Erkyihun et al.

One Health Outlook (2022) 4:8

https://doi.org/10.1186/s42522-022-00064-z
One Health Outlook

REVIEW Open Access

A review on One Health approach in Ethiopia

Gashaw Adane Erkyihun1,2* , Fikru Regassa Gari1,2, Bedaso Mammo Edao2 and Gezahegne Mamo Kassa2

Abstract
The risk of spreading emerging and reemerging diseases has been increasing by the interactions of human – animal
– ecosystems and increases account for more than one billion cases, a million deaths and caused hundreds of billions
of US dollars of economic damage per year in the world. Countries in which their household income is dependent on
livestock are characterized by a strong correlation between a high burden of zoonotic disease and poverty. The One
Health approach is critical for solutions to prevent, prepare for, and respond to these complex threats. As part of the
implementation of the Global Health Security Agenda, Ethiopia has embraced the One Health approach to respond
to the existing and emerging threats. Several developments have been made to pioneer One Health schemes in Ethi-
opia which includes establishment of the National One Health Steering Committee and Technical Working Groups,
prioritization of zoonotic diseases based on their impact on human and livestock, the development of prevention and
control working documents for prioritized zoonotic diseases, joint disease surveillance and outbreak investigation,
prioritization of zoonotic diseases, capacity building and other One Health promotions. Nevertheless, there are still so
many challenges which need to be addressed. Poor integration among sectors in data sharing and communication,
institutionalization of One Health, lack of continuous advocacy among the community, lack of financial funds from
the government, limited research fund and activities on One Health, etc. are among many challenges. Hence, it is criti-
cal to continue raising awareness of One Health approach and foster leaders to work across disciplines and sectors.
Therefore, continuous review on available global and national one health information and achievements to provide
compiled information for more understanding is very important.
Keywords: Awareness, Collaboration, Ethiopia, One Health Approach, Multi-sectoral, Zoonoses

Background infectious diseases arise from pathogens shared with wild

Zoonotic diseases account for more than one billion or domestic animals. However, ecological, evolution-
cases and a million deaths per year with the high costs ary, social, economic, and epidemiological mechanisms
responsible for emerging and pandemic ones [1]. Now affecting zoonoses persistence and emergence are not
a days, the risk of spreading these diseases has been well understood. Multi-sectoral collaboration, including
increasing by the interactions of human – animal – public health scientists, ecologists, veterinarians, econo-
ecosystem due to the exponential growth in human mists, and others, is necessary for effective management
and livestock populations, rapid urbanization, rapidly of such diseases [3]. Health threats aggravators such as
changing farming systems, closer integration between war, nutrition insecurity, pollution, loss of biodiversity,
livestock and wildlife with forest encroachment, destruc- degraded ecosystem and climate change are becoming
tion of habitat, changes in ecosystems, and the glo- common factors [4]. A One Health approach is not only
balization of trade [2]. Nearly two-thirds of humans critical for solutions to respond to these threats but also
an effective platform to address challenges, coordination
mechanisms and global development goals [5]. Countries
*Correspondence: gashawdane@gmail.com
1
Ministry of Agriculture, Federal Democratic Republic of Ethiopia, P.O.
in which their household income depends on livestock
Box 62347, Addis Ababa, Ethiopia are characterized by a strong correlation between a high
Full list of author information is available at the end of the article burden of zoonotic disease and poverty (6). Ethiopia has

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Erkyihun et al. One Health Outlook (2022) 4:8 Page 2 of 13

the largest livestock, second largest human population are reviewed from retrieved articles to identify relevant
and considerable wildlife species in Africa. About 80% publications. In addition to literature found via PubMed,
of her citizens are dependent on agriculture and have data publicly available on websites of the World Health
direct contact with domestic animals. This could cause Organization (WHO), the United Nations Food and
a high risk of zoonotic disease transmission and emerg- Agriculture Organization (FAO), United States Centre of
ing and reemerging pandemic threats and the country is Disease Communication (US CDC), International Live-
believed to be on a high burden of zoonotic disease [7]. stock Research Institute (ILRI), Ethiopia’s One Health
The country is also near to East African countries which responsible Ministries and other websites were also
are frequently prone to emerging and epidemic diseases included.
(such as avian influenza and Ebola). For instance, Ebola
Virus Disease (EVD) outbreak has occurred more than General perspective of One Health
13 times, 6 times and 3 times in Democratic Republic Definition of One Health
Congo, Sudan and Uganda respectively [8]. On the other The terms ‘One Medicine’ and ‘One Health’ have been
hand, a highly pathogenic avian influenza outbreak was used to describe the concept of an integrated approach
reported from Uganda in 2017 and Zambia in 2019 [9]. to animal, human and environmental health and to
In addition to these, the presence of endemic zoonotic acknowledge that we are all part of ‘One World’ in which
diseases (like rabies, anthrax, brucellosis etc.) coupled animals, people and the environment are interdependent
with limited animal and human health care is also cause a and must rely on each other for basic survival [12].One
significant impact on the national economy.Thus, reduc- Health is collaborative approach for strengthening sys-
ing the zoonotic disease burden through One Health tems to prevent, prepare, detect, respond to, and recover
approach will improve the overall health of populations from infectious diseases and related issues such as anti-
and contribute to the alleviation of poverty [10]. microbial resistance that threatens human -animal—
Ethiopia has achieved considerable One Health environmental health collectively [1]. It is an approach
approach activities to push forward the Global Health as ‘a collaborative and all-encompassing way to address
Security Agenda (GHSA) commitments and to prevent, animal and public health globally not only at interna-
detect, and respond to existing and emerging threats tional level, but must be translated as a new paradigm at
since the 2000s. It has already established a National One national levels’[13]. One Health approach is described
Health Steering Committee (NOHSC) and Technical as either a narrow approach primarily combining public
Working Groups (TWG) with a five-year strategic plan health and veterinary medicine or as a wide approach as
for the period 2018–2022. In Ethiopia, several achieve- in the wide-spread ‘umbrella’ depiction (Fig. 1) including
ments have been recorded so far (such as extension of both scientific fields and interdisciplinary research areas
one health schemes to the regional governments, joint [14], 15. The One Health concept is a worldwide strategy
disease surveillance and outbreak investigation activi- for expanding interdisciplinary collaborations and com-
ties, joint vaccination activities against zoonotic dis- munications in all aspects of health care for humans,
eases, prioritization of zoonotic diseases, development animals and the environment. The synergism achieved
of control and prevention strategic documents for dif- will advance health care for the twenty-first century and
ferent prioritized zoonotic diseases [11], one health and beyond by accelerating biomedical research discoveries,
world rabies day celebration. However, awareness crea- enhancing public health efficacy, expanding scientific
tion about One Health principles and importance, for knowledge, and improving medical education and clini-
the community and responsible bodies is limited. Little cal care. When properly implemented, it will help protect
or no review (to provide compiled information) has been and save untold millions of lives in our present and future
conducted regarding One Health in Ethiopia. Therefore, generations [16].
there is a need to strengthen One Health approach by One Health is a collaborative, multi-sectoral, and trans-
reviewing available achievements, initiatives, activities disciplinary approach (Fig. 2)—working at the local,
and challenges. So, this review is believed to highlight regional, national, and global levels—with the goal of
potential areas of collaboration between the Ethiopian achieving optimal health outcomes recognizing the inter-
medical, veterinary sector and other scientific communi- connection between people, animals, plants, and their
ties. A semi-quantitative method of review on available shared environment [18].
literature and consultations with selected One Health
stakeholders was conducted. Specifically, all avail- The rise of One Health concept
able information on One Health related to Ethiopia was Rudolf Virchow (1821–1902) considered as the father of
searched for in global peer-reviewed databases using comparative medicine, cellular biology and veterinary
relevant search terms related to One Health. References pathology for his contribution to medicine, incorporating

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Erkyihun et al. One Health Outlook (2022) 4:8 Page 3 of 13

Fig. 1 The ‘One Health Umbrella’ developed by the networks ‘One Health Sweden’ and ‘One Health Initiative’ to illustrate the scope of the ‘One
Health concept’ [17]

Fig. 2 Typical example of one health coordination, Lilongwe Wildlife Trust, Clinical Project in One Health, Malawi [19]

veterinary medicine in human health care and effectively coined the term “zoonosis” for a disease transmissi-
launched the One Health concept in the nineteenth cen- ble from animals to humans. This founding concept is a
tury. He asserted that there is no dividing line nor should worldwide paradigm shift strategy for expanding inter-
there be between animal and human medicine. He also disciplinary collaborations and communications in all

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Erkyihun et al. One Health Outlook (2022) 4:8 Page 4 of 13

aspects of health care for humans and animals [20]. The food borne Salmonella in the European Union [26]. The
building concept of “One World, One Health” was also WHO, OIE, and FAO also formed the tripartite agree-
formulated by the Wildlife Conservation Society in 2004 ment in 2010 to work together on AMR, rabies, zoonotic
by establishing an interdisciplinary and cross-sectoral influenza, zoonotic tuberculosis and Middle East Respir-
approach to prevent epidemic or epizootic disease and atory Syndrome-Coronavirus (MERS-CoV) [27]. A One
for maintaining ecosystem integrity [21]. In 2008, the Health Operational Framework published by the World
importance of this concept is further strengthened by Bank in 2018 also provides an overview and compendium
the FAO, OIE,WHO, United Nations Children’s Fund), of work with key initiatives and entities, implementation
the World Bank and United Nations System of Influenza guidance, and an annex of resources [1]. Several agencies
Coordinator and produced a document entitled ‘contrib- in various countries have One Health webpages with a
uting to One World, One Health’, a strategic framework variety of resources, including US CDC [28]. The WHO,
for reducing risks of infectious diseases at the animal- FAO and OIE, as well as the United Nations Environmen-
human-ecosystems interface [22]. The World Medical tal Programme (UNEP) are working together to facilitate
Association (WMA) in its resolution on the collabora- cross-sectoral collaboration at the global level to manage
tion between Human and Veterinary Medicine, adopted health risks and improve global health security [29].
in October 2008, recommends the collaboration between Currently, FAO and WHO through the Global
human and veterinary medicine and supports the con- Health Security Agenda’s Zoonotic Diseases and
cept of joint educational efforts between human and vet- Animal Health in Africa (GHSA-ZDAH) has been
erinary medical schools [21]. Since then the One Health supporting many One Health interventions through
concept has become more important and in recent years policy documents, control strategies, protocols, evalu-
its initiatives have been rapidly gaining ground [23]. ations, national veterinary laboratories strengthening,
Another important action, which increased the platform epidemio-surveillance capacity and workforce develop-
of One Health, is the Global Conference on One Health ment [30]. The One Health approach has been adopted
(held in Spain, May 2015) by the World Veterinary by various countries as the core driver of the Global
Association (WVA) and the World Medical Association Health Security Agenda (GHSA) [31]. The Global
(WMA),. The conference has recommended the need Health Security Agenda (GHSA), an alliance of over 70
to increase cross-disciplinary collaboration between the governments and international partners, was launched
veterinary and medical professionals in order to improve in February 2014 with the aims of driving and advocat-
human and animal well-being [24]. ing for a world safe and secure from infectious disease
threats; bringing together nations from all over the
Global One Health initiatives
world to make new, concrete commitments, and elevat-
The importance and interventions of One Health are ing global health security as a national leaders-level pri-
fundamentally linked in food systems, health impact of ority [32]. Due to its urgency and various importance,
zoonotic diseases, drug resistance, economic losses and One Health approach has increasingly been adopted in
many other health impacts [5]. The risk of spreading national and international plans and strategies of many
emerging and reemerging diseases has been increasing by countries [33].
the interactions of human– animal–ecosystem increases
due to the exponential growth in human and livestock
populations, rapid urbanization, rapidly changing farm- One Health frameworks in Ethiopia
ing systems, integration between livestock and wildlife, Ethiopia is a GHSA member country and many of its One
forest encroachment, destruction of habitat, changes in Health activities are supported within the framework of
ecosystems, and the globalization of trade [2]. Due to this, improving global health security. While emerging and
there is a need for interconnections among the health epidemic-prone diseases such as avian influenza and
of humans, animals, and the environment for effective Ebola present a global threat, endemic zoonotic diseases,
prevention and control measures through collaboration such as rabies and anthrax, affect the health of animals
approach [25]. Hence, several institutions are formally and humans and are a major source of economic loss
supporting One Health approaches in the country and [10]. In recognition of the intrinsic relationship between
at global level [24]. With national, transnational or global humans, animals, and their environment, and as part of
partnerships, various One Health collaboration actions the implementation of the GHSA, the country increas-
have achieved so far, such as controlling rabies in Bali, ingly has embraced the One Health approach to prevent,
Indonesia; controlling Q fever outbreaks in the Nether- detect, and respond to existing and emerging threats and
lands; the Human Animal Infections and Risk Surveil- there is a strong political commitment by the govern-
lance (HAIRS) group in the United Kingdom; control of ment [34], 14.

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Erkyihun et al. One Health Outlook (2022) 4:8 Page 5 of 13

The establishment of One Health platform Jimma and Mekelle representing OHCEA. In addition,
In 2015, the first One Health Zoonotic Disease Prioritiza- International Organizations and Partners participated in
tion workshop, in Ethiopia, was held and brought multi- NOHSC include: US CDC, FAO, USAID, WHO, Emerg-
ple ministries and partners together to develop a list of ing Pandemic Threat (EPT-2) Partners, and OSU-GOHI).
zoonotic diseases of the greatest national concern. Key Only government stakeholders had a voting right during
national government stakeholders involved and imple- the period of the establishment. The Steering Commit-
mented joint zoonotic disease surveillance, control and tee has an operational framework of a chair, co-chair and
outbreak response activities such as such as MOH, MOA) secretary nominated from core government sectors. The
and the EWCA were involved in the implementation of committee would hold a meeting on a monthly basis. It
joint zoonotic disease surveillance, control and outbreak shall also adopt a formal system of recording its business
response activities [34]. Within the MOH, the EPHI in line with relevant rules and guidelines from the gov-
leads human outbreak investigations, surveillance, and ernment of Ethiopia [10]. One of the NOHSC’s primary
laboratory diagnostics for humans, as well as diagnostics goals is to strengthen zoonotic disease prevention, detec-
for rabies in animals. Within the MOA, the Veterinary tion and response through a long-term and collaboration
Public Health Directorate, the Disease Prevention and at the national and sub-national level. The responsibilities
Control Directorate, and the Epidemiology Directorate of the Committee’s leadership are to ensure balance and
are primarily responsible for surveillance and response overcome previous problems with multi-sectoral coordi-
activities in livestock, in partnership with NAHDIC), nation as well as promoting one health goal. The Steering
where most animal disease diagnostics are performed. Committee received financial and technical support from
The EWCA is responsible for the conservation and man- partners, local non-governmental organizations (NGOs);
agement of wildlife and its habitats in collaboration with and Ethiopian universities [36]. The NOHSC has laid
MOA. In line with this, One Health collaborations have many critical milestones since its inception. For exam-
continued and the National One Health Steering Com- ple, the four Ethiopian Ministries signed the memoran-
mittee (NOHSC) was established and got momentumin dum of understanding (MOU) (Fig. 3) in 2018 which was
its effort to create a sustainable national One Health Plat- believed to formalize the commitment between the par-
form [10]. ties to work together on joint disease surveillance, data
sharing, preparedness and communication planning, out-
The development of National One Health Steering break investigation and response, and related activities.
Committee and signing of memorandum of understanding It has also drafted a National One Health Strategic Plan
In 2016, four key Ethiopian Ministries joined together for 2018–2022. This strategic plan included an organi-
to establish the NOHSC with the support of the govern- zational framework with detailed guidance on how the
ment of Ethiopia and other partners [35]. The members National Steering Committee would address One Health
of the NOHSC were constituted from the MOH, MOA, engagement across disciplines and sectors in its task to
EWCA, MCT and Universities such as Addis Ababa, prevent, detect and respond to endemic, emerging and

Fig. 3 The founding members of Ethiopian National One Health Steering Committee and the Signed Memorandum of Understanding (obtained
from NOHSC with permission)

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Erkyihun et al. One Health Outlook (2022) 4:8 Page 6 of 13

re-emerging infectious disease threats at the human–ani- field attachment, experiential learning, training and
mal–environment interface [34]. research.
• Moreover, international organizations such as
Initiatives which encourage ethiopian One Health USAID, WHO, CDC, FAO and others have been
approach aggressively supporting one health issues and work-
There are various Partner One Health Initiatives in the ing on advocacy and awareness on antimicrobial
country which have been working in collaborations with resistance.
government and other institutions, such as universities/
research institutions, Non-Governmental Organizations
(NGOs) and donor organizations with three main pur- One Health approach achievements in Ethiopia
poses: the prevention of new zoonotic disease emergence, The establishment of different technical working groups
early detection of new threats, and timely and effective The National One Health Steering Committee has estab-
response to them [35]. According to Onyango et al. [36] lished different national Technical Working Groups
and Fasina and Fasanmi [14]some of them include: (TWGs) including Rabies, Anthrax, Brucellosis, Emerg-
ing Pandemic Threats (EPT), Antimicrobial Resistance
• Jigjiga One Health Initiative (JOHI) is funded by the (AMR) and National One Health Communication Task
Swiss Agency for Development and Cooperation Force to promote multi-sectoral coordination and col-
(SDC) and run by Jigjiga University, the Armauer laboration on One Health related activities. Each TWG
Hansen Research Institute (AHR) and the Swiss represents a specific zoonotic disease with particular
Tropical and Public Health Institute in Basel. It was emphasis on prioritized ones (such as anthrax, rabies
aimed at building the capacity of Jigjiga University and brucellosis) and main pandemic threats like highly
to become a center of excellence for One Health pathogenic avian influenza, Rift Valley Fever (RVF). The
studies and creating innovative systems for the technical working groups are composed of veterinary and
improvement of health and wellbeing of pastoral medical experts in virology, bacteriology, microbiology
communities. and epidemiology and provide a platform for strategic
• The Ohio Global One Health Initiative by the Ohio discussions. The working group members include gov-
State University Health Sciences which focused on ernment and non-government stakeholders and are offi-
improving the capacity of pre-service health pro- cially nominated from line ministries to the National One
fessionals in Ethiopia and established the African Health Steering Committee [10].
regional office in Addis Ababa in 2017.
• One Health Regional Network For the Horn Of Africa Extension of One Health schemes to the regional
is a multidisciplinary, international partnership led by governments
the University of Liverpool in partnership with Liver- So far, the national One Health coordination structures
pool School of Tropical Medicine, United Kingdom; have already been extended to 7 Regions (Amhara,
University of Nairobi, and International Livestock Oromia, Southern Nations Nationalities People Region
Research Institute, Kenya; University of Addis Ababa, (SNNPR), Tigray, Somali, Benishangul-Gumuz, and
and the International Livestock Research Institute, Gambella). In addition to this, the structure has further
Ethiopia; Sheikh Technical Veterinary School, Somali- extended to 7 Zones, and 17 districts in different regions
land; Hamelmalo Agricultural College, Eritrea; and of the country [37].
other national and international organizations. The
project was funded by the Biotechnology and Bio- The development of national One Health strategic plan
logical Sciences Research Council Fund and aims at (2018 ‑2022)
improving the research capacities of individuals and The NOHSC developed a National One Health Stra-
institutions particularly on human and animal health tegic Plan (2018–2022) for the overall guidance of one
issues and creating a One Health Regional Network health approach in Ethiopia (Fig. 4). The strategic plan
for knowledge and information sharing [14]. is the roadmap for the country to achieve the long-term
• One Health Central and East African (OHCEA) goal of prevention, detection and response to “negligible
University Network is a network of 21 public health risks and impacts of endemic, emerging and re-emerging
and veterinary universities from 8 countries in the health threats at the animal-environment-human inter-
East, Central and West Africa regions. In Ethiopia, face". Moreover, the strategic plan includes an organi-
3 universities, Jimma, Mekelle and Addis Ababa are zational framework with detailed guidance on how the
members of this network that aims at cultivating NOHSC will address One Health engagement across
the culture of multi-sectoral collaboration through disciplines and sectors in its tasks [38]. Ethiopia aims to

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Erkyihun et al. One Health Outlook (2022) 4:8 Page 7 of 13

Fig. 4 The National One Health Strategic Plan and Its Communication Message Guide taken from NOHSC with permission)

achieve this goal through the five key pillars and objec- FAO principles), stepwise approach and implementation
tives which include: coordination and collaboration to phases.
ensure effective one health schemes, preparedness and The first national control and prevention strategy
response to emerging and re-emerging priority threats, document which has been endorsed to be implemented
multi-sectoral surveillance and reporting system, advo- from 2018–2030 and currently under enactment is the
cacy and communication as well as research and capacity National Rabies Control and Elimination Strategic Doc-
building. The National One Health Steering Commit- ument. It was developed with the goal to eliminate all
tee has also developed and been implemented a Risk human rabies deaths by 2030 through a strategic vaccina-
Communication and Community Engagement (RCCE) tion campaign that achieves and maintains a vaccination
strategy document (Fig. 4) which provide a compre- rate of at least 70% of the domestic dog population in the
hensive guidance for response zoonotic disease includ- country (Fig. 5). The second strategic document which
ing COVID-19 outbreak and to mitigate the impact of was endorsed to be implemented from 2018 – 2030 is
emerging and reemerging diseases, Anthrax Prevention and Control Strategic Plan. The
overall mission of this plan is to significantly reduce and
The development of control and prevention strategic ultimately control the public health impact of anthrax
documents for different prioritized zoonotic diseases in humans and animals, in Ethiopia, through sustained
Several strategic documents for prioritized zoonotic dis- surveillance, laboratory diagnosis, prevention and con-
eases have also been developed and validated by each trol systems and community awareness (Fig. 4).The other
National Technical Working Groups together with part- strategy document is the National Brucellosis Preven-
ners and other stakeholders and finally endorsed by the tion and Control Strategic Plan (2020–2030). This has the
National One Health Steering Committee. With the over- mission of reducing the impact of brucellosis in livestock
all leadership of the members of each National Technical and humans in Ethiopia by 2030 through multi-sectoral
Working Group in drafting their strategic document, key and community engagement at all levels.
responsible ministries, regional health and livestock and/ The fourth important strategic documents, prepared by
or animal health bureaus, research institutions, universi- the key ministries having a role in the one health activi-
ties and development partners have engaged during the ties, are a Multi-sectoral Preparedness and Response
development of the document. Each strategic document Plan for Highly Pathogenic Avian Influenza. It was pre-
is a joint plan of key ministries ( Ministry of Health, Min- pared with financial support of Partners. The purpose of
istry of Agriculture, Ministry of Culture and Tourism and the preparedness and response plan is to prevent and/
Ministry of Environment, Forest and Climate Change or mitigate transmission of pandemic Avian Influenza
which has been endorsed by NOHSC. International part- virus strain and protect the health, social and economic
ners and other stalk holders were also represented and wellbeing of the population. Rift Valley Fever Multi-
actively participated during the development and vali- sectoral Preparedness and Response Plan is also among
dation of the documents. Each strategic document has the strategic documents. The plan is thought to address
its own framework (developed based on OIE, WHO, prevention and control of Rift Valley Fever in humans

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Erkyihun et al. One Health Outlook (2022) 4:8 Page 8 of 13

Fig. 5 Some of validated One Health approach strategic documents (obtained from Ministry of Agriculture with permission)

and animals through professionals and relevant institu- disease surveillance and outbreak investigations activities
tions through involvement of professionals in the sur- following reports received from various locations in the
veillance, detection and response to RVF outbreaks. The territory of the country. It has conducted joint anthrax
scope could extend to bilateral agreements with neigh- disease outbreak investigations in 2018 for suspected ani-
boring countries to jointly prevent and control the threat. mal and human cases. The investigation team consisted
Another important strategic document is Prevention and of regional veterinarians, medical workers and national-
Containment of Antimicrobial Resistance. Its goal is to level laboratory and epidemiology experts were deployed
prevent, slow down, and contain the spread of antimicro- for the investigation. Safe sample collection and trans-
bial resistance through the continuous availability of safe, portation training was completed only days before the
effective, and quality-assured antimicrobials and their outbreak investigation mentioned above. As a result, the
effective use thereof. This can only be achieved through responders were better prepared and equipped to collect
collaborative actions among partners in human health, samples from both animal and human suspected cases
animal health, the environment, agriculture, the food (Fig. 6). A joint investigation team composed of commu-
industry, teaching and research institutes, civil societies nity animal and human health experts, local representa-
and associations, the pharmaceutical industry, and global tives and faculty members of College of Health sciences
stakeholders to synergize efforts and resources (Fig. 5). of Jimma University were engaged on another anthrax
outbreak investigation in Oromia Regional State in 2018.
Joint disease surveillance and outbreak investigation In the same year, Rabies joint outbreak investigation was
activities led by the Ministry of Health and Ministry of Agricul-
The country with the Technical Working Groups ture after having trained on animal sample collection
(TWGs) has been coordinating and conducting joint and transportation. Furthermore, in the mid-2018, Rift

Fig. 6 CDC and Ethiopian animal rabies surveillance officers in Ethiopia, 2016 [39]

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Erkyihun et al. One Health Outlook (2022) 4:8 Page 9 of 13

Valley Fever outbreak was reported across an extensive can help in materialising and sustaining the goals of the
geographic range in East Africa, including areas border- TWGs and workforce [10].
ing Ethiopia. Thus, in preparation for its possible spread
to Ethiopia, the Ministry of Agriculture worked with the Prioritization of zoonotic diseases in Ethiopia
NOHSC to organize One Health preparedness planning, There are three strategies — predict, respond, and pre-
coordinating teams to conduct enhanced surveillance vent — and eleven packages which were developed to
activities in at-risk border zones [10]. achieve the strategies by GHSA. One of the main pack-
A multidisciplinary and multi-sectoral team (Fig. 7). ages is addressing the burden of zoonotic diseases [40].
was also organized and deployed by the Emergency Pan- In Ethiopia, there are large numbers of zoonotic diseases
demic Threat-Technical Working Group for joint survey which are endemic. Hence, prioritization of zoonotic dis-
and potential outbreak investigation was conducted in eases based on impacts on both human and animal is of
the Borena zone of Oromia region. This was conducted paramount importance so as to jointly address experts
following the Rift Valley Fever outbreak report in north- from both animal health agencies and public health
ern Kenya and mass wild birds (pigeons) mortality in the authorities. Accordingly, two prioritization processes of
South Omo zone of Southern Nations Nationalities Peo- zoonotic diseases were conducted; in 2016 and 2019.
ple Region. This multidisciplinary team also conducted
anthrax outbreak investigation in Wag Himra and North The first prioritization of zoonotic diseases in Ethiopia
Gondar zones of Amhara Region and Assosa zone of The first zoonotic diseases prioritization workshop in
Benishangul-Gumuz region. Ethiopia was held in 2015 by participating organizations
form Federal Ministry of Health represented by Ethio-
Vaccination activities against zoonotic diseases pian Public Health Institute, the Ministry of Livestock
The Ministry of Health represented by the Ethiopian and Fishery Resources, the Ministry of Environment and
Public Health Institute (EPHI) and Ministry of Agricul- Forestry, WHO, United States Centres for Disease Con-
ture with the support of global partners US CDC, Ohio trol and Prevention, Defence Threat Reduction Agency/
State University Global One Health Initiative (GoHi) and Cooperative Biological Engagement Program, the Ohio
the Global Alliance for Rabies Control, and the European State University, Food and Agriculture Organization of
Union-Health of Ethiopian Animal for Rural Develop- the United Nations, and Armauer Hansen Research Insti-
ment (HEARD) project have been conducting mass dog tute/Swiss Tropical and Public Health Institute using a
vaccination campaign(MDVC) in collaboration with in Addis Ababa [7]. The workshop participants identi-
regional and city administrations. Since 2016, more than fied five criteria for ranking among 43 zoonotic diseases
50,000 dogs have been vaccinated. The campaigns were through group discussion. The criteria used to select the
achieved after providing training for veterinary, medical final five prioritized zoonotic diseases are unique to Ethi-
and public health staff regarding animal handling, vac- opia and includes: Severity of human disease in Ethiopia
cine safety, vaccination evaluation and dog population (diseases having the highest number of deaths rates per
estimation methods. The vaccination activities were a population in humans were deemed to have priority),
reflection of how successful One Health collaborations proportion of human disease attributed to animal expo-
among government partners were. It also showed how sure, burden of animal disease (priority was given to dis-
strategic support and mentoring from global experts eases that have negative impacts at the household level

Fig. 7 Joint outbreak field investigation team discussing while anthrax outbreak investigation and Laboratory workers collect samples from the
bone remains of a suspected anthrax case [10]

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Erkyihun et al. One Health Outlook (2022) 4:8 Page 10 of 13

in Ethiopia by causing production losses in Livestock), disease in Ethiopia. After the two days exercise, a list
availability of interventions (vaccines targeting diseases of five top zoonotic diseases of greatest national con-
in animal and medical intervention available for peo- cern was agreed upon by voting members. These are:
ple), and existing inter-sectoral collaboration ( disease Anthrax, Rabies, Brucellosis, Rift valley fever, and
which has focus of inter-sectoral collaboration gained Zoonotic Avian Influenza which are identified as the
full credit). Finally, five top zoonotic diseases (rabies, five national priority zoonotic diseases in Ethiopia [41].
anthrax, brucellosis, leptospirosis, and echinococcosis)
were selected and ranked for inter-sectoral engagement
by human and animal health agencies [39]. Awareness creation
The NOHSC established National One Health Communi-
Re‑prioritization of zoonotic diseases in Ethiopia cation Taskforce (OHCTF) in 2019 to facilitate planning
Ethiopia is the first country in Africa to utilize the and implementation of advocacy and communication
One Health Zoonotic Disease Prioritization Process interventions for One Health program in the country. The
(OHZDP) for the second time to update the prior- task force has been working aggressively since its estab-
ity zoonotic disease list. Because of the request from lishment. The communication taskforce has developed
Ministry of Agriculture and other relevant stakehold- One Health website and telegram channel, prepared,
ers for the reprioritization of current country’s pub- printed and distributed many copies of national zoonotic
lic health and economic importance of diseases, the diseases message guide and National Rabies Control and
National One Health Steering Committee in collabo- Elimination Strategic Documents (Fig. 4). At the global
ration with US CDC and Human Resource for Health level, the World Health Organization WHO), OIE, FAO
-2030 (HRH2-030) organized national level zoonotic and the Global Alliance for Rabies Control (GARC) have
diseases re-prioritization workshop from September launched ’World Rabies Day’ (WRD) campaign in 2007 as
24–25, 2019 in Addis Ababa. Experts from national and a response to the call to raise global awareness and mobi-
regional level and key stakeholders of the National One lize resources for rabies prevention and control and it has
Health Steering Committee (Ministry of Health; Minis- been celebrating annually every September 28 which is
try of Agriculture; Environment, Forestry, and Climate the largest unifying initiative on the prevention of the dis-
Change Commission; and the Ethiopian Wildlife Con- ease [42]. Based on this, celebration of the World Rabies
servation Authority and partners such as USAID, CDC, Day in Ethiopia promoting One Health has begun since
FAO, WHO, Veterinary Sans Frontiers -Suisse, etc.…) 2017. The 2021 celebration day workshop was held on 28
were participated on the workshop (Fig. 8).. Accord- September (Fig. 9).
ingly, 41 Zoonotic diseases were considered for prior-
itization and criteria utilized to determine the ranked Opportunities, challenges and solutions of One
outcomes of the One Health Zoonotic Disease Repri- Health approach in Ethiopia
oritization process are epidemic or pandemic potential, Opportunities and challenges
availability of prevention and control strategies, sever- There are several achievements and opportunities to
ity in humans, socioeconomic impact and presence of extend the One Health schemes and philosophies to

Fig. 8 Participants of One Health zoonotic disease re-prioritization workshop in Ethiopia, Photo taken from the workshop by the first author

Content courtesy of Springer Nature, terms of use apply. Rights reserved.

Erkyihun et al. One Health Outlook (2022) 4:8 Page 11 of 13

Fig. 9 Moment of World Rabies Day Celebration in Ethiopian, 2021 September 28(Ministry of Agriculture)

deal with zoonotic diseases in Ethiopia. The opportu- disciplines and sectors, rapidly Institutionalize the One
nities include strong interest from technical people in Health approach. The NOHSC with its TWGs should not
the ministries, the establishment of the National One only extend the One Health concept to the community
Health Steering Committee and prioritized zoonotic level but also begin operation of prioritized zoonotic dis-
diseases Technical Working Groups and their active eases prevention and control measures based on urgent
engagement, and interest and support from various revision of competing priorities. Universities should
NGOs. However, there are still considerable challenges include One Health philosophies and principles to aca-
which stakeholders and responsible government bod- demic curricula, including designated degree programs
ies should be aware of [38], 30. According to Fasina and as well as incorporating the One Health research issues
Fasanmi, 2020, some of the challenges include: into their thematic areas. In addition to these, capacitat-
ing diagnostic laboratories, encouraging research activi-
• Poor integration among animal and human health ties and advising to increase leadership commitment are
sectors in data sharing and lack of awareness and very important.
continuous advocacy across the relevant sectors
and community members Conclusion
• Leadership and commitment from higher govern- The risk of spreading of emerging and reemerging
ment officials including budgeting is still not strong zoonotic diseases has been increasing by the interac-
• Weak encouragement and collaboration between tions of human, animal and ecosystem and accounts
regional One health task forces for more than a billion cases, a million deaths and hun-
• Competing priorities among prioritized zoonotic diseases dreds of billions of United States dollars of economic
prevention and control strategic plans (Ethiopia has already damage per year. The One Health approach is criti-
planned more than three zoonotic diseases to control and cal for solutions to prevent, prepare for, and respond
eliminate them by 2030). to these complex threats. Countries, like Ethiopia, in
• Limited laboratory diagnostic capacity, resulted in which their household income is dependent on live-
poor detection of outbreaks/causative agents stock, are characterized by strong correlation between
• One Health-based course in the curriculum of human a high burden of zoonotic disease and poverty. Thus,
medicine, veterinary medicine and other related disci- reducing the zoonotic disease burden through OH
plines in most universities are still not included. approach is crucial to improve the overall health.
• Lack of clear legislation on the engagement of pub- In recognition of the intrinsic relationship between
lic–private partnership pertinent to One Health humans, animals, and their environment, and as part of
the implementation of the GHSA, the country increas-
ingly has embraced the One Health approach to pre-
Solutions vent, detect, and respond to existing and emerging
Possible solutions could be awareness of One Health and threats. Several One Health initiatives and workforces
foster leaders who are uniquely skilled to work across have been developed so far including the establishment

Content courtesy of Springer Nature, terms of use apply. Rights reserved.

Erkyihun et al. One Health Outlook (2022) 4:8 Page 12 of 13

of the NOHSC and different prioritized zoonotic dis- Funding

This work was achieved by the inspiring by the correspondent author
eases Technical Working Groups, the development of (Zoonotic Disease Prevention and Control Expert in Veterinary Public Health
control and prevention strategic documents for dif- Directorate of Ministry of Agriculture of Ethiopia and a student at Addis Ababa
ferent prioritized zoonotic diseases, conducting joint University, College of Veterinary Medicine) and initiatives and/or full commit-
ment of all authors.
disease surveillance and outbreak investigation activi-
ties, re-prioritization of zoonotic diseases, beginning of Availability of data and materials
capacity building for diagnostic laboratories and other All reviewed data and materials during the period of review are included in
this article.
One Health promotions. Nevertheless, there are still
so many challenges which require serious considera-
tions. Poor integration among sectors in data sharing Declarations
and communication, lack of advocacy, lack of financial Ethics approval and consent to participate
support from government, limited research fund and Not applicable.
activities etc. are among many challenges. Hence, it is Consent for Publication
critical to continue to raise awareness of OH and foster Permission for unreferenced figures is obtained from NOHSC, Ministry of
leaders who are skilled to work across sectors. Institu- Agriculture and Moment of workshops and they are open to public.
tionalization of One Health is a vital step in material- Competing Interests
izing One Health policy. The N OHSC and its different The authors declare that they have no competing interests.
national Technical Working Groups (TWGs) should
Author details
not only extend the One Health concept to the grass- 1
Ministry of Agriculture, Federal Democratic Republic of Ethiopia, P.O.
roots level and/or community level but also begin the Box 62347, Addis Ababa, Ethiopia. 2 College of Veterinary Medicine, Addis
operation of prioritizing zoonotic diseases prevention Ababa University, P.O. Box 34, Bishoftu, Ethiopia.
and control measures. Universities should include One Received: 3 January 2022 Accepted: 2 March 2022
Health philosophies and governing principles to aca-
demic curricula, including designated degree programs
as well as incorporating the One Health research issues
into their thematic areas. References
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