Cracking One Health

#2: Dr. Juan Lubroth

May 05, 2020 Sara Perestrelo Season 1 Episode 2
Cracking One Health
#2: Dr. Juan Lubroth
Show Notes Transcript

Dr. Juan Lubroth takes us on his journey from becoming a wildlife Veterinarian to being Veterinary Chief Officer at FAO (Food and Agriculture Organisation). As a wildlife Veterinarian, Dr. Juan Lubroth attended and is a co-author of the "Manhattan Principles", which formalized the One Health concept in 2004. 

His knowledge in Public Health and One Health is immense and his perspectives on the global challenges that we're are currently facing bring a great understanding of what needs to be improved in order to bring the One Health approach more into live.

During this interview we cover different topics ranging from antimicrobial resistances, to waste management, wet market regulations and the role of Veterinarians during the Covid-19 pandemia.


Links mentioned on the episode:

12 Manhattan Principles:

FAO World Livestock 2013 - Changing Diseases Landscapes

Connect with Sara Perestrelo (host):

If you like today’s episode, then please subscribe and leave a review so more people can learn about the podcast. Thank you!

spk_0:   0:06
you're listening to cracking one health podcast where I'll be interviewing experts in animal, human and environmental health Of your host, Sarah and Dave is it starts now. Thanks for tuning in. Today I have with me Dr who won Lubroth. He became a wildlife veterinarian and then later on, went to be chief veterinary officer at F A O. The Food and Agriculture Organization. This organization is simply the most important organization in the world when it comes to food security, amongst other topics as well as so, we will have a lot to learn from Dr Huang liberals. He has a lot of experience in one health and public health. And in other topics, our episode could have lasted for two hours. But of course we have to make it shorter. The amount of things that I learned from Dr Horn liberals were incredible. And I do hope also did you enjoy and take as much as you can from this interview. Hello, Doctor. Who on the broth? How are you doing?

spk_1:   1:16
I am well away from, um the mayhem that this global pandemic is occurring. We have now been in over eight weeks in confinement, and me and my wife are are well, the dogs are well. The cats are well, the olive trees air well and right wine is starting to come out in springtime.

spk_0:   1:37
Wow sums idea leak. So let's start our conversation by talking a bit more about your background. You started in biology than you want to have a masters in mint medical microbiology. Then he went to veterinary medicine than another musters in our bovine ology and then it beauty and epistemology in public health. What made you realize that you wanted to narrow more and more your studies? Because he went from the broad world off biology than to animal health and then, later on this interaction of humans and animals.

spk_1:   2:11
I wanted to become a veterinarian since I was 11 years old and I worked in Madrid, Spain, in the neighborhood clinic. They're clean cages, taking care of whatever the veterinarian and his staff wanted me to take care of. I spoke English and Spanish, and that area of Madrid was quite international, So I think the English also helped me with communication between clients, the veterinarians and their their pets ven throughout secondary school, becoming much more engaged politically and socially more attuned to poverty, poor countries, communities. I became a bit more interested without really understanding what tropical medicine was all about now. At that time, Franco was alive and there were a lot of unstable situation at the university level and and in society. And I wanted to become a veterinarian. And because I spoke English, I did apply for veterinary education outside Spain. I was accepted in Given a a scholarship to study in the United States. Now they're very education is quite quite different from the rest of the world. You have to do a pre veterinary curriculum before you can go into the professional school. It could be chemistry. Could be biology could be art history. And in my case, I did biology and then I did veterinary school. So that's why I became a biologist. And I think that that was actually very, very helpful to have a broad perspective of life on earth biotic and a biotic environment before even pursuing the veterinary professional career. Now, during ah veterinary school, my interest was more on research on infectious diseases. More than the sincerity, clinical practice and my first job outside Once I became a vegetarian was as a as a wildlife veterinarian. At that time, I was very interested in. Everybody gets excited about outbreaks, you know, whether it's foot and mouth disease or salmonella or Rift Valley Fever or Cove in 19. But my interest was more on. Where is the pathogen hiding when we don't have thes epidemics or epizootic sor outbreaks? What it Where's the reservoir? If it's Rift Valley fever, it's in the egg of the eighties mosquito. And at last decades, if it's foot and mouth disease, it could be in the asymptomatic carrier of the virus or in food products, where it's surviving with African swine fever. Certainly, that is the case that viruses surviving in pork products. So my work with wire life, you know, what is the relationship between wired life and domestic animals or wire life in humans and transmission of these pathogens? That was my keen interest, and so I think that that without knowing when health is looking at the environment or our production practices of ah ah, and how we create the system where there is convergence between a susceptible host and they are opportunistic pathogens,

spk_0:   5:18
and I guess many things happened between the time that you were a wildlife veterinarian and the time that you started at F A O. So can you share a bit more? What major busy in this? Meantime,

spk_1:   5:30
after my stint as a wildlife veterinarian, I worked. I went to work at the United States Department of Agriculture Research facility called Plum Island Animal Disease Center. This was a high security laboratory, and we did a lot of diagnostic testing for outbreaks. So at this diagnostic facility, I was involved with looking at samples and isolating. Viruses or bacteria are doing serological testing not only for in the event of outbreaks but also with the importation of animals, whether it's too private collections or zoos or domestic animals to improve breeds or livestock in the United States or North America. And be sure that thes animals did not necessarily bring in unwanted pathogen that would affect livestock agriculture. From there, I went also with the U S. Department of Agriculture toe a joint commission between Mexico and the United States to look at health systems in Mexico. Outbreak investigations, preparedness, planning for the possible incursion of a disease into Mexico that would affect maybe United States, Canada or beyond. So there I worked in the lab and also in the in the field. After that, I felt that I needed to have more, more robust scientific approach, and I toyed with the idea of going back to school, and I wanted to have maybe the medical degree. You're not only the veterinary degree, but I thought about it, and I recognize that humans are terrestrial mammals. So I'm only really learning about one additional species and went ahead to go for my my PhD in epidemiology and public health at Yale Medical School. My the research that I was doing was on the carrier state of foot and mouth disease and be able to determine if there was a diagnostic test that I could differentiate between a vaccinated animal and a and a carrier animal for the virus. After that, I went to Brazil again with the Pan American Health Organization, where they have a research facility outside Rio de Janeiro, looking at foot in mouth disease and some other important pathogens, including soon OSI's and after Brazil, I went back to the Plum Island Animal Disease Center. They're heading up the diagnostic lab and after that, That's when I applied for the Food and Agriculture Organization to lead their infectious disease group. And when my boss retired as the chief veterinary officer, I applied for that job. And that was a position I held from 2009 to 2019. December 31st when I retired,

spk_0:   8:14
you mentioned some international experiences, and I also know that he had quite a few more. Also in Asia and in Africa and the Caribbean. Is there any international experience that you regard as the most rewarding or special to you?

spk_1:   8:28
I think the relationship and the importance that communities have with their animals on safe food and lively hoods I cannot pinpoint. I cannot say working with Yama is in Peru or with ducks in Vietnam or with Buffalo in India, generally more from a the importance of of life, stock or animals toe a community. I correct myself when I say livestock because I think that the bush meat or wild meat is very important for communities in large parts of Africa or Asia or even Central America

spk_0:   9:05
when you join a FIO. So if he was the Food and Agriculture Organization from the United Nations. It's the most important organization for food security in the world. It operates in 130 countries, and there are many, many topics where veterinarians are needed when it comes to zoonotic diseases in direction, off white life and life stoke humans in life, stuck vaccination and off course resistance to anti Magara bills. Can you share more? I know that she worked in so many different things at the same time. But can you share more about the topics that you focused mostly during your work in this organization

spk_1:   9:41
at F A O. When I first arrived, it was very much infectious disease related to years from arriving there, we had the H five n one highly pathogenic avian influenza outbreaks that expanded very rapidly in 2004 from 10 countries in Southeast Asia's toe over 60 countries by 2006. So that really absorbed a lot of my time during that same period. Of course, we did have civil strife in some countries around the world. The Arab spring very much concerned about people's livelihoods and being able toe handle food security as well as food safety, dealing also with other divisions and departments within the organization and how to address the issues for communities and countries where there is instability and ensure that they would be proper nutrition. We also recognized that trade is an issue and ensure that that trade or those markets that value chain I had the right proper regulatory or oversight. So strengthening the veterinary systems or animal health care in countries was an important aspect professional continuing education, ensuring that the laboratories had the capability establishing networks of epidemiologists in different regions around the world. We did set up under the emergency center for Trans boundary animal diseases, some hubs around the world from external financial showed resource is whether the European Commission, United States Government, Japan, Sweden, Norway, other countries provided funding to be able for for us to carry on this work.

spk_0:   11:32
A lot of the experiences that you just mentioned have to do a lot with one health. You were working in different places of the world with different aspect off public health. Do you have your own definition off one health?

spk_1:   11:45
It's been now over 35 years. Eso for me, a definition of one health. I've been asked this question many many times, and I am not able to give it. Certainly, I would agree that one health is, ah, multi disciplinary intra disciplinary and would require inputs from many different views, whether it's economists, politicians, communication specialists and not just a discussion between veterinarians and physicians. You would need the wildlife biologist, environmentalists, climatologists. But I think the most important thing is that it's interdisciplinary tryingto arrive to a common view toe address. A common problem, actually, when health is not that new, I think it properties mentions this over 2000 years ago, in the 19th century, it was rediscovered in some ways in the 20th century. I think it's more a rediscovery.

spk_0:   12:47
You were also involved in this rediscovery. Can you share a bit of your role also in bringing the one health concept into life?

spk_1:   12:54
Let me go back to September 2004 and you and your listeners may be interested in looking at what was then termed the Manhattan principles. And this was a meeting that was held in Manhattan, New York City, of which I participated. So I'm a co author of of this, and it was the one world one health at that time it was the Wildlife Conservation Society and it brought different disciplines, and I, as a veterinarian, participated in that and developing are those principles that caught on and that became one health? Has it caught on enough? I would say not in certain circles. It's still seeing very much of a veterinary realm. You speak to certain physicians and they see it in a different light. I think that we do need to be broader than just the medical community talking about when health,

spk_0:   13:47
What do you think is lacking in order to convert the ones that a bit more resistant to the concept?

spk_1:   13:54
Well, I would say that even even at f A o, not everybody was, um, not everybody bought into the one health concept immediately. I think it took a long time. There were some groups or individuals at at FAA that didn't quite get it. I think now and in the present environment with with this novel Corona virus, perhaps it is the one. Health is becoming a little bit more infectious if you don't mind the pun, Uh, you mentioned antimicrobial resistance. I think antimicrobial resistance did bring a lot of disciplines together, but Even so, there's a lot more to do, I think the economics and the communication and how to communicate to be able to affect those financial planners or the urban planners or the politicians, um, is needed. I think there is a very selfish approach and it, you know what's in it for me. What am I going to get out of participating in this one? Health? Oh, it's just a veterinary catchword slogan and are trying to convince them that it's not. And perhaps one of the issues that's missing still in my mind is to make the financial argument of why, when health makes sense

spk_0:   15:14
and how can we save money through one house,

spk_1:   15:16
save money or earn money? I think it could go both ways because I think at the bottom bottom issue, and we see it in today's environment is, you know, trying to get the economy back up as soon as possible because of covert 19 and when are we going back to work? And when we will stop the lock down? We have to get the country up and running again. So the financial argument has to be made,

spk_0:   15:38
and what would be your argument then for the economists.

spk_1:   15:42
I'm not. I'm not an economist and I have to talk to economists. And I think in the late, late sir part of my time at F A o. I would see more economists knocking on my door, I think, with the African swine fever outbreaks that were occurring in in Asia, particularly China, I think that that was a big eye opener for some of the economists. China having over 50% of the world's bigs That was, I think, instrumental that argument of the economics and swine industry, the international trade, the importance of China, the how sorghum or grains are being imported into China to feed that large swine population, winners and losers in this globalized economy, it made sense there. African swine fever, as perhaps most many of your listeners do no is not a zoonotic disease. However, the impact on food security, the livelihoods of communities to the small producer can be looked at also as a one health issue when health is beyond Zuno sees as well.

spk_0:   17:01
Before we go into Corona virus and depth, maybe a little bit more about anti mackerel resistance is because it's always been considered a crucial topic when it comes to public health, and it's also one of the most important pillars of one health. But still, I believe that general audience isn't aware off antimicrobial resistance is we take them since we are kids. But normally the connection off antimicrobials in animals and an environment in how it impacts our health. It's not known at all. What is your opinion? Which states are of the awareness? Are we at the moment and what is it needed to make it broad knowledge or something that it that everyone understands?

spk_1:   17:41
I was named coordinator for F ao for incipient antimicrobial resistance issue, working very closely with the World Organization for Animal Health, also known as Theo I E. And the World Health Organization W h o. Together we would call the tripartite and we deal with a lot of different issues where we also tackled together antimicrobial resistance, recognizing that antibiotics and other antimicrobials are used widely in life stock as growth promoters and we see this as a risk not only toe animal health but also human health, the misuse or overuse abuse of these antimicrobials for growth promotion, economic gain and resistance were to develop would make the same medicines ineffective in your daughter, son, spouse, patient and therefore we wanted to have a better communication to limit or to phase out the use of antimicrobials as growth promoters and really perpetuate the prudent use under veterinary or physician or dentist prescription of these life saving medicines. Now therapeutic use is ah, understandable and that would be the correct use for an anti microbial. The individual is sick. He want that individual to be healthy. Ah, I say individual. And in the veterinary realm, it gets a a bit cloudy because you may be dealing with a flock or heard. So how do you treat the rest of the flock or the rest of the herd? And here there was some areas of contention of How do you use thes lifesaving anti microbial for maybe a more preventive way? I think that we do not have very good agreement on the use of antimicrobials for preventive purposes. Now, if there's a outbreak of meningitis in a school classroom in Children, all the Children get treated, so that is prevention. So the same thing we use in veterinary science. If part of your herd or individuals of your herd are affected, you may wish to treat all of them to protect them from this disease. What else? On antimicrobial resistance about getting a common understanding? I think you're pointing it out as faras being awareness. So for me, it's communication, communication, communication and not necessarily in that order, the pharmacies at the farm store, where you may buy your grains at the veterinary clinic waiting room at the physicians or the dentists to be able to alert this. And I think that this she needs to start out in elementary in primary school.

spk_0:   20:39
In the end, it's It's not just one countries issue. It end up being a global issue in European Union. We already have some regulations in terms off the meat that can enter our markets. But in some other parts of the world, the problem maintains. So how can we make this issue be a global issue? In a world where countries work in so many different ways and policies are so different?

spk_1:   21:04
Antimicrobial resistance is a trans boundary issue. You're absolutely right. Yes, Europe is probably monitoring the milk or the meat that's coming in, but antimicrobials are also being used on plants in date palms on oranges. Is that being looked at this room for improvement, even in such advanced societies or agreements that we do see with the in the European Union and the European Commission? I do think that public health is too important just to be left for the ministries of health or wh o alone. It requires all of society, the industry, the producers. We do see antimicrobial resistance in the environment. How does that affect animals, or how does that directly affect humans? I think there's a controversy or some gaps of knowledge there. If you are using antibiotics or into other antimicrobials, most of them are eliminated in urine or in manure or in feces. And where does that go? Well, it goes into water treatment plants, maybe in countries or in communities that have water treatment plans. If not, they go into rivers, ponds and into the sea. Monitoring the environment or the wildlife would be important to know what that cycle of anti microbial pathogens or resistant pathogens. And how does that effect our food systems in our health would be is a big gap that requires investment in so from a developed or developing a country perspective. It is to create, as you have said, the awareness among those that have the finances. We do spend a lot of money on military weapons, submarines, tanks, mines, machine guns. Could you imagine if we were to shift our priorities and spend it on food systems and that hygiene that health ensuring consumer protection?

spk_0:   23:06
I think you just such a very, very important topic, and this lack off connection off what we eat and put in our plight and where it comes from, it's still huge. Does a huge get

spk_1:   23:18
excellent point There is a huge gap? And so, rather than look at H five n one or looking at brucellosis or looking at foot and mouth disease or looking at Cove it 19 if we take a more of a systems approach and we we improve the hygiene in the production value chain or forest to consumer, we would be ableto address Corona virus like we would be able to address salmonella like we would be able to address the hormones or other residues much, much better than a specific pathogen approach. I think that that is a mistake that we're making is to look at the specific pathogen instead of a assist, more systematic approach of our food systems and and you've probably heard and your listeners have probably heard the reference of stable to table ah, farm to fork. But something happens after the fork we go to the bathroom. And so what is happening to that waste? So waste management is also critical.

spk_0:   24:24
If we already had one health mindset or a systems approach, what could have been different during the spending? Mia, Do you think it would just have bean an outbreak in the first countries? And then we could have actually managed to pend EMEA earlier.

spk_1:   24:39
The world will change. B, C and A. C have now a different meaning before Corona virus and after Corona virus. I don't have a crystal ball lessons to be taken from this will be important to dissect, certainly, and we do know a lot about Corona viruses, and we know about zoonotic Corona viruses that are in wired life, particularly in bats. And we do know about wet markets that are very important to many societies around the world. Whether Central America, Central Africa, China, Southeast Asia is Aaron. Very, very important. Can these wet markets be regulated better? I think so. And I think that that is where we could have avoided the outbreak in Wuhan. Should that those life stock, ducks, rabbits, sheep, pigs, fish, molluscs and wired life bats, civets, other animals be properly regulated and ensure that they're not bringing in a pathogen that will trigger a spillover effect or a now outbreak in consumers would have been a gone a long way to be able to halt the outbreak much, much sooner. But we do not have those systems in place. In my village here in central Italy, we have the first Sunday of every month. We have a market and you buy plastic, you buy clothes and you can buy a pig. So this is also wet market. And this is also happening in Europe. What sort of controls through those pigs have before they're coming here next to my village. I'm sure this is probably well regulated. I do not know about the thousands or millions of other wet markets across the world.

spk_0:   26:30
Why do you think that the regulations off this wet markets are still not on the level that they should be.

spk_1:   26:37
I think that the veterinary systems and I don't only refer to a veterinary services the official regulatory service of a country or or of a province or state, but are quite under resourced. Shanghai has 1000 wet markets. How many veterinarians do? Why would I need or regulators would I need day in day out to be able to have the proper inspection of thes what sort of investment is required from the public sector to be able to ensure that these markets are complying with regulations? But it's not only about the public sector, I think the private sector industry or the individual sellers have a responsibility. And I think communication again, bringing them together, being more cooperative, the veterinary services, they're not the enemy. They're part of the solution as well.

spk_0:   27:28
And the Hadi see also them environmental changes when it comes to that, because we also know that once the environment off this wildlife is being destroyed, this also means that the wildlife is coming together more and more in contact with domesticated animals and ones that we end up eating and also humans. How is your perspective on the debuts on the environment.

spk_1:   27:51
While I was chief veterinary officer of F ao, we wrote a book with many different uh oh authors, and it was the world of life stock. It was published in 2013 and it's called Changing Disease Landscapes, and I encourage you to look upon the F a o ah website for the changing disease landscapes where we do talk about the encroachment on the environment and what this will do for disease spillover or encountering the new pathogen. And we've seen this with Lyme disease in the United States and now many parts of the of the world where to building suburbia you replace dear with humans, which becomes the big mammal for the tick, and therefore the pathogen spills over into the big mammal, the human. So that's a lot. That's the Lyme disease story that we see this over and over again, and you're absolutely right. We change the environment. We, as humans have been doing this for millennia. We probably do not belong as as a species. We don't belong in Italy. We don't belong in in Sweden or Canada or Patagonia were probably limited to a very narrow band along the equator. However, we as humans with our magnificent intellect, change our environment. So we build houses, we build fireplaces. We build nuclear plants to change our environment, to lift there. So encroachment into the pristine areas, we will encounter new pathogens. So from a surveillance point of view, I think we do need to strengthen that veterinary wire life interface.

spk_0:   29:34
And I don't know, Have you been seeing also these videos now with all the cities that don't have people anymore in the streets and suddenly you see wildlife coming also again into the cities. And so many people are now concerned that the amount of zoonotic diseases also increasing gets suddenly we're leaving the streets to wildlife.

spk_1:   29:55
What amazes me of those off images is actually the clear blue sky over Beijing or London or Madrid. Uh, that, to me, is quite quite impressive. As far as that wildlife urban interaction, it bound to happen, I think, also the way we handle waste and garbage pits. Ah, in our peri urban areas that that's attractive. They're looking for food.

spk_0:   30:22
Yeah, it's incredible. How can nature suddenly just grow against super fast and having this confrontation sometimes can be? I think many people confront this with fear. But at the same time, it's also amazing how it's so fast.

spk_1:   30:37
Yes, yes, a very, very good point.

spk_0:   30:40
And how you living this experience On a personal level? I know that you were in your village and everything is fine. But he's still in Italy, right? It's one of the most effective company in Europe.

spk_1:   30:51
Yes, I live in Italy, about 67 kilometers from the capital, from Rome. After my retirement, I decided to stay here. I'm pretty isolated already, so the lock down really hasn't affected me too much. I have an olive grove. I make my own wines. We have a vegetable garden, so I'm able to go outside and plant and water. We have several dogs, so play with the dogs. Certainly the lock down for me is been quite quite easy. And in the neighboring area, we've had had cases of covert. 19 were required. If I'm to leave to get potable water or to go to, uh, the market. The supermarket. I am required to do an auto certification before I get into my car and sign it. And each time there's been quite a few jokes and images that are keeping people's, I think, humor up, and I think that that is important. It is magnificent to hear on opera Ardian April's or Ah can't a condo in Sylvia. It's Ah, heartbreaking to see how communities have come together to talk to each other from balcony to balcony. It's quite amazing. I know that in Spain at eight PM, everybody goes to their balcony or window and claps and clapping for the for the health care workers. But I would also say that they're clapping for others for the garbage men who are in women who are picking up the rubbish. They're clapping for the store owner that maintains the store open so that people get their food or the postal worker who was able to get mail or deliveries of packages. I think that those air these air, all other heroes of our community,

spk_0:   32:34
I also think that people end up clapping to each other, kind of to support their neighbors and everyone living in the same situation, especially in the cities. Where is a bit tougher at this time, going more into the human to human interaction part off this situation, Do you foresee that we will change also the way that we relate to others, because we're learning a lot about the environment, about public health and and so many things at the same time, but will be also learned and change some behaviors towards other people.

spk_1:   33:10
I'm very, very. I'm hopeful for this. Certainly I'm an optimist. In many ways. I'm also a definition for a pessimist. Is a well informed, informed optimist. That said, I would hope that the lessons or that we've experience has been so personal for all communities around the world that this will not be forgotten. It's affected us in our homes, in our building, in our city, in our country, whether you're in Auckland, New Zealand, or you're in Ottawa, Canada, or your in winners itis. It's affected everybody. So I think that there will be the before and after I think Children who are not necessarily even even school aged Children. My grandson will remember the time that they were enclosed and couldn't go out and couldn't be playing with their friends and couldn't go to a birthday party. I think this will be a moment in their history, their personal history. I think we are able toe to have a bit more compassion. We do need to seek, from a professional point of view, more collaboration and to ah, learn from others recognize the imp important role that the civil servants have to keep us safe, to keep the food chain safe, to make the right decisions and not necessarily the political expediency that we sometimes see in the news today. And I think also to promote the best in people and have, you know, be self critical. Hold up a mirror to yourself, be a better person. Walk softly on Earth

spk_0:   34:47
on a more futuristic approach. Also again, apart from antimicrobial resistance, is what other topics concern you, Or do you think that will be a priority in the future?

spk_1:   34:59
Well, the inequality in in society creates uneven access to health care services, education opportunities. So to be able to stabilize that I know it's altruistic to think, but let's shoot for what is right, and I think that we do need to have social unrests that we're seeing the infighting between communities or different religions, or even within within, even within the same religions, different sects. You need to have a better perspective. What is it that we're really fighting for? Having a closer horizontal level playing field is required, the haves and the have nots. This needs to have some sort of degree of understanding that the impacts on poor societies, air poor fragment of society does not necessarily do the whole of the world good or the community's good. There has to be more justice there. And so the humanitarian relief the social stability ease are areas where I have a greater interest in being able to provide from the medical perspective or one health perspective. Where environmental perspective of how that can be achieved is one area that I wish to contribute to tow the other disciplines out there. I would like to leave with your listeners with a quote from from Einstein, which is, well, I think some liberties on the quote. The mind, like a parachute, works better when it's open.

spk_0:   36:31
Do you have any project now in your hands, or are you working in something specific that you want to share?

spk_1:   36:38
A recently co published with some Danish and Swedish colleagues Ah, an Italian colleagues, a paper on surveillance for for covert 19 extracting from some tools that we use in the veterinary realm that could be applied for public health. And this was on systemic random surveillance to be able to pick up on asymptomatic carriers. For this, I'm looking at ways that I'm able to contribute toe other disciplines. Um, I wrote a op ed piece that was rejected from The New York Times, and I have to admit, and I resubmitted it with a bit changes to The Wall Street Journal. And that was in late January, early February, also on, um, lessons not learned from previous outbreaks and run reference to Two Cove in 19. So I'm active. Ah, I mostly in contact with my previous colleagues at the Food and Agriculture Organization and also at the World Health Organization, of how I may able to to assist or provide advice or guidance. What other projects do I have? I come from a non artistic family. I'm the only one that went into into science or medicine, so there are some aspects of sculpture and designed that I'm playing with. As a retiree, I'm retired, but I'm not tired

spk_0:   38:02
exactly, and he should also using them to do things that you never had time before.

spk_1:   38:06
Absolutely, like putting photographs in the pictures in order.

spk_0:   38:11
That's great just to finalize our conversation. Do you have any recommendations? Advices for anyone that wants to start and work in one Help

spk_1:   38:21
go into the one health curriculum, which I think can start in primary school and secondary school? It doesn't have to. You don't have to be a graduate veterinarian to embark on a when health master's program. So I think we should be starting earlier and influencing earlier about hygiene, about antimicrobial use about food preparation. I would like to take it more upstream and not wait for the professional to talk about when health, I think to look at the profession is to how they are contributing. But what is there? Roll to these wicked problems that we face as a community error as a planet, and I'm sure that your listeners would also maybe want toe look at some aspects of planetary health. Let's look at climate change what is happening? They're from a much more macroscopic level than just looking at animal plant environment. So I think that the planetary health, or ICO health does make sense,

spk_0:   39:22
and what can end one start doing on an individual or community level in order to become more involved in one health. Commonly, people don't know where to start or how can they give their impact. Also,

spk_1:   39:35
Like I said before, I think the mind like a parachute, works best when it's open that we do as veterinarians or as professionals do. Keep that open mind. And that has to be very much from a from a discipline point of view, as well as from an individual professional point of view. That would be the strongest advice that I can that I am able to give. Everybody has something to contribute. When we became veterinarians or you become a physician, you take the Hippocratic oath. Above all, do no harm. Will this list be broader than this? Look at our society. Look at ourselves. Look at our environment. Let's not do

spk_0:   40:14
harm. I think that's the right way to finalize our conversation. Thank you so much. Dr. Who on the broth was a real pleasure speaking to you.

spk_1:   40:22
The pleasure was all mine. Thank you very much. And I look forward to engaging you in the future.