Multisectoral prioritization of zoonotic diseases in India: A One Health perspective

IntroductionTo tackle the risk of emerging and re-emerging diseases, it is critical for countries with limited resources to prioritize endemic and emerging zoonotic diseases of greatest national concern. One Health is an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals, and ecosystems. In India, as a first step towards a multi-disciplinary, multi-sectoral, One Health approach to preventing and detecting zoonotic disease outbreaks, a national-level multi-stakeholder zoonotic disease prioritization workshop was organized to identify a list of zoonotic diseases of greatest national concern for India. MethodsWe followed the Good Reporting of a Mixed Methods Study (GRAMMS) guidelines to finalize a list of priority zoonotic diseases through a participatory action research approach involving 50 experts in zoonotic diseases. We used a prioritization process based on the U.S. Centers for Disease Control and Preventions semi-quantitative One Health Zoonotic Disease Prioritization (OHZDP) Process, with modifications per country need. ResultsWe ranked forty zoonotic diseases based on five criteria: severity of illness in humans, the economic burden of the diseases, pandemic potential, capacity for prevention and control, and potential for introduction or increased transmission in India. The final list of zoonotic diseases ranked in the order of national significance includes the following top ten priority zoonotic diseases: Zoonotic Influenza (Zoonotic Influenza A viruses), Anthrax, Japanese Encephalitis, Leptospirosis, Brucellosis, Dengue, Rabies, Scrub typhus, Plague, and Crimean-Congo hemorrhagic fever. We conducted a sensitivity analysis to assess the impact of each criterion on the prioritized list; this analysis showed minimal changes in ranking for the top ten diseases. ConclusionFor the successful adoption of One Health practices in India, multi-sectoral collaboration is critical at all levels - national, state, and provincial. This collaborative prioritization process conducted at the national level has the potential to catalyse such efforts and enhance zoonotic disease prevention and detection efforts at the state and local levels across India.