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News & Reports BVA congress

Wildlife – an integral part of One Health Most discussions of One Health focus on the health of domestic animals and people, and wildlife may be overlooked. In a debate at the BVA Congress at the London Vet Show last month, it was argued that wildlife plays an important role in the health of both people and domestic animals, and should be considered as critical to the One Health approach. Laura Feetham reports

‘Wildlife isn’t close to One Health, it’s an absolutely integral part of it,’ said Nic Masters, head of veterinary services at the Zoological Society of London (ZSL), the first speaker in the debate. His comments were made in response to the title of the debate, ‘Closer than you think: One Health and wildlife’. To illustrate his point, he highlighted the example of the drastic decline in vulture populations that has occurred in recent years in the Indian subcontinent, and how this had knock-on effects on the health of domestic animals and people. The decline in vulture populations, Mr Masters said, was first identified by Vibhu Prakash during the late 1990s. In the course of his fieldwork in India, Dr Prakash saw that, in the space of just a few years, the vulture population had plummeted, with a reduction of around 99.9 per cent. The main vulture species in the region was the oriental white-backed vulture (Gyps bengalensis), but declines had also occurred in other species. The reduction in the number of vultures had some unforeseen effects on people and animals in the region, explained Mr Masters. One such consequence was an increase in the free-roaming dog population. This was because the carcases that were previously being consumed by vultures now provided a food source for dogs. The increase in freeroaming dogs led to an increase in canine rabies and a rise in rabies cases in people. There was also an economic impact: ‘It is estimated that costs, predominantly in the form of postexposure prophylaxis for rabies, to the Indian government, are in the tens of billions of dollars since the decline of these vultures,’ he said. He explained that the vultures used to dispose of an estimated 10 million tonnes of fallen stock every year in India, and that leaving these carcases to rot, rather than to be scavenged, posed another risk to human health. Furthermore, some Parsi communities that practised traditional sky burials, in which a body was left outside to be consumed by birds of prey, found that their burials were no longer working. It took researchers some time to work out the cause of the decline. After lots of work, mainly by the Peregrine Fund in Pakistan and the Ornithological Society of Pakistan, it was discovered that the majority of the vulture carcases that were found had severe visceral gout and renal failure. They

Nic Masters: the drastic declines in vulture populations on the Indian subcontinent, and the impact this had on the health of people and domestic dogs, is a valuable example of how wildlife is key to a One Health approach

also had high levels of the NSAID diclofenac in their tissues. At the time, Mr Masters explained, diclofenac was widely used by veterinarians in the region, who gave it to cattle and other domestic ruminants. A paper published in Nature in 20041 showed that diclofenac was the cause of declines in the vulture population. Following the discovery, a consortium of organisations called Saving Asia’s Vultures from Extinction (SAVE), which included the RSPB, ZSL and the World Wide Fund for Nature, was set up to try to combat the problem. By 2006, the veterinary use of diclofenac had been banned in India; however, it was unclear exactly how effective the ban had been. Mr Masters said that, while there had been year-onyear reductions in the levels of diclofenac in livestock carcases, human diclofenac was still used by vets in some regions. However, the use of diclofenac had fallen and the use of other NSAIDs in livestock, mainly meloxicam, which had been shown to be safe for vultures, had increased. A paper published in 20142 suggested that the number of vulture deaths caused by diclofenac following the ban would have fallen by two thirds. Despite the reductions in diclofenac concentrations in livestock carcases, Mr Masters noted that very significant reductions were actually needed: ‘It’s predicted that less than 1 per cent of carcases

need to be contaminated with lethal levels of diclofenac to prevent recovery in these populations.’ He noted that vulture populations were beginning to show signs of recovery, but that the numbers were currently so low that these increases could be the result of random events. Another intervention to save the vultures had been the establishment of ‘vulture safe zones’, which were closely monitored such that no veterinary diclofenac was used within a 100 km radius. Captive breeding centres had also been set up in India and Nepal and Mr Masters reported that these captive breeding schemes were going well. However, the problems posed by diclofenac to wild birds might not be over. ‘Disappointingly, I’m not sure how much of a lesson we’ve learnt from all of this,’ said Mr Masters. Recently, he reported, diclofenac had been licensed as a veterinary drug in Europe. This could potentially pose significant problems to birds of prey in some countries, for example Spain, which was home to a large population of Eurasian griffon vultures (Gyps fulvus). He noted that the European Commission had asked the European Medicines Agency to run a consultation on the risk that the licensing of diclofenac posed. ‘I hope very much that this decision to license this drug will be reversed,’ he concluded.

Sustainable model

The second speaker, Gladys KalemaZikusoka, a wildlife veterinarian and chief executive of the charity Conservation Through Public Health (CTPH), gave a different example of how the health of people and wildlife were intertwined. After graduating from the Royal Veterinary College, Dr Kalema-Zikusoka began working at Bwindi Forest National Park in Uganda, where she studied the parasites and bacteria present in the dung of the gorillas living there. Bwindi is home to some 320 mountain gorillas, representing almost half of the wild population of this critically endangered species. Through her research, she found that humans – both tourists and those that lived nearby – could have a significant effect on the health of gorillas. In one case, the park rangers noticed that gorillas were losing their hair and developing

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News & Reports scaly skin. Scabies – the most common skin disease in people – was suspected. Samples were taken from an infant gorilla that had shown clinical signs and later died of pneumonia that was thought to be a related secondary infection. Scabies infection was confirmed. Dr Kalema-Zikusoka noted that the people who lived around Bwindi were some of the poorest in Africa and had little access to healthcare. It was found that they were putting out scarecrows with scabiesinfested clothes on them. The gorillas, which sometimes strayed out of the park and near to human dwellings, were touching the clothes out of curiosity and becoming infected. This, said Dr Kalema-Zikusoka, was one of the experiences that led her to understand that the health of gorillas, people and other animals were all related, and this in turn led to the founding of CTPH. The charity aims ‘to promote conservation by encouraging people and wildlife to coexist and improving the health and livelihoods of people living around protected areas’, she said. The focus of the organisation had originally been just on health, but it was soon realised that the link between health and livelihoods was so strong that both had to be taken into account. One part of CTPH’s work was the monitoring of pathogens affecting animal and human populations in and around Bwindi. The Gorilla Research Clinic, she said, analysed large numbers of faecal samples collected from night nests and compared the pathogens present to those found in samples from nearby livestock and sick people. The charity had a partnership with a local hospital which provided human samples. This work, she explained, could show whether the same parasites were affecting people and animals.

Gladys Kalema-Zikusoka: integrating conservation, public health and improving peoples’ livelihoods can have positive effects on the health of people and animals

Lessons had also been learned about the way that conservation and public health projects were run, said Dr Kalema-Zikusoka. ‘As much as possible, we try and get park staff to do this work,’ she said. ‘We noticed that charities set up a lot of programmes but, once the funding ends, the programmes go, and it is not sustainable. So we tried our best from the beginning to try and ensure that it is the park staff who are doing this work and we are just supporting them.’ The charity also works with local communities to improve health, education and livelihoods. Dr Kalema-Zikusoka explained that CTPH had found that when people in nearby communities had large families and lived in poverty, this could have a range of negative knock-on effects on the gorillas living around them. It had therefore

created a scheme that encouraged people to have smaller families and to ensure that all of their children went to school. This included providing family planning services. In collaboration with the human health charity FHI360, CTPH took part in a pilot study to assess whether it was safe for non-medically trained volunteers to administer contraceptive injections to local communities. They trained a group of volunteers who provided contraception to a community of some 44,000 people living near Bwindi. The results showed that it was safe and effective, and the scheme has since been adopted as a national policy in Uganda. The charity’s work seemed to have had a positive effect, she said. Local people’s attitudes towards conservation had become more positive, communities were protecting gorillas more (at least in part due to the money being brought in by ecotourism) and poaching rates seemed to be going down. ‘Integrating conservation, public health and microfinance has resulted in a sustainable model,’ she concluded. 1. Lindsay Oaks, J. L., Gilbert, M., Virani, M. Z., Watson, R. T., Meteyer, C. U., Rideout, B. A. & others (2004) Diclofenac residues as the cause of vulture population decline in Pakistan. Nature 427, 630-633 2. Cuthbert, R. J., Taggart, M. A., Prakash, V., Chakraborty, S. S., Deori, P., Galligan, T., Kulkarni, M. & others (2014) Avian scavengers and the threat from veterinary pharmaceuticals. Philosophical Transactions of the Royal Society B doi: 10.1098/ rstb.2013.0574 doi: 10.1136/vr.g7659

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Wildlife − an integral part of One Health

Veterinary Record 2014 175: 607-608

doi: 10.1136/vr.g7659 Updated information and services can be found at:

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Wildlife--an integral part of One Health.

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