The Challenge & Opportunity of One Health Approach to ......The Challenge & Opportunity of One...
Transcript of The Challenge & Opportunity of One Health Approach to ......The Challenge & Opportunity of One...
The Challenge & Opportunity of One Health Approach to Indonesia’s Laboratory on Identification and Early Detection of Zoonotic Emerging Infectious Diseases
Prof. Wiku Adisasmito, DVM, M.Sc, PhD Adjunct Professor, Infectious Disease and Global Health, Tufts University, USA
Affiliate Professor, Environmental Health Sciences, UMN, USA Professor – Health Policy
Faculty of Public Health, Universitas Indonesia INDOHUN Coordinator
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2 Outline
• Background
• Laboratory in Indonesia
• Sectoral laboratory network in Indonesia
• Laboratory Roles
• Capacity assessment in 12 MoH, MoA, and University laboratory
• Biorisk spectrum
• One Health Laboratory Network Platform
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3 Global and National Challenges
Land Use Change Global Mobilization
Disaster
Terrorism (Bioterror)
Infectious Diseases
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Climate Change
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Source : Emerging & Re-Emerging Infectious Disease Challenges. Nature 430: 242-49 (Morenz. DM et al, 2004)
Source : Emerging & Re-Emerging Infectious Disease Challenges. Nature 430: 242-49 (Morenz. DM et al, 2004)
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Source : Emerging & Re-Emerging Infectious Disease Challenges. Nature 430: 242-49 (Morenz. DM et al, 2004)
Life Science Laboratory in Indonesia
* This data is for discussion only
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Source : Emerging & Re-Emerging Infectious Disease Challenges. Nature 430: 242-49 (Morenz. DM et al, 2004)
Life Science Laboratory in Indonesia
LIFE SIENCE Laboratory
19.648 This has not been included thousands of individual clinical laboratory, food industrial,
and private animal health laboratory
Total
Laboratorium
590
* This data is for discussion only
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Source : Emerging & Re-Emerging Infectious Disease Challenges. Nature 430: 242-49 (Morenz. DM et al, 2004)
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Sectoral Laboratory Network in Indonesia
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9 Laboratory Network in Indonesia
Ministry of Health Laboratory Network based on Diseases (focus on referral system)
Improved and Migrated
MoH In the process of Establishing Public Health Laboratory Network (PHLN)
Public Health Laboratory Network
(PHLN)
The PHLN platform scope of work will be:
- Lab-based surveillance and referral system for 23
notifiable diseases, food-borne diseases, and NCD
(eg. Congenital disorder etc.)
- Screening (including neonatal)
- Environmental health (toxin, metal, soil etc.)
- Testing for outbreak investigation
The PHLN member will be 10 BBTKL PP and 4 BBLK
*Supported by ministerial regulation
Leptospira Lab Network
*Polio Lab Network
AI Lab Network
*Measles & Rubella Lab Network
ILI Lab Network
Diphtheria Lab Network
*HIV Diagnostic Lab Network *National
Referral TB Lab
Other Clinical Laboratory for diagnostic (non
network)
Infectious Disease Lab-Based Surveillance
Network
The MoH will also establish Infectious Diseases Lab-based Surveillance Network involving
PHLN member, hospital labs, clinical private labs, and university/research labs
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13 Laboratory Network in Indonesia
Ministry of Agriculture Animal Health Laboratory Networks (referral and targeted diseases surveillace system) based on Kepmentan 668/2002 concerning National Animal Quarantine, Coordinating Committee
Ditjen PKH
Badan Karantina Pertanian
Badan LITBANG Pertanian
Lab Veteriner Provinsi
Balai Besar Pengujian Mutu dan Sertifikasi
Obat Hewan
Balai Veteriner
(5)
Pusat Veteriner
Farma
Balai Besar Veteriner
(3)
Balai Pengujian Mutu dan Sertifikasi
Pakan
Balai Pengujian Mutu dan Sertifikasi
Produk Hewan
Balai Besar
Penelitian Veteriner
Lab. Veteriner Provinsi
Balai Besar/ Balai/Stasiun
Karantina Pertanian
Balai Besar Uji Standar Karantina Pertanian
Balai Uji Terap Teknik
& Metode Karantina Pertanian
It is not include in Kepmentan 668/2002
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Microbiology Laboratory and Parasitology Laboratory, FM, Universitas Indonesia
Microbiology and Parasitology Laboratory FM, Padjadjaran University Microbiology Laboratory, FM Hasanuddin University
Veterinary Microbiology Laboratory, FVM, Bogor Agriculture University
Microbiology and Parasitology Laboratory, FM and FVM, Gadjah Mada University
Microbiology and Veterinary Microbiology Laboratory, FM and FVM, Airlangga University
Parasitology Laboratory, FM, Sam Ratulangi University
8 Microbiology, 3 Parasitology, 1 Microbiology & parasitology
One Health Laboratory Network Current University Laboratory Member
8 Human Health Laboratory
4 Animal Health Laboratory
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17 Life Science Laboratory Roles
2. Early Detection and Referral System
1. Developing New Vaccine and Drugs
3. Training and Education
BIOSAFETY & BIOSECURITY
ANTI-MICROBIAL RESISTANCE
BIOTERROR
BIOTECH NOLOGY
INFECTIOUS DISEASE
(EID, Zoonotic, NTD)
Utilization Aspects National Security and
Defense Aspects
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18 Laboratory Assessment Tool
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19 Laboratory Capacity in 3 Ministries
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1
6
4
3
1
5
1
2
9
4
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4
7
5
6
4
6
1
1
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7
6
3
5
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7
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5
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9
3
2
3
5
1
2
5
1
10
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0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Laboratory collaboration
National lab networking
Communication means
Staff Security/Health
Biosafety/Biosecurity
Quality Assurance
Training
Available technology
Sample accession
Staff skills + availability
Reagent supply
Equipment
Infrastructure
Organization
Basic supply
Laboratory Budget
Geographic location
Var
iab
les
20 Laboratory Capacity from Ministry of Health, Ministry of Agriculture, and University Capacity Based on FAO LMT
0 - 20 21 - 40 41 - 60 61 - 80 81 - 100
Mapped based on FAO LMT, 2017
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20 Laboratory Bio-risk Spectrum
Outbreak Epidemic Pandemic
Laboratory Infections Containment Failure
Behavior
Sabotage DURC
Bio-crime Bioterrorism
Natural Accident Deliberate
BIOSAFETY BIOSECURITY
EID: 2019-nCoV
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1. Anthrax 2. Rabies 3. Salmonellosis 4. Brucellosis (Brucella abortus) 5. Avian Influenza (AI) 6. Porcine Reproductive and Respiratory Syndrome (PRRS) 7. Helminthiasis 8. Septicaemia Epizootica (SE) 9. Nipah 10. Infectious Bovine Rhinotracheitis (IBR) 11. Bovine tuberculosis 12. Leptospirosis 13. Brucellosis (Brucella suis) 14. Jembrana 15. Surra 16. Paratuberculosis 17. Toxoplasmosis 18. Classical Swine Fever (CSF)/ Hog Cholera 19. Swine Influenza 20. Campylobacteriosis 21. Cysticercosis 22. Q Fever 23. Penyakit Mulut dan Kuku (PMK) 24. Bovine Spongiform Encephalopathy (BSE) 25. Rift Valley Fever (RVF)
Infectious Disease Priority between MoA and MoH
1. Acute Diare 2. Malaria Konfirmasi 3. Tersangka Demam Dengue 4. Pneumonia 5. Diare Berdarah 6. Tersangka Demam Tifoid 7. Jaundice Akut 8. Tersangka Chikungunya 9. Tersangka Flu Burung pada Manusia 10. Tersangka Campak 11. Tersangka Difteri 12. Tersangka Pertussis 13. AFP (Lumpuh Layuh Mendadak) 14. Kasus Gigitan Hewan Penular Rabies 15. Tersangka Anthrax 16. Tersangka Leptospirosis 17. Tersangka Kolera 18. Kluster Penyakit yg tdk lazim 19. Tersangka Meningitis/Encephalitis 20. Tersangka Tetanus Neaonatorum 21. Tersangka Tetanus 22. Influenza like-illness (ILI) 23. Hand, foot, and mouth diseases (HFMD)
Ministry of Agriculture Based on Kepmentan 4 0 2 6/2013 con c e rn ing S t r a teg ic I n f ec t ious D i sease s
Ministry of Health Based on P e rmenkes 1 5 0 1/2010 Con c enring I n fect ious d i s eases t h at po t entia l ly c au s e ou t b r eak
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What should be done to better identify and detect the Emerging Infectious Disease (EID)?
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23 Establishing One Health Laboratory Network
Strengthening Collaboration and Laboratory Capacity to Identify, Detect the Emerging Infectious Diseases (EID) and Zoonosis
Collaboration
Linking Related Government Laboratories to Combat EID and Zoonosis
Advocacy
Promotion and Advocacy on the Implementation and Development of OHLN and Biorisk Management national
policy
Support
Strengthening Laboratory Capacity
Mission
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24 Technical Core Function of One Health Laboratory Network
1. One Health related infectious disease identification and early detection (diagnostic testing)
2. One Health related infectious disease surveillance
3. Reference and specialized testing (eg. outbreak test)
4. One Health related infectious disease research
5. Data integration management
6. Capacity building (training and education)
7. One Health preparedness and emergency operation
OHLN is focusing on combating national and international priority EID and zoonosis by promoting:
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25 Current Function of Human and Animal Health Laboratory
Human Clinical Labs (GoI & Private) Public Health Labs (GoI) Animal Health Lab
(GoI)
Human and Animal University Lab
(GoI and Private)
• Diagnostic testing • Some reference testing • Medical management • Data sharing (potential) • Focus Individual health
• Some diagnostic testing • Some reference testing • Surveillance and monitoring • Data sharing (potential) • Focus Public health
• Some diagnostic testing • Reference testing • Surveillance and monitoring • Data Sharing (potential) • Research • Focus Animal health
• Research • Some diagnostic testing • Some Reference testing • Data sharing (potential) • Focus Both human and
animal health
Ministry o f Hea lth MoA Ministry RHE
Aquatic Animal Lab (GoI)
• Some diagnostic testing • Reference testing • Research • Data sharing (potential) • Focus Aquatic animal health
Marine Affairs
One Health Laboratory Network Establishing Integrated diagnostic, referral, surveillance, epidemiology and clinical data sharing,
and research system for Emerging Infectious Diseases and Zoonosis
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Thank You CONTACT:
Kampus Baru Universitas Indonesia Depok, Faculty of Public Health, G Building, 3rd Floor,
Room G316 Universitas Indonesia, Depok, West Jawa, Indonesia
+62 2129302084 [email protected] indohun.org