Enhancing global health security in Thailand: Strengths and challenges of initiating a One Health approach to avian influenza surveillance

Gabriel K Innes; Anastasia S Lambrou; Pornchai Thumrin; Yupawat Thukngamdee; Ratanaporn Tangwangvivat; Pawinee Doungngern; Kirana Noradechanon; Punnaporn Netrabukkana; Karen Meidenbauer; Thomas Mehoke; Christopher D Heaney; Soawapak Hinjoy; Anissa N Elayadi

doi:10.1016/j.onehlt.2022.100397

Enhancing global health security in Thailand: Strengths and challenges of initiating a One Health approach to avian influenza surveillance

One Health. 2022 May 11:14:100397. doi: 10.1016/j.onehlt.2022.100397. eCollection 2022 Jun.

Authors

Affiliations

¹ Yuma Center of Excellence for Desert Agriculture, The University of Arizona, Tucson, AZ, USA.
² Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
³ Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA.
⁴ Office of International Cooperation, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand.
⁵ Burea of Disease Control and Veterinary Sciences, Department of Livestock Development, Bangkok, Thailand.
⁶ Division of Communicable Diseases, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand.
⁷ Division of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand.
⁸ Wildlife Conservation Office, Department of National Parks Wildlife and Plant Conservation, Bangkok, Thailand.
⁹ Avian Veterinary Services, CPF (Thailand) PCL, Bangkok, Thailand.
¹⁰ Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

Abstract

Infectious disease surveillance systems support early warning, promote preparedness, and inform public health response. Pathogens that have human, animal, and environmental reservoirs should be monitored through systems that incorporate a One Health approach. In 2016, Thailand's federal government piloted an avian influenza (AI) surveillance system that integrates stakeholders from human, animal, and environmental sectors, at the central level and in four provinces to monitor influenza A viruses within human, waterfowl, and poultry populations. This research aims to describe and evaluate Thailand's piloted AI surveillance system to inform strategies for strengthening and building surveillance systems relevant to One Health. We assessed this surveillance system using the United States Centers for Disease Control and Prevention's (U.S. CDC) "Guidelines for Evaluating Public Health Surveillance Systems" and added three novel metrics: transparency, interoperability, and security. In-depth key informant interviews were conducted with representatives among six Thai federal agencies and departments, the One Health coordinating unit, a corporate poultry producer, and the Thai Ministry of Public Health-U.S. CDC Collaborating Unit. Thailand's AI surveillance system demonstrated strengths in acceptability, simplicity, representativeness, and flexibility, and exhibited challenges in data quality, stability, security, interoperability, and transparency. System efforts may be strengthened through increasing laboratory integration, improving pathogen detection capabilities, implementing interoperable systems, and incorporating sustainable capacity building mechanisms. This innovative piloted surveillance system provides a strategic framework that can be used to develop, integrate, and bolster One Health surveillance approaches to combat emerging global pathogen threats and enhance global health security.

Keywords: Avian influenza; Global health security; One Health; Surveillance; Thailand; Zoonoses.