OneHealth


Village women and livestock in Niger (photo credit: ILRI/Stevie Mann).

Governments are currently negotiating a historic global pandemic treaty to protect us from future pandemics. The special session of the 2021 World Health Assembly agreed that the new accord will focus on early detection and prevention of pandemics, as well as the One Health approach which recognises the interconnectedness of human, animal and environment health.

On Tuesday 28 June 2022, the Action for Animal Health coalition will host an online event during which experts from civil society and multilateral organizations will discuss why robust animal health systems are critical to putting One Health into practice to reduce the risk of zoonoses spilling over to people.

The International Livestock Research Institute (ILRI) is a member of the Action for Animal Health coalition which calls on governments, donors and international agencies to invest in animal health systems through five pillars of action:

  • Support community engagement and equitable access to animal health services
  • Increase the numbers and improve the skills of the animal health workforce
  • Close the veterinary medicines and vaccines gap
  • Improve animal disease surveillance
  • Enhance collaboration for One Health

Join the online event to hear more about why stronger animal health systems are key to preventing another pandemic. 

Below are details of the event and how to register.

Date: Tuesday 28 June 2022

Time: 1200–1315 hours (BST, GMT+1)

Location: Online (a Zoom link will be sent to registered participants the day before the event)

Registration link: https://takeaction.thebrooke.org/page/103248/event/2 

Speakers

  • Klara Saville, head of animal health, welfare and community development, Brooke/Action for Animal Health
  • Gladys Kalema-Zikusoka, founder and chief executive officer of Conservation Through Public Health
  • Mariana Vale, Ecology Department, Federal University of Rio de Janeiro, Preventing Pandemics at the Source, and member of the Intergovernmental Panel on Climate Change
  • Chadia Wannous, One Health global coordinator, World Organisation for Animal Health
  • Angélique Angot, laboratory specialist, Food and Agriculture Organization of the United Nations

Moderator: Patricia Amira

Photo credit: Village women and livestock in Niger (ILRI/Stevie Mann)

To commemorate this year’s World Food Safety Day (7 June) under the theme Safer food, better health, the International Livestock Research Institute (ILRI) has launched an online food safety campaign and landing page to showcase its collaborative research on risk-based approaches to improving food safety in low- and middle-income countries.

Better management of foodborne diseases could save nearly half a million lives a year and safeguard the livelihoods of over one billion small-scale livestock producers.

ILRI’s approach to food safety research is based on risk analysis. We identify the hazards in food and build the capacity of policymakers to understand risk-based approaches.

Policy will be more effective and efficient if based on actual risk to human health rather than the presence of hazards. ILRI’s approach is therefore to generate research evidence and develop solutions to improve the safety of animal products in informal food markets.

Visit the landing page to read key food safety messages as well as the latest food safety news from ILRI and information on projects and selected publications. You will also find the profiles of ILRI scientists involved in food safety research.

Join the online conversations by following the hashtags #FoodSafety, #SafeFood and #WorldFoodSafetyDay.

Photo credit: World Health Organization

Delia Grace

We congratulate Delia Grace, professor of food safety systems at the Natural Resources Institute and joint appointed scientist at the International Livestock Research Institute (ILRI), on winning the 2022 Arrell Global Food Innovation Award in the research innovation category.

Delia Grace is a renowned scientist with unique and transformative impacts on the safety of food systems and public health in developing countries.

As a trained veterinarian and epidemiologist, she brings a special expertise on the interconnectedness of animal health, human health and ecohealth to her work. A focus of her work is improving food safety in informal markets in developing countries.

‘I’m honoured to be named the recipient of the Arrell Global Food Innovation Award in the area of research impact,’ she said.

‘There is a very critical relationship between animal, human and environment health and I hope we can continue to research and find ways to help improve food safety and thus the health of humans and animals. While there is still a lot to learn, by listening and engaging, thinking and trying, we can achieve much more.’

‘Congratulations to Delia Grace Randolph for being awarded with the Arrell Global Food Innovation Award for excellence in research,’ said Evan Fraser, Arrell Food Institute Director.

‘Food safety is critical to food systems, and Delia Grace Randolph’s research in this field has clearly had a positive impact on many people.’

The mission of the Arrell Food Institute at the University of Guelph is to bring people together to conduct research, train the next generation of food leaders and shape social, industrial and governmental decisions, always ensuring food is the central priority.

The Arrell Global Food Innovation Awards are adjudicated by a group of internationally recognized scientists and community activists. This year’s adjudicators are Nadia Theodore, senior vice president, global government and industry relations, Maple Leaf Foods; Florence Lasbennes, managing director, 4SD; Lawrence Haddad, executive director, Global Alliance for Improved Nutrition; and Adrienne Xavier, acting director of the Indigenous Studies Program, McMaster University.

Browse Delia Grace’s research publications here

Photo credit: Vegetable market in Ethiopia (East African Policy Research Institute/Birhanu Lenjiso)

The rapid evolution of global food safety systems in response to population growth, urbanization, climate change and other socio-economic factors poses many food safety challenges.

Globally, unsafe food causes an estimated 600 million illnesses and 420,000 deaths annually, with Africa disproportionately bearing the highest burden of foodborne diseases.

To effectively tackle the challenge of foodborne diseases in Africa, a team of scientists from the International Livestock Research Institute (ILRI) and Ohio State University has proposed the use of risk-based and One Health approaches.

These approaches to food safety management were put forward in a presentation titled Better food safety solutions in Africa: Understanding the complex social, economic and policy perspectives. The presentation was given at the 37th World Veterinary Association Congress held in Abu Dhabi, United Arab Emirates on 29–31 March 2022.

The main foodborne hazards in the African context were discussed, with local and continental examples of food safety initiatives aimed at reducing the burden of foodborne disease and improving public health. Examples of action research and political decision-making on food safety at the continental level were also described.

In light of the complex nature of global and African food safety systems, food safety interventions to reduce foodborne diseases need to be well designed and coordinated, the researchers say.

Citation

Amenu, K., Alonso, S., Mutua, F., Roesel, K., Lindahl, J., Kowalcyk, B., Knight-Jones, T. and Grace, D. 2022. Better food safety solutions in Africa: Understanding the complex social, economic and policy perspectives. Oral presentation at the 37th World Veterinary Association Congress, 29-31 March 2022, Abu Dhabi, United Arab Emirates. Nairobi, Kenya: ILRI.

Photo credit: Vegetable market in Ethiopia (East African Policy Research Institute/Birhanu Lenjiso)

Market near Khulungira Village, in central Malawi

The role of food crops as a conduit for transmission of antimicrobial resistance from soil and water to humans has not been widely studied. Contamination of food crops with antimicrobial-resistant pathogens presents an added foodborne risk to human health.

A team of researchers from the London School of Hygiene and Tropical Medicine, the International Livestock Research Institute, the University of Copenhagen, Royal Veterinary College and CABI carried out a systematic literature review to consolidate the current state of knowledge on antimicrobial resistance in food crop value chains globally. The review is published in Frontiers in Sustainable Food Systems (3 Feb 2022).

The review summarized and compared baseline descriptive data on antimicrobial resistance detected in crops and crop inputs globally. This enabled the identification of gaps in understanding of the potential food safety risks to consumers. 

A search of four bibliographic databases using synonyms of antimicrobial resistance in food crop value chains identified 196 studies of interest from 49 countries, mostly in Asia (89 studies) and Africa (38 studies). 

The four most frequently recorded species of interest were Escherichia coli, Salmonella enterica, and Enterococcus faecium or Enterococcus faecalis. Salad crops, vegetables, and culinary herbs were the most sampled crops. 

The review found that acquired antimicrobial resistance in human pathogens is disseminated throughout food crop value chains in multiple regions around the world. 

However, there were variable patterns of distribution of antimicrobial resistance. Chloramphenicol resistance was reported in food value chain samples in low- and middle-income countries in Asia and Africa while vancomycin resistance in enterococci was reported in food crops from high-income countries.

“This review confirms the widespread reporting of resistance to antimicrobials of medical importance in human pathogenic microbes isolated from crops, both in the field and marketplace,” the authors state.

However, it is difficult to conclusively quantify the risks of exposure to consumers because of the low number of longitudinal studies and diverse sampling methods used.

“Firm conclusions cannot be drawn on the prevalence and relative importance of different kinds of resistance and antimicrobial resistance transmission pathways because of the substantial heterogeneity between study methods and conditions,” the authors caution.

“There is a need to include agriculturally-derived antimicrobial resistance in monitoring food safety risks from plant-based foods, and the challenges facing its surveillance,” the authors recommend.

Citation

Brunn, A., Kadri-Alabi, Z., Moodley, A., Guardabassi, L., Taylor, P., Mateus, A. and Waage, J. 2022. Characteristics and global occurrence of human pathogens harboring antimicrobial resistance in food crops: A scoping review. Frontiers in Sustainable Food Systems 6: 824714.

Funding

This scoping review was partially supported by the CGIAR Research Program on Agriculture for Nutrition and Health (A4NH), led by the International Food Policy Research Institute.

Photo credit: Market near Khulungira Village, in central Malawi (ILRI/Stevie Mann)

Fruit and vegetables on sale alongside other food items in a local market in Addis Ababa, Ethiopia (photo credit: ILRI/Geraldine Klarenberg).

The CGIAR Research Program on Agriculture for Nutrition and Health (A4NH) published its 2020 annual report on activities and accomplishments from its five research flagships:

  • food systems for healthier diets;
  • biofortification;
  • food safety;
  • supporting policies, programs, and enabling action through research; and
  • improving human health.

Noting that the year 2020 was dominated by the COVID-19 pandemic, A4NH director John McDermott said: “The pandemic emphasized the importance of A4NH core research strengths: One Health, nutrition, and food systems, into which gender and equity considerations are integrated as critical to improve nutrition and health outcomes. As a result, A4NH research leaders and teams were called into central roles in COVID-19 response and recovery efforts during 2020 by CGIAR as well as in programs and projects in partner countries.”

The 10-year research program ended in December 2021 as CGIAR transitions to a new research structure and portfolio from 2022.

Access the A4NH 2020 annual report or read the online version.

Photo credit: Local food market in Addis Ababa (ILRI/Geraldine Klarenberg)

International Open Access Week is an annual scholarly communication event that is marked globally during the last full week of October to raise awareness about open access publishing of research and scholarly outputs to enable their universal online accessibility. The theme of Open Access Week 2021 (25 to 31 Oct) is ‘It matters how we open knowledge: Building structural equity’.

In the field of academic and research publishing, the peer-reviewed journal article is considered as the ‘gold standard’ for quality research outputs. However, many researchers nowadays also consider preprints as important and highly relevant outputs that contribute to the body of knowledge and enable discoverability of current research developments.

A preprint is a version of a scholarly or research manuscript that precedes formal peer review, typesetting and publication in a scholarly or scientific journal. Preprints are often uploaded to online preprint servers or institutional repositories where they are freely accessible as non-typeset versions of the manuscripts.

Publishing of preprints allows researchers to quickly share new findings with their peers and receive early feedback and comments which can help in revising manuscripts for submission to a scholarly journal.

At the International Livestock Research Institute (ILRI), scientists from the Animal and Human Health program carry out collaborative research to effectively manage or eliminate livestock, zoonotic and foodborne diseases that matter to the poor through the generation and use of knowledge, technologies and products, leading to higher farmer incomes and better health and nutrition for consumers and livestock.

While most of their research outputs are published as peer-reviewed journal articles, the program scientists also publish their findings in other formats including books, book chapters, conference proceedings, infographics, presentations, posters, reports, theses and videos. These outputs are all indexed in CGSpace, an open access institutional repository of agricultural research outputs.

The scientists are also increasingly making use of preprints to share their research via open access. In line with the theme of Open Access Week, we present below a curated list of preprints by scientists from ILRI’s Animal and Human Health program and research partners, to highlight the contribution of these outputs to open knowledge and open science.

  • Ejigu, B.A., Asfaw, M.D., Cavalerie, L., Abebaw, T., Nanyingi, M. and Baylis, M. Assessing the impact of non-pharmaceutical interventions (NPI) on the dynamics of COVID-19: A mathematical modelling study in the case of Ethiopia. medRxiv preprint. https://doi.org/10.1101/2020.11.16.20231746
  • Kibugu, J.K., Mburu, D., Munga, L.K., Kurgat, R., Mukasa, B., Lusweti, F.N., Grace, D. and Lindahl, J. Food-borne mycotoxin hazards in the Kenyan market: A retrospective study. bioRxiv preprint. https://doi.org/10.1101/773747
  • Muloi, D., Wee, B., McClean, D., Ward, M., Pankhurst, L., Phan, H., Ivens, A., Kivali, V., Kiyonga, A., Ndinda, C., Gitahi, N., Ouko, T., Hassell, J., Imboma, T., Akoko, J., Karani, M., Njoroge, S., Muinde, P., Nakamura, Y., Alumasa, L., Öhgren, E., Amanya, F., Ogendo, A., Wilson, D., Bettridge, J., Kiiru, J., Kyobutungi, C., Tacoli, C., Kang’ethe, E., Davila, J., Kariuki, S., Robinson, T., Rushton, J., Woolhouse, M. and Fèvre, E.M. Landscape genomics of Escherichia coli in livestock-keeping households across a rapidly developing urban city. InReview preprint. https://doi.org/10.21203/rs.3.rs-172737/v1
  • Mutembei, A., Mutai, F.K., Mwololo, D., Muriuki, J., Obonyo, M., Kairu-Wanyoike, S.W., Wainaina, M., Lindahl, J., Ontiri, E., Bukachi, S., Njeru, I., Karanja, J., Sang, R., Grace, D. and Bett, B. Leptospira spp. seroprevalence in humans involved in a cross-sectional study in Garissa and Tana River Counties, Kenya. bioRxiv preprint. https://doi.org/10.1101/2020.07.17.208363
  • Njaramba, J.K., Wambua, L., Mukiama, T., Amugune, N.O. and Villinger, J. Species substitution in the meat value chain by high-resolution melt analysis of mitochondrial PCR products. bioRxiv preprint. https://doi.org/10.1101/2021.01.12.426171
  • Njeru, J., Nthiwa, D., Akoko, J., Oyas, H. and Bett, B. Incidence of Brucella spp. in various livestock species raised under the pastoral production system in Isiolo County, Kenya. bioRxiv preprint. https://doi.org/10.1101/2020.06.25.170753
  • Ogutu, H.J., Owiny, M., Bett, B. and Otieno, C. Contribution of livestock marketing chains and role played by stakeholders’ knowledge, attitude and practice in spreading cystic hydatidosis to Busia Town, Kenya, 2018. bioRxiv preprint. https://doi.org/10.1101/638502
  • Talenti, A., Powell, J., Hemmink, J.D., Cook, E.A.J., Wragg, D., Jayaraman, S., Paxton, E., Ezeasor, C., Obishakin, E.T., Agusi, E.R., Tijjani, A., Marshall, K., Fisch, A., Ferreira, B., Qasim, A., Chaudhry, U.N., Wiener, P., Toye, P., Morrison, L.J., Connelley, T. and Prendergast, J. A cattle graph genome incorporating global breed diversity. bioRxiv preprint. https://doi.org/10.1101/2021.06.23.449389 
  • Xie, S., Tao, D., Fu, Y., Xu, B., Tang, Y., Steinaa, L., Hemmink, J.D., Pan, W., Huang, X., Nie, X., Zhao, C., Ruan, J., Zhang, Y., Han, J., Fu, L., Ma, Y., Li, X., Liu, X. and Zhao, S. Rapid visual CRISPR assay: a naked-eye colorimetric detection method for nucleic acids based on CRISPR/Cas12a and convolutional neural network. bioRxiv preprint. https://doi.org/10.1101/2021.07.17.452802

Photo credit: International Open Access Week

Village women and livestock in Niger (photo credit: ILRI/Stevie Mann).

A special issue (Aug 2021) of the Scientific and Technical Review journal of the World Organisation for Animal Health (OIE) turns the spotlight on the operation of veterinary services in a world affected by various external factors such as climate change and emerging zoonotic diseases.

The COVID-19 pandemic has drawn the world’s attention to the threat of emerging zoonotic diseases and the importance of a One Health approach in preventing and responding to these and other global health challenges.

Veterinary services are a global public good underpinning animal agriculture. Therefore, governments need to ensure the sustained performance and resilience of veterinary services in the face of external factors.

The special issue was edited by three scientists from the International Livestock Research Institute (ILRI): Delia Grace (also affiliated with the Natural Resources Institute, University of Greenwich), Hu Suk Lee and Jimmy Smith.

The 18 open access articles in the special issue—10 of which were co-authored by ILRI scientists—take an in-depth look at the implications of key external factors on veterinary services; these factors include animal welfare, antimicrobial resistance, climate change, digital technologies, planetary boundaries and zoonotic disease risks.

Future-facing initiatives relevant to veterinary services, such as global nutrition security, animal health and food safety risk assessments, and sustainable development, are also discussed.

Access the special issue: Veterinary services in a changing world: climate change and other external factors, Scientific and Technical Review 40(2).

Photo credit: Village women and livestock in Niger (ILRI/Stevie Mann)

Locally made beef stew sold in Bagnon market at Yopougon, Abidjan, Côte d’Ivoire (photo credit: ILRI/Valentin Bognan Koné).

The world’s largest publicly-funded agricultural research partnership, CGIAR, is currently developing a series of initiatives to implement its 2030 research and innovation strategy that was launched in early 2021.

The research initiatives are designed to create lasting impact in five key areas:

  • nutrition, health and food security;
  • poverty reduction, livelihoods and jobs;
  • gender equality, youth and social inclusion;
  • climate adaptation and mitigation; and
  • environmental health and biodiversity.

One of these research initiatives, Protecting human health through a One Health approach, aims to improve the prevention and control of antimicrobial resistance, foodborne diseases and zoonoses in seven target countries: Bangladesh, Côte d’Ivoire, Ethiopia, India, Kenya, Uganda and Vietnam.

The development of the One Health initiative is being led by a team of scientists from four CGIAR research centres — the International Food Policy Research Institute (IFPRI), the International Livestock Research Institute (ILRI), the International Water Management Institute (IWMI) and WorldFish — in collaboration with external research partners from Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, EcoHealth Alliance and the University of Liverpool.

To ensure alignment of the proposed initiative with national priorities, the team convened a series of online consultative meetings with research collaborators to gain insights on the main One Health priorities, challenges, interventions and partner organizations in the respective countries.

The Côte d’Ivoire meeting, hosted by ILRI, took place on Thursday 12 August 2021, bringing together some 35 participants from government ministries, universities as well as national and international research organizations.

Dieter Schillinger, ILRI’s deputy director general for biosciences research and development, opened the meeting with a word of welcome and an overview of CGIAR’s 2030 research and innovation strategy that will guide the implementation of the 33 new research initiatives, including that on One Health—the focus of the online consultation.

He mentioned that the development of the One Health research initiative is a collaborative process and ILRI is working closely with other CGIAR research centres as well as external partners from research and academia, including those represented at the meeting. He therefore welcomed feedback and suggestions from the participants to ensure the research of the One Health initiative is relevant and impactful.

Hung Nguyen, co-leader of ILRI’s Animal and Human Health program, followed with an overview of the rationale of the One Health initiative, citing the need for a One Health approach to tackle the complexity of the global public health challenges posed by the rising incidence of antimicrobial resistance, foodborne diseases and zoonoses.

He then outlined the three main objectives of the One Health initiative, namely, to generate evidence for decision-making; evaluate impacts of One Health approaches; and scale up innovations into national policies and programs.

He further highlighted the initiative’s Theory of Change, explaining how the research outputs are expected to lead to specific development outcomes and impact by 2030, in line with the United Nations Sustainable Development Goals. The team estimates that between 4 million and 41 million cases of disease will be averted annually through the initiative’s efforts.

The initiative’s research activities will take place through five work packages:

  • zoonoses;
  • food safety;
  • antimicrobial resistance;
  • environment (water and wildlife interfaces); and
  • economics, governance and behaviour.

The zoonoses work package aims to pre-empt the spread of zoonoses at the wildlife–livestock interface and reduce the incidence of zoonotic pathogens associated with poverty. Innovations include risk mapping of key endemic zoonoses and developing diagnostic kits for surveillance of zoonoses.

The food safety work package aims to reduce the burden of foodborne disease in traditional (informal) food value chains, with a focus on animal-source foods and other perishables such as fruits and vegetables. Innovations include training and certification of food handlers and traders, promotion of consumer demand for safe food, and behavioural nudges to encourage safe food handling practices.

The antimicrobial resistance work package will focus on reducing the burden of antimicrobial resistance by promoting the prudent use of antimicrobials in crop, fish and livestock production systems. Innovations include surveillance of antimicrobial resistance and communication of evidence on the costs and benefits of rational use of antimicrobials

The environment work package will focus on improving land use and water management to reduce health risks such as antimicrobial residues and zoonotic pathogens. Approaches will include recovery and reuse of animal waste to prevent water pollution and promotion of good practices to ensure the safe use of marginal quality water.

The economics, governance and behaviour work package aims to understand the drivers of people’s behaviour within food systems and the impact of policies and governance approaches on this behaviour. An example of an innovation under this work package is a performance management system for government officials responsible for implementing surveillance and enforcing regulations on antimicrobial use or food safety. Another innovation is a system to ensure inclusion of small-scale farmers, traders, food vendors and vulnerable groups so that they benefit from One Health outcomes.

During parallel group discussions on the work packages, the participants gave feedback on the main One Health challenges, priority interventions, actions to ensure inclusion and partner institutions in Côte d’Ivoire.

Among the main food safety challenges identified were the informal food sector (street foods) and low awareness on food safety. Priority interventions include risk analysis, consumer education and strengthening of capacity to assess risks.

With regard to control of zoonoses, some of the key challenges identified were non-compliance with disease control measures and non-adaptation of laws to current challenges. Priority interventions include improved communication among actors involved in control of zoonoses and an effective monitoring network.

Regarding antimicrobial resistance, some of the key challenges identified were environmental contamination through hospital and slaughterhouse waste, misuse of antimicrobials in livestock and aquaculture production systems and lack of surveillance of antimicrobial use. Priority interventions include strengthening of regulation and control of antimicrobial use and increasing awareness on rational use of antimicrobials and the dangers of self-medication with antibiotics.

To ensure inclusion, all important actors in the value chain need to be identified and invited for meetings where they can participate in exchange of information. In this regard, stakeholder mapping and the use of gender-focused approaches will be important.

The identified partner groups to work with included government ministries, universities, hospitals, public health institutes, pastoralists, the private sector, pharmaceutical companies and food manufacturers.

As the meeting ended, Vessaly Kallo, deputy director of animal health at the Directorate of Veterinary Services, lauded the proposed CGIAR One Health initiative. He noted that the initiative’s activities would support the implementation of a One Health multisectoral platform in Côte d’Ivoire.

Once approved, the CGIAR One Health initiative will start in January 2022 and run for an initial three years.

For more information, please contact Hung Nguyen (h.nguyen@cgiar.org) or Vivian Hoffmann (v.hoffmann@cgiar.org).

Access the meeting notes and presentation slides

Citation

ILRI, IFPRI, IWMI and WorldFish. 2021. Côte d’Ivoire stakeholder consultation on a proposed CGIAR One Health initiative. Nairobi, Kenya: ILRI. https://hdl.handle.net/10568/114915

Photo credit: Locally made beef stew sold in Bagnon market at Yopougon, Abidjan, Côte d’Ivoire (ILRI/Valentin Bognan Koné)

A local cattle owner walks his cattle on a rainy day in Hung Yen province, Vietnam (photo credit: ILRI/Nguyen Ngoc Huyen).

Action for Animal Health is a coalition of multilateral organizations, non-governmental organizations and research institutes with expertise in animal, human and environmental health. The coalition advocates for increased investment in strong and resilient animal health systems that protect people, animals and the planet. The International Livestock Research Institute (ILRI), one of 15 CGIAR research centres, is a member of the coalition.

Ahead of this year’s G20 Health Ministers’ Meeting, scheduled for 5–6 September 2021, the Action for Animal Health coalition urges G20 countries to support four transformative actions for stronger animal health systems:

  1. Ensure communities have access to animal health services
  2. Increase and upskill the animal health workforce globally
  3. Improve access to safe medicines and vaccines for animals
  4. Strengthen early warning disease surveillance systems that are effective from the community level upwards

With 75% of new diseases emerging from animals, the G20 must fund and implement a One Health approach to prevent future pandemics. A One Health approach recognizes that the health of people is closely linked to the health of animals and their shared environment. It involves the collaborative efforts of multiple disciplines and sectors to prevent and control diseases. It is especially useful for managing zoonoses, diseases transmitted between animals and people.

Zoonoses, like COVID-19, and antimicrobial resistance are among the major global public health threats facing humanity. The G20 urgently needs to invest in animal health to strengthen and secure global health systems and build resilience to future health challenges.

Photo credit: A local cattle owner walks his cattle on a rainy day in Hung Yen province, Vietnam (ILRI/Nguyen Ngoc Huyen)

Next Page »