A Cross-Sectoral Coordination in One Health: A Case Study of Anthrax Prevention and Control in Maros, Indonesia
Abstract
Introduction: This study aimed to explore how the One Health (OH) approach was applied in the prevention and control of anthrax in Maros Regency, an anthrax-endemic area of Indonesia with recurrent human and animal cases. With the continued public health threat posed by anthrax as a zoonotic disease, especially in endemic regions, our objective was to assess intersectoral coordination and collaboration efforts to address gaps in disease prevention identified in existing literature.
Methods: This qualitative study involved a case study design conducted across the Maros Regency from February 2022 to June 2022. A total of 29 informants were enrolled, including 17 from the human health sector, five from the animal health sector, and seven from local government, through purposive sampling method. Ethical approval was obtained from the Health Research Ethics Committee of Public Health Faculty, Diponegoro University (Approval Number: 74/EA/KEPK-FKM/2022), and all participants provided informed consent.
Results: The primary outcome of the study was the One Health approach has been applied in the Maros Regency, including sharing information; cross-sectoral meetings; coordination and collaboration.
Conclusion: In conclusion, our study contributes to the understanding of anthrax prevention and control by highlighting the role and implementation of the One Health approach in an anthrax-endemic setting. This research provides insights into the practical benefits of cross-sectoral coordination and shared responsibilities. Future studies should explore strategies to institutionalize One Health mechanisms and evaluate their impact.
References
Goel AK. Anthrax: A disease of biowarfare and public health importance. World J Clin Cases. 2015 Jan;3(1):20–33.
Nicholson WL, Galeano B. UV Resistance of Bacillus anthracis Spores Revisited: Validation of Bacillus subtilis Spores as UV Surrogates for Spores of B. anthracis Sterne. Appl Environ Microbiol. 2003 Feb;69(2):1327–30.
Carter G. Bacillus. In: Carter G, Cole J, editors. Diagnostic Procedure in Veterinary Bacteriology and Mycology . 5th ed. San Diego: Academic Press; 1990. p. 221–8.
Driks A. The Bacillus anthracis spore. Mol Aspects Med. 2009 Dec;30(6):368–73.
Turnbull PCB. Introduction: Anthrax History, Disease and Ecology. Curr Top Microbiol Immunol [Internet]. 2002 [cited 2025 Aug 6];271:1–19. Available from: https://doi.org/10.1007/978-3-662-05767-4_1
CDC. Framework for enhancing anthrax prevention & control. Pathology. NC for E and ZID (U. S). D of HCP and, editor. Atlanta, GA: Centers for Disease Control and Prevention; 2016.
Hugh-Jones M, De Vos V. Anthrax and wildlife. Revue Scientifique et Technique-Office International des Epizooties. 2002;21(2):359–83.
Bakhteeva I, Timofeev V. Some Peculiarities of Anthrax Epidemiology in Herbivorous and Carnivorous Animals. Life. 2022;12(6).
P. Purwo Suseno, K. Rysava, E. Brum, K. De Balogh, I. Ketut Diarmita, W. Fakhri Husein, et al. Lessons for rabies control and elimination programmes: a decade of One Health experience from Bali, Indonesia. Rev Sci Tech. 2019 May;38(1):213–24.
Mwakapeje ER, Høgset S, Fyumagwa R, Nonga HE, Mdegela RH, Skjerve E. Anthrax outbreaks in the humans - livestock and wildlife interface areas of Northern Tanzania: a retrospective record review 2006-2016. BMC Public Health. 2018;18(1):106.
Kelly TR, Machalaba C, Karesh WB, Crook PZ, Gilardi K, Nziza J, et al. Implementing One Health approaches to confront emerging and re-emerging zoonotic disease threats: lessons from PREDICT. One Health Outlook. 2020;2(1):1–7.
Nana SD, Caffin JH, Duboz R, Antoine-Moussiaux N, Binot A, Diagbouga PS, et al. Towards an integrated surveillance of zoonotic diseases in Burkina Faso: the case of anthrax. BMC Public Health. 2022 Dec 1;22(1).
Wilde H, Hemachudha T, Wacharapluesadee S, Lumlertdacha B, Tepsumethanon V. Rabies in Asia: The Classical Zoonosis. In: Mackenzie JS, Jeggo M, Daszak P, Richt JA, editors. One Health: The Human-Animal-Environment Interfaces in Emerging Infectious Diseases: The Concept and Examples of a One Health Approach. Berlin, Heidelberg: Springer Berlin Heidelberg; 2013. p. 185–203.
CDC. CDC. 2022. One Health Basics. Available from: https://www.cdc.gov/onehealth/basics/index.html
Iatridou D, Bravo A, Saunders J. One health interdisciplinary collaboration in veterinary education establishments in europe: Mapping implementation and reflecting on promotion. J Vet Med Educ. 2021;48(4):427–40.
Acharya KP, Karki S, Shrestha K, Kaphle K. One health approach in Nepal: Scope, opportunities and challenges. One Health. 2019;8(August):100101.
Asaaga FA, Young JC, Oommen MA, Chandarana R, August J, Joshi J, et al. Operationalising the “One Health” approach in India: facilitators of and barriers to effective cross-sector convergence for zoonoses prevention and control. BMC Public Health. 2021;21(1):1–21.
Degeling C, Johnson J, Kerridge I, Wilson A, Ward M, Stewart C, et al. Implementing a One Health approach to emerging infectious disease: Reflections on the socio-political, ethical and legal dimensions. BMC Public Health. 2015;15(1):1–11.
Amuguni H, Bikaako W, Naigaga I, Bazeyo W. Building a framework for the design and implementation of One Health curricula in East and Central Africa: OHCEAs One Health Training Modules Development Process. One Health. 2019;7(September 2018):100073.
Mansingh A, Choudhary H, Shandilya J, Bhattacharya D, Kshatri J, Parai D, et al. A qualitative exploratory study using One Health approach for developing an intervention package for elimination of human anthrax in an endemic district of Odisha, India. Indian Journal of Medical Research. 2021;153(3):394.
Yasobant S, Bruchhausen W, Saxena D, Falkenberg T. One health collaboration for a resilient health system in India: Learnings from global initiatives. One Health. 2019;8(January):100096.
Adnyana IMDM, Utomo B, Eljatin DS, Sudaryati NLG. One Health approach and zoonotic diseases in Indonesia: Urgency of implementation and challenges. Vol. 3, Narra J. Narra Sains Indonesia; 2023.
Denis Oxy Handika, Mubasysyir Hasanbasri. Policy Model Structure in Anthrax Prevention: A One-Health Approach at the Cross-Border Regional Level. BKM Public Health and Community Medicine [Internet]. 2024 [cited 2025 Aug 5]; Available from: https://journal.ugm.ac.id/v3/BKM/article/view/13377
Aptriana CD, Sudarnika E, Basri C. Nationally and locally-initiated One Health approach in controlling rabies in West Kalimantan, Indonesia. Vet World. 2022 Dec 28;2953–61.
Subrata M, Purnama SG, Utami A, Karang Agustina K, Swacita I. Role of Stakeholder in Rabies Control with Integrated One Health Approach In Bali. Jurnal Kebijakan Kesehatan Indonesia : JKKI. 2020 Mar 1;09(9):20–32.
Sudewi AAR, Swastika K, Sudarmaja IM, Wulanyani NMS, Dharmawan NS, Wirawan IMA, et al. One health approach for taeniasis/cysticercosis control measure in Bali, Indonesia: updated situations, implementations, and challenges. Bali Medical Journal. 2024 Feb 5;13(1):709–14.
Mardiana A, Maulana D, Stiawati T. Implementasi Pendekatan One Health melalui Collaborative Governance dalam Pengendalian Penyakit Zoonosis Rabies di Provinsi Banten. Jurnal Imu Sosial dan Ilmu Politik Universitas Jambi (JISIP-UNJA). 2025;9:122–36.
Marhaban, Reza Ferasyi, Asnawi Abdullah. Eksplorasi Penerapan Strategi Pengendalian Malaria Berbasis Konsep One Heath antara Dua Wilayah yang Sudah Berstatus Eliminasi dan Belum Eliminasi di Propinsi Aceh. J Kes Cehadum |. 2019;1(2).
Siswani, Yudianingtyas DW, Djatmikowati TF, Haeriah. Kejadian Kasus Penyakit Anthrax di Kecamatan Simbang, Kabupaten Maros, Provinsi Sulawesi Selatan [Incidence of Anthrax Cases in Simbang District, Maros Regency, South Sulawesi Province]. Buletin Diagnosa Veteriner. 2013;13(1):14–6.
Djatmikowati TF, R. A, Haeriah, Hasniah. Anthraks Case Investigation in Cenrana, Maros, South Sulawesi. Diagnosa veteriner. 2015;14(2):1–6.
Putra HH, Djatmikowati TFS, Faisal. Investigasi Kasus Kematian Sapi dan Kuda di Desa Laiya, Kecamatan Cenrana, Kabupaten Maros pada April 2020 [Investigation of the Death of Cows and Horses in Laiya Village, Cenrana District, Maros Regency in April 2020]. Diagnosa veteriner. 2020;19(2):20–30.
I Gde Adika Priyamanaya. Investigasi Wabah Anthraks di Kabupaten Pinrang Propinsi Sulawesi Selatan Tahun 2016. Proc of the 20th FAVA CONGRESS & The 15th KIVNAS PDHI. 2018;436–8.
Khairullah AR, Kurniawan SC, Effendi MH, Widodo A, Hasib A, Silaen OSM, et al. Anthrax disease burden: Impact on animal and human health. Vol. 10, International Journal of One Health. Veterinary World; 2024. p. 45–55.
Grant C, Anderson N, Machila N. Stakeholder Narratives on Trypanosomiasis, Their Effect on Policy and the Scope for One Health. PLoS Negl Trop Dis. 2015;9(12):1–19.
WHO. WHO. 2017. One Health. Available from: https://www.who.int/news-room/questions-and-answers/item/one-health
FAO. Anthrax outbreaks: a warning for improved prevention, control and heightened awareness. EMPRES Watch. 2016;37(September 2016):1–8.
Kock R, Haider N, Mboera LE, Zumla A. A One-Health lens for anthrax. A One-Health lens for anthrax Outbreaks. 2019;3(7).
Li Q, Guo C, Hu H, Lu J. Towards One Health: Reflections and practices on the different fields of One Health in China. Biosaf Health. 2022;4(1):23–9.
Mackenzie JS, McKinnon M, Jeggo M. One Health: From Concept to Practice. Yamada A, Kahn LH, Kaplan B, Monath TP, Woodall J, Conti L, editors. Confronting Emerging Zoonoses: The One Health Paradigm. 2014 Jul 19;163–89.
Belay ED, Kile JC, Hall AJ, Barton-Behravesh C, Parsons MB, Salyer S, et al. Zoonotic disease programs for enhancing global health security. Emerg Infect Dis. 2017;23(December):S65–70.
Subedi D, Pantha S, Jyoti S, Gautam B, Kaphle K, Yadav RK, et al. Anthrax in Humans, Animals, and the Environment and the One Health Strategies for Anthrax Control. Pathogens. 2024 Sep 7;13(9):773.
Rahaman MR, Hodgetts K, Milazzo A, Marshall H, Chaber AL, Crabb D, et al. Q fever prevention in Australia: general practitioner and stakeholder perspectives on preparedness and the potential of a One Health approach. Aust N Z J Public Health. 2022;46(2):196–202.
D H. The One Health Approach: Perspectives for Environmental Epidemiology. Environmental Epidemiology. 2019;3.
Dórea FC, Dupuy C, Vial F, Reynolds TL, Akkina JE. Toward One Health: are public health stakeholders aware of the field of animal health? Infect Ecol Epidemiol. 2014;4(1):24267.
Destoumieux-Garzón D, Mavingui P, Boetsch G, Boissier J, Darriet F, Duboz P, et al. The One Health Concept: 10 Years Old and a Long Road Ahead. Front Vet Sci. 2018 Feb 12;5.
Taaffe J, Sharma R, Parthiban ABR, Singh J, Kaur P, Singh BB, et al. One Health activities to reinforce intersectoral coordination at local levels in India. Front Public Health. 2023 Mar 7;11.
Suhail MK, Hannis D, Armstrong A, Rhodes A. Implementation of ‘One Health’ approach in Kerala state, India – A systematic review. Vol. 9, Veterinary Medicine and Science. John Wiley and Sons Inc; 2023. p. 2625–33.
Yopa DS, Massom DM, Kiki GM, Sophie RW, Fasine S, Thiam O, et al. Barriers and enablers to the implementation of one health strategies in developing countries: a systematic review. Vol. 11, Frontiers in Public Health. Frontiers Media SA; 2023.
Savadogo M, Zangré H, Nana SD, Ilboudo AK, Dahourou LD, Ilboudo SG, et al. Adoption of the One Health approach to improve zoonosis control in low-income countries: Insights from the case of rabies management in Burkina Faso. Int J One Health. 2021;7(2):182–9.
Gebreyes WA, Dupouy-Camet J, Newport MJ, Oliveira CJB, Schlesinger LS, Saif YM, et al. The Global One Health Paradigm: Challenges and Opportunities for Tackling Infectious Diseases at the Human, Animal, and Environment Interface in Low-Resource Settings. PLoS Negl Trop Dis. 2014 Nov 13;8(11):e3257.
Chatterjee P, Kakkar M, Chaturvedi S. Integrating one health in national health policies of developing countries: India’s lost opportunities. Infect Dis Poverty. 2016 Oct 3;5(1).
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