Episode 16 - Joining forces for humans, animals, environment: One Health (II)

Intro (00:00:09:22)

Science on the Menu. A podcast by the European Food Safety Authority.

James (00:00:17:24)

Hello and welcome to Science on the Menu. You join us for the second part of a very special two-part series on One Health. If you want a basic primer on One Health, then I'd encourage you to check out the first episode in this series. As a quick reminder, by One Health, we mean an approach that recognizes the interconnection between the health of people, animals, plants and the environment.

We were joined for the first episode by guests from five EU agencies dealing with One Health issues, and they are: Carlos das Neves, Chief Scientist at EFSA; Mike Catchpole,  Chief Scientist at the European Centre for Disease Prevention and Control; Dario Piselli, Expert in Environment and Health at the European Environment Agency; Wim De Coen, Head of Hazard Assessment at the European Chemicals Agency, and Steffen Thirstrup, Chief Medical Officer at the European Medicines Agency.

We're going to jump straight back now into the discussion where we'll be covering a whole host of issues, including what's been achieved over the last 20 years for One Health, and One Health at a global level. So, sit back. I hope you enjoy the episode and I'll see you on the other side.  

Steffen, I imagine in your position as Chief Medical Officer at the European Medicines Agency, you have a pretty broad perspective of how other countries and jurisdictions around the globe approach One Health and One Health issues. Maybe looking beyond the EU for a moment, are there any scientific or government initiatives and projects that you think are particularly interesting and from which we might learn? 

Steffen (00:01:49:11)

Thanks for that question and I’ve given some thought to it, and I know it's not polite to pat yourself on your shoulder, but I think actually in Europe we are the front runners in thinking about this concept and involving as many stakeholders as possible, and you see this cross-agency collaboration really being fruitful. From a global perspective, I think we are. 
Also, the environment, climate change and so forth are very high, not only on the political but also on the public agenda in Europe. I think we have a good position here. 
If I should mention something else, I would point to the World Health Organization, who is doing a lot and have a lot of focus. They have a wealth of good information on their website. And they are working in other parts of the world that are less developed than Western Europe and where the challenges of One Health are even bigger than we see in Europe. WHO might be the only one that I will pick up on for this question.

Carlos (00:02:52:04)

Carlos, here. And this is why it's good to have five agencies so that we can all team up again here as well. Just to highlight, I think Steffen is right that we are doing quite a good work and it's not to pat ourselves but to stay on course. But since you brought up WHO, I think also to be fair to our UN colleagues and to the World Animal Health Organization, the quadripartite.
So just like we’ve teamed up - the World Health Organization, with the Food and Agriculture Organization, with the United Nations Environmental Programme, and with the World Animal Health Organization - they've also teamed up to do this quadripartite on One Health. They're also trying to think together. And I think all of us agencies have good contacts with our colleagues in the UN and with WOAH, as we call the Animal Health Organization.
These interactions help to also move the table forward. And I think it is a very good example. They are thinking of the entire world. We're just thinking more of Europe. But I think good stuff will come out of this collaboration.   

James (00:03:59:18)

It's reassuring to hear that there's such a good level of cooperation not only within the EU, but also beyond as well.
Here I wanted to bring Mike in, maybe to give us a kind of historical perspective. And the reason I want to talk to you, Mike, about this is because someone told me that your long, illustrious career at ECDC is due to come to an end soon - you'll be retiring in 2024. 
I wanted to ask you: if you look back over the last 15 or 20 years, how far do you think the scientific community, policymakers, and decision makers have come in terms of recognizing the importance of dealing with the big public health, animal health or environmental problems we have in this interconnected One Health way?

Michael (00:04:43:24)

Well, that's a great question, James. 
I'm pleased to say that I think we've come a long way, not only in recognizing the interconnectedness of these problems, but also in starting to respond to big public health, animal health and environmental problems in an interconnected One Health way. I think we've come a long way and I mentioned before the work we've done together in producing this report on antimicrobial resistance and consumption, and we're seeing that have an impact.
We've seen EU legislation on the use of antimicrobials in animals and we've seen an encouraging reduction in the use and the levels of resistance as a result of that. I think that's really positive. That's where science and policy come together. 
That's why I also mentioned that in terms of the scientific collaboration at EFSA - along with the other agencies that sit around the table – EFSA took a lead in organizing a major One Health conference in 2022. So that was all the agencies talking about the science related to One Health. 
In our most recent ECDC scientific conference only a couple of weeks ago, we had a major One Health item on the agenda; in fact, we had the European Commission's Director-General for Health and Food Safety talking during that session as well as colleagues from EFSA.
So, I think that we're really seeing not only the scientists, but also policymakers recognizing the importance of One Health. I think that the future is rosy. 
One last thing for people listening, I hope that they will take from this: the interconnectedness of everything. But also, I would make the plea that on the topics that I'm particularly passionate about, which is antimicrobial resistance, that people treat antimicrobial medicines, antibiotics, as the precious resource that they are and only use them when necessary. And when they do use them, use them correctly. 
With that, I'll pass over to my colleagues who will be carrying the baton beyond 2024, unlike myself.

James (00:06:59:19)

Thank you very very much, Mike. That's great. 
Wim, I want to change track a little bit here and talk about data. As I understand it, data is the lifeblood of scientific bodies working in a regulatory or public health environment like the agencies that we have around the table here today.
And, ECHA, in order to carry out your activities under the chemicals’ legislation regulation in the EU, you have to manage and assess, I imagine, extremely large amounts of data and scientific information. I presume as well that some of this data may be of use and interest to other organizations - for example at EFSA. Can you explain why this is important and what systems ECHA is working on to make its data available to others?

Wim (00:07:46:17)

Data are the lifeblood, as you say. It's for regulatory agencies like everyone around the table here and our decisions and opinions, they're all based on scientific technical data. And that's why sharing this data is critical. And as you said, ECHA has had from its beginning this data mindset, and it's actually been an IT agency from the beginning, and that allows ECHA to process high volumes of information submitted by stakeholders.
We use quite a lot of structured formats: that's the benefit from the beginning for ECHA. We use the IUCLID format, for example, for a lot of our processes that allows us to share, compare, interpret data consistently in a structured format. The beautiful thing is that it's international like Carlos was talking about WHO. Also here in terms of data, we're talking about international standardized formats that are used not only within the EU but also outside. And that's one pillar. 
The other key strength that ECHA has developed over time is the ability to disseminate, to share information to the public. I think we're managing the largest public chemical database in Europe and one of the largest in the world even, because all the information we receive, we more or less publicly make available on our website.
Currently I think we have over 350,000 entries, mainly substances - 30 million published items that can be documents, pages, etcetera. And we have a lot of tools to make users kind of aware if they have a chemical, for example, you can have in one go an overview in the legislation finder. You can check about 60 different regulations, whether your chemical is affected or not – so 30 million views last year, just to give you an idea. 
That expertise indeed has allowed us to help out other authorities, for example like EFSA: we've helped in implementing the IUCLID system. But again, something coming up recently which refers back to this one substance, one assessment, is the idea and the proposal from the European Commission to propose an EU common data platform, and that will also be important for all of us so that it will provide a kind of one stop shop - at least that's the idea. 
So, we all have access to this vast amount of information that we all keep. All the EU agencies and the Commission will try to concentrate that information under that one data platform. It will also help us to overcome the challenges of data sharing, because currently that's an issue to be mindful of that the information submitted under various pieces of legislation is not so easily shared.
This idea that ECHA's expertise will now help this one data platform is really great. Data collection and management will be standardized, the interoperability and data sharing will be ensured. 
The positive times, I think it will take some time to get this running. But all of us, all stakeholders, being authorities, member states and stakeholders, will benefit from this one data platform.

James (00:11:19:05)

Thanks Wim. It's nice to hear. We talk about One Health a lot at a conceptual level, but there you really bring it down to something that you can almost touch and feel when we talk about data and sharing data in that way.
I want to ask you, Dario: the world is converging, as we record the podcast today, in Dubai for the COP28 talks and there, obviously, climate change is central to the discussions - it’s a growing concern for us all. The European Environment Agency has a broad overview about how climate change impacts many aspects of our lives - health, food, chemicals, sustainability. Can you tell us a bit more about this impact and what a One Health approach can do to help fight the threats brought about by climate change? 

Dario (00:12:08:04)

You mentioned COP28 and indeed, as you know, health was a prominent theme of the discussion and this shows in a way that the impacts of climate change and human health cannot really be ignored any further, including in Europe. It's not really an issue of something that's happening outside of our borders. And speaking of the overview of what is happening, how climate change is already starting to impact human health in Europe, of course, we're talking about a broad range of issues. And right now, heatwaves are the ones causing the largest number of deaths among weather and climate-related events in Europe.
Over the next few decades, we expect more frequent extreme heat episodes and increasing vulnerability also of the population. This will likely lead to a substantial increase in the impact of heatwaves. 
But then we're talking about other extreme weather events - flooding, wildfires - and these are like more direct health impacts. You may or may not consider them under the One Health umbrella, depending on how you frame One Health, but they’re still pretty much part of the picture, according to the EEA. 
Beyond that, there are also a lot of other issues that may benefit from taking a One Health approach, both in policymaking but also in assessing the risks and communicating the risks. And I'm talking about how climatic conditions across Europe are making certain areas more suitable for the emergence and transmission of infectious diseases that may affect the population, that may affect also those working in certain sectors that are of high exposure, such as agriculture, forestry and so on. 
We've seen really a lot of research also done, by the way, by the EEA together with the colleagues at the ECDC on how climate sensitive infectious diseases are really on the rise in terms of the risks they pose to citizens, or they will be on the rise in the future. 
Another important aspect is the risks through water. Here I'm talking about the risks posed to water availability, water quality in the future, but also all the increased exposure to harmful pathogens and chemicals that the impacts of climate change on water will then cause as a result. Think about the risks of water-borne disease outbreaks after flooding. Think about how flooding also increases exposure of citizens to chemicals that are mobilized as a result of these floods.
So, a broad range of issues, really. And as I mentioned in the context of infectious diseases, the agencies are working together on these. We work together with EFSA, for example, to look at emerging risks that are of a climate origin to pose risks to food safety for example, we work with the ECDC on climate-sensitive infectious diseases.
There is a lot of collaboration really here that takes this One Health framing. What is important is to also have a One Health approach to policymaking and to measures, to responses to the threats posed by climate change to health. Because this is one of the main issues, for example, in having climate adaptation measures, in preparedness measures - the different sectors need to communicate with each other. The health sector, the public health sector, they need to step up their consideration of climate change impacts and how the health system can respond and then the environmental sector incorporating health considerations in its plans for nature restoration, for nature-based solutions and so on. 
The One Health approach really brings a lot of benefits here on the climate change side.

James (00:15:54:00)

Thanks a lot, Dario. You spoke very clearly about what we're doing among the agencies, let's say, on the issue of One Health. And maybe just to wrap up, I think it's important also to recognize the contribution of agencies, policy makers, European Commission and so on is absolutely crucial.
There's maybe also a role for us as individual citizens to take: to behave or act in a certain way. So as a final question to all of you, I'd like for you to tell us one thing that you think, or you would like our listeners to do after hearing this podcast today to help advance One Health across Europe.
Jump in as you see fit.  

Carlos (00:16:36:01)

Well, I'm here sitting right next to you, so I can start. I think what I would say to everyone listening to us is: be curious. And by be curious, I mean, information is flowing at an incredible speed. But we, citizens, need to take decisions based on facts, not fictions. 
The agencies together here are giving a small contribution. We're investing a lot of resources in communicating and making sure that all of you listening have the best, correct, possible information to make your own decisions. And when I say be curious, I mean it even more if, by any chance you’re a parent or an educator and in some ways are linked, closer, to the future generations. We need this new wave of future scientists, of future politicians, of future journalists, of future citizens, to be One Health supporters. So, help us to drive curiosity forwards. 

James (00:17:32:09)

Curiosity is the key word for you there. Let's come to you, Steffen.

Steffen (00:17:38:09) 

I agree completely with you that we should be encouraging citizens to be curious, but we should also encourage them to be critical because I think the COVID-19 - and we discussed that earlier in this podcast - showed us that information is one thing, but correct information is another thing. Debunking fake news, false messages, threats in the social media area is an important threat to One Health - in the sense that it can drive populations in the wrong direction. We all have to acknowledge that we are a small piece of a bigger puzzle, and this is not just something to leave for bureaucratic organizations and politicians to decide upon: we all have a responsibility to be curious and to be critical. Thank you.    

James (00:18:36:03) 

We're building up the word cloud now. Curious, critical. 
What have you got for us Dario? 

Dario (00:18:42:23)

I will circle back to what I was saying at the beginning with your first question and kind of play the role as the European Environmental Agency here and say that I would hope that the main takeaway here for our listeners is that protecting the environment is ultimately about also protecting our own health. This is for me is just the biggest thing that we always need to keep with us when we try to maintain issues of nature, conservation and restoration, climate change mitigation, adaptation on the agenda.
If we want to keep the attention high in the public debate on these issues, also to steer the debate and policy discussions, we need to remember this inescapable link between our environment, our ecosystems and our health and our well-being. 

James (00:19:35:00)

Very good. We've got environment and the important link to health and wellbeing, and Wim? 

Wim (00:19:43:00)

If you're a consumer, I'd like you to be mindful when you buy something: check the labels, preferably opt for eco-friendly products and properly dispose in terms of products. Reduce your environmental impact, protect our health, but also make use of your rights. There's a lot of rights that you have as a consumer to ask whether there are certain substances in a product - check our website.
If you are not a consumer, but if you're more interested as a researcher and you would like to make a difference in your research area, also check our website because there we have a lot of proposals in the area of chemicals to make this planet a better place.
Thank you.  

James (00:20:29:17) 

Thanks a lot, Wim. And finally, to ECDC.  

Michael (00:20:33:06)

What we do in one field has an impact on others. And if I could just make a particular plea in respect to antibiotic resistance is – please, anybody listening to this - treat antibiotics as the precious resource that they are and only use them when necessary. And when you’re using them, use them correctly.

James (00:20:57:17) 

That's it for now. I hope you enjoyed this special episode on One Health. It's a big topic, but I think the discussion we had goes a really long way to explaining why it's so important. 
For more information about EFSA’s work and that of our sister agencies, do check out the description in the podcast where you'll find all the relevant links to our websites and to our joint social media accounts.
Finally, a big thanks to all those who contributed to this episode. And see you next time on Science on the Menu.