Optimising forest benefits whilst minimising impacts of emerging zoonotic diseases: co-developing an interdisciplinary tool for forests in India

Lead Research Organisation: NERC Centre for Ecology and Hydrology
Department Name: Biodiversity (Wallingford)

Abstract

Vast numbers of poor people in Low and Middle Income Countries (LMICs) depend on healthy ecosystems for their livelihoods and food security. In India, around 300 million people depend on forests that are badly degraded by human settlement, agricultural expansion, and over-grazing. When they access food, fuel, fodder and other products from degraded forests, these people risk exposure to harmful pathogens that circulate naturally in wildlife. The ecological balance between diverse wildlife and arthropod vector communities can be altered by forest degradation, but these ecological changes interact with the priorities and behaviour of people in the landscape to determine when and where exposure occurs. Upsurges in human cases of zoonotic diseases (diseases that circulate between animals and humans) in LMICs, like malaria and Leishmaniases, have been linked to deforestation, reforestation or particular forest activities. Knowledge gaps on the role of ecology and sociology in underpinning these changes prevents development of intelligent disease control strategies that allow people to benefit from forests but minimise exposure to disease. Such strategies require cooperation of policy-makers and forest users from across the animal health, human health and forestry sectors, from national and international decision-makers down to village communities, that all interact with the disease system.
By bringing such stakeholders together in a network, along with experts in public and animal health, ecology, epidemiology and social science, this project aims to develop a new inter-disciplinary framework and decision-support tool to reduce health, welfare and livelihood impacts of zoonotic diseases on people that depend on forests in LMICs. It will be developed initially for Kyasanur Forest Disease (KFD), a fatal haemorrhagic disease of forest populations in India that cycles naturally amongst ticks, rodents and primates.
The research underpinning the tool will include:
1. Mapping of key stakeholders in each sector, their knowledge, needs for decision-support tools and how they are impacted by or impact upon the disease system.
2. Intensive field observation of (i) how the priorities, behaviour and perceptions of disease risk of different forest groups, like traditional hunter-gatherer tribes and farmers, change; (ii) how the numbers and species of wildlife hosts and tick vectors, and the consequent hazard of KFD changes along forest landscape gradients from closed through fragmented to open forest.
3. Matching of historical geographical patterns in human cases of KFD with environmental patterns within models to disentangle social, climate and forest landscape drivers across the affected region in India.
A geographical decision support tool, integrating this knowledge, will map how disease risk varies across forest landscapes, from which activities and by which forest user groups, with other constraints on disease management, availability and access to health care and medicines.
The project will reduce impacts of KFD on health, welfare and livelihoods by increasing awareness of disease risk in forest users, especially tribal groups that harvest non-timber forest products and farmers that graze livestock. These groups will further benefit from specific guidance on (i) the key forest locations and habitats, seasons and activities, and (ii) why and how to access medicine and other protective measures. The decision-support tool will help disease managers to better target vaccination and risk communication efforts towards the forest communities that are most at risk and will inform planning of land use in forests.
The project platform and approach of co-developing research and decision support tools on zoonotic diseases with stakeholders across sectors, accounting for their needs and underlying ecological and social processes, will build significant capacity in science, policy and practitioners to respond to emerging global threats.

Technical Summary

Vast numbers of poor people in Low and Middle Income Countries (LMICs) depend on healthy forest ecosystems for their livelihoods and food security. In India, around 300 million people depend on forests that are badly degraded. Forest habitats in these countries are a major source of food, fuel, livestock fodder and other non-timber forest products but also of emerging infections. Upsurges in zoonotic diseases (e.g. malaria, Leishmaniases) have been linked to deforestation or re-afforestation and to forest usage in LMICs but the social and ecological mechanisms underlying these changes are unknown.
Advancing the global One Health initiative, involving stakeholders across public health, animal health and forestry, this project develops a novel interdisciplinary framework and decision-support tool to understand how forests can best be used to enhance livelihoods whilst minimising exposure to zoonotic disease. The framework is developed initially for the tick-borne Kyasanur Forest Disease Virus that causes debilitating and fatal haemorrhagic human disease in forests in India. The tool will be framed by cross-sectoral, multi-scale mapping of stakeholder knowledge, human sensitivity to disease impacts and forest-user needs for decision-support. The links between forest structure and (a) the human behaviour, priorities and perceptions of risk that govern exposure and (b) the distribution and infection rates of wildlife host and tick that govern disease hazard will be quantified, along fragmented forest gradients. This research will generate spatial decision-support tools that help disease managers to better target risk communication, vaccination and prevention measures as well as guidance for individual forest user groups on forest locations and habitats, seasons and activities that pose the most risk of exposure. Wider application of this inter-disciplinary framework to emerging forest zoonotic diseases in LMICs will be explored with the global research community.

Planned Impact

Health, welfare and economic development impact:
The proposed research addresses an area of economic development and welfare relevant to Low and/or Middle Income Countries (LMICs) where threats from emerging zoonotic diseases in forest ecosystems present a risk to human health, well-being and livelihoods. The majority of poor communities in LMICs depend on healthy forest ecosystems for livelihoods and food security. Forest habitats in these countries are a significant source of food, fuel, livestock fodder and other non-timber forest products but also of emerging infections. Upsurges in zoonotic diseases have been linked to deforestation or re-afforestation in LMICs and to forest usage. Forest communities are rendered even more vulnerable by their remoteness from healthcare infrastructure.
This project will improve the economic development, health and welfare of the people who depend on forests ecosystems in India by developing a novel interdisciplinary tool to understand how forests can be used sustainably to maximise ecosystem benefits whilst minimising exposure to zoonotic disease. The framework will be developed initially for Kyasanur Forest Disease Virus that causes debilitating and fatal haemorrhagic disease in forest communities. The project will scope out how the framework could be generalised to understand trade-offs between infectious disease burdens, trade, and forest ecosystem benefits in different global contexts. Key novel elements are: co-production of decision supports tools with actors and beneficiaries across the public health, animal health and forest policy sectors at landscape to national scales; joint interdisciplinary examination analysis of ecological and social processes; quantification of links between forest structure and habitat use by hosts, non-hosts and vectors.
Scientific impact:
This project will increase international scientific collaboration, post-doctoral training and global scientific understanding of threats from emerging zoonotic diseases in forest ecosystems. By developing novel inter-disciplinary methods for understanding ecological and social processes underpinning disease impacts and for integrating important actors, behaviours and priorities across human health, animal health and forest sectors, it will significantly advance the global One Health initiative. The project will build and integrate capacity in ecological and epidemiological modelling, tick vector ecology and taxonomy, forest remote sensing, participatory methodology in both India and the UK. It will provide novel data resources (tick vector communities, forest remote sensing and GIS farmer grazing routes) to underpin future research on forest zoonoses.
Policy impact:
'Silo' thinking in policy sectors often results in a disconnected and piecemeal approach to disease management, and a lack of mainstreaming of actions. We will address this by identifying and engaging across the public health, animal health and forest policy sectors. Our approach of jointly framing the problem and solutions from the start of the project with these policy stakeholders, and maintaining strong engagement throughout, will pave the way for cross-sectoral integration in this and future projects. We will ensure that the research we produce is not only tailored and relevant to the range of stakeholders affected by and affecting zoonotic diseases, but importantly research will be credible and legitimate, building on the knowledge and needs of stakeholders across sectors and scales. Stakeholder collaboration and engagement will be facilitated through a range of activities (multi-stakeholder workshops, interviews, focus groups, one to ones). We expect this strong focus on cross-sectoral and cross-disciplinary (including co-production of knowledge) working will result in research that is more robust and have greater impact, but will also strengthen the science, policy and practitioners capacity.

Publications

10 25 50
 
Description Attendance by project partners and PDRAs at Technical Advisory Committees on Kyasanur Forest Disease, January 2019
Geographic Reach Local/Municipal/Regional 
Policy Influence Type Membership of a guideline committee
Impact Project partners and PDRAs attended a State Level Technical Advisory Committee meeting during the recent outbreak of Kyasanur Forest Disease in Karnataka on 7th February 2019 held at Directorate of Department of Health and Family Welfare Services, Bengaluru and involving World Heath Organisation representatives. The purpose of these meetings was to obtain in-depth information on the present KFD management strategy and ways in which it could be improved. Research project members contributed to changes in policy concerning e.g. ensuring that all case data and locations collected in different laboratories across Karnataka are shared, compiled and reported back to by the Virus Diagnostic Lab Shimoga to enable affected districts to have full knowledge of their infection status to inform their management, that aerial distance rather than road distance of 5km around a postive case or sample location should be used to target sensitisation and vaccination efforts.
 
Description Integrating participatory approaches and traditional models to strengthen One Health responses to zoonotic diseases in India's changing environments - DFID/ESRC/MRC/Wellcome Trust Health Systems Initiative
Amount £201,877 (GBP)
Funding ID MR/S012893/1 
Organisation Medical Research Council (MRC) 
Sector Academic/University
Country United Kingdom
Start 04/2019 
End 04/2021
 
Title Land cover map, Shimoga district, India 
Description Map is derived from satellite image mosaic of Landsat TM imagery, spatial resolution: 30m, image time period: 2016-10-20 to 2017-03-22 (cloud free mosaic is produced by taking for each pixel the median value of all cloud free observations for that pixel). A random Forest classification approach was applied, training and validation points were identified by local expert, using existing maps and identifying suitable points using Google Earth. 8 land cover classes: Wet evergreen forest, Moist deciduous forest, Dry deciduous forest, Plantation, Agricultural Field, Fallow Land, Waterbody, Built-up Creator: Munees Waran, ATREE, Bangalore 
Type Of Material Database/Collection of data 
Year Produced 2017 
Provided To Others? No  
Impact As part of the project the map provides crucial information on the landscape patterns of the district, enabling field site selection. The map is an input to the Generalised Linear Mixed Models which will be used to identify and map of environmental hazard (i.e. human contact rate with KFD infected ticks). The map represents the most up to date and spatially detailed land cover map for the district. When made available to others it will become an important source of information on the current land cover distribution in the district. 
 
Title Land cover map, Chamrajnagar district, India 
Description Map is derived from satellite image mosaic of Landsat TM imagery, spatial resolution: 30m, image time period: 2017-02- 03 (single scene). A random Forest classification approach was applied, training and validation points were identified by local expert, using existing maps and identifying suitable points using Google Earth. 8 land cover classes: Moist deciduous forest, Dry deciduous forest, Grassland, Plantation, Agricultural Field, Fallow Land, Waterbody, Outcrop Creator: Munees Waran, ATREE, Bangalore 
Type Of Material Database/Collection of data 
Year Produced 2017 
Provided To Others? No  
Impact As part of the project the map provides crucial information on the landscape patterns of the district, enabling field site selection. The map is an input to the Generalised Linear Mixed Models which will be used to identify and map of environmental hazard (i.e. human contact rate with KFD infected ticks). The map represents the most up to date and spatially detailed land cover map for the district. When made available to others it will become an important source of information on the current land cover distribution in the district. 
 
Title Land cover map, Sindhudurg district, India 
Description Map is derived from satellite image mosaic of Landsat TM imagery, spatial resolution: 30m, image time period: 2017-02-02 to 2017-05-28 (cloud free mosaic is produced by taking for each pixel the median value of all cloud free observations for that pixel). A random Forest classification approach was applied, training and validation points were identified by local expert, using existing maps and identifying suitable points using Google Earth. 7 land cover classes: Moist deciduous forest, Dry deciduous forest, Woodland savanna, Mangrove, Agricultural field, Fallow land, Water body Creator: Munees Waran (ATREE, Bangalore) 
Type Of Material Database/Collection of data 
Year Produced 2017 
Provided To Others? No  
Impact As part of the project the map provides crucial information on the landscape patterns of the district, enabling field site selection. The map is an input to the Generalised Linear Mixed Models which will be used to identify and map of environmental hazard (i.e. human contact rate with KFD infected ticks). The map represents the most up to date and spatially detailed land cover map for the district. When made available to others it will become an important source of information on the current land cover distribution in the district. 
 
Title Multiscale stakeholder mapping 
Description The database forms part of a multiscale mapping process of key stakeholders involved in the governance of land use, and human and animal health in forest ecosystems. The main purpose of the mapping process is to identify actors and polices that impact on the disease system in each sector; identify actors who hold knowledge on the disease system in each sector; and identify potential beneficiaries of the research and of spatial decision support tools. 
Type Of Material Database/Collection of data 
Year Produced 2017 
Provided To Others? No  
Impact The stakeholder mapping database identifies members of a new inter-disciplinary network of scientists, human and animal health experts, and government departments. This network is critical for identifying knowledge gaps, datasets and needs for spatial decision support tools regarding emerging zoonotic diseases in India. 
 
Title Preliminary risk map for Kyasanur Forest Disease in Shimoga 
Description Historical patterns in human case data were compiled for Shimoga district (2014-2018) and analysed in relation to key topographical, forest and social characteristics using statistical distribution models. This resulted in maps of predicted probability of presence at a 1km and 2km grid square resolution that indicate the areas of Shimoga district that are most likely to support KFD and how these extend outside of those areas already known to be affected. 
Type Of Material Computer model/algorithm 
Year Produced 2019 
Provided To Others? No  
Impact These have been supplied to the Department of Health officials that are currently managing the 2019 outbreak and correctly predicted a substantial proportion of the outbreak sites from 2019. We are now validating these maps with the Health Department so that finalised prediction maps will be available and tailored to their needs for the 2019/2020 outbreak season. We are examining whether this model framework can be applied to other zoonotic diseases circulating in these forest communities. 
 
Description "3 UK scientists visit villages to research on monkey fever" National Newspaper Article, Times of India, January 2019 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact This article followed an interview with ToI journalist highlighted the risks of KFD and the project approaches of looking at ecological and social risk factors. It highlighted the preliminary risk mapping work and inferred types of landscape that are at highest risk due to their mosaic of crop and forest types. It unfortunately neglects to mention the contribution of the wide array of Indian institutes and scientists involved in the project.
Year(s) Of Engagement Activity 2019
URL https://m.timesofindia.com/city/bengaluru/uk-scientists-visit-villages-to-research-on-monkey-fever/a...
 
Description "KFD:Infected people can't transmit it to others" National newspaper article in The Deccan Herald, India 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact This was a brief article following an email exchange with a DH journalist that highlighted some of the key aims of the project.
Year(s) Of Engagement Activity 2019
URL https://www.deccanherald.com/state/kfd-fact-you-will-infected-713057.html
 
Description "Monkey Fever in Shivamogga: Kyasanur's ticking time bomb" National Newspaper Article - The Hindu, India, January 2019 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Following interviews between the journalist and multiple Co-investigators and field team members this newspaper article highlighted the fieldwork campaign and how it addresses the potential roles of ticks, alternative hosts and livestock in transmission as well as the social factors that underpin exposure. It also highlighted our preliminary risk mapping work and how this was contributing to understanding potential areas of further spread during the outbreak season.
Year(s) Of Engagement Activity 2019
URL https://www.thehindu.com/news/national/karnataka/kyasanurs-ticking-time-bomb/article26093497.ece
 
Description Inter-departmental sensitisation workshops on KFD in districts in Karnataka 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact The project members including the PDRA at the Department for Health and Family Welfare, Shimoga conducted three inter-departmental sensitisation workshops on KFD in different districts of Karnataka during the outbreak season. These were held on 25th January 2019 at Udupi, attended by 40 Members of Udupi and Dakshina Kannada District, 29th January 2019 at District Health Office Shivamogga attended by around 100 members of Shivamogga and Chickmagaluru District. A second workshop was held in Shivamogga on 22nd February 2019 and gathered another 77 Members of Shivamogga and Chickmagaluru District. The purpose of these workshops was to educate public and animal health and forest management practitioners as well as other local government officials in about the risk of KFD and train them in how to handle the outbreak situation (e.g. vaccination, surveillance, personal protective measures). These workshops also involved meetings with local policy makers and legislative representatives to discuss how to improve KFD preparedness and management and the need for a new vaccines. Initiatives instigated by the project team in this setting included providing standardised protocols and forms for vaccination and human and tick surveillance, raising awareness of the importance of enforcing 5km buffer zones as hotspots around reported human cases and tick or monkey positives, training in mapping human cases and wildlife positives using GPS and visualising within a GIS and integrating coordinates into reporting forms, developing a kit for all Primary Health Centres for use when attending monkey deaths.
Year(s) Of Engagement Activity 2019
 
Description Interview for National newspaper, following a presentation to the local politician (Deputy District Commissioner) 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact This interview conducted by the Indian PI, Dr Hoti, lead to 11 articles in the national ( Deccan Herald, Indian Express, the Hindu) and local (Kannada Prabha, Tunga Taranga Kannada Daily, Prajavani, Udayavani, Vijaya Karnataka, Vikaya Vani) newspapers. It aimed to sensitise policy-makers and the public to the aims of our project, the threat of Kyasanur Forest Disease and the need to understand ecological and social risk factors. It is helping us to establish relationships with key potential beneficiaries and actors across sectors so that we can co-produce decision support tools with them.
Year(s) Of Engagement Activity 2017
URL http://www.thehindu.com/news/national/karnataka/research-project-to-study-causes-for-kfd-outbreak/ar...
 
Description KFD One Health WhatsApp group 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact The purpose of the WhatsApp Group was to establish a One Health network of scientists, public and animal health and forest management practitioners interested in Kyasanur Forest Disease and other zoonotic diseases. The need for such a network was put forward by the Stakeholders that attended the first Stakeholder Workshop in August 2018 as a way to improve inter-sectoral One Heath collaboration and create a dynamic science-policy interface and WhatsApp was suggested as an appropriate communication mechanism. The group was set up in November by the research project participants at Department for Health and Family Welfare Karnataka that are the key institute involved in the public health response for KFD so that it would be sustainable into the future. The group currently contains 77 members has been used for many purposes including sharing of surveillance and media reports during the recent outbreaks in Karnataka, case tracing, information on public health responses and key officers to contact, sharing of protocols for tick sampling and vaccination and information on appropriate personal protection measures and transmission ecology, raising awareness of field research, inter-departmental sensitisation workshops for KFD, and national and regional research events connected to One Health and tick-borne diseases.
Year(s) Of Engagement Activity 2018
 
Description MonkeyFeverRisk project website 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact A project website was set up to set out the project objectives and publicise the project activities and available tools to researchers, policy makers, disease managers in animal and public health and to the public. It has been used as a reference document in interactions with National and State level media in India and policy makers and to explain the overall framework of the project to research participants and as a depository for reports and tools arising from the project.
It went live in November 2018 and has already lead to two National Media enquiries.
Year(s) Of Engagement Activity 2018,2019
URL https://www.monkeyfeverrisk.ceh.ac.uk/
 
Description Online UK news story from host organisation introducting project 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact This news story introduces the One Health inter-disciplinary approach to zoonotic diseases and the importance of tackling zoonotic diseases and developing decision support tools. It highlights the key participants and forming inter-disciplinary network. The news story has prompted requests from students and other researchers about participation and interest from journalists who went on to write newspaper articles
Year(s) Of Engagement Activity 2017,2018
URL https://www.ceh.ac.uk/news-and-media/news/tackling-tick-borne-diseases-forests-india
 
Description Problem Framing Workshop with cross-sectoral stakeholders in zoonotic disease management 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact The Centre for Ecology & Hydrology, UK in partnership with Ashoka Trust for Research in Ecology and Environment (ATREE) hosted a one day stakeholder workshop on "Optimizing Forest Benefits whilst Minimizing Impacts Of Kyasanur Forest Disease and Other Zoonotic Diseases". The workshop was held in Bengaluru on 16th August 2018.

An overarching aim of the MonkeyFeverRisk project is to co-produce decision support tools and guidance based on this improved scientific understanding with the wide-ranging actors and beneficiaries that interact with the disease system across the public health, animal health and forestry sectors. As part of this co-production process, this first 'framing' workshop was held with over 20 experts from different KFD-affected districts and state level officials of Karnataka, Maharashtra and Kerala from the public and animal health, agriculture, forestry and social welfare sectors. The workshop aimed to map stakeholders' knowledge about KFD, prioritizing risk factors for the disease, identifying key policies that affect KFD, and feeding that knowledge into project approaches and models. This workshop will be followed by two more: on knowledge integration (planned for September 2019) and experimentation (planned in late 2019) to complete the co-production process.

Top ranked risk factors identified by stakeholders for Kyasanur Forest Disease included lack of education/awareness about KFD, under or late reporting of monkey deaths, deforestation and/or forest degradation, lack of awareness of preventative measures (tick repellants, vaccination), lack of awareness or understanding of alternative wildlife hosts, low vaccine coverage and poor diagnostics and surveillance. Key needs to improve management included those related to human resources i.e. the need for better trained manpower; more equipment; tick experts and taxonomists, improved surveillance including active surveillance; surveillance for disease, vectors and hosts, better diagnostic facilities and better inter-sectoral communication and coordination.

Concerning the impacts of national and state level policies on KFD management, key policies that were identified as having a negative impact or as being poorly implemented were those concerning deforestation, grazing and encroachment in and around forest areas, with abrupt shifts in land use in these areas being identified as making communities more vulnerable to KFD. In the health sector, policy changes that were suggested to benefit management were making KFD a notifiable disease, learning from wide-scale vaccination and vector control campaigns for other diseases, improving the coordination between veterinarians conducting post-mortems and public health professionals involved treating human patients, improving the screening of livestock for pathogens and ecto-parasites before transportation.
Year(s) Of Engagement Activity 2018
URL https://www.monkeyfeverrisk.ceh.ac.uk/news-and-media/news/first-stakeholder-workshop-report-availabl...
 
Description Twitter account (@MonkeyFever_) set up for the project 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact The project twitter account enables rapid dissemination of information, including background to the project, proposed research, updates on progress, outputs, and also links to news articles with details of disease outbreaks. Recent studies have shown that twitter is an effective and important tool for science communication (Finch, O'Hanlon &Dudley (2017) Tweeting birds: online mentions predict future citations in ornithology. R. Soc. open sci. DOI: 10.1098/rsos.171371) and this project twitter is a useful way of keeping the general public and scientific community up to date with developments in this project.
Year(s) Of Engagement Activity 2017,2018
URL https://twitter.com/MonkeyFever_
 
Description Visit of project team to District Health Officer, Deputy Commissioner, hospitals, affected villages and virus diagnostic laboratory in Shimoga District 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Scientists from the project team travelled to Shimoga District to meet the District Health Officer, hospital staff and community health and laboratory workers that are involved in implementing control strategies for Kyasanur Forest Disease. We discussed and observed how the current strategies are tuned to the knowledge/beliefs on the socio-ecology of the KFD system as well as key constraints on the public health system within which the control strategies must be implemented. We had discussions with the District Deputy Commissioner about his priorities for research into the KFD system and sensitised a wide range of people in the public health system in this long-affected district to our research. Key participants were identified for the problem framing and knowledge integration parts of the co-production process we are following to develop new decision support tools for KFD.
Year(s) Of Engagement Activity 2017