Multisectoral prioritization of zoonotic diseases in India: A One Health perspective

Introduction To tackle the risk of emerging and re-emerging diseases, it is critical for countries with limited resources to prioritize endemic and emerging zoonotic diseases of greatest national concern. One Health is an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals, and ecosystems. In India, as a first step towards a multi-disciplinary, multi-sectoral, One Health approach to preventing and detecting zoonotic disease outbreaks, a national-level multi-stakeholder zoonotic disease prioritization workshop was organized to identify a list of zoonotic diseases of greatest national concern for India. Methods We followed the Good Reporting of a Mixed Methods Study (GRAMMS) guidelines to finalize a list of priority zoonotic diseases through a participatory action research approach involving 50 experts in zoonotic diseases. We used a prioritization process based on the U.S. Centers for Disease Control and Prevention’s semi-quantitative One Health Zoonotic Disease Prioritization (OHZDP) Process, with modifications per country need.   Results We ranked forty zoonotic diseases based on five criteria: severity of illness in humans, the economic burden of the diseases, pandemic potential, capacity for prevention and control, and potential for introduction or increased transmission in India. The final list of zoonotic diseases ranked in the order of national significance includes the following top ten priority zoonotic diseases: Zoonotic Influenza (Zoonotic Influenza A viruses), Anthrax, Japanese Encephalitis, Leptospirosis, Brucellosis, Dengue, Rabies, Scrub typhus, Plague, and Crimean-Congo hemorrhagic fever. We conducted a sensitivity analysis to assess the impact of each criterion on the prioritized list; this analysis showed  minimal changes in ranking for the top ten diseases. Conclusion For the successful adoption of One Health practices in India, multi-sectoral collaboration is critical at all levels – national, state, and provincial.  This collaborative prioritization process conducted at the national level has the potential to catalyse such efforts and enhance zoonotic disease prevention and detection efforts at the state and local levels across India. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The author(s) received no specific funding for this work. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: N/A I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All relevant data are within the manuscript and its Supporting Information files.