key: cord-0008380-mpleawr2 authors: Baradaran-Seyed, Zahra; Pishraft-Sabet, Leila title: A chance to implement One Health in the Middle East and north Africa date: 2019-04-01 journal: Lancet Planet Health DOI: 10.1016/s2542-5196(18)30285-7 sha: eec27da706806079315e4fb814515647f622b07f doc_id: 8380 cord_uid: mpleawr2 nan Epidemic intelligence and the ability to identify an outbreak early can provide a crucial advantage in the eradication of infectious diseases, prompting response to prevent epidemics and the implementation of biological countermeasures. 3 In 1851, when the World Health Assembly, WHO, and the International Health Regulations (IHR) were not yet established, after epidemics of cholera, plague, and yellow fever, the first International Sanitary Conference was held. 14 conferences and many years later, WHO was established. 4 The aims of the International Sanitary Conference were legislation, enforcement of the reporting of the status of contagious diseases, and encouragement of international cooperation in controlling infectious diseases. The concerns of the 19th century are still concerns of today, giving rise to an urgent need to deal with these issues. 4 Although the IHR came into effect in June, 2007, in practice, at that time there was little incentive to allow external investigation of a country's progress in dealing with epidemics. After the establishment of the Joint External Evaluation (JEE), political will increased and integrated logistical support for the Global Health Security was provided by national institutes and agencies, international organisations, and donors, resulting in more than 40 countries allowing external evaluation of their One Health infrastructure within 3 years. 5 The effects of the IHR JEE on the evaluation of One Health performance in the Middle East and north Africa, with the participation of 14 countries, revealed that more than 90% had an established surveillance system; however, only half had the capacity to monitor one to four zoonotic diseases. More than 80% of the countries had fundamental problems with the national stewardship plan for antimicrobial resistance. 6 The effects of non-human epidemics are not limited to zoonotic diseases; the economic effect of mass depopulation and biodiversity loss ignites social inequity and unrest because of the complexity of social determinants of health. Additionally, financial instability will result from focusing solely on the human sector, at the cost of the animal kingdom and ecosystem. The political, economic, and societal consequences of epidemics of animal and zoonotic diseases (including, but not limited to, Middle East respiratory syndrome coronavirus, highly pathogenic avian influenza, and foot-and-mouth disease) in the Middle East and north Africa over the past decade indicates that it is time to direct more attention to the animal kingdom and the environment. The implementation of any policy and practice under the One Health and planetary health umbrellas will guarantee sustained success. 2, 7 If we look at the status of the countries of the Middle East and north Africa in controlling the outbreaks of animal and zoonotic diseases, as well as overcoming environmental challenges such as environmental damage, air pollution, drought and scarce fresh water, and a paucity of arable land, the most important initial step should be the establishment of a governing body to oversee an integrated One Health surveillance system for the early detection of threats at the animalhuman-ecosystems interfaces. 3, 6 The challenges of the implementation of such a system should be carefully investigated. It might be that the experience of a publicprivate partnership such as the Middle East Consortium on Infectious Disease Surveillance (MECIDS) in a region, www.thelancet.com/planetary-health Vol 3 April 2019 which has a history of decades of challenges, could be extended to other countries in the Middle East and north Africa. 8, 9 The most serious challenge is developing the political will to support not just the establishment of an integrated surveillance system, but also intersectoral partnerships to help prevent and control diseases. 3, 5 Considering decades of conflict, war, and unrest, the main question remains whether leaders in the Middle East and north Africa are willing to collaborate to implement the One Health surveillance system. The Seventh World Health Summit Regional Meeting to be held in Iran offers an exceptional opportunity to promote One Health and planetary health in the region. Topics such as health in uncertain situations, noncommunicable diseases and mental health, global health in a transitional world, planetary health, and medical education are all emerging fields that stakeholders and decision makers from all around the globe can produce an operational plan for achieving their goals. Without a doubt, this will only be possible with the support of domestic policy makers and upstream policies. Education and Extension Organization, Karaj, Iran (ZB-S, LP-S) z.bseyed@rvsri.ac.ir We declare no competing interests. Copyright 2018 © The Author(s) The growth and strategic functioning of One Health networks: a systematic analysis Strengthening global public health surveillance through data and benefit sharing From international sanitary conventions to global health security: the new International Health Regulations Joint external evaluation process: bringing multiple sectors together for global health security Addressing challenges in the Middle East at the human-animal interface under the 'One Health' concept. 14th Conference of the OIE Regional Commission for the Middle East Initiation of global burden of animal diseases programme Regional infectious disease surveillance networks and their potential to facilitate the implementation of the international health regulations One Health surveillance-more than a buzz word?