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"EcoHealth Alliance is the only organization in the world that is completely focused on integrating global health with critical conservation challenges to make our world a better place for all. I'm really honored and proud to be a member of the EcoHealth Alliance team and work with our partners around the globe."

Scientists Bio

Dr. William B. Karesh is the Executive Vice President for Health and Policy at EcoHealth Alliance. He serves as the president of the World Animal Health Organization (OIE) Working Group on Wildlife Diseases and also chairs the International Union for the Conservation of Nature (IUCN) Wildlife Health Specialist Group, a network of wildlife and health experts around the world. Dr. Karesh also serves on the World Health Organization's (WHO) International Health Regulations Roster of Experts focused on the human-animal interface and wildlife health. Currently, Dr. Karesh is the EPT Partner Liaison for the USAID Emerging Pandemic Threats PREDICT-2 program, a >$120 million effort focused on predicting and preventing pandemic diseases. He is a Life Member of the Council on Foreign Relations.

Dr. Karesh coined the term "One Health" in 2003 to describe the interdependence of healthy ecosystems, animals and people and has pioneered solutions-oriented initiatives with this concept as the guiding principle. International programs under his direction in over 45 countries have covered terrain from Argentina to Zambia and include efforts in the Congo Basin to reduce the impact of diseases such as Ebola, measles, and tuberculosis on humans and endangered species such as gorillas and chimpanzees, to global surveillance systems for emerging diseases.

In addition to his work in the private sector, Dr. Karesh has also worked for the USDA, DOD, DOI and the Food and Agriculture Organization of the U.N. Dr. Karesh is internationally recognized as an authority on the subject of animal and human health linkages and wildlife. He has published more than 165 scientific papers and numerous book chapters, and written for the Huffington Post and journals such as Foreign Affairs

One Health is at the intersection of human health, animal health, and environmental health.

One Health is "the collaborative efforts of multiple disciplines working locally, nationally, and globally, to attain optimal health for people, animals and our environment", as defined by the One Health Initiative Task Force (OHITF).^[1]

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History

The recognition that environmental factors can impact human health can be traced as far back as to the Greek physician Hippocrates (c. 460 BCE – c. 370 BCE) in his text "On Airs, Waters, and Places".^[2] He promoted the concept that public health depended on a clean environment.^[3] In the mid-1800s, Rudolf Virchow, a physician, recognized the link between animal and human medicine, came up with the term zoonosis to describe a disease that can be passed from animals to humans, and actively advocated for veterinary medical education.^[4] The founding of the Veterinary Public Health Division at the Centers for Disease Control and Prevention (CDC) in 1947 by [Dr. James Hahn Steele (born 1913)], a veterinarian trained in public health, contributed to the understanding of how diseases are spread between animals and humans, or the epidemiology of zoonotic diseases.^[4] [Dr. Calvin Walter Schwabe (born 1927)], another veterinarian trained in public health, coined the term One Medicine in a veterinary medical textbook in 1964, which reflects the similarities between animal and human medicine and stresses the importance of collaboration between veterinarians and physicians to help solve global health problems.^[4] "One Health" was first mentioned in a story about Ebola hemorrhagic fever on April 7, 2003, when Rick Weiss of the Washington Post quoted William Karesh as saying, "Human or livestock or wildlife health can't be discussed in isolation anymore. There is just one health." [see [HN020T][GDrive] ]. In 2004, The Wildlife Conservation Society held a conference at Rockefeller University in New York called One World, One Health, out of which the twelve Manhattan Principles were created.^[6][7] These principles highlighted links between humans, animals, and the environment, how these links are integral to understanding disease dynamics, and the importance of interdisciplinary approaches to prevention, education, investment, and policy development.^[7]

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TRAPPED within a few forested acres on the South Pacific island of Borneo, an orangutan blustered as wildlife researchers tightened their circle around her, then she retreated angrily up a tree. Many hours later, the orangutan crept near the ground, close enough for a marksman to shoot a tranquilizer dart into her thigh, and she tumbled into brush that had been piled up to cushion her fall. When she opened her eyes again, she was in a wildlife reserve with room to roam.

The rescue, described by [Dr. Annelisa Marcelle Kilbourn (born 1967)], a veterinarian with the Wildlife Conservation Society, was one of 58 she directed in the last year in Sabah, a Malaysian region on Borneo. During an interview at the society's offices at the Bronx Zoo, Dr. Kilbourn said that such patient, sweaty missions are necessary because the relentless clearing of land for plantations on Borneo is driving orangutans onto virtual islands of rain forest too small to support their population.

But the rescue project, carried out with the Sabah Wildlife Department, is aimed at helping more than the trapped orangutans. Medical examinations by [Dr. Annelisa Marcelle Kilbourn (born 1967)] before the animals were released are giving researchers their first look at the physiology of wild orangutans, information that will help in managing the semi-wild animals held at rehabilitation centers and those made homeless by the illegal pet trade.

Blood and fecal samples are still being analyzed, said [Dr. William Bamberger Karesh (born 1955)], director of the field veterinary program for the Wildlife Conservation Society, but early results show that reintroduction of captive orangutans into the forests should be done far from wild populations. That is because the orangutans that have been in close contact with people commonly are infected with hepatitis and tuberculosis, Dr. Karesh said, while wild orangutans appear to be free of them.

Dr. Kilbourn's work fills a crucial gap in orangutan research, Dr. Karesh said. ''People have been studying wild orangutans for 30 years,'' he said, ''but they've been looking at behavior. In all that time, no one took a blood sample.''

Orangutan populations have been squeezed on several fronts: wild animals are losing their habitats, and many are killed or injured by hunters and by workers defending plantation crops. Thousands of females have been killed so their offspring could be captured and sold as pets, and about half of those captured infants are thought to have died in transit.

The demand for orangutan pets was strong in Asia, especially Taiwan, in the 1980's and early 1990's. Marcus J. Phipps, a World Wildlife Fund official based in Taiwan and a former head of the Orangutan Foundation Taiwan, said that a children's television show there in the late 1980's called ''The Naughty Family'' inadvertently contributed to the problem because it featured an orangutan as a cute companion, which helped to create demand for such pets.

Crackdowns on the pet trade since then have slowed it considerably throughout Asia. But Mr. Phipps said that most of the orangutans shipped to Taiwan in the late 1980's and early 1990's had probably died.

That has contributed to an overall population decline estimated at 30 percent to 50 percent in the last decade. While wild orangutans, the only great ape in Asia, were once found throughout Southeast Asia, a World Wildlife Fund report estimates that they now live on only 2 percent of their original range. Fewer than 30,000 are left, all of them on Borneo -- which is divided among Malaysia, Indonesia and Brunei -- and Sumatra, part of Indonesia.

Recent fire and smoke damage has been widespread in the region, killing some orangutans and other wildlife and damaging habitats, according to the World Wildlife Fund. But [Dr. William Bamberger Karesh (born 1955)] said that smaller animals would be more vulnerable to the smoke than the orangutans and that the population in Sabah had not been affected.

Another focus of Dr. Kilbourn's work in Sabah has been to teach Malaysians at the Sepilok Wildlife Center how to rehabilitate injured wildlife and pets that have been confiscated or turned in.

Sometimes orphaned or injured orangutans are taken to the rehabilitation center after attacks by plantation workers, [Dr. Annelisa Marcelle Kilbourn (born 1967)] said. The workers are not necessarily intending to hurt the apes, she said, but are trying to keep them from eating crops.

''The only thing they've got to round them up with are machetes,'' she said. ''So by the end of the day, the mother can be badly hurt or dead.''

Dr. Karesh said that the deaths of adult females were devastating for the orangutan population because they produced young at a slow rate. It takes 10 years or more for females to start reproducing, and they each produce only four or five offspring in a normal life span of 40 years.

The wildlife workers are winning the trust of Sabah residents, Dr. Kilbourn said, so more plantations are asking the rehabilitation center to rescue trapped orangutans instead of trying to handle the problem themselves.

The rehabilitated animals at Sepilok are semi-captives, [Dr. William Bamberger Karesh (born 1955)] said, able to get food at the center but encouraged to migrate into the surrounding forest reserve.

Once they reach full size -- about 200 pounds for males and half that for females -- orangutans can push people around, [Dr. Annelisa Marcelle Kilbourn (born 1967)] said, which explains why people who buy infant orangutans as pets abandon them after they grow. At the rehabilitation center, everything is double-locked in an effort to keep out the orangutans because they can figure out locks or pop padlocks open with sheer strength.

Dr. Karesh said some rehabilitated orangutans from Sepilok had been reintroduced into areas of Borneo that did not have natural wild populations, as have animals in Indonesia, including some former pets returned from other countries. ''They are naturally solitary animals, so that makes reintroductions easier,'' he said.

Dr. Kilbourn will return to Sabah soon to work with a Malaysian veterinarian who will be taking over the rescue and rehabilitation work.

Africa's gorillas and chimpanzees are dying off at a startling rate despite their protected status, even in the more remote parts of the continent that have long been considered their strongholds, according to newly collected survey data.

Surveys conducted from 1998 to 2000 found that ape populations have shrunk by more than half since 1983 in Gabon and the Republic of Congo, two nations where forests remain largely undisturbed and most of Africa's apes live today. The main causes are hunting for bushmeat and an epidemic of Ebola hemorrhagic fever, which has left thousands of dead primates in its bloody wake.

With hunters venturing ever deeper into the forest along newly cut logging roads, and the Ebola virus poised to sweep into parks where many of the world's remaining gorillas and chimpanzees have taken refuge, disaster is close at hand, researchers said.

"The stark truth is that if we do not act decisively our children may live in a world without wild apes," the international team of scientists conclude in their report, posted yesterday on the Web site of the journal Nature.

It remains unclear what it would take to slow or halt the decline, scientists said in interviews. Indeed, differences of opinion have already spilled over into political wrangling that experts hope to sort out next month at an emergency meeting in Washington, where conservationists, infectious disease specialists, international aid workers and public health officials will try to forge a cooperative strategy.

Meanwhile, the researchers want their data used to reclassify gorillas and chimpanzees as "critically endangered," a strictly defined category that would justify greater conservation measures for the animals, now listed as "endangered."

"We need more law enforcement to stop the poaching and we need money for field research to understand how Ebola is spreading," said Peter D. Walsh, a Princeton quantitative ecologist who led the new study with scientists from groups in Gabon, Britain, Spain and the United States.

The new analysis is the most comprehensive comparison of 1980s survey data with surveys conducted in the past few years. It involved labor-intensive searches for nesting sites in Gabon and Congo -- countries that remain relatively unknown to armchair conservationists but are home to about 80 percent of the world's gorillas and most of the world's chimpanzees.

Those countries are considered the most hospitable for apes because they retain so much forest cover -- crucial for chimps, which nest in trees, and also for apes, which build nests on the ground from branches and leaves. The two countries retain between 60 percent and 80 percent of their original forest cover, compared with 7 percent to 14 percent in eastern and western Africa, respectively.

Yet tree cover is no guarantee of survival, the new research shows.

Even where trees have not yet begun to fall in large numbers, new logging roads have given hunters unprecedented access to apes -- and easy truck transport of the meat not only to villagers but also to Africa's growing urban markets. Demand for bushmeat remains high despite ongoing efforts to educate people about the threat of extinctions and the risk to consumers, who can die from handling Ebola-tainted meat.

Ebola hemorrhagic fever -- an incurable disease that causes massive, fatal bleeding and has killed more than 100 Congolese people in recent months -- now rivals hunting as the biggest threat to apes, the researchers said. Thousands -- perhaps even tens of thousands -- of the animals are believed to have succumbed to the rapidly fatal disease.

"All the evidence points to a very dramatic and severe impact of Ebola," said William Karesh, head of the field veterinary program of the Wildlife Conservation Society, one of the groups involved in the latest work. The disease has wreaked havoc in Congo's Lossi sanctuary, Karesh said, and now is on the borders of Odzala National Park, home to the world's highest densities of gorillas and chimpanzees.

In northern Gabon's Minkebe forest, the new survey indicates, ape densities have declined by 99 percent in the past decade, mostly as a result of Ebola.

Scientists are not sure how best to slow the virus's spread, in large part because they don't know whether it is passed only from ape to ape or via other animals.

Scientists also differ in their approaches to reducing the bushmeat trade. Many groups favor eco-tourism and other means of making nature profitable for local people. But these programs take time to set up, and time may be short.

The new study, which documents a 56 percent decline since 1983, predicts that ape populations will decline another 80 percent in the next 33 years -- less than two ape generations. Walsh says that justifies implementing politically unpopular crackdowns on poachers and an emergency infusion of $10 million for field research from the U.S. Fish and Wildlife Service.

That agency currently spends about $250,000 a year on ape conservation in Congo and Gabon, said Richard Ruggiero, Africa program officer for the service's office of international affairs. A preventive health program for gorillas and a great-ape disease study are among the agency's programs.

"We consider the latest Ebola outbreaks to be significant to the point of alarm," Ruggiero said. "We need to pay attention to this."

In the longer term, governments need to consider setting aside more protected areas, said Rebecca Kormos, a research fellow with the Center for Applied Biodiversity Science at Conservation International in Washington. "We're learning that you can't have just one area where you're protecting the apes. Not just because of diseases like Ebola, which can wipe out an area, but also because of things like civil unrest and conflict."

Perhaps most important, and most difficult, said Karesh of the Wildlife Conservation Society, is to forge better relations with local villagers. "They've been neglected and isolated for decades, they have different contexts about what causes disease, and they're scared of outside people and scientists," he said. "It's very hard to do conservation in that climate."

Karesh noted that the most recent outbreak of Ebola in Congo was detected in gorillas before it started killing people -- a warning that could have saved lives.

"Human or livestock or wildlife health can't be discussed in isolation anymore," Karesh said. "There is just one health. And the solutions require everyone working together on all the different levels."

DAVIS, Calif. - Bang! Inside an improvised duck blind -- her parked car -- Grace Y. Lee presses a switch, and her gun blasts a square of light volleyball net over the dirt road she is watching.

One of the two magpies she has baited into range with cornbread, cheese-flavored rice snacks and dog food is snagged, flopping furiously around.

"We mostly catch the young ones," Ms. Lee said. "These birds are too smart to be caught again. We get them once, and they don't shop here anymore."

With the country waiting nervously for avian flu to arrive, catching wild birds is no hobby. It has become part of a national early detection effort, and Ms. Lee, a researcher at the University of California here, is a sentry on the country's epidemiological ramparts.

She is one of hundreds of ornithologists, veterinarians, amateur bird-watchers, park rangers and others being recruited by the National Wildlife Health Center to join a surveillance effort along the major American migratory flyways. They will test wild birds caught in nets; birds shot by hunters on public lands, who must check in with game wardens; and corpses from large bird die-offs in public parks or on beaches.

The plan also calls for sampling bodies of water for the influenza virus, which is shed in bird feces. And it is designating some ducks and geese -- like those in backyard flocks or living year-round in park ponds -- as "sentinels" to be captured, tested, released and periodically retested.

Surveillance of poultry is already in place. Long-standing federal and state laws require farmers to report deaths of birds from any flu strain. The surveillance system was worked out this summer by the Agriculture Department, which oversees poultry, and the wildlife health center in Madison, Wis., part of the Interior Department, which oversees wildlife -- including migratory birds, which are thought to be the most likely entry route for the flu virus.

Dr. Christopher J. Brand, the center's research chief, estimated the cost at $10 million. [On Nov. 1, President Bush announced a $7.1 billion plan to guard against a flu pandemic; Dr. Brand said he hoped money for the surveillance system would come from that.] The sampling plan had a small test run this fall in Alaska, which Dr. Brand said was the obvious choice because of the flu's surprise appearance in Siberia in July. Birds from there mingle in the summer Arctic nesting grounds with birds that migrate down the North American coast.

Now the flu's recent crossing of Europe "has opened up more eyes," Dr. Brand said. It is unlikely that infected birds will cross the Atlantic, because most migrate north-south and the birds detected in Eastern Europe were from species that migrate to Africa. Still, Dr. Brand said, there is now talk of setting up a surveillance network for Greenland, eastern Canada and the East Coast.

The threat of avian flu has also sped a transformation that was begun by the fear of bioterrorism and fueled by the fight against West Nile virus: veterinarians and doctors, as well as the agencies overseeing them, are joining forces.

Previously, said [Dr. William Bamberger Karesh (born 1955)], head of the field veterinary program at the Wildlife Conservation Society, which runs the Bronx Zoo, the two fields almost never worked in tandem.

"Human medicine and veterinary medicine have advanced beautifully in the last 30 years, but they were not linked," Dr. Karesh said. That has always frustrated him, he said, because "diseases don't care which way they flow -- there is a whole world of bacteria, viruses and fungi that move between wild animals, domestic animals and humans."

[Dr. William Bamberger Karesh (born 1955)] described once trying to get a research grant for surveillance of animal diseases that infect humans, known as zoonoses. The National Institutes of Health told him to apply to the Department of Agriculture, he said, and officials there sent him to the Fish and Wildlife Service, which told him it had no mandate to study disease.

"Then we went to Homeland Security, and they understood what we were talking about," Dr. Karesh said. "But they said: 'You're an orphan. No one does this.' And in their rankings, we're lower than people trying to blow up the subway in New York."

Now, instead of sharing information haphazardly and getting into jurisdictional disputes -- problems that cropped up during the 2003 monkeypox outbreak and in surveillance for mad cow disease -- health officials are writing plans that emphasize teamwork.

The United States still does far better at animal surveillance than most other countries because its medical and veterinary systems are each excellent and because outbreaks cannot be hushed up -- as, for example, the SARS outbreak was in China.

But zoonoses fall into a gray area, and the 2003 monkeypox outbreak in the Midwest is a perfect example of what can go wrong, said [Dr. Peter Daszak (born 1965)], director of the Consortium for Conservation Medicine at the Wildlife Trust, a group specializing in human-animal diseases.

The disease, related to smallpox but less deadly, arrived in a shipment of 18 Gambian giant pouched rats imported for a Chicago pet store, where they infected prairie dogs. By summer's end, there were 37 confirmed human cases -- none fatal, but some scary -- mostly among prairie-dog owners.

"Millions of live animals come into the country each year, and very few have really good surveillance," [Dr. Peter Daszak (born 1965)] said. "Fish and Wildlife checks cargoes to see if they have endangered species, but it's the U.S.D.A. that does health checks, and they don't go unless it's an agricultural product, so the pet trade tends to get a pass."

"The C.D.C. does a great job with outbreak investigation, but that's after the fact," he said of the federal Centers for Disease Control and Prevention. "After monkeypox, they put a blanket ban on rodents from some West African countries. But who's looking at rodents from other places? Nobody. And that's a gap."

Surveillance for diseases in wild animals is particularly difficult, since they do not come to hospitals, are not watched by veterinarians and do not like to be caught.

In the case of the magpie in Davis, it took Ms. Lee and her boss, Dr. Walter M. Boyce, director of the university's Wildlife Health Center, more than 30 minutes to disentangle the bird, set up a lab table, zip themselves into disposable coveralls and get a beak swab, a feces swab and a blood sample before releasing the miffed-looking bird, which high-tailed it for the nearest tree.

Dr. Boyce also gets swabs from hunters' ducks, and his colleagues at the state-run agriculture laboratory on campus get them from poultry farms and from dead crows, jays and robins collected by city health departments on the watch for West Nile virus, which arrived in California earlier this year.

During the test run in Alaska, Dr. Jonathan Runstadler, a biology professor at the University of Alaska in Fairbanks, said he had collected nearly 5,000 fecal samples from ducks, geese, gulls and other shorebirds, owls and other raptors, and even songbirds.

With limited money, Dr. Runstadler could not mount his own bird-catching efforts, but university ornithologists and dedicated amateurs who study migratory patterns run what he called "ring and fling" leg-banding operations. "Our technicians and grad students go out with them, pull out a Q-Tip and say, 'Excuse me, can I take a sample here?' " he said.

Another difficulty is deciding which species to pursue. [Dr. William Bamberger Karesh (born 1955)] expressed frustration that no country with birds dead of flu, from China to Romania, had noted which healthy species were nearby, because survivors were the more likely carriers, he said.

Which explains why Ms. Lee was netting birds that live year-round in Davis.

It's "a bit of a maverick approach," Dr. Boyce admitted, but his theory is that scavengers like magpies, crows and cattle egrets are the most likely vectors for moving the virus from the millions of ducks flying down California's Central Valley each fall to domestic chicken farms.

American industrial farms have high levels of biosecurity, penning thousands of birds in hangar-size barns "that no self-respecting duck or goose is looking to get into," Dr. Boyce said, "but there's a lot of free food there for an opportunist."

Since scavengers also bathe in the ponds where ducks stop over and hang around humans' garbage cans, he said, "we're looking for flu in species that can make the link between wildfowl, poultry and people."

NEW YORK — Those of us who have been studying avian influenza and other bird diseases for decades, when few people beside pet owners and the poultry industry cared, are dismayed that voices of reason are being drowned out with regard to the role played by wild birds in the spread of the H5N1 virus.

This past week alone, both the United Nations and the Office of Homeland Security implicated migratory birds as the most likely carriers of H5N1 to American shores, while cable news scrambled to get bird migration maps.

Migratory fowl could, of course, bring H5N1 here on the wing. But there is an equal, if not greater, chance that H5N1 will fly to North America on an airplane transporting poultry legally or otherwise. Recently a shipment of chicken feet was smuggled into the United States from Thailand, arriving in Connecticut marked "jellyfish." Luckily, our trade surveillance system worked and the chicken parts were confiscated.

Over the last 30 years we have learned a tremendous amount about how avian influenza spreads. In nature, avian influenza viruses live innocuously in many types of wild birds and cause only mild effects, sometimes none at all, similar to many bacteria and viruses that live in humans.

This is not to say that the virus can't be carried by, and kill, wild birds, because it can. Yet the spread of H5N1 from the activities of wild birds pales in comparison to a very human activity- trade.

We know that international trade in wild or exotic birds, both legal and illegal, has helped moved H5N1around the world. However, the virus has likely gotten its biggest boost through the trade, both legal and illegal, in poultry.

As part of a multi-billion dollar industry, poultry markets and farms span the globe. The conditions of these facilities vary greatly; some are plagued by highly unsanitary conditions and close bird-to-bird contact. This environment provides the ideal setting for deadly strains of the avian flu virus to develop.

Moving these infected poultry and poultry products as well as contaminated fecal matter on trucks, boots or in cages results in the further spread of avian flu.

The current focus on the role of migratory birds in the spread of H5N1 has shifted discussion away from this trade.Even perfect security ultimately won't work if we do not begin to address the role of trade in the spread of avian flu and the host of other diseases that can jump between humans, wildlife and domestic animals.

A similar concern arises when we look at the multi-billion dollar legal and illegal trade in wild animals. Not only does this practice put wildlife populations at risk, it also creates unique opportunities for novel pathogens (viruses, bacteria, and fungi carried by these animals) to exploit new hosts unprepared for their arrival.

The pet trade in African rodents brought Monkey Pox to our doorstep just a few short years ago. Yesterday it was Monkey Pox, today it is avian flu, and tomorrow avian flu could morph into a pandemic. If we do not address animal and wildlife trade, it is just a matter of time before the next zoonotic disease hits.

Understanding the spread of H5N1 is critical to our ability to contain it. Congress recently passed legislation including provisions for a global H5N1 monitoring network for both wild and domestic birds that will help determine areas at future risk. Without this type of network, along with sound epidemiological study, conclusions will remain in large part conjecture.

We need to remember that the human deaths related to H5N1 since its identification in 1997 have been traced to close contact with poultry. We also need to understand that changing our current practices on a global scale is necessary to contain this and future viruses.

The first step is educating peopleon how to safely handle domestic poultry. Ultimately, our goal should be a global system of trade that ensures the movement of quality domestic animal food products and excludes wildlife for food or as pets.

To that end, border security must be enhanced so that the potential for contaminated products of the domestic and wildlife trade do not cross into nations that are not yet infected.

(Robert A. Cook is chief veterinarian and vice president and William B. Karesh is director of the Field Veterinary Program at the Wildlife Conservation Society, Bronx Zoo, New York.)