Viet Nam
Main results of studies under the project “Strengthening Capacity for Implementation of One Health in Viet Nam” (SCOH)
Being implemented from December 2013 till June 2016, one of the important results of the project “Strengthening Capacity for implementation of One Health in Viet Nam” funded by USAID through UNDP has been support and small grants provided for key research and other priority studies as identified by the Technical Advisory Committee (TAC) in One Health field. Within the scope of the project, seven studies were conducted by national and international experts, who were mobilized by the Viet Nam One Health Partnership for Zoonoses (OHP) Secretariat, which is the focal point for implementing SCOH. The finalized study reports were sent to technical agencies of the Ministry of Agriculture and Rural Development (MARD) and the Ministry of Health (MOH) for appraisal before official dissemination.

A summary of the results of the seven studies is as follows:

1. The study “Human, animal and environmental health risks from pig farm wastewater in northern Viet Nam” was conducted in Hoang Tay commune, Kim Bang district, Ha Nam province. The results show that pathogens and antibiotic residues in wastewater from livestock production pose a threat to human, livestock, and environmental health. Key risks include contact with wastewater during livestock rearing and using livestock wastewater to fertilize fields, as well as the discharge of untreated or poorly treated wastewater into community drainage systems and fields. Recommendations include that specific communication programs should be designed to improve knowledge and practices on animal feeds, antibiotics, livestock wastes, and human, animal and environmental health issues. Also, local authorities should promote and support appropriate management and treatment of livestock wastes, integrating health education messages. What is more, biogas systems are a priority option; however, a communication program is needed to ensure appropriate household knowledge and practices on using biogas.

2. The study “Investigating the use of antibiotics in livestock production within Viet Nam” was implemented in Chuyen Ngoai commune of Duy Tien district and Le Ho commune of Kim Bang district, Ha Nam province. The results of the study of knowledge, attitudes and practices (KAP) of Vietnamese pig farmers indicate the potential for overuse and inappropriate use of antibiotics in pig rearing. Antibiotics are commonly used in pig husbandry, and readily accessible from veterinary drug stores at the commune. Pig owners, who mostly have no background on diagnosis pig diseases or antibiotic use, commonly rely on the recommendations of local vets, veterinary drug suppliers, or their own experience. Therefore, several recommendations were given by study team for better use of antibiotics in livestock production, including: (i) Effective communications and technical support for improved awareness, knowledge, attitudes and practices of pig farmers on safe and appropriate antibiotic use; (ii) Enhancing the role and responsibilities of livestock extension services to encourage farmers and local veterinary practitioners to use antibiotics safely and appropriately for animal disease prevention and treatment; and (iii) A minimum surveillance program on antibiotic residues in food products of animal origin and assessment of the environmental impacts of antibiotic-resistant bacteria. On top of that, a roadmap for the gradual banning and eradication of the preventive use of antibiotics in animal feeds is specifically required.

3. The study“Developing a risk analysis and assessment program on the food safety of animal originated products and zoonotic diseases. Case study: Risk assessment on Salmonella contamination in chicken meat in the production chain related to consumer health risks” was implemented in Gia Lam and Thuong Tin districts of Ha Noi, estimating salmonellosis risk due to consumption of boiled chicken meat. The study results illustrate that, alongside the trend of poultry production sector development in recent decades, there is a need to improve food quality and safety. The assessment of Salmonella from slaughter points to markets showed a high prevalence and load in chicken carcasses, chicken meat and environmental samples. The yearly incidence rate of salmonellosis between households with and without using cool storage were 0.83 (90% CI: 0-4.45) and 2.51 (90% CI: 0-12.84) percent, respectively. There is a statistically significant difference in annual risk between using and not using cool storage (p<0.01). This finding underlines the requirement for improving hygienic conditions along the poultry production chain, especially at slaughterhouses and markets, as well as at households. Enforcement of regulations on food safety management should be addressed and applied at all levels. The active involvement of each production actor in adopting good hygiene procedures and food handling practices is needed. Further dissemination, training and workshops on food safety are necessary to continue identifying opportunities to support and develop the poultry sector sustainably and effectively.

4. According to the study“Estimating the economic impact of canine rabies in Viet Nam, 2005-2014”, over this 10-year period, a total of 914 human deaths were reported, averaging 91.4 deaths per year. The total economic impact of canine rabies in Viet Nam was over 14.8 trillion VND. The results of this study indicate that canine rabies impacts in Viet Nam are consistent with how these impacts have been characterized in Asia, in that there are large expenditures on PEP and very small expenditures on dog vaccination. Dog vaccination coverage in this period has only reached an average of 48% in Viet Nam, while canine rabies elimination requires a level of dog vaccination coverage that exceeds 60%. To achieve the objective of ending rabies in humans by 2020, Viet Nam must increase expenditures on the dog vaccination efforts while maintaining or increasing PEP coverage during this period. Dog vaccination represents human rabies prevention while PEP represents suppression of canine rabies in humans. As the experience of Latin America has indicated, increasing expenditures on dog vaccination to increase prevention will ultimately reduce the need for suppression.

5. According to Jones, K. E., et al. (2008), Emerging Infectious Diseases (EIDs) events are dominated by zoonoses (60.3% of EIDs)—that is, diseases originating in animals—and the majority of these (71.8%) originate in wildlife. Through desk review and interviews with stakeholders, the results of the study “State management of captive wildlife in relation to wildlife health and the risk of inter-species and zoonotic disease transmission” recognizes the efforts of actual implementation of legislation in the management of captive wildlife, as well as identifying gaps and overlaps in collaboration and coordination between agencies in Viet Nam. Recommendations are provided on strengthening the state management of captive wildlife to improve the legislation framework in relation to animal health, public health and zoonotic disease. These recommendations include having adequate revision and supplementation of the legislation on the responsibilities and collaboration between agencies, and strengthening management of captive wildlife farming and consumption, including having an updated database on wildlife farms and wildlife value chains, and operating standards for farming and disease prevention. The study team also suggests revising and modifying legislations on prosecution of wildlife trafficking,however,this may need a more in-depth study as it involves other law enforcement agencies and relevant ministries at national, regional and international levels.

6. Epidemiology and laboratory collaboration between the human health and animal health sectors in Viet Nam is a fundamental requirement and basis for an effective One Health response to the challenges posed by emerging infectious diseases (EIDs) with the potential to spread between wildlife, livestock and human populations. The results of the study “Epidemiology and Laboratory Collaboration and Information Sharing between the Human Health and Animal Health Sectors: enhancing a One Health Approach” show that, building on existing capacity and achievements in Viet Nam over the past decade, further progress on the following areas is recommended: (i) Operationalizing effective cross-sectoral collaboration at all levels through implementation guidelines and standard operating procedures for Circular 16 (2013) on joint surveillance, information sharing, investigation and response; (ii) Establishing a new overall national coordination mechanism (steering committee) for One Health and zoonotic diseases, building on earlier mechanisms for responding to influenza and other emerging diseases; (iii) Strengthening intra- and inter-sectoral laboratory networking through regular meetings, scientific conferences and workshops, integrated training and exchanges; and especially (iv) Continuing to foster international cooperation through the Viet Nam One Health Partnership for Zoonoses, key global initiatives such as ZDAP and EOC action packages of the GHSA, cross-border information sharing, and regional working groups.

7. According the recommendations given from the study “Global and Regional One Health Initiatives: best practices and recommendations”, Viet Nam should continue to adopt and refine One Health approaches to disease control and prevention for problems at the animal-human-ecosystem interface. Strengthening activities should explore ways to utilize expertise both within and outside Ministries through advisory committees. Viet Nam should develop strategies to address each of the five broad areas identified in the document for which a One Health approach is required, and for the components within each of these areas, building on systems already in place. Strategy development for these areas should be documented in a follow up to the OPI and AIPED, covering the period 2016–2020. Viet Nam should continue to provide information on One Health activities to selected international and regional One Health meetings to help build the database of experiences and to demonstrate the importance of this approach. Viet Nam should continue to seek donor support for One Health activities to support identified and developed strategies.