‘Community animal health workers are our first line of defence against the next zoonotic outbreak’

Dilip Bhandari, who leads Heifer International’s work on animal health, livestock and One Health, was recently given the American Veterinary Medical Association’s (AVMA) Global Veterinary Service Award. He is recognised for building community-based animal health systems that have become a model for delivering veterinary services in places where few veterinarians are available.

Bhandari has spent over 25 years working at the grassroots on animal health across Asia and Africa, beginning in Nepal in the early 2000s. In a conversation with Down To Earth, he spoke about why community animal health workers remain central to catching disease outbreaks early, how climate change is reshaping livestock disease patterns, and why the One Health approach needs to be embedded in local governance rather than treated as a separate silo.

Among the diseases he flagged as ongoing or emerging concerns are peste des petits ruminants (PPR) in small ruminants, avian flu in poultry, lumpy skin disease in cattle (increasingly linked to climate factors such as extreme rainfall and warmer nights driving vector breeding), and — his biggest worry — a possible new strain of foot-and-mouth disease (FMD) in cattle and dairy herds across South and Southeast Asia. Edited excerpts:

Shagun: You have spent over 25 years working on animal health at the grassroots. Despite decades of veterinary science and development investment, why do the gaps at the community level still persist?

Dilip Bhandari: I have been in the animal health sector, especially at the grassroots, for the last 25-plus years, starting in Nepal in the early 2000s. After college, I worked with an NGO that trained community animal health workers. This training model was very successful at the time, and it gave me a platform to scale it up.

As for why the problems persist: Governments, international development organisations and others are doing this work, but the scale is not yet there. Training programmes sometimes miss the overall ecosystem of animal health — the entire chain from the community all the way to the consumer. While there has been significant progress, reaching sufficient scale and sustaining coordinated investment across the entire animal health ecosystem remains a challenge.

Shagun: Official biosecurity monitoring often misses outbreaks that start as hyperlocal events, especially among marginal and landless farmers who cannot easily reach state veterinary offices. How can a community-based animal health worker model bridge that gap and alert health systems before an outbreak escalates?

DB: The fundamental principle is how we design and deliver these programmes. For example, there is ‘Pashu Sakhi’ in India, under which we need to train someone who is already part of the community. The selection of that person matters because if they aren’t motivated to contribute to the community’s overall animal health, the model won’t work. The quality and design of the training matters too.

The other, arguably more critical, side is community engagement. We build what we call social capital — self-help groups, cooperatives, farmer producer organisations in India — and use that network to create awareness. If a community animal health worker is well trained and the community itself is motivated and engaged, and both work in tandem with the government veterinary system, outbreaks can be caught and managed far better. Many of these ecosystem elements are missing in current reporting systems across countries, which is why outbreaks are often not caught in time and strengthening these ecosystem elements would further improve early reporting and response.

Shagun: Do you have a tangible example of this model working, such as a measurable drop in mortality or faster containment of an outbreak?

DB: In India, Heifer currently has 350 trained Community Agro-Veterinary Entrepreneurs and Pashusakhi — more than 90 per cent of these are women — providing animal health services to the communities in Bihar, Odisha and Andhra Pradesh. We run similar programmes in 19 countries, each adapted to local contexts.

In our poultry projects in Odisha, for instance, we trained community animal health cadres and worked with communities to treat the entire village as a single farm — like a biosecurity fencing system where every household plays a role, restricting the movement of poultry and livestock and staying alert together.

In our goat-rearing programme in Bihar a few years ago, we saw mortality from a PPR outbreak drop from about 20 per cent to less than three per cent in participating communities. This came from effectively mobilising community animal health workers, creating awareness, and collaborating closely with the local veterinary system and vaccine manufacturers as reliable vaccine supply is critical, and no single actor can ensure all this alone.

We have seen similar trends with PPR in Nepal and Cambodia, where a bird flu outbreak spread widely in surrounding areas but not in our project villages, because communities were already proactively restricting animal movement.

Shagun: India has, in the recent past, seen a devastating lumpy skin disease outbreak, one that has also been linked to climate factors like extreme rainfall and warmer nights driving vector breeding. How can community animal health workers be trained to anticipate and manage such climate-linked disease surges?

A few things matter here. First, communities need to adapt local breeds, local feeding systems and local management practices. Broadly, our approach is to integrate climate-smart livestock production that looks holistically at fodder, water resources, housing and management practices within a community. Second, we continue building social capital and using cooperatives as a one-stop point for knowledge, resources and awareness, so that communities and community animal health workers can be proactive.

That said, for diseases like lumpy skin disease or avian flu, the scale of impact is much bigger. So, a wider systems approach involving government and the private sector becomes essential. Organisations like Heifer and local NGOs can play a catalytic role bridging what government, private sector and civil society can each offer. Places where that social capital already exists, were found to be better positioned to respond and reduce losses. This correlation was witnessed during the recent lumpy skin disease outbreaks in Bangladesh and Nepal where we mobilised our worker networks.

Shagun: Given that a growing share of emerging infectious diseases in humans originate in animals, and given that investment in this space is shrinking globally, are we better or worse prepared for the next zoonotic pandemic compared to before COVID-19?

DB: These things are genuinely unpredictable — even with infrastructure, capacity and manpower, we often don’t know when or what is coming. But based on my experience, integrating the One Health approach has started showing results. There is a global One Health network coordinated by UN system organisations, and countries have agreed to formally establish One Health statutory bodies, though these are at different stages of implementation in different places.

What we have started doing at the grassroots is working with the local government — village or block-level in India, municipal level elsewhere — where human health, animal health and environmental health budgets often exist separately and aren’t managed together. Heifer has been supporting local governments to facilitate a process to bring these three units together into a local One Health committee, pool resources and use them for awareness, training community animal health workers and environmental work. Scaling that kind of bottom-up integration is, I believe, the key message here: When communities become more aware, it becomes easier for governments to implement disease-outbreak response, because communities are already motivated to act.

Shagun: Is there a disease you are particularly worried about hitting us in the next few years, something you feel isn’t getting enough attention right now?

DB: On the animal health side, the diseases we already track will continue to be a concern. For us, that’s largely small ruminants, poultry and dairy diseases, which are the focus of our current programmes. Emerging infectious diseases can arise anywhere in the world, making strong surveillance systems globally essential. Some recent outbreaks have originated in different regions, including parts of Africa. 

Then there are diseases like avian flu and PPR, though the World Organisation for Animal Health, the FAO and governments are investing heavily in PPR eradication, similar to how rinderpest was eradicated a few years ago, so that will take time but is on a good trajectory.

The one I would flag as a growing concern is FMD in dairy and cattle. The virus mutates fast and different strains keep emerging for which vaccines may not yet be available. 

Animal health experts continue to monitor the emergence of new FMD strains. And there is worry about a new FMD strain in South and Southeast Asia. If a new strain does take hold, it could affect Nepal, India and Bangladesh together, since all three have large populations of indigenous cattle breeds, and the impact could be devastating.

Predicting exactly which strain emerges next is difficult — that’s the domain of epidemiologists who do the modelling — but it’s a live concern, and one that doesn’t get as much public attention as it probably should.

Shagun: Cross-border and informal livestock trade is a major driver of transboundary disease spread, and many community workers themselves live along border areas. Is there scope for community-level disease traceability or an informal cross-border biosecurity network?

DB: Strong government leadership and sustained cross-border coordination remain essential. If the issues I have mentioned are addressed at the epicentre — in the community where livestock are raised — transboundary spread can be minimised, even if not eliminated. Strict, neutral implementation of cross-border regulation matters a great deal here. And this isn’t unique to South Asia, it’s the same story in Africa.

On coordination, the World Organisation for Animal Health has a mandate that member states have signed on to, and there are regional bodies as well. Between individual countries, it tends to come down to bilateral agriculture agreements and stricter regulations. For instance, Australia restricts anyone from bringing in meat products, which even extends to something as small as instant noodles carried by travellers. Stricter regulations genuinely help.

(These were Bhandari’s personal remarks based on his own field experience, and do not necessarily represent an official position of Heifer International.)