A reframed notion of global health – one that recognises that we live in an interconnected ecosystem in which animal, environmental and human health are integral to our wellbeing – will be one of many facets of the work undertaken by the new Australian Institute for Infectious Disease (AIID). The AIID will be a hub of groundbreaking research and industry partnerships which will be housed within the one building.
A University of Melbourne panel discussion on 17 October 2024 – One Health: Interconnected solutions for a healthy Australia – brought together experts in human, animal and environmental health for a discussion in the Kenneth Myer Building and online. The event was presented by the AIID, which promises to be a world-leading centre for infectious disease and public health research.
Professor Jodie McVernon and Professor Kathryn Bowen speaking on the panel.
Featuring speakers from AIID Foundation Partners the University of Melbourne, the Peter Doherty Institute for Infection and Immunity (Doherty Institute), and Burnet Institute, key focus areas discussed included: the need for equity; inclusivity and coherence in pandemic preparation and response; the role of strong governance and financing; the crucial part universities can play in a One Health world; and the danger of misinformation and eradication of trust.
The post-COVID-19 landscape
Panel moderator Professor Jodie McVernon (Director, Doherty Epidemiology, Doherty Institute) opened proceedings with a graphic from the 2022 World Health Organisation (WHO) report Imagining the future of pandemics and epidemics.
It outlined four perceived scenarios in the aftermath of the COVID-19 pandemic, ranging from “Happy Days”, in which the pandemic was under control, through to “Here Comes Trouble”, where new diseases emerge, resilience is low, inequality escalates and economies and collaboration break down.
Dr Sandra Steele (Senior Lecturer in Veterinary Epidemiology (One Health), University of Melbourne Veterinary School) viewed the current landscape as nudging scenario three, where pathogens evolve, and health systems struggle to keep up. She noted research done by vets showed significant animal health and welfare issues during the pandemic had resulted from public health interventions that left them unable to be cared for.
“I reflect back to being a veterinary clinician,” Dr Steele said. “I always thought it’s not just the dog on the table, it’s a dog that may have a disease, but that dog is part of a family, and that family is part of a community, and that community is part of a bigger region.”
For Associate Professor Suman Majumdar (Chief Health Officer, COVID & Health Emergencies, Burnet Institute), how the landscape looks can depend on where you live – which speaks to issues of equity, something he believes must be “baked into” One Health’s core.
In Parkville, he recognises elements from scenario two (“I love you, I hate you”), where health systems have largely adapted. In other regions where Burnet has offices, such as in Papua New Guinea, risks including climate change and conflict push it towards scenario three.
“And if you’re a truck driver, a sex worker or a farmer living in west Africa, you’re probably in scenario four because you’ve got Mpox affecting your family, you’ve got Marburg [virus disease, or MVD] in Rwanda. These things are getting worse.”
Get proactive
Dr Alicia Arnott (Deputy Head of Epidemiology, Victorian Infectious Diseases Reference Laboratory) looks for pathogens to generate information that fuels decision-making. It consumed her work during COVID-19, and now viruses like Mpox and Japanese encephalitis (JEV) are her focus.
She chose an action-movie analogy, where the bad guys wait their turn to tackle the hero in fight scenes. “We are not dealing with that with viral pathogens at the moment,” Dr Arnott said. “They are all coming at us at once – nobody’s waiting their turn, nothing’s polite.”
Dr Alicia Arnott and Dr Sandra Steele speaking on the panel.
Illustrating how much work needs to be done, she noted that 20 million SARS-CoV-2 genomes were generated over four COVID years. For the clade 1 form of Mpox, which has prompted a second public health warning of international significance, only 600 genomes had been generated in close to a year.
“The people who are trying to develop vaccines, make treatments, do all of the things that people who are experiencing this disease need, they need information. If this information isn’t being generated, they can’t do their work.”
The power of education
Professor Kathryn Bowen (Professor – Environment, Climate and Global Health; Director Climate CATCH Lab, Deputy Director, Melbourne Climate Futures, University of Melbourne) is excited at the prospect of climate scientists working at the AIID.
With extreme weather events expected to increase in frequency and intensity, she noted that infectious diseases are also going to evolve. Increased funding, proper governance and education will all play greater roles, with universities ideally placed to meet challenges head-on.
Associate Professor Suman Majumdar speaking on the panel.
“Given the chaos that we see in our current state of the world, the multiple crises and the lack of trust in governments, universities are more important than ever to show our leadership and to show that our research is policy-relevant and, crucially, can provide some level of hope and optimism.”
Associate Professor Majumdar noted the role of education in rebuilding trust that was eroded during the pandemic, describing misinformation as “a technical issue that can be vaccinated against”.
Collaboration is key
For Dr Steele, having all stakeholders represented at the table is key to bringing diversity and equity to One Health. She cited project work in South-East Asia, where vets build relationships with human health colleagues by doing passive surveillance for diseases such as African swine flu.
Indigenous colleagues have fuelled similar knowledge growth, with One Health effectively a way of living that has existed for tens of thousands of years. “They don’t even divide it into human, animal and environmental health. They see it as a more holistic entity.”
Dr Arnott likened the landscape ahead to “a multidisciplinary team sport”, where organisations that have operated in silos are challenged by coming together under one roof for a greater good – and the AIID would be providing that roof.
“It is an approach, a different way of thinking – you’ve got to not just stay in your lane, you’ve actually got to challenge yourself to tackle the bigger problems with others.”
The panel members with AIID Foundation Partner representatives Professor James McCluskey AO, Professor Sharon Lewin and Professor Brendan Crabb AC.
For Professor James McCluskey (Assistant Vice-Chancellor, University of Melbourne), the “critical mass” of expertise embraced by the AIID will be an enormous boon in helping to protect the community against future infectious disease threats.
“It includes everyone from front-line healthcare workers – clinicians, nurses, primary care workers – through to scientists who are developing diagnostics and therapeutics, through to epidemiologists and mathematical modellers who are figuring out how the infection is transmitted and how best to interfere with that, through to policy thinkers who work with government to advise and support the government as it develops its policies,” Professor McCluskey said. “To get the right answer, they need to work together.”
“We need to have a very holistic view to be able to make the best decisions – and you can’t just ‘magic’ that up when a pandemic arrives. You need the working relationships and the mutual trust, and the shared knowledge and conversations and dialogue need to be happening in the background all the time. And when a pandemic hits you click into a different gear, and you’re not starting from scratch.”
Learn more about the AIID’s visionary work to protect Australia and the region against infectious disease and future pandemics.