Mieghan Bruce

In Sahelian Africa and connected regions, the burden of transboundary animal diseases is poorly understood. This is due in part to the lack of robust estimates of the distribution and intensity of these diseases within the region. However, the problem is compounded by the complexity of the types of losses attributable to specific diseases, including the impact on human health of zoonotic transboundary diseases such as brucellosis and Rift Valley fever. There is also a balance between disease losses and the cost of our response to the presence or perceived threat of transboundary animal diseases. This chapter presents a framework for measuring the burden of transboundary animal diseases in the Sahel region, explores disease distribution data and collates what information is available on productivity losses and expenditure on disease mitigation, namely surveillance, prevention, control and treatment activities. We highlight the need for standardised data collection processes that capture disease loss estimates as well as expenditure related to our response. Reporting changes in losses and expenditure over time will provide a basis for making informed disease control policies for transboundary animal diseases. The outcome of this will be an evidence-base for mobilising resources in an efficient and effective manner.

Beef production is considered to have a large water footprint, with values ranging from 3.3 to 75,000 L H20/kg. The water consumption in beef production is primarily associated with feed, estimated to be about 98%, with other requirements representing less than 1%. However, beef production is a complex system where cattle are often raised in different areas using a range of resources over their lifetime. This complexity is demonstrated using three countries with very different environments and production systems, namely Australia, Brazil, and Kenya. To achieve efficient water use in beef systems, and food systems more generally, a classification system that reflects how animals are managed, slaughtered, and processed is required. Methods for assessing water use in livestock systems, from production to consumption, need to be standardized, whilst also including the alternative uses, multiple uses, and benefits of a certain resource in a specific location.

This chapter provides an overview of the main methods and techniques available for the economic evaluation of One Health initiatives to introduce scientists and professionals from backgrounds other than economics to key considerations and implications of such assessments. The first part of the chapter describes the main analytical tools currently used in economic evaluations and discusses their potential and limitations when applied in a One Health context. A critical assessment is provided in particular to issues dealing with complexity of interrelations between human and animal health, and effective management of environmental resources. The second part of the chapter introduces and describes a range of pragmatic approaches to economic evaluation which have been inspired from the need to deal with and account for such complexity. It also investigates how systems approaches and methods used in One Health can enhance the capacity of economic evaluations to support informed decision making. With this chapter we are making a contribution to develop One Health economics as a scientific trans-disciplinary topic and stimulate further economic evaluations of One Health activities from a broader range of disciplines.

Challenges calling for integrated approaches to health, such as the One Health (OH) approach, typically arise from the intertwined spheres of humans and animals, and the ecosystems constituting their environment. Initiatives addressing such wicked problems commonly consist of complex structures and dynamics. The Network for Evaluation of One Health (NEOH) proposes an evaluation framework anchored in systems theory to address the intrinsic complexity of OH initiatives and regards them as subsystems of the context within which they operate. Typically, they intend to influence a system with a view to improve human, animal, and environmental health. The NEOH evaluation framework consists of four overarching elements, namely: (1) the definition of the OH initiative and its context; (2) the description of its theory of change with an assessment of expected and unexpected outcomes; (3) the process evaluation of operational and supporting infrastructures (the 'OHness'); and (4) an assessment of the association(s) between the process evaluation and the outcomes produced. It relies on a mixed-methods approach by combining a descriptive and qualitative assessment with a semi-quantitative scoring for the evaluation of the degree and structural balance of 'OH-ness' (summarised in an OH-index and OH-ratio, respectively) and conventional metrics for different outcomes in a multi-criteria-decision analysis. We provide the methodology for all elements, including ready-to-use Microsoft Excel spread-sheets for the assessment of the 'OH-ness' (Element 3) and further helpful worksheets as electronic supplements. Element 4 connects the results from the assessment of the 'OH-ness' to the methods and metrics described in Chapters 4 to 6 in this handbook. Finally, we offer some guidance on how to produce recommendations based on the results. The presented approach helps researchers, practitioners, policy makers and evaluators to conceptualise and conduct evaluations of integrated approaches to health and enables comparison and learning across different OH activities, thereby facilitating decisions on strategy and resource allocation. Examples of the application of this framework have been described in eight case studies, published in a dedicated Frontiers Research Topic (https://www.frontiersin.org/researchtopics/5479).