2023-10-25-世界银行-保护粮食系统_预防未来的流行病_以中亚一个健康计划为例（英）_108页_2mb

Summary of “Protecting Food Systems, Preventing Future Pandemics: The Case for a Central Asia One Health Program”

Executive Summary:
Central Asia faces interconnected challenges including zoonotic diseases, antimicrobial resistance (AMR), food safety issues, climate change, and land degradation. These threats pose significant risks to regional food security, public health, and economic stability. Adopting a One Health approach—collaboration between human, animal, and environmental health sectors—is essential to address these challenges effectively. The report outlines the need for strengthened regional cooperation, institutional capacity, surveillance systems, and targeted investments to build resilience against pandemics and ensure sustainable development in Central Asia.

Main Issues in Central Asia

1. Human Population, Mobility, and Urbanization:

   • High poverty rates (e.g., 17–66% below $6.85/day) and limited urbanization strain health systems.
   • Migration and trade increase disease transmission risks.

2. Livestock Production Systems and Trade:

   • Low animal productivity, poor husbandry practices, and limited biosecurity hinder competitiveness.
   • Countries are net importers of live animals/products despite high livestock numbers, constrained by trade barriers and SPS compliance gaps.

3. Climate Change, Wildlife, and Ecosystem Transformations:

   • Land degradation, water scarcity, and desertification exacerbate disease spread and reduce agricultural resilience.
   • Climate change drives wildlife-livestock interactions, increasing zoonosis risks.

4. Public Health:

   • High burdens of zoonotic diseases (e.g., anthrax, brucellosis, rabies) and AMR due to weak surveillance, limited diagnostics, and fragmented systems.

5. Priority Zoonoses and Food Safety:

   • Zoonoses like HPAI, LSD, and echinococcosis threaten trade and food safety.
   • Food safety deficits stem from fragmented regulatory frameworks and limited enforcement, hindering access to international markets.

6. Antimicrobial Resistance:

   • Overuse of antibiotics in human and animal health drives AMR. Ecosystems and surveillance systems are underfunded, limiting detection and control.

Institutional and Governance Aspects

• Current Initiatives: Countries have developed national One Health Action Plans but lack harmonized policies and institutional coordination.
• Capacity Gaps: Limited veterinary epidemiology, diagnostic capacity, and laboratory infrastructure constrain effective response.
• Disparities: Significant progress in urban areas but rural communities face challenges in accessing healthcare and disease prevention.

Recommendations for a Regional One Health Program

1. Strengthen National and Regional Capacity: Harmonize SPS regulations, improve surveillance data sharing, and build lab infrastructure.
2. Enhance Regional Cooperation: Establish a Central Asia One Health Framework for Action to coordinate cross-border efforts and data sharing.
3. Targeted Investments: Invest in early-warning systems, AMR surveillance, food safety infrastructure, and human-animal interface studies.
4. Policy Integration: Develop integrated national policies addressing zoonoses, AMR, and food safety with clear cross-sectoral mandates.
5. Capacity Building: Train professionals in epidemiology, diagnostics, and biosecurity while promoting interdisciplinary collaboration.

The implementation of a robust One Health program in Central Asia is deemed feasible and crucial for safeguarding health, food security, and economic growth, while mitigating risks of future pandemics.