Health ministry, agriculture ministry, and stakeholders Thimphu on November 6 signed an MoU to implement Bhutan One Health Strategic Plan (BOHSP) 2017–2021.

Lack of strategic framework to formalise, guide and sustain the implementation of One Health approach to prevent and control zoonotic and high-impact diseases in the country called for the institutionalisation of One Health concept in Bhutan.

Khesar Gyalpo University of Medical Sciences, Royal University of Bhutan, Ministry of Home and Cultural Affairs and National Environment Commission are the other stakeholders.

Lhengye Zhungtshog endorsed the BOHSP 2017-2021 on November 22 last year.

Programme director with the agriculture ministry’s National Centre for Animal Health, Dr Kinzang Dukpa, said One Health is collaborative effort of multiple disciplines working locally, nationally and globally to attain optimal health for people, animals, and environment.

Dr Kinzang Dukpa said the emergence and re-emerging of infectious zoonotic diseases because of various reasons like increasing population and climate change, increasing interactions between people, domestic and wild animals leading to a higher potential for the emergence of novel pathogens, have been a major driver for the adoption of a One Health approach to managing diseases.

Rabies, avian influenza, scrub typhus, anthrax and cystic echinococcosis are some of the zoonotic diseases in Bhutan.

The stakeholders jointly developed the National Influenza Pandemic Preparedness and Response Plan after an emergence of highly pathogenic avian influenza (HPAI) caused by H5N1 virus in the region in 2003.

Lyonpo Yeshey Dorji said Bhutan faced several outbreaks of HPAI, all of which were successfully controlled.

The first outbreak of H5N1 was reported in the country in February 2010.

“Another success indicator of our One Health in action is rabies control programme,” Lyonpo said.

Despite a large number of dog bites cases (approximately 7,000 dog bites a year) and several outbreaks in animals, only two cases of human rabies occurred since 2012.

Lyonpo said the country continue to face several threats from increasing incidence of emerging and re-emerging infectious diseases, including problems related to antimicrobial resistance.

About 60 percent of emerging infectious disease is zoonotic.

“This requires multifaceted, coordinated and collaborative approach by key sectors of human health, animal health and the environment, applying One Health concept to detect and respond rapidly and effectively,” Lyonpo said.

He added that to achieve the elimination of zero human dog-mediated rabies by 2023 is another important task to be achieved under One Health umbrella. “As per our situation analysis towards achieving this goal, Bhutan has scored 3.5 out of 5. I am confident we can achieve this easily if we all worked together in a coordinated and collaborative manner, with more vigour than we work today.”

The strategic framework and action plan were prepared by involving key stakeholders from the health ministry and the MoAF and allied institutes in the country in April 2014.

The framework comprises of seven strategies that cover specific requirements and objectives for the implementation processes.

“A logical framework plan and timeline has also been developed to operationalise the One Health Concept,” Dr Kinzang Dukpa said.

Lyonpo said BOHSP 2017-2021 was developed based on the principle of multi-sectoral coordination and collaborative actions, and the implementation of the plan required support and commitment of stakeholders.

The estimated budget for the implementation of BOHSP is Nu 77M (million).

Deputy chief regulatory and quarantine officer with Bhutan Agriculture and Food Regulatory Authority, Dr Sithar Dorjee, said the amount is to kick-start implementation of key activities on a priority basis. “Ideally we would require USD 3M).

World Bank, Government of India, and European Union are some of the potential supporters.

“We request the ministers, secretaries, director generals to present BOHSP to all potential donors,” Dr Sithar Dorjee said.

Dechen Tshomo