Opinion | Importance of 'One Health' approach in the time of COVID-19 outbreak

Mid -December 2019, an outbreak of a novel influenza-like illness was traced to workers and customers of  Huanan Seafood Wholesale Market in Wuhan a city in China. It created a pandemonium world over following which the World Health Organisation (WHO) recognised and named it as a novel coronavirus.

Questions are being raised on the outbreak of that virus whether China has flouted the International Health Regulations 2005 (IHR), International Covenant on Civil and Political Rights 1966 (ICCPR), International Covenant on Economic, Social and Cultural Rights 1966 that too at a time when many public health organisations world over are still furious and enraged of the secretive and non-cooperative manner in which China had handled and responded to the SARS outbreak which itself is being criticised as a clear violation of the IHR 2005.

SARS virus, it is well known, had originated in another Chinese province of Guangdong and then transmitted to Hong Kong and other countries.

The impact of COVID-19 will have serious international ramifications. Under Article 21 of the WHO, the World Health Assembly can adopt regulations on specific issues that are legally binding on member states like China, India and so on. SARS outbreak, to a large extent, was an eye-opener to the world community and to all international organisations like WHO, WTO, FAO and OIE.

WHO then framed IHR 2005, which was formally adopted by the World Health Assembly in May 2005, and entered into force in 2007. It is a binding set of international rules that aims “to prevent, protect against, control and provide a public health response to the international spread of disease”. The IHR imposes positive and binding obligations on state parties to core health capacities to detect, assess and report diseases to the WHO. IHR 2005, therefore, provides the legal framework for global infectious disease control and the Global Outbreak Alert and Response Network (GOARN) established in April 2000 continued to be the primary mechanism by which WHO mobilises the technical resources for the investigation of, and response to, disease outbreak of international importance.

Undisputedly, in recent times, all these deadly viruses have their origin in China, especially from the Chinese wet-markets, which are the epicentre for transmission of potential viral pathogens, new gems may be acquired or existing genes modified through genetic re-assortment, recombination and mutation. The World Conservation Society (WCS), in a recent statement, stated: “Poorly regulated, live-animal markets mixed with illegal wildlife trade offer a unique opportunity for viruses to spill over from wildlife hosts into the human population”.

Evidently the novel coronavirus, apart from many other deadly diseases, has its origin from the Chinese wet markets due to animal-human contacts. 

Repercussions 

COVID-19 pandemic has serious economic, political, human and sociological repercussions, which cannot be compensated by money, and the very existence of humanity is at threat which has no parallel in the recent history. China’s recalcitrance and deception and the lethargy shown to release timely and the vital information to WHO on the outbreak of COVID-9 have caused a serious setback to the efforts of not only of WHO but also to the bodies like FAO, OIE etc.

Lancet, a leading general medical journal, has a published an article on January 24, 2020, wherein it has stated that China has acknowledged the outbreak coronavirus only by January 2, 2020, while people got infected somewhere in December 2019 and the WHO only on February 11, 2020, could announce the specific virus that caused the diseases as COVID -19. 

China announced its first death of a 61-year-old, who had purchased goods from the Hunan seafood market, very late. Further, it is widely reported that the Chinese Administration was also the threatening arrest of persons who started revealing its symptoms.

Caution by WHO

WHO, in its handbook titled 'Managing Epidemics', published in 2018, a year before the COVID-19 outbreak, had cautioned its member states, including China as follows:

“Given the effects of globalisation, the intense mobility of human populations and the relentless urbanisation, it is likely that the next emerging virus will spread fast and far. It is impossible to predict the nature of this virus or the source or where it will start spreading.”

WHO stated that a potentially fatal combination of newly discovered diseases and the re-emergence of many long-established ones demand urgent responses in all countries and planning and preparation of epidemics prevention and control are essential. Even before that, WHO had warned its member states following the Ebola Epidemic, the SARS outbreak in 2002, MERS 2012 and many like deadly diseases of the extreme necessity of prevention of spreading this contagious diseases from animals to humans.

European Food Safety Authority (EFSA) has opined that 75% of infectious diseases that affect humans have their origin in animals. WHO, after listing 15 deadly diseases in its Hand Book, referred to earlier stated that since 1970 more than 1,500 new pathogens were discovered of which 70% proved to be of animal origin, a connection that deserved renewed scrutiny due to the possibility of their contagious nature across the globe.

US Centers for Disease Control and Prevention (CDC) stated 75 % of emerging diseases of people are zoonotic or originated with animals. Food and Agricultural Organisation (FAO) of the United Nations and World Organisation for Animal Health  (OIE) and WHO had given an early warning for Major Animal diseases including Zoonoses. 

One Health approach

In the above background, the necessity of a coordinated, collaborative, multi-disciplinary and cross-sectorial approach to address potential or risks that originated at the animal-human- ecosystems interface was keenly felt, which paved the way for the concept of  'One Health', which has been endorsed by the world organisations like WHO, FAO, OIE, UNSIC, World Bank etc. 

One Health is a collaborative effort of multiple disciplines working locally, nationally and globally to attain optimal health for people, animals and our environment, as defined by the One Health Initiative Task Force  (OHITF). 

One Health approach is inevitable or else early signals of the emergence of such viruses in animals or on the environment would be missed. Animal health and human health are therefore interconnected. Food and Agricultural Organization (FAO) has opined that a comprehensive approach to One Health is needed to deal with the complexities of changing disease landscape.

FAO, in a review article, appeared in the International Journal of Infectious diseases (Vol.25,2014), opined that China is the major contributor to infectious diseases in the world. 

Public Health Authorities the world over have acknowledged that in China animals of all kinds are subjected to extreme cruelty, which might be one of the reasons for the rapid transmission of many microbes from animals to humans. 

China has one-fourth of the global population and has close ties with other countries, and control of infectious diseases in China implies the control of infectious diseases to a large extent world over.

Scientific studies have unmistakably proved that these emerging infectious diseases are zoonoses or zoonotic diseases a group of diseases and infections naturally transmitted from vertebrate animals to humans and it is reported that Coronavirus has originated from Chinese food market like SARS virus.

Chinese, in my view, is answerable to the rest of the world for violating various international covenants especially IHR 2005, which meant not only to prevent and protect but also its spread to other countries.

Communicable diseases like SARS, COVID -19 have now re-shaped the boundaries of sovereignty of a country and the issues have to addressed on the legally binding international and conventions and regulations. 

China it is seen has taken the stand that their responsibility under IHR 2005 is over once they report to WHO of the possible outbreak of a novel virus in their country, forgetting the other international obligations cast upon them under IHR 2005. 

Facts would unmistakably prove that even the aftermath of SARS virus and the framing of IHR 2005 nothing has been done by China to prevent the transmission of such types of viruses from animal to humans leave aside human beings among themselves.

Supreme Court judgement

Supreme Court of India, its judgement in Animal Welfare Board of India vs A Nagaraja, has laid down the principle of eco-centrism, which is a nature-centric approach by which the court has reminded the community that humans are only one of the species on this earth and it is seen that principle is sought to be achieved by the One Health approach. This universal principle and requirement to prevent the outbreak of such viruses from animals to humans were given a complete go-by the Chinese administration thereby flouting the IHR 2005 and the One Health approach or else the transmission of this virus from animal to human beings could have been prevented. Prevention is better than cure and no efforts had been taken by the Chinese administration to prevent the transmission of such a  deadly virus from animals to humans.

China may try to take shelter on the plea of Sovereign Immunity. IHRegulations 2005 has legalised the fundamental principles of global health security at the expense of state sovereignty and hence it is answerable to the serious human rights violation including loss of life, property, international trade and a range of issues related to the transboundary spread of the present deadly contagious disease COVID-19.

(Justice KS Radhakrishnan served as a judge of the Supreme Court of India between November 2009 and May 2014. Views expressed are personal)