answer on that now um the other reflection i would like the panelists to have uh relates to the policy needs this is not specific to any panelists i would give you the leverage to take on it at a uh on a volume databases are there major policy needs to bridge the gaps in the collaboration and coordination in the implementation of one health agenda in africa you will recall that in as many presentations there are calls for policies policies uh to fill certain gaps to bridge certain gaps also in your presentations from the government perspectives you insist that there are a number of policies that already exist but you also do acknowledge that more can be done what are these major policy needs that we need to bridge the gaps in collaboration and coordination uh in implementation of one health agenda in africa dr yasi if you may just have a sentence or two on this yes um given that the diseases that we are dealing with uh trans boundary nature um and also um mr is a problem that does not respect boundaries it is important that we we have in place policy needs on how the countries within at least the sub-saharan countries which have a lot of commonality in regard to the diseases that they have uh share information we need to have a strong policy on this that we should be able to pass on uh information from one country to another uh quickly uh because this again is part of our early warning system um can we have a common database where we share data on zoonosis across the region uh those are the kind of needs that would enhance collaboration within the countries maybe the trainings uh of our people um the curricula that we we should be having in this region should also be have something in common so that we are we are actually uh coming up with uh personnel who understand the approach towards uh one health the need to share across the the various players in one health and the advantages that we we we as we will be able to get if we have that uh common approach thank you great okay thank you uh dr philip engere from the uh medical perspective what could be your take thank you i think first and foremost this one health implementation of one health you know brings together uh different sectors these different sectors uh are traditional uh you know different backgrounds different culture different ethics and different documents guiding their activities so whenever we are developing any policy it is imperative that we make sure that uh the policies that we develop uh you know communicates or resonates well with whatever other document exists within this uh guides practices within these other sectors within the sectors involved uh otherwise uh if this is not done then i think um uh adopting uh the the policies that we develop for one health might be difficult might be difficult at them the sectoral levels uh like i alluded to in the initial remarks uh uh i concur with the doctor yes that's um we also needed to find a way of um you know revising our traditional curricula curricula so that um uh we incorporate one health issues into this curriculum and we develop policies where uh trainings and activities can be jointly undertaken uh uh at that level bringing together all these sectors because what we've seen is that um at lower levels we might not be advocating for much but when you come at the at the higher level the technical level and um and policy levels then we have a lot of uh activities that we are doing uh to to foster one health initiatives i think this needs to trickle down to to to lower levels as well so that um this becomes part and parcel of the entire chain thank you. Dr. Mumu just to not to leave you behind as a policymaker uh in just a sentence or two uh what could be your take on the policy needs before we transit. From the the bias on environmental issues uh because um you know these actually sectors has actually really suffered um uh significantly even from the presentation that we've had for the last three days i doubt whether there's even one that has even touched on environmental you know but i would want to make it very clear that you know there's quite a lot of interlinkages for example there are quite a number of tools that are used in environmental management for example the environmental impact assessment environmental audit you also have regulations that will you know help in the management of waste uh you know you're looking at issues from uh poetry from animal manure you're looking at large-scale farming you know this kind of waste you know need the need tools for their management and uh when we have pollution for example there was pictures that actually shown that show peaks that were actually swimming in a sewage water now you know we look at aspect of water pollution the also regulations that actually touch on water quality and of course we also look at tools for you know preventing environmental pollution so there's quite a number but there's quite a number of aspect that environmental management can offer because the other aspect always focus on the curative and the and the and the problem aspect but you know when you look at the environmental aspect this actually helps in actually the preventive aspect um you know specifically here we look at you know tools that are going to be used to strengthen the regulatory requirements and capacities for waste management you are looking at water treatment and the water management we need to look for a different way of how to deal with this we need to come up with a effluent standard standard currently our water quality standards are actually focusing on the chemical aspects you look at issues about heavy metals but there's nothing that there's very little about eco-like the biological aspects that actually you know cause you know these zoonotic diseases we also need to look at how we are going to have best available technologies that are going to meet our needs that are also coming and also we need we need to improve also education that actually helps us to understand the aspect of environmental management in the concept of one health so there's education there's policy we need also to review our current regulations so that we are able to incorporate aspects of one health for example you I know most of us have been hearing about a circular economy but in this case we can also have also have one health person integrating environmental management but you know when you're talking about policy this actually has to be done in an integrated manner not only the environmental you know we need to come and sit together in one platform so that um when we are making a policy change here it does not become in our backlog or it does not become an antagonism it does not become an obstacle you know when it comes to the time of implementation so that we have a clash of mandates between these various sectors we need to work on the research you know research and development and also you know we need to improve monitoring and surveillance surveillance surveillance system across you know not only on the animal health side but also we look at you know you know what for example you're talking about covid you know nobody's actually wondering nobody's even talking about what effect our waste feature contaminated by this virus is having on our treatment system on our waste management system you know you're thinking about even the you know the pigs we do farming on our sewage can we be returning this back to our system so in a nutshell we look at policy regulatory education monitoring so I think I'll let me leave it there thank you thank you thank you doctor I think the overviews from the three policy experts does acknowledge that there are policy gaps and that there are need for policy frameworks and regulations to be developed to fill these gaps there is a call for a policy that will facilitate and enable the establishment of common databases that facilitate sharing of information we hear of standardization of training training curriculums and joint training programs we hear of standards in the management of waste and the matters to do with coordination in terms of policy formulation formulation and application to avoid a clash of mandates in terms of enforcement and of course matters of M&E now Dr Nanyingi the three colleagues are custodians of policy within the national government departments do you think they have sufficient data to enable them formulate policies or do you believe there are certain gaps in terms of the data that they need and therefore if there are some gaps what kind of data do they need and how do you think that this data should best be communicated thank you very much Martin I think from my own short experience of interacting with the mainly the DVS and the LMOH that is through the platform of ZDU we have realized that there's tons of data available from the routine work that is being done on surveillance and the evidence of some of these data has come out in terms of very good publications that have come from the support of the DVS and the LMOH key authorship coming from technical experts at the ZDU I think the way to go forward and this has been proposed by very many other research scientists in the country we need to create channels for communication we need to share data more robustly and openly I think the issues of data privacy and utilization has been a very big issue in a way of trying to give an example of having like the DHSI2 which is probably the repository for the health surveillance data we have seen proposals actually was trying to create relational databases that can speak to and communicate with the DHS2 a very good example and probably this will be emphasized by Harry here that we are looking at CARBS for example the Kenya Animal Surveillance Platform that has been created and supported by institutions like WSU and CDC which actually helps to bring out most of the data that is being collected on zoonotic diseases and groups of people who are analyzing this data and coming up with probably policy briefs or probably just evidence best because for you to make a policy you need actually to rely on this evidence that's been generated from research so creating a bridge between the ministries of health, livestock and bringing the environmental aspect as Mooba has said and this will be supported by the subject matter experts probably who will be churning out this kind of data that will actually the data driven system of actually providing evidence for policy making so I think that will be the way to go thank you thank you Dr Nanyangi I think we take note that large amounts of data is actually available the impediment remains the channels of communication and I think a call for open data access protocols repositories where data can be easily accessed of course we do acknowledge that research and policy development is works in progress but we need frameworks that facilitate sharing of information across disciplines to make more data relevant data available to aid policy formulation. Now Anthony as an NGO implementing One Health how do you think research work influence the implementation of One Health activities? Well thank you very much Martin from where I sit I think research influence a lot and what we would expect also from a research team is a robust documentation of one health intervention especially the lessons learned and probably the good practices and this good practices should actually be also based on scientific evidences because you know we are trying most of the time we try new things and as we continue to implement also it is a learning process for us and as I say we are coming up with new models of service provision we still need to learn a lot and from those that we learn we still need to document and support this so basically what I say if we do that probably we'll be able to come up with some models that will be responsive to the needs to the One Health needs of different communities in different areas or in different locations yeah thank you. Thank you very much I think that is a reflection on a robust documentation in scientific palace could be publications that then provides access to information that you could need for a programming efforts which is evidence based thank you. Now let's transition we have just about two more items to wind up this in the last three days we have reflected very strongly on the need for a different disciplines to work together to implement One Health and I'm glad that in the panel here we have representatives from the veterinary medical and environmental fraternities. Now without following any specific order what do you think are the main challenges you have experienced working with the colleagues from different ministries and we would love to hear how you have addressed these challenges. Dr. Yasi let's start from with you. Thank you yes we have had quite a number of instances where we needed to really bring together the One Health approach in addressing challenges that were coming up as Dr. Nyanying had pointed out the 2006 2008 outbreak of Rishi Valle Fiva was quite a challenge and during that period the loss in terms of human life was quite high down the road about 10 years later 2018 we get another outbreak which is incidental more widespread because nearly 60 percent of the country was reporting Rishi Valle Fiva either in animals humans but the toll with regard to human life was much lower and of the two I can say the difference was the way we approached it the first one we seem to be working in silos as has been reflected here within this forum we were not working together and the outbreak spread within the human population much faster but with the 2018 one the early warning system that we had set up under One Health was very good we were able to pick out the outbreak very fast although in this case it was actually in humans but the same person who reported in humans was able to tell us that there's a problem in livestock so that was somebody who was very well informed that you need to look around it's not just what you're seeing the patient you're seeing in front of you but what are the other factors environmental and otherwise that are causing this problem so we were able to mobilize very fast joint teams to carry out surveillance to map out the areas and to conduct the response it was very good the challenges are there obviously we had the advantage that through ZDU we were able to link very fast but this is not always the case either at the national level or at the county level and we need to really come up and here is where I think researchers can assist to come up with the systems that can easily bring us together as players both in all the concern setters and mobilize the various resources in the different ministries or departments so that we work as a in a common we have a common approach whenever when we're doing not only surveillance but also response to the outbreaks so these are the challenges the other one that I'm seeing and has been mentioned is we need within the various ministries or directorates to recognize that one health should be supported just like any other activity within our mandates and this is the creation of dedicated funding to the process the deployment of the right human resources and the equipment that they need so that it sometimes doesn't look like it's just an afterthought and we have to run around to try and raise some of these when we are having a crisis I do see that as we develop the structures more that is not only ZDU right now we are trying to bring in environment very strongly there but at a higher level the national zoonotic technical working group which will have a wider group of membership not only within the government but private sector and NGOs and partners that we should be able to break down those barriers and be able to mobilize the various teams that we have under ZDU that go out whenever we need to address an emergency we have the laboratory team and the other teams all these rely a lot on funding and if we have a common platform where we can pull our resources I think we will be much better thank you thank you Dr. Mumu in just a few sentences I hope to wind up this in the next five minutes but what's your experience yeah I think much of it has been said by Harry but I would want to mention a few one of it is that there's actually I've actually noted that there's actually lack of awareness on the tools that are available in the sector of environmental management that can actually contribute to one health strategies you know like I mentioned earlier earlier EIA we also have developmental audits water quality regulations you know those tools that can support one health approach and also there's also the challenge about you know much of the policy tools and the planning that are developed you know the environment has actually come later has a lot of contribution only on two sectors that is animal and health sector so we find much of these tools the policy that were presented earlier by Dr. Mark Nangingi you know really has very little about environmental management so we are trying to work on a catch-up mechanism the other one is about the issue of you know we the lack of a coordinated approach when it comes to implementing our activities we know you know this ad hoc approach you know we meet once for an event and then after that we go but there's work which is working on like we have a national steering committee on antimicrobial resistance whereby you know you know we also have the Ministry of Health you know under one health approach they're actually reaching out to the environment sector always informing us that you know this is actually what is happening and I'm looking forward maybe to in future this kind of ad hoc participation and working in events we will actually be a thing of the past and also you know also looking at the funding much of the funding has actually been going to the health and the veterinary sector and very little to the environmental management such that when it comes to any activities to to facilitate one health you know we have to rely on what we have so I'll just leave it there but you know it's I don't take the negative picture we are actually working towards working together as you know you know together on this on these aspects thank you. Thank you very much Dr. Mark and Nangingi just in a word or two what do you see in your engagements with these multiple disciplines as the main challenge in terms of how they work together? I think the main challenge is sector specific priorities. Different sectors will prioritize their activities to be implemented based on how impactful this will be for example the Ministry of Health and the Ministry of Livestock they might have their different strategic plans that put into place those issues that they think are the most important in their sector but to heal this will be probably to have like the strategy that we are just about to launch which actually the developmental process involves all these sectors including the environment, social studies, anthropology so that we can actually cure all those gaps that arise due to having this tunnel vision in our specific sectors thank you. I think those have been quite insightful remarks it goes without saying that in the One Health agenda the environmental pillar seems to be the weak link and that goes without saying and would require a more targeted focus to make sure that there is better coordination and that the environmental aspects are very well anchored in any policies for regulatory frameworks regarding One Health implementation plans. I think resource allocation is another contentious issue here that is problematic to the disciplines that some departments or dockets get more attention in terms of resource allocation and then of course the traditional barriers that I think they are working to break so that there is more collaboration. The other one is about the establishment of common systems that can facilitate the different teams from the different disciplines to work together I think there was somebody speaking to join surveillance systems for example the One Health platforms, the national steering committees on specific thematic One Health areas like the antimicrobial resistance would be good solutions to this pressure. Now to bring this to our close now I wanted to ask that you reflect on the engagements we have had with the participants, the audience over the last three days and we thank them for their patience for their resilience and just in a closing remark to ask you what you think this audience should take home with them today after the One Health conference comes to an end. I think that with protocol observed let me just ask Dr Aoyase representing the DDS what is that one thing that you would like the audience to take away as this conference comes to a close? I can only say that I would like that they appreciate the fact that the way forward is One Health. We need to put a lot of emphasis on it for us to tackle the challenges of zoonosis, MR, food safety and other environmental issues. We need the One Health approach, we need a mind change we don't work in cocoons but to realize that we need each other to put forward our agenda and to roll it out. That is the challenge that I give the people who are in this forum that they go away with. Thank you. Thank you very much. Dr Mumo representing DG Nema. Yeah, thank you once again for attending this conference. My encourage what I would actually communicate especially to the researchers is that there's quite a lot of information that you have and data. I've seen quite a number of recommendations. I would encourage you that when you're doing your recommendations don't just limit it only to looking at the curative aspect, look at how you can also use it to enrich other sectors. For example, how can your tools be used to improve method development, monitoring, developing tools like standards. We like standards for estimating pollutants within the environment and what are the information that can be able to use policies. Try to cross over and translate your research finding tools that can be used in the environment, animal and health sector. Thank you. Thank you. That was Dr Philippe Nguere. So Dr Mumo, please come on. Your final closing remark. I already talked so. Oh, thank you. You have just done it. All right, next is Dr Nguere. Thank you. Thank you, the moderator. I think personally, I'm happy in the sense that as much as one health is not a new concept, way back 400 BC, there's already indications of its relevance. It is now gaining prominence. I'll wait late in the day, which is not a good thing, which is not a bad thing. It's a good thing. And my plea to all of us in this conference is that we should not sit on the good information that we've been sharing with our peers. Simply put, all of us who are in this conference are already converted and sharing with them as far as creating a sensitization and advocacy for unhelp doesn't add value, add much value as far as converting everybody else to join the ship. So my advice is that my plea would be that all of us try and make as much as possible, develop as much as possible, advocacy briefs out of the presentations that we have, and use this to reach out to those of us who still don't appreciate the value of unhelp. Through doing so, then it means we'll take this to a new level, make more people appreciate and understand the importance of unhelp initiatives, and subsequently improve the uptake of this concept. And I think by doing so, then it means we'll be making more people understand, we'll be making it easier to get resources and mobilize for resources, we'll be getting it, making it easier for our colleagues to understand these documents, appreciate their value, and understand them as far as when it comes to implementing the unhelp activities that we think through. Otherwise, thank you so much for the opportunity. Thank you, thank you very much representatives of the government directorates kindly convey our utmost regards to the director generals that you have very ably represented here. And together with your colleague panelists, thank you very much for honoring the invitations to come and participate in this session. We have benefited immensely from your great insights in your respective areas of expertise, and therefore a great contribution to the expected outcomes of this conference. May we give them a round of applause. Now panelists by my privilege, you have the pleasure to vacate your positions of panelists, and I now have the pleasure to hand back over the program management to Dr. Bennett. Over to you, Bennett. Thanks a lot Dr. Barassa, Martin. Yeah, I think that was a very interesting session. We will not spend more than let's say at least five minutes to just to applaud and really recognize the contributions of all the people who have really contributed to the success of this conference. So my main role here would just be to give both of thanks. And I want to start with all the participants, wherever you are, whether online or in the room. Let's applaud each other. Up to now, we have 279 there. I think it's really a good demonstration of our interest and participation in this conference. The next group of people I want to recognize are the presenters. Those people who prepared papers and it takes a lot of effort to really summarize that information and come and give and really contribute effectively to this conference. So let's also applaud all the presenters who gave us that very good piece of information. The third group of people I want to recognize are the panelists. And we in this afternoon in this session, when we had representatives of the government, NGOs, FAO, and many other people, I think it's also demonstrates a very good interest on one health and that interest to partner and work with the rest of us. But in addition to really applauding you, we also have some presents which Leon has prepared for you, especially the panelists who are here this afternoon. I think Dr. Oyas is here. We can give you one, Dr. Nningi, but the rest will send them because some of us are online. So let's give Dr. Oyas, one of them. Yeah. Do we have a picture or maybe? Dr. Nningi, you can come as well as, oh, Diambo, yes, sorry. Yes, I forgot about you. I thought you are online. So let's start with Dr. Diambo then. Maybe I hope it through. Thanks a lot for coming. Thanks. You capture? All right. Thank you. So one more for Dr. Oyas. We didn't follow any order. Dr. Oyas has been our greatest partner in many projects we do. So we thank you very much for that. Thank you. For my ill-recredited fellow. Yeah. We have one for Dr. Ngeri and there was another panelist. I think there were five. Yes, we'll keep those ones and then we'll send them as a parcel. So that's that for the panelists. Let's now have that slide on the organizing committee. I think that's another team that we really need to thank. It was in one of the slides which you are rolling. Yes. I think the success of this conference has really been in the steering committee that was formulated to prepare this. And you could see we had, as Lian said, we had up to around 1,000 people who logged in. And I think that's a testimony of how each of these people really came together and brought all sorts of networks that they already have. So we have Martin Parasa from PSF. Thanks a lot. Do we want to do one by one or just give them one? Yeah. All right. So Martin, you have a present here? Yes. Salome, I don't think we will send to her. The next is Victor. Thanks a lot, Victor. And also he managed to help us get the CPD points for the KTB, which was also a game changer because we managed to bring all those people on board. The next one is Lian. We were having a special mention for you because you are the chairperson for the committee, but for the presence. Yes. So, Adia, I'll have a word for you later on. Maybe Penina is not here. We will send to her. But thanks a lot, Penina, again, for bringing the CDC input. Patrick Mouinde also, oh yeah, all right. A former Ilri Crabiot fellow. Thanks a lot. Michael Victor is not here. We will send to him. Eric Feb is not also here. We will send to him. Samuel, I've seen Samuel. Yeah. Okay. We had the pleasure of linking him to the Abrahun, the entire network. Thanks a lot. Next is Thumbi. I think I saw Thumbi running away. Yeah, we will send to him. Wellington also is not here. We will send to him. Nick Bor. Although we have a special mention for you, but yeah, let's have a present for now. Let me skip Joffrey. Matthew Muturi is not here. We'll send to him and Atman. Muatondo. Joffrey and Nick, let's skip Joffrey in the present past. I was skipping Joffrey because I know he will sleep today. He has not been sleeping the rest of the last how many days. And we're really very grateful for the input that you have had is our communication officer in Oreka. I think he has really put in a lot of effort to have this conference running this way. And yeah, thanks a lot. I think we've got this robot. I skipped robot. Robot Onsare. I think left already will send to him. Yeah. Or Hadija. She's from CDO. Yeah, we'll also send to her. That's really the organizing committee. But before I finish, I want to really recognize first of all, Nick, all the effort that you put in in all the mentees and all the letters that you sent and all the organization. But lastly also for, oh yeah, the next slide where we have Nick. We have Nick. We have Roskellen, Rosmanu, Joffrey, Edwin, the IT team. Yeah, they've been very, I think the conference has really run so smoothly because of your support. And really, we really thank you for that. Leon, I wanted to really thank you because this was your brain child. And we really see that it has come out so nicely. And I think it has really been a very perfect conference and your efforts in making this come through. So special. So lastly, I've been saying lastly for the last how many times you realized that the DG came here. He had another meeting, but luckily we have our DDG, Suponisomoyo, is the Deputy Director of Biosciences in charge of genetics and feeds. So I have requested her to close the conference officially and of course say hi to us. So welcome and do the final close conference. Thank you so much, Bernard. I'm told that I hold the key. So I would do exactly that. Dear participants, colleagues, distinguished delegates, those online and those who are here present, all protocols observed. It is indeed my pleasure this afternoon or this early evening to follow on where the Director General for Ilri left just to again give some closing remarks and to thank everyone for these rich three days. I think Bernard has done a great job in thanking each and every category. I just want to add on to say I personally participated in some of these sessions for these last three days towards the learning sessions for me. And I was really excited to see the engagement, the interaction, the exchange, even now the active engagement on the chart. So this is an indication that this has been very successful. And also to see senior officials engage and sit through. So I really enjoyed this last session and I'm glad I sat through it. So thank you again, everyone, for your participation and the organizing committee, the people behind the scenes, our ICT, the connectivity. It's been long three days. So you can sleep well tonight and continue on this journey of engagement. So we really appreciate this opportunity and that Oreka and Ilri were able to host. So again, thank you. Thank you so much. I just want to officially declare this Kenya One Health online conference closed. Again, thank you so much.