One Health Workshop: Brazil

On  28-29 March 2023, the UK Academy of Medical Sciences organised a workshop exploring One Health  in partnership with the Brazillian National Academy of Medicine (ANM) and Brazillian Academy of Sciences (ABC), exploring One Health in Brazil.  The workshop was aimed at discussing how to advance a One Health approach in Brazil to address the challenge of infectious diseases. 

A final report of the workshop proceedings is available to download on the right hand side of this page. 

Brazil in particular is especially vulnerable to climate change impacts including reduced water availability, risk of coastal flooding and increased occurrence and severity of river floods, and health risks associated with heat stress including heat-related deaths in the elderly. As mentioned above, climate change is also linked to the recent increase in zoonotic and vector-borne diseases, such as malaria, dengue fever, vesicular stomatitis or New World screwworm. The life cycle of the vectors of many zoonotic and vector-borne diseases is strongly influenced by climate conditions (including temperature, precipitation and humidity), which are predicted to allow increased temporal and geographical distribution of certain disease vectors, thereby increasing disease transmission. Beyond zoonotic diseases, climate change is also expected to worsen disease burden more broadly, including an increase in infectious diseases in general, and an increase in cardiovascular and respiratory diseases. In fact, a recent study found that of 375 human infectious diseases investigated in this study (ranging from waterborne viruses to plague), 58% are expected to be exacerbated by climate change. It should be noted that climate change is also predicted to diminish certain diseases, however most diseases are predicted to be worsened. The One Health approach can play a pivotal part in improving health and more broadly facilitate positive developments to wellbeing, livelihoods, and the environment, by aligning separate efforts to work collaboratively. This involves bringing together key players across the sectors such as medical doctors, veterinarians, agricultural experts, social scientists, and public health experts. Bringing together expertise across the ecosystem, could also support with identifying and bridging key research gaps. 

The main objectives of this workshop were to convene researchers, policy makers and wider stakeholders together, to identify key research opportunities and barriers to enable the successful implementation of a One Health approach in the region: 

• Bring together evidence and research on developments in Brazil on a One Health approach.
• Comprehensively review previous and ongoing One Health initiatives and research innovations across the sectors, with a focus on infectious diseases and climate change, to understand where the gaps are and how a multi-sectoral approach could support in addressing these gaps.
• Provide a platform for different regions and sectors to share their experiences, challenges and successes to allow learning from one another.
• Based on the evidence, identify existing knowledge gaps and discuss the mechanisms to address these gaps in order to support improvements within and across settings.
• Identify solutions and key actions that can facilitate greater multi-sectoral collaboration that could enhance research and policy responses to infectious disease and climate change challenges.
• Agree on a list of research priorities and solutions to overcome the identified barriers and gaps which can be addressed on local, regional, and national levels.

To achieve this, the workshop aimed to: 

• Learn from existing initiatives, evidence, and successes from across the country and wider region and the UK on the implementation of One Health approaches.
• Identify country/region specific challenges, barriers, and gaps to enhancing One Health capabilities across research areas, that could be addressed through multi-sectoral collaboration.
• Consider how initiatives and research can prioritise community engagement through greater multi-sectoral collaboration.
• Identify key actions and research areas for multi-sectoral collaboration that can enhance One Health capabilities.

Following the workshop, the steering committee with the input of participants developed a high-level outcome statement outlining the key messages that emerged from the workshop around the actions needed.

An overarching final report (available to download on the right) synthesises the key discussion points from the workshop, capturing barriers, priorities, and next steps with the aim of informing policy and research decisions on One Health in the region.

• Professor Marcello Barcinski (co-chair), Professor, Federal University of Rio de Janeiro
• Professor Alison Holmes FMedSci (co-Chair), Professor of Infectious Diseases and the Director NIHR Health Protection Research Unit, Imperial College London
• Professor Chris Dye FMedSci, Professor of Epidemiology, University of Oxford
• Professor Helena Lage Ferreira, Professor (Associate) University of Sao Paolo
• Dr Ottorino Cosivi – Center Director, Pan American Center for Foot-and-Mouth Disease and Veterinary Public Health; (PANAFTOSA) Pan American Health Organization
• Professor Celso F. Ramos Filho, Professor, Federal University of Rio De Janeiro
• Professor Claudio T. Daniel-Ribeiro, Full Professor, Oswaldo Cruz Foundation 
• Professor Helena B. Nader, Professor and Head of the Institute of Pharmacology and Molecular Biology, Federal University of Sao Paulo
• Professor Pedro F. da Costa Vasconcelos, Professor, Department of Pathology at Pará State University

Following the workshop, the steering committee with the input of participants developed a high-level outcome statement outlining the key messages that emerged from the workshop around the actions needed:

Taking a One Health approach is essential in Brazil, given the high levels of biodiversity in the Amazon region, the threats posed by known vector-borne diseases, and the potential risk of emerging novel zoonoses or re-emerging epidemic transmission of endemic zoonoses. Extensive land-use changes, including deforestation and natural resource extraction, plus urbanisation, migration and climate-change impacts, further emphasise the need to consider the interdependencies between human, animal and ecosystem health in Brazil. Participants at a joint One Health workshop hosted by the Brazilian National Academy of Medicine, Brazilian Academy of Sciences and the UK Academy of Medical Sciences, held in Rio de Janeiro, Brazil, on 28–29 March 2023, concluded that the country’s extensive track record in this area provided an excellent foundation for it to make major contributions to global One Health research and to support policy decisions.

The meeting heard multiple examples of One Health research excellence in Brazil [see below]. However, a number of outstanding /ongoing Challenges were highlighted, including:

• The need to raise awareness of the One Health approach among researchers health professionals, policymakers and the public
• Strengthening interdisciplinary, cross-sectoral and international collaborations;
• Ensuring that funding mechanisms are compatible with the need for long-term interdisciplinary collaborations and cross-sectoral partnerships.

The meeting aimed to foster future UK-Brazil collaboration to support this important area of science. A more detailed workshop report is currently underway which will summarise the key discussions and next steps from the workshop and provide additional context to the actions identified in the outcome statement. We hope the report will support Brazilian policymakers, funders, and researchers, along with global and regional stakeholders working across the One Health space, to make decisions about future policy interventions and research priorities, and to aid the strengthening of One Health initiatives in Brazil.