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EDITORIAL |
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Year : 2013 | Volume
: 6
| Issue : 4 | Page : 349 |
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Losing sight of the forest for the trees: Paradigm shift needed for disease control
Amitav Banerjee
Department of Community Medicine, Padmashree Dr. D Y Patil Medical College, Hospital and Research Centre, Dr. D Y Patil Vidyapeeth, Pune, Maharashtra, India
Date of Web Publication | 17-Sep-2013 |
Correspondence Address: Amitav Banerjee Department of Community Medicine, Padmashree Dr. D Y Patil Medical College, Hospital and Research Centre, Dr. D Y Patil Vidyapeeth, Pune, Maharashtra India
Source of Support: None, Conflict of Interest: None | Check |
DOI: 10.4103/0975-2870.118264
How to cite this article: Banerjee A. Losing sight of the forest for the trees: Paradigm shift needed for disease control. Med J DY Patil Univ 2013;6:349 |
The old adage cautions against losing sight of the forest for the trees, implying that if one gets engrossed in admiring only the individual trees, one loses sight of the forest or misses the big picture. Traditional disease control strategies have been on similar lines. "Doctors often act as though their professional responsibility does not go beyond the sick… and politicians, who influence health more than the doctors, are rarely troubled by thoughts for the distant future." [1] We are so fascinated by individual diseases that we miss the big picture, i.e., the ecosystem, which sustains these diseases. One outcome of this approach has been the neglect of the threat posed to human health by the zoonoses.
Time and again, this approach has caught us unawares and will continue to do so in the future if we do not bring about a paradigm shift in our approach to disease surveillance.
History has shown that human infections constantly emerge from the animal kingdom. Such threats have evoked panic fueled in recent times, by the emergence of human immunodeficiency virus, Ebola, Nipah, Lassa, severe acute respiratory syndrome, H5N1 and H1N1 influenza viruses and Escherichia More Details coli 0157: H7, all of animal origin. [2]
Several zoonoses are not only endemic, but also epidemic - prone, such as leptospirosis, Brucellosis More Details and rabies. [3] Epidemiological data suggests that about 75% of emerging infectious diseases are zoonotic originating mainly from wildlife. [4] These emerging diseases pose a public health threat that deserve attention by health policy makers.
Against this background in recent times, there is an emerging concept of "one health," which is the key to defeating emerging and re-emerging diseases at the interface between human health, animal health and the ecosystem. [3] It envisages better integration of animal, human and environmental health programs. It also underlines the need for the strengthening of the animal and human health systems, without which the fight against diseases cannot be successful.
Joint investigations by medical and veterinary professionals at the field level should be encouraged. Networking of veterinary and medical laboratories and use of available resources by collaboration will help in case detection. It also calls for reviewing the existing medical and veterinary curricula so that a new generation of medical and veterinary professionals will understand "one health - one medicine" concept in harmony with a collaborative approach to improve and protect human and animal health. [5] Unless, we bring about the much needed paradigm shift, we would keep "missing the wood for the trees."
References | | |
1. | Rose G. The Strategy of Preventive Medicine. Oxford: Oxford University Press; 1992. p. 2. |
2. | World Health Organization. Research priorities for zoonoses and marginalized infections. World Health Organ Tech Rep Ser 2012;971; 1- 119. Available at http://apps.who.int/iris/bitstream/10665/75350/1/WHO_TRS_971_eng.pdf. [Last accessed on 2013 Aug 15]. |
3. | Rabozzi G, Bonizzi L, Crespi E, Somaruga C, Sokooti M, Tabibi R, et al. Emerging zoonoses: The "one health approach". Saf Health Work 2012;3:77-83. [PUBMED] |
4. | Blancou J, Chomel BB, Belotto A, Meslin FX. Emerging or re-emerging bacterial zoonoses: Factors of emergence, surveillance and control. Vet Res 2005;36:507-22. [PUBMED] |
5. | World Health Organization South East Asia Region. Zoonoses in the implementation of IHR. Available at www.searo.who.int/entity/ihr/topics/International_Health_Regulations_IHR6.pdf [Last accessed on 2013 Aug 15]. |
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