Operationalizing a community-based One Health surveillance and response in Adadle district of Ethiopia
Authors: Osman Yahya , Zinsstag Jakob , Abtidon Rahma , Hattendorf Jan , Crump Lisa , Wali Halane , Mo’alin Ahmed , Muhumed Abdifatah , Tschopp Rea 
Published: June 2023

Abstract
Surveillance of human and animal health is often carried out separately worldwide, which leads to the under-reporting of zoonotic and emerging diseases. Early cross-information between wildlife, domestic animal and public health sectors may reduce both exposure and cost of outbreaks. We have assessed the feasibility of a One Health Surveillance and Response System (OHSRS) in the Adadle district of Ethiopia in the Somali Region (SRS), with regard to integration into the existing regional surveillance-response system in the Somali Region of Ethiopia (SRS). To meet the objectives of a surveillance-response system, we established a One Health Surveillance and Response Unit (OHSRU) at the district level. Community Animal Health Workers, Community Health Workers (CHWs), and both human and animal health district staff and regional experts were trained together on the OHSRS. An inception workshop was held with all relevant stakeholders. To ensure the active engagement of communities in the surveillance response system, a Community-Based Emergency Fund (CBEF) and CAHW cost recovery mechanisms were established. All public and animal health staff of different administration levels were linked together. Human and animal health information was collected and shared effectively among sectors. This approach helped bridging the physical separation between the public and animal health sectors in disease surveillance in the Adadle district. Joint interventions, such as disease outbreak investigations and community awareness were initiated by the OHSRU. We demonstrated that the OHSR was successfully operationalized in Adadle districts and contributed to improving the early detection and response of zoonotic diseases. However, technical barriers, cost-effectiveness, legality of data and ethical safeguarding, along with political commitment should be addressed to effectively operationalize the OHSR in the whole region. Designing the OHSR through the existing surveillance system, engaging communities and other relevant sectors using a participatory process is an important contribution to a sustainable OHSR.

One Health Impact Statement
In this research work, the public and animal health sectors collaborated in data collection and initiated joint interventions. By integrating the surveillance operational costs for disease outbreak investigation and cost of public health associated with zoonotic diseases can be reduced as One Health surveillance and response lead to early detection and response to zoonotic diseases. As one health is collaborative efforts multispectral, multidisciplinary and transdisciplinary, i.e. involvement of all relevant sectors including community members and different disciplines in the launching workshop of surveillance system helped to define and agree the role of each sectors or partner’s in the One Health approach. This played a curtail role in the success of the approach. Lessons learned from this work can be used for further improvement in One Health approach in different settings.