One world – one healthcare standard
Modern healthcare research should be as holistic as possible. This is why Jakob Zinsstag's work at the Swiss Tropical Institute in Basel is based on the principle of One Health in which the conventional division between animal and human medicine is radically broken down.
Research in healthcare today should adopt the most holistic approach possible. One person consistently pursuing this approach is Jakob Zinsstag, Veterinarian at the Swiss Tropical Institute in Basel and, a Deputy Project Manager of the National Centre of Competence in Reseach (NCCR) "North-South: Research partnerships for mitigating syndromes of global change". Researchers in this project involve stakeholders, in seeking strategies to improve public health in developing countries. From Jakob Zinsstag's perspective this also includes livestock. This view is based on the concept of One Health in which the conventional division between animal and human medicine is radically broken down. The success of this obvious, yet often neglected approach, speaks for itself.
"The One Health concept is currently having a wide impact," comments Jakob Zinsstag, who outlined his strategy in a highly acclaimed contribution to the medical journal The Lancet in 2005. Instead of considering animals and humans separately, their illnesses should be analysed and approached interspecifically (i.e. occurring between the species). This project fits perfectly within the philosophy of the NCCR "North-South".
Jakob Zinsstag's approach is based on two approaches. The first approach focuses on public healthcare. In an earlier study, the group of researchers working with Jakob Zinsstag had discovered that while most livestock belonging to herders in Chad were inoculated, barely any of the people had been. In these societies the standard of veterinary medicine was obviously good, while child mortality on the other hand was very high. This is why the researchers opted for joint inoculation campaigns for animals and humans. It saved resources and reached more people. Whether anthrax or measles, the refrigeration and transport chain for the vaccines is the same in each case.
At least in Chad the strategy was successful: prior to the campaign practically no children were fully inoculated against measles, tuberculosis, polio, tetanus, diphtheria and whooping cough. Today, at least 40 percent of the children are fully and 80 percent are partially inoculated in the study area.
The second aspect of the Basel veterinarian's concept is tackling zoonoses, i.e. diseases that are transferable from animals to humans. In this case human and veterinary expertise is pooled; starting with diagnosis and extending to treatment and inoculations. Jakob Zinsstag's team evaluated these combined strategies scientifically. The researchers were able to show that despite the high costs entailed, consistent inoculation of animals, for example against brucellosis, was worthwhile. The advantages lay not just in the benefits to the healthcare system, but also to all affected sections of society.
These comprehensive projects can be successful if they include all those involved at an early stage and take cultural differences into consideration. "The cooperation with partners in the South is one of the strengths of the NCCR 'North-South'," comments Jakob Zinsstag. In 2004 he received the Swiss Transdisciplinarity Award for his holistic approach to research. And the One Health concept is enjoying increasing support. The most important professional associations of American physicians and veterinarians have now committed themselves to this strategy in a draft paper. The journal Science just recently reported on this subject and invited the researchers from Basel, as the only European representatives of this strategy, to voice their opinion.
Jakob Zinsstag is now going above and beyond the One Health concept and considering a radical system-theoretical approach in healthcare. "This sort of approach involves taking into account the dynamism of all non-linear processes – from the spread of an infectious disease to society’s reactions to it." Jakob Zinsstag is explicitly referring to the emotional dimension of wellbeing that has often been neglected in the past. "An illness such as rabies will always carry an emotional burden."