One world, one health, one medicine

The World Veterinary Congress (WVC) hosted by the Canadian Veterinary Medical Association (CVMA), and in conjunction with the Can West Veterinary Conference, in Vancouver, British Columbia (July 27 to 31, 2008) offered a variety of educational opportunities for veterinarians and other veterinary health care providers. The program was divided into 2 major tracks, clinical practice/private practice and public practice/public health. The program dealt with almost all aspects of veterinary medicine and the theme, “Celebrate our diversity” was certainly highly appropriate. Although the fields of work in veterinary medicine are quite diverse, there are common threads that run through the profession and are worth emphasizing.

One world

About two-thirds (60.3 %) of emerging infectious diseases (EID) result from zoonoses; the majority of these have their origin in wildlife (71.8%) and have been increasing in recent years. The researchers found that over 50% (54.3%) of EID events were due to bacteria, and that their database included a large number of drug resistant organisms (1). A major finding was that there was a high correlation between EID origins and socio-economic, environmental and ecological factors, thereby providing a mechanism by which areas (called “emerging disease hotspots”) where EIDs are most likely to originate.

The research also demonstrated that lower latitudes were the regions where there was a combination of a high risk of zoonotic and vector-borne EIDs in wildlife and a low reporting effort. Country borders do not exist for vector-borne diseases! According to these authors, global resources to combat the emergence of infectious disease are not well allocated as most of the research and surveillance activities are occurring in countries that do not fit the predicted sites from which new diseases are likely to emerge (1).

Humans serve as a primary reservoir for only 3% of known zoonotic pathogens. Yet the capability to identify outbreaks of disease relies on identification of human cases. Effective surveillance of zoonotic pathogens and control of the diseases they cause requires integration across human and animal populations. Such integration is lacking in contemporary veterinary and medical communities (2).

The recall of melamine-contaminated pet food demonstrated how small the global market is. The actions taken by only 2 protein suppliers in China affected a large number of pet food suppliers in the United States and Canada, and created a nationwide animal and human food crisis in both countries (the FDA listed more than 1100 entries on a spreadsheet of recalled pet food products). This situation clearly showed how relatively few suppliers shipping large amounts of a product to the United States and Canada can have a huge impact (3). Travel by air and transportation via water have connected all countries into one world. Microorganisms can travel by plane across the world in time frames shorter than their incubation periods. A quote by Lonnie King taken from the plenary session of the WVC in Vancouver summarizing this notion is that “nowhere is remote and no one is disconnected” (4).

One health

In 2008, both the American Veterinary Medical Association (AVMA) — at its New Orleans Convention — and the WVC/CVMA through the Vancouver Convention offered a variety of speakers from different backgrounds to discuss the concept of “One Health.” This concept is defined as the collaborative efforts of multiple disciplines, working locally, nationally and globally, to reach optimal health for people, animals and the environment. (4). Veterinarians in all areas of the profession have opportunities and responsibilities to protect the health and well being of people in all the areas in which they work: food security, food safety, antibiotic sensitivity testing, research on zoonoses, emerging infectious diseases, ecosystem protection, comparative medical research, and human physical/mental health.

One medicine

The concept of “One Medicine” has been discussed for many years. But for all practical purposes and despite the ongoing discovery of numerous commonalities in the physiology and pathophysiology of humans and animals, this “One Medicine” concept was lost and the human and veterinary medical disciplines developed into separate professions (5).

The veterinarian is the only health care professional likely to see both people and their animals, so he/she therefore has an awareness of the potential threat of zoonotic disease and has the ability and responsibility for detecting zoonotic/emerging diseases. Fortunately, veterinarians have considerable training in comparative medicine, zoonoses, and public health. Physicians on the other hand do not receive extensive training in comparative medicine and zoonoses. Therefore veterinarians are in a better position to discover public health threats than are physicians. They are also in an ideal position for establishing a disease surveillance system using pets as sentinels of disease exposure in the home environment (5) and in the wild (6). In addition, veterinarians in companion animal practice could work together with family physicians by using common tools such as family genogram with pets; this tool is being presented to family physicians and introduced to veterinarians as well (7).

Veterinarians, regardless of their field of practice, all play a significant role in human health and animal health. The future will most likely bring more collaborations of veterinarians from all fields with multiple professions such as public health, human medicine, bio-engineering, animal science, environmental science, and wildlife. Together, we are stronger to fight disease, and we are, indeed, wiser.