Investigating Unidentified Liver Disease (ULD) in Ethiopia: a Testament to the “One Health” Approach

http://www.cdc.gov/nceh/stories/Ethiopia.html

According to their website, the “One Health concept is a worldwide strategy for expanding interdisciplinary collaborations and communications in all aspects of health care for humans, animals and the environment.” It is an über-collaboration designed to pull from a host of different disciplines to address health issues that cut across disciplines, and is supported by a number of major organizations. 

An example of a “One Health” approach to addressing health issues is the investigation of Unidentified Liver Disease (ULD) that was first reported in northern Ethiopia in 2002. Epidemiologists and scientists from the CDC, the USDA, the Ethiopian Ministry of Agriculture, Addis Ababa University, the Chinese University of Hong Kong among other groups all worked together to solve this mystery, ultimately finding that the disease was due to toxic pyrrolizidine alkaloids that people were exposed to when their fields were not properly weeded. Grain farmers in this region now have the information they need to prevent this illness. Although this investigation does illustrate remarkable collaboration across multiple organizations and countries, another striking feature is the time it took to identify ULD’s etiology-around 6 years from the initial investigation in 2005 until a firm epidemiologic link was established in 2011. Arguably, however, this link likely would not have been elucidated without the close collaboration of the numerous groups involved in this investigation. 

The “One Health” movement is intriguing and the close collaborations it espouses will be critical to addressing critical health issues that cut across disciplines, such as antibiotic resistance.