Smallholder farmer and tribal communities are often characterised as marginalised and highly vulnerable to emerging zoonotic diseases due to their relatively poor access to healthcare, worse-off health outcomes, proximity to sources of disease risks, and their social and livelihood organisation. Yet, access to relevant and timely disease information that could strengthen their adaptive capacity remain challenging and poorly characterised in the empirical literature. This paper addresses this gap by exploring the role of disease information in shaping the adaptive capacity of smallholder farmer and tribal groups to Kyasanur Forest Disease (KFD), a tick-borne viral haemorrhagic fever. We carried out household surveys (n = 229) and in-depth interviews (n = 25) in two affected districts–Shimoga and Wayanad–in the Western Ghats region. Our findings suggest that, despite the generally limited awareness about KFD, access to disease information improved households’ propensity to implement adaptation strategies relative to households that had no access to it. Of the variety of adaptation strategies implemented, vaccination, avoiding forest visits, wearing of protective clothing and footwear, application of dimethyl phthalate (DMP) oil and income diversification were identified by respondents as important adaptive measures during the outbreak seasons. Even so, we identified significant differences between individuals in exposure to disease information and its contribution to substantive adaptive action. Households reported several barriers to implement adaptation strategies including, lack of disease information, low efficacy of existing vaccine, distrust, religio-cultural sentiments, and livelihood concerns. We also found that informal information sharing presented a promising avenue from a health extension perspective albeit with trade-offs with potential distortion of the messages through misinformation and/or reporting bias. Altogether, our findings stress the importance of contextualising disease information and implementing interventions in a participatory way that sufficiently addresses the social determinants of health in order to bolster households’ adaptive capacity to KFD and other neglected endemic zoonoses.

Central to contemporary debates on land tenure in sub-Saharan Africa are questions concerning appropriate pathways to successfully harmonize customary and statutory land tenure arrangements to address normative goals of improving access to land and security of tenure for the poor and marginalized. These are particularly prevalent in the face of increasing commodification and individualisation of land rights. Developing appropriate land policies requires a detailed understanding of existing tenurial dynamics. This paper draws on a mixture of qualitative methods and a household survey among 380 farmers from 19 villages in the Kakum and Ankasa areas of southcentral and western Ghana, to explore the mechanisms of land access, control and ownership arrangements, focusing on key differentiations around gender, age and ethnicity. The results articulate how transformations in land tenure have shifted patterns of accessing land in favour of wealthier individuals to the relative disadvantage of women, young people and poor people regardless of ethnicity. The analysis further indicates that the 'self-transformation' or dynamism of local customary tenure arrangements is inadequate for addressing issues of challenges in access to and control of land, particularly by the vulnerable social groups. This is evidenced by some traditional authorities and local powerful elites capitalizing on the 'new opportunities' afforded by the emergent tenurial relations to advance their individual interests at the expense of the vulnerable groups. Overall, the study highlights how ongoing changes in customary tenure arrangements towards individualisation are far more complex and socially embedded than is often assumed. The paper underscores the need for land policy reforms to shift away from static approaches geared towards promoting efficiency or merely lauding customary tenure arrangements towards more flexible approaches that accommodate the complexity of contemporary changes to land tenure arrangements.

Zoonoses disproportionately affect tropical communities and are associated with human modification and use of ecosystems. Effective management is hampered by poor ecological understanding of disease transmission and often focuses on human vaccination or treatment. Better ecological understanding of multi-vector and multi-host transmission, social and environmental factors altering human exposure, might enable a broader suite of management options. Options may include “ecological interventions” that target vectors or hosts and require good knowledge of underlying transmission processes, which may be more effective, economical, and long lasting than conventional approaches. New frameworks identify the hierarchical series of barriers that a pathogen needs to overcome before human spillover occurs and demonstrate how ecological interventions may strengthen these barriers and complement human-focused disease control. We extend these frameworks for vector-borne zoonoses, focusing on Kyasanur Forest Disease Virus (KFDV), a tick-borne, neglected zoonosis affecting poor forest communities in India, involving complex communities of tick and host species. We identify the hierarchical barriers to pathogen transmission targeted by existing management. We show that existing interventions mainly focus on human barriers (via personal protection and vaccination) or at barriers relating to Kyasanur Forest Disease (KFD) vectors (tick control on cattle and at the sites of host (monkey) deaths). We review the validity of existing management guidance for KFD through literature review and interviews with disease managers. Efficacy of interventions was difficult to quantify due to poor empirical understanding of KFDV–vector–host ecology, particularly the role of cattle and monkeys in the disease transmission cycle. Cattle are hypothesised to amplify tick populations. Monkeys may act as sentinels of human infection or are hypothesised to act as amplifying hosts for KFDV, but the spatial scale of risk arising from ticks infected via monkeys versus small mammal reservoirs is unclear. We identified 19 urgent research priorities for refinement of current management strategies or development of ecological interventions targeting vectors and host barriers to prevent disease spillover in the future.

Background There is a strong policy impetus for the One Health cross-sectoral approach to address the complex challenge of zoonotic diseases, particularly in low/lower middle income countries (LMICs). Yet the implementation of this approach in LMIC contexts such as India has proven challenging, due partly to the relatively limited practical guidance and understanding on how to foster and sustain cross-sector collaborations. This study addresses this gap by exploring the facilitators of and barriers to successful convergence between the human, animal and environmental health sectors in India. Methods A mixed methods study was conducted using a detailed content review of national policy documents and in-depth semi-structured interview data on zoonotic disease management in India. In total, 29 policy documents were reviewed and 15 key informant interviews were undertaken with national and state level policymakers, disease managers and experts operating within the human-animal-environment interface of zoonotic disease control. Results Our findings suggest that there is limited policy visibility of zoonotic diseases, although global zoonoses, especially those identified to be of pandemic potential by international organisations (e.g. CDC, WHO and OIE) rather than local, high burden endemic diseases, have high recognition in the existing policy agenda setting. Despite the widespread acknowledgement of the importance of cross-sectoral collaboration, a myriad of factors operated to either constrain or facilitate the success of cross-sectoral convergence at different stages (i.e. information-sharing, undertaking common activities and merging resources and infrastructure) of cross-sectoral action. Importantly, participants identified the lack of supportive policies, conflicting departmental priorities and limited institutional capacities as major barriers that hamper effective cross-sectoral collaboration on zoonotic disease control. Building on existing informal inter-personal relationships and collaboration platforms were suggested by participants as the way forward. Conclusion Our findings point to the importance of strengthening existing national policy frameworks as a first step for leveraging cross-sectoral capacity for improved disease surveillance and interventions. This requires the contextual adaptation of the One Health approach in a manner that is sensitive to the underlying socio-political, institutional and cultural context that determines and shapes outcomes of cross-sector collaborative arrangements.

Background Zoonotic diseases disproportionately affect poor tropical communities. Transmission dynamics of zoonoses are complex, involving communities of vector and animal hosts, with human behaviour and ecosystem use altering exposure to infected vectors and hosts. This complexity means that efforts to manage and prevent human spillover are often hampered by a poor ecological evidence base and intervention strategies tend to focus on humans (e.g. vaccination, preventative drug treatment). However, integrating ecological and evolutionary understanding of multi-vector and host transmission, human and environmental factors into disease control policy is essential. Recent frameworks have been developed to guide appropriate design of “ecological interventions” which have the potential for being more long-term, effective and economical approaches to managing human disease.Results We extended new frameworks to identify the hierarchical series of barriers that need to be overcome by a vector-borne pathogen to facilitate human spillover, focusing on an emerging, tick-borne zoonotic pathogen in India, Kyasanur Forest Disease Virus (KFDV). Current management recommendations focus on human barriers, through personal protection and vaccination, as well as targeting vector control on cattle and at the sites of monkey deaths. Assessment of the validity of current management practices for KFD through literature review and interviews with disease managers found the efficacy of interventions difficult to quantify, due to poor empirical evidence and a lack of understanding of KFDV-vector-host ecology, particularly regarding the role of cattle in amplifying tick populations and the spatial scale of risk arising from ticks infected via monkeys, which are considered to be amplifying hosts for KFDV. The spraying of malathion around dead monkeys and the burning of vegetation to reduce tick abundance were particularly unfounded interventions. The need for community guidance and education in best practice for tick-prevention and improved vaccine efficacy and surveillance were also identified. We highlight 18 urgent research priorities and identify those which could refine current management strategies or facilitate ecological interventions targeting vectors and host barriers to spillover in the future. Conclusions We emphasise that inter-disciplinary One Health approaches involving collaboration across diverse disciplines including ecology, epidemiology, animal and public health, health systems and social sciences, and with meaningful involvement of local communities, are necessary to refine predictive models of spillover, develop new interventions and target vaccination strategies and surveillance more effectively. Applying such approaches to understand the complex ecological systems involved in zoonotic spillover, and refine and develop appropriate management interventions, including ecological interventions targeting non-human barriers, will ultimately lead to more sustainable and long-term reductions in human cases of neglected zoonoses in the future.

There is increased global and national attention on the need for effective strategies to control zoonotic diseases. Quick, effective action is, however, hampered by poor evidence-bases and limited coordination between stakeholders from relevant sectors such as public and animal health, wildlife and forestry sectors at different scales, who may not usually work together. The OneHealth approach recognises the value of cross-sectoral evaluation of human, animal and environmental health questions in an integrated, holistic and transdisciplinary manner to reduce disease impacts and/or mitigate risks. Co-production of knowledge is also widely advocated to improve the quality and acceptability of decision-making across sectors and may be particularly important when it comes to zoonoses. This paper brings together OneHealth and knowledge co-production and reflects on lessons learned for future OneHealth co-production processes by describing a process implemented to understand spill-over and identify disease control and mitigation strategies for a zoonotic disease in Southern India (Kyasanur Forest Disease). The co-production process aimed to develop a joint decision-support tool with stakeholders, and we complemented our approach with a simple retrospective theory of change on researcher expectations of the system-level outcomes of the co-production process. Our results highlight that while co-production in OneHealth is a difficult and resource intensive process, requiring regular iterative adjustments and flexibility, the beneficial outcomes justify its adoption. A key future aim should be to improve and evaluate the degree of inter-sectoral collaboration required to achieve the aims of OneHealth. We conclude by providing guidelines based on our experience to help funders and decision-makers support future co-production processes.

Yadvinder. 2020. Questioning the link between tenure security and sustainable land management in cocoa landscapes in Ghana.

Forest-based communities manage many risks to health and socio-economic welfare including the increasing threat of emerging zoonoses that are expected to disproportionately affect poor and marginalised groups, and further impair their precarious livelihoods, particularly in Low-and-Middle Income (LMIC) settings. Yet, there is a relative dearth of empirical research on the vulnerability and adaptation pathways of poor and marginalised groups facing emerging zoonoses. Drawing on a survey of 229 households and a series of key-informant interviews in the Western Ghats, we examine the factors affecting vulnerability of smallholder and tribal households to Kyasanur Forest Disease (KFD), an often-fatal tick-borne viral haemorrhagic fever endemic in south India. Specifically, we investigate how different socio-demographic and institutional factors interact to shape KFD vulnerability and the strategies employed by households to adapt to disease consequences. Although surveyed households generally perceived KFD as an important health issue in the study region, there was variability in concern about contracting the disease. Overall results showed that poor access to land (AOR = 0.373, 95% CI: 0.152–0.916), being at or below the poverty line (AOR = 0.253, 95% CI: 0.094–0.685) and being headed by an older person (AOR = 1.038, 95% CI: 1.006–1.071) were all significant determinants of perceived KFD vulnerability. Furthermore, KFD vulnerability is also modulated by important extra-household factors including proximity to private hospitals (AOR = 3.281, 95% CI: 1.220–8.820), main roads (AOR = 2.144, 95% CI: 1.215–3.783) and study location (AOR = 0.226, 95% CI: 0.690–0.743). Our findings highlight how homogenous characterisation of smallholder and tribal communities and the ‘techno-oriented’ approach of existing interventions may further marginalise the most vulnerable and exacerbate existing inequalities. These findings are important for designing context-specific and appropriate health interventions (including the prioritisation of awareness raising, knowledge networks, livelihood diversification) that enhances the resilience of at-risk social groups within the KFD context. More broadly, our findings highlight how a focus on social vulnerability can help national and international health planners improve health interventions and prioritise among diseases with respect to neglected endemic zoonoses.