IndiaZooRisk+: Using OneHealth approaches to understand and co-develop interventions for zoonotic diseases affecting forest communities in India

Zoonotic diseases (that spread from animals to humans) disproportionately affect poor tropical communities and can lead to loss of life, impaired livelihoods, health and welfare. Forest habitats are a significant source of such diseases. For communities that depend on forests for food, fuel and income, accessing forests comes with the increased risk of being exposed to zoonotic pathogens. Although we know that zoonotic diseases are increasing globally, we still lack knowledge on how these diseases circulate between wildlife, livestock and people as they use forests, and how environmental changes like forest degradation interact with human migration, local culture and society (knowledge sharing), and policy (land tenure, disease prioritisation) to exacerbate emergence and spread. Focussing on India as a key global hotspot for endemic and emerging zoonotic diseases and bringing together a network of policy makers and practitioners from the human health, animal health and environmental sectors with experts (public and animal health, ecology, epidemiology and social science) - thereby following the One Health approach -, this project aims to reduce health, welfare and livelihood impacts of zoonotic diseases by (1) better understanding the impacts of different drivers on health outcomes and spread of zoonotic diseases (2) co-develop improved interventions, integrating traditional knowledge, with affected forest communities and, thereby building the capacity of local communities to be more resilient to zoonotic diseases. Three neglected zoonotic diseases, Leptospirosis, Kyasanur forest Disease and Scrub Typhus that are widespread across the Western Ghats forest communities and cause severe complications and death if untreated, yet have different transmission routes, will be taken as key case-studies for field research.

The research underpinning these improvements will include:
(1) understanding how local culture and policies, nutrition and environment factors affect community interventions, perceptions and health outcomes from zoonotic diseases.
(2) investigating how different communities share knowledge on diseases and health intervention, including traditional knowledge, both with each other and with practitioners and managers, to improve communication strategies.
(3) studying the role of different wildlife and livestock hosts and tick and mite vectors in transmission of disease to humans in different seasons.
(4) understanding how long distance seasonal migration of pastoralists may promote resilience or increase their exposure to diseases and environmental change.
(5) developing computer models and risk maps, integrating environmental and social data, for predicting the distribution and spread of diseases.
(6) building capacity in research, data analysis and cross-sectoral collaboration to underpin future One Health approaches in India.

Improved decision-support tools and Apps and prioritisation of traditional knowledge will help disease managers, policy makers and community workers to develop novel interventions and better target vaccination and communication efforts towards the communities that are most at risk and help managers in agriculture and environmental sectors to understand how, for these communities, disease impacts may coincide with other negative impacts of environmental change. The project platform and approach of co-developing research, training 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 these emerging and endemic global threats in India and beyond.

Zoonotic diseases disproportionately affect poor tropical communities leading to loss of life, impaired livelihoods, health and welfare. Forests are a significant source of such diseases. Communities that depend on forests for food, fuel and income, incur an increased risk of being exposed to zoonotic pathogens. Social and environmental change appears to increase zoonotic diseases, but little is known on the drivers of change and how they interact. This project will (1) better understand the impacts of different drivers, such as forest degradation, land tenure, human mobility, power dynamics and knowledge systems, and seasonal ecology, on health outcomes and spread of zoonotic diseases and (2) co-develop improved interventions with affected forest communities and policy makers and practitioners from the human health, animal health and environmental sectors thereby building the capacity of local communities to be more resilient to zoonotic diseases. The research underpinning these improvements will determine (1) the contextual and biological factors that underpin vulnerability to zoonotic pathogens; (2) knowledge sharing impacts on zoonotic disease management; (3) seasonal exposure to zoonotic diseases and (4) human mobility interactions with disease ecology and integrate this understanding into predictive models and decision support tools.
This project will benefit human health sector policy makers and managers understand better contextual and mobility risk factors for zoonotic diseases thanks to co-developed predictive models, targeting of surveillance and diagnostic protocols, vaccination programs and risk communication strategies at District-to-State levels. Affected communities will benefit from co-developed interventions building on traditional knowledge, increased awareness of zoonotic diseases, protection measures and health care services reducing the likelihood of death, illness or loss of income due to zoonotic disease infection.

All beneficiaries will benefit through the creation of a long-term and effective science-policy-practitioner interface for zoonotic disease management building on more diverse and explicit cross-sectoral networks and governance systems. In particular, the impact will benefit practitioners, researchers and cross-sectoral stakeholders in the following ways:

Health, welfare and economic development impact: Benefiting practitioners
Our research addresses an area of economic development and welfare increasingly relevant to and important in Low and/or Middle Income Countries (LMICs) where threats from emerging and endemic zoonotic diseases are evolving in response to complex socio-political, ecological and environmental change drivers. The project will help human health sector policy makers and disease managers in India to target and prioritise interventions such as vaccination programs, risk communication strategies, and traditional knowledge, thereby reducing the disease burdens and impacts on livelihoods of tribal groups, resident and migratory farmers. Animal health sector policy makers will gain awareness of the social, political and ecological mechanisms underpinning zoonotic infection thereby providing the basis on which to develop national management and research agendas for other tick- and mite- borne diseases of livestock linked to forests. Forestry sector policy makers and managers will be able to improve the spatial planning of forests and reduce the risk of exposure to zoonotic diseases.

Scientific impact: Benefiting researchers
Academics will benefit from the baseline datasets and novel methodologies generated by this project. Relevant researchers from outside the project consortium will be involved from the start of the project through workshops and through a tailored training course in order to build long-term capacity and improve the inter-connectedness of researchers in India working on different aspects of zoonotic diseases. By the end of the project, researchers will be better aware of how data, surveillance and expertise can be leveraged across sectors to understanding disease dynamics and predict potential impacts of interventions. In addition, this project will strengthen the capacity of researchers in India and other LMICs through cross-sector scientific collaboration, post-doctoral mentoring and training and advance global scientific understanding of the biological and socio-economic drivers and management of zoonotic diseases.

Policy impact: Benefiting cross-sectoral policy stakeholders
This project will build on the successful implementation of co-production in the MonkeyFeverRisk project. The approach was chosen to address the common challenge of lack of mainstreaming in policy sectors often resulting in a disconnected and piecemeal approach to disease management, and ineffective interventions. We addressed this by identifying and engaging actively and genuinely with stakeholders across the public health, animal health, forestry and agriculture policy sectors and beyond. In this project, we will repeat the approach of jointly framing the problem and solutions from the start of the project through focussed and participatory workshops with all relevant policy stakeholders across sectors, and maintaining strong engagement throughout the project through a co-production of knowledge approach. We will, however, apply lessons learned from the MonkeyFeverRisk project to improve the cross-sectoral impact of this new project. Namely, we will ensure that the interventions are co-developed with all identified stakeholders from the start of the project to ensure their implementation and take-up by all relevant sectors.

The strong focus on cross-sectoral and cross-disciplinary working applied in this project will result in research that is more robust, with greater policy impact, and strengthened capacity of stakeholders across disciplines and sectors to respond to zoonoses using the One Health appr