Zoonoses and marginalised infectious diseases of poverty: Where do we stand?

Infectious diseases disproportionately affect poor and marginalised populations which are subjected to a cycle of ill-health and poverty. With 60% of human infectious diseases caused by zoonotic pathogens [1] effective public health policy must recognise the importance of interactions between humans and animals [2]. The control of neglected tropical diseases (NTDs) for poverty alleviation has become an increasing priority [3,4], but endemic zoonotic diseases are still largely ignored by public health and veterinary services, despite causing a substantial health burden [2,5]. In contrast, for zoonotic diseases with pandemic potential, such as avian or swine influenza and SARS, the international community has responded vigorously with committed resources, reflecting concerns of potential consequences for higher-income countries.Many endemic zoonoses have a dual impact on human health and livestock production. Human populations dependent on livestock are not only most at direct risk from zoonotic disease but are most vulnerable to the indirect impacts on health of reduced production on livelihoods and food security, which exacerbates the poverty cycle. It is estimated that over 600 million people globally are livestock-dependent, and represent up to 70% of the population in the most marginal areas [6]. These communities are typically isolated from political processes, communication, education and health care, due to geographic, economic and socio-cultural factors, which exacerbate problems of awareness and health-care delivery.Effective surveillance and control of zoonotic diseases usually requires multisectoral collaboration involving the human health, veterinary, agricultural, educational, wildlife and environment and sanitation sectors. It remains a considerable challenge to coordinate these different interests, and to achieve collaboration in policies, priorities, resourcing and communication at the national and international levels.Over the last decade significant