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Workshop “German – Central Asian Cooperation on Zoonotic Diseases”

The international workshop “German – Central Asian Cooperation on Zoonotic Diseases” took place on June 12, 2019 in Munich, organized by the Bundeswehr Institute of Microbiology and the German Research Platform for Zoonoses.

Prof. Dr. H. Meyer, the deputy head of the Bundeswehr Institute of Microbiology (BMI), nicely phrased the aim of the workshop in his introduction note: bringing together different partners that share a common interest in zoonoses research in Central Asia to promote the scientific exchange, to identify challenges, to bundle resources and knowledge and to create research networks.

Participants of the Central Asia workshop on Zoonotic Diseases in Munich

Potential funding options for zoonoses research in Central Asia

PD Dr. Sandra Essbauer from the BMI) and member of the Internal Advisory Board of the German Research Platform for Zoonoses started the workshop with an overview of different funding opportunities for zoonotic research in Central Asia like the Volkswagen Foundation, the Kreditanstalt für Wiederaufbau (KfW), the German Research Foundation (DFG), the German Biosecurity Program (funded by the Ministry of Foreign Affairs), the German Ministry of Education and Science and the European Union. Dr. Essbauer concluded that so far the number of zoonoses research projects funded in the region is still small compared to other topics. Not many organizations focus on zoonoses even though zoonoses are a relevant health burden.

Importance of zoonoses research in Central Asia and potential approaches

Dr. Bernadette Abela-Ridder from the World Health Organization (WHO) presented the importance of zoonotic diseases for public health in Central Asia and some strategies on how to address that issue. As head of the department for neglected tropical diseases zoonotic diseases also fall into her sector. The five key strategies from WHO to tackle zoonoses are disease management, promotion of veterinary health, vector management and ecology, prevention strategies and stable water, sanitation and hygiene systems. Especially for Central Asia, the poor data availability and the language hurdles would be a problem to overcome. In general, referring to Dr. Abela-Ridder, all measures should be adapted to the individual countries and aim to build capacities in the countries rather than building dependencies. Key to the success of all endeavors would be a close cooperation between all involved civil and political organizations. For securing research funding, the economic angle should be considered in the argument. Concepts that share the required costs between sectors and that advocate the mission in society might be successful. Further, lining up with the resources available for the fight against neglected tropical diseases might be promising since the two fields share many common challenges.

Dr. Mario Latini from the World Organization for Animal Health (OIE) presented the results of the first Zoonoses Meeting for Central Asian and Caucasian countries hosted by the OIE sub regional representative office in Nur-Sultan, Kazakhstan. The meeting addressed the current situation in controlling rabies, brucellosis and echinococcosis in that region. The aims of the meeting were to introduce the One Health concept to the participants, to strengthen knowledge and built networks between the relevant sectors. As an outcome, recommendations for the states as well as for the OIE/WHO were formulated. For the future follow-up meetings are planed that will go into more detail on what measures are to be taken against the mentioned zoonoses. Dr. Latini stressed in the discussion that one main goal should be to generate reliable data to obtain a realistic impression of the current situation in the individual regions. The data can then serve as a basis for decision-makers.

Prof. Dr. Jakob Zinsstang of the Swiss Tropical and Public Health Institute claimed that for integrated zoonoses control in Central Asia working together would provide a benefit. In particular, to show that the social benefits can outweigh the invested funds, will convince decision makers to take actions, referring to Prof. Zinsstang. For Central Asia he named some challenges that could hinder the success of interventions such as wrong storage of vaccines, poor logistics, uncontrolled livestock numbers (lack of control since collapse of the Soviet Union), among others. The core elements of controlling zoonotic infections would be awareness rising, prevention strategies, vaccinations as well as education programs. He also introduced the idea of interrupting infection circles of more than one disease at a time with an intervention program to increase efficiency and lower costs. However, convincing governments/investors that investments will be profitable in a long-term perspective would be a key to get the funding needed to establish sustainable programs in the control of zoonoses.

Research projects of German institutions in Central Asia

Over the last decades, different German institutions have established numerous research projects addressing zoonoses control in Central Asia.

Dr. Claudia Sievers presented the current cooperation of the Robert Koch-Institute (RKI), Unit Highly Pathogenic Microorganisms, Centre for Biological Threats and Special Pathogens, with Central Asia. Since 2014 the RKI was involved in many international activities that included outbreak support, biosafety measures, research activities as well as International Health Regulations (IHR) strengthening. In Central Asia the RKI conducted a capacity building program that included outbreak investigation and response training along with a biosafety and biosecurity training in Kazakhstan and Tajikistan. Dr. Sievers reported that the reduction of language barriers was essential for the success of the training programs. Short duration of employment contracts at the participating institutions hampered to some extent the establishment of long-term cooperation. However, some stable networks could be established. For the future closer collaboration with the public health system of Tajikistan, more training of personal and establishment of laboratories are planned. Especially a better interdepartmental collaboration might be key to successfully fighting zoonoses in Kazakhstan and Tajikistan.

One former trainee within the RKI program in Tajikistan, Dr. Suhayli Muminojonov, reported on the follow-up program, which resulted from the initial cooperation with the RKI. The BMBF funded project includes the set-up of an anthrax diagnostic laboratory were the first human samples could already be investigated. To test the quality of the newly established laboratory, the Unit Highly Pathogenic Microorganisms, Centre for Biological Threats and Special Pathogens, RKI, served as a reference laboratory, where the samples were analyzed a second time. For the future testing of animal samples is planned. In the following discussion, the lack of monitoring programs for tularemia in Tajikistan was addressed. So far, the country cooperates more with Russia than with other border states such as Iran or Afghanistan.   

Dr. Tserennorov Damdindorj from the National Center for Zoonotic Diseases (NCZD) in Mongolia reported on the joint collaboration activities of her institute with the BMI that exist since 2009. The focus of the studies are tick-borne diseases and different plague strains. The collaboration aims to strengthen the capacities of the Mongolian health system in fighting the zoonotic infections as well as to increase scientific knowledge. A veterinary vaccination program in cooperation with Russia is already implemented in the country against some zoonoses.

Dr. Olesksii Solodiankin provided insight on the German-Ukrainian Biosecurity Initiative for zoonoses risk management near the external EU border. The project is a part of the German Biosecurity Program and a joined venture of the BMI, the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) and the Institute of Experimental and Clinical Veterinary Medicine (IECVM) in Kharkiv. The goal is to build capacities in Ukraine that allow the country to handle independently zoonotic infectious diseases. This includes the training of employees, the set-up of laboratory equipment as well as the collection and publication of scientific data. So far, samples from wild boar, ticks, rodents and water have been collected and tested for tularemia. Further, soil samples are tested for anthrax. The program is designed to overcome the shortcomings in zoonoses prevention, monitoring and control currently exiting in the country.

Another project of the German Biosecurity Program in the Caucasus Region was introduced by Dr. Corinna Schwarz of the BMI. The partnership existing since 2013 between Germany and Georgia aims to increase the capacities at the National Center for Disease Control and Public Health (NCDC) in Tbilisi. The program includes training of PhD students as well as of lab workers in working with Leptospira and tick-borne encephalitis virus (TBEV). So far, 280 rodent probes could be collected in the area of Batumi (location of an international airport) to be tested for Leptospira. The speaker pointed out that especially the logistics and the planning phase of the project were time consuming. For TBEV diagnosis cow sera probes collected in cooperation with veterinarians from the National Food Agency (NFA) of Georgia have been tested yielding some positive results. However, so far no milk-transmitted cases of TBEV have been reported in the country. Cows were chooses for analysis because they can run free in many areas of the country covering great expanses in this way. For investigation of other species relevant for TBEV transmission, such as ticks and dogs, the financial resources are currently not sufficient.

The Friedrich-Loeffler-Institute (FLI) contributes to biosecurity measures in Central Asia with projects in Egypt, Pakistan and Ukraine under the head of the German Biosecurity Program. The efforts to enhance biosafety and biosecurity in Pakistan were presented by Dr. Hosny El-Adawy of the FLI. The project aims to combat and control brucellosis in Pakistan. Therefore, disease surveillance, control strategies (e.g. vaccination programs), training of human and veterinarian health professionals, communication strategies and building up networks between different sectors are part of the project. The FLI serves as reference laboratory for the collected samples in Pakistan though transfer of samples from the country is difficult. Since in many rural areas of Pakistan humans and animals live close together, raising awareness in the public is essential to fight zoonotic diseases in Pakistan. According to Dr Hosny El-Adawy, solid scientific data on zoonotic infectious strains in the country are required to convince the government of Pakistan that measures are needed and be beneficial both for human as well as for animal health.

Insights into zoonoses in some Central Asian countries

Looking back on two decades of collaboration on zoonotic diseases between the Vetsuisse Faculty of the University of Zurich and Central Asian institutes, Dr. Paul Torgerson gave an insight into the experiences gained. The EU (INTAS), Swiss National Science Foundation, Welcome Trust and the National Institute of Health (USA) have funded these research activities. These mmany funded projects documented the increase in importance of zoonotic diseases in Central Asia after the collapse of the Soviet Union. The possible infection pathways in Central Asian countries, such as Kyrgyzstan, Kazakhstan and Tajikistan, are diverse. Surveillance programs along with mathematical models to identify suitable intervention strategies in the individual countries are one route to approach the problem. Also new treatment strategies have been developed to positively influence the disease outcome for patients suffering from echinococcosis.

Duriya Charypkhan (University of Zurich) presented a project that tries to increase the capacities in Kazakhstan to control brucellosis in the country. The disease possesses a huge health burden for the country with more or less stable incidence numbers during the last decade. So far, the implementation of test slaughter and vaccinations could not decrease the number of diseases. The problem is to be addressed by a One Health approach. Data obtained from first evaluation studies will serve as a fundament to improve the exiting policy. Strategies to handle Brucellosis will include the investigation of infection pathways as well as raising awareness in the population.

Brucellosis is not only a problem in Kazakhstan but also in Tajikistan as Khuseyn Egamnazarov from the Avicenna Tajik State Medical University described. Incidences in humans and livestock cause economic losses to the individual as well as to the state. The changes in livestock farming after the collapse of the Soviet Union favored the spread of brucellosis in Tajikistan and make its control difficult.

Prevention strategies – being one-step ahead of zoonoses

One concept to prevent potential outbreaks of vector-borne zoonoses in the future was presented by Alexandra Lawrence (University of Bayreuth). She introduced a modelling software to predict the distribution of different tick species by taking into account the environmental factors in a specific region. For instance Hyalomma ticks serve as reservoirs for Crimean-Congo Hemorrhagic Fever (CCHF), which is why the human cases of CCHF are linked to the tick’s distribution. Knowing the distribution of the tick species can thus reveal the exposure risk and the risk of an outbreak for a specific region in Central Asia.

Dr. Norbert Schwarz (BNITM) introduced two projects under the framework of the German Biosecurity Program with involvement of the Bernhard Nocht Institute for Tropical Medicine (BNITM). First, the Global Partnership Initiated Biosecurity Academia for Controlling Health Threats (GIBACHT) an initiative of the RKI, the BNITM, the Swiss Tropical and Public Health Institute and the African Field Epidemiology Network (AFENET) was introduced. GIBACHT is a training program in biosecurity and biosafety (BSB) for postgraduate students. It targets the dangers that arise from high mobility of goods and persons, from unprepared health systems and from deliberate or accidental release of pathogens. The overall goal of the project is to minimize these dangers. The project GO4BSB, an e-learning platform designed to train people that are involved in BSB related teaching activities, aims in the same direction. It provides learning materials, tests, evaluation tools, and additional interactive modules to support experts in their teaching activities. The platform is accessible for experts after a registration process. The idea behind both projects is that in strengthening individual health systems the global ability to prevent or handle infection outbreaks is increased.

Promotion of scientific exchange and development of concepts for the future

The workshop was successful in bringing together numerous researchers and organizations that participate in zoonoses research in Central Asia. Many fruitful discussions, which took place during the talks as well as in the breaks, testified of the successful exchange of the participants. The newly built network will now serve as a platform to address the following question: “How to implement the One Health concept in Central Asian countries in order to overcome zoonoses?” The workshop was a first step towards answering the question. All efforts should be fueled by the knowledge that combating zoonoses cannot only improve the health of people and animals, but can also improve the economy and quality of life in the region.


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