Development of the Stanford One Health Initiative
Primary Contact: Ashley Zehnder
Primary Stanford Email: firstname.lastname@example.org
- Donna Bouley
- Jose Vilches-Moure
- Carlos Bustamante
- Michele Barry
Key areas: (all)
- Engagement Beyond Our University
Key Conceptual category: (all)
- Advancing frontiers
- Strengthening foundations
- Stimulating synergies
- Anticipating change
What critical long-term issue relating to Stanford’s future are you addressing? (250 characters)
Stanford, a preeminent interdisciplinary research institution, is uniquely situated to be a leader in leveraging the interconnectedness of people, animals, and the environment. Major, innovative breakthroughs in human health are possible through use of a “One Health” approach to research.
Idea and Proposal Summary: (1024 characters)
Diseases affecting humans occur in a population that interacts with animals and the environment. The solutions to many diseases affecting humans require cooperation of human medical doctors, veterinarians and environmental scientists. Veterinary colleges have embraced this idea. However, very few basic science research universities have a significant program to build these collaborations, resulting in silos that often separate human and veterinary research. Stanford is a preeminent interdisciplinary research institution, but does not have a program to promote collaborative research projects among human medical and veterinary researchers, clinicians and environmental researchers. We propose Stanford One Health (SOH) to strengthen collaborations with the larger veterinary community, encourage innovative research programs, enhance environment and human health research on campus and provide unique training opportunities to integrate knowledge from human and veterinary medicine and environmental sciences. Improving interdisciplinary research is key to moving forward in an era of precision medicine and accurate disease prediction, prevention and treatment.
The majority of diseases affecting humans also affect other animals. Approximately 75% of recently emerging infectious diseases in humans are of animal origin. Approximately 60% of all human pathogens are zoonotic (NIH Physician-Scientist Workforce Working Group Report 2014). There is a substantial increase in the use of animal models of disease and recognition of the value of engaging veterinarians in basic research programs. The NIH recognizes the value of this type of research, providing support for veterinarians pursuing PhD training in many fields and supporting the use of animal models of disease in several ways: 1) Veterinarian residency training programs through the NCI, 2) Funding through the Office of Research Infrastructure Programs, 3) Fellowships in global health (Fulbright-Fogerty), 4) Physician-Scientist Workforce Working group report recommends increased training and support for veterinary scientists, 5) NIH T32 programs to support veterinarians pursuing PhD degrees and T35 programs to expose veterinarians to basic research opportunities, and 6) NIH R25 program to support veterinarians pursuing Laboratory Animal Medicine Clinical Specialty Training and research (ended in 2016).
Veterinarians participate in biomedical research in a variety of roles, not only as supervising veterinarians for animals used in biomedical research, but also as principal investigators with NIH support for the study of human and animal diseases. In addition, veterinarians are also used as experts in wildlife ecology and the natural biology of many pathogens and non-infectious diseases in animals. Veterinary students receive excellent comparative training in multiple animal models and many veterinarians pursue additional training in specialties that mimic those in human medicine, providing the training to critically evaluate current animal models in research and greatly improve the efficiency and translation of basic science discoveries into patient therapies.
Historically, and again more recently, there have been major advances in science that have relied on the understanding of diseases in animals with crucial impacts on human health. In cancer research, the original discovery of oncogenes was through the understanding of the pathogenesis of sarcomas in chickens and the transformative ability of the Src oncogene. More recently, in recognition of the role companion animals play in cancer research, the NCI has expanded its clinical trial network to leverage the dog as a pre-clinical model for translating cancer therapeutics. This has led to improvements in dosing and adverse events prediction for human chemotherapeutics as well as biomarker prediction. Other fields which have benefited from the use of natural animal models include such varied fields as diabetes and other auto-immune diseases, obesity, sleep science, neurology and psychiatry, and aging.
Infectious disease research and global health is another area which is greatly enhanced by incorporation of veterinary collaborators and the understanding of natural disease mechanisms. The Centers for Disease Control One Health Office has catalogued the zoonoses affecting 15 countries world-wide as well as the level of veterinary involvement in its Annual Report on One Health and Zoonoses Activities. Among diseases of highest concern include viral (e.g., influenza, rabies, viral hemorrhagic fevers), bacterial (e.g., Anthrax, Brucellosis, Salmonella, Campylobacter) and parasitic (e.g., Leishmania, Giardia) zoonoses. The recent outbreak of Ebola in West Africa is suspected to be due to a cross-over event from bats to humans. Additionally, large government grants, such as a recent approximately $30 million statement of work for Cooperative Biological Engagement Program (CBEP) Scientific and Technical Engagement Partnership (STEP) Program, have emphasized the importance of utilizing a One Health approach and specified a need for veterinary epidemiology and veterinary infectious disease experts in the role of global biosurveillance. These, and many other examples, highlight the need for better integration of physician scientists, biomedical researchers and veterinarians at all levels of basic scientific and translational research at Stanford.
As researchers seek to quantify the effects of a changing environment on human health, it is vitally important to consider the animals that share resources with humans and also provide food and livelihoods for people across the planet. There are several areas where this is particularly important. Some examples include: 1) The spread of disease vectors into novel territories and interactions with naïve populations 2) The effect of urbanization on livestock, human health and effects on wildlife 3) Monitoring of antibiotic resistance in human, companion animal and wildlife populations 4) Environmental contamination of waterways and oceans with effects on human and animal populations 5) Effects of loss of artic ice and changing interactions and diseases of artic populations.
Stanford is particularly well-suited to explore novel areas of intersection between veterinary and human health research that are not a focus of One Health programs at other institutions. These areas include biomedical informatics, economics, cost-benefit analysis and computational modeling. Successful research projects in these realms have the potential for transformative impact in human and veterinary medicine through novel methods in data integration as well as providing evidence for the benefits of an integrated approach that can improve large-scale fiscal support. With this in mind, our proposal incorporates collaborators from these sectors who have worked on interdisciplinary research programs in healthcare.
We propose to create Stanford One Health (SOH) as a research center comprised of affiliated biomedical researchers, clinicians, veterinarians and environmental/ecology researchers. This group would have a faculty executive director who would coordinate affiliated research faculty and coordinate outside collaborations with veterinary institutions. Deputy directors would be appointed as needed to oversee particular areas of focus within the center. Similar to the highly successful seed grants offered by Bio-X, the center would accept research grant proposals that explore spontaneous diseases in animals as novel models of human disease, seek to better understand disease physiology in non-model animals, have an interdisciplinary research team which includes internal or external veterinary collaborators, or utilize veterinary medicine, animal health care or environmental researchers to improve animal or human health. The center would provide $10,000-50,000 seed grants to help support early project collaborations and provide advisory support to help these projects obtain further NIH and other larger grant funding through foundations and other sources.
Additionally, SOH will continue to host seminars and symposia as they have in 2014, 2016 and 2017 to provide opportunities for cross-talk and collaboration between veterinarians, physicians, biomedical and environmental researchers. Past conferences have featured talks on topics such as Cancer Imaging, Novel Animal Models, Influenza, Toxoplasmosis, Antibiotic Resistance, and Bats: at the Interface of Human-Animal Disease. Previous speakers were from Stanford, UC Davis, MIT, Cornell, Tufts, Univ. of Minnesota, Univ. of Illinois, Montana State University, CDC, and California Fish and Game. These, and other related symposia, have sparked many new research collaborations within and outside the Stanford community in the areas of cancer research, microbiome, molecular imaging, immune-mediate disease, genomics and data science. As in the past, these forums will actively recruit participation by graduate and undergraduate students to educate them on research being performed in biomedical and veterinary laboratories here and at partner institutions. Additional information on One Health conferences at: https://soh2017.stanford.edu with testimonials at: http://med.stanford.edu/compmed/one-health-2016/testimonies.html.
As part of our educational mission, we are investigating collaborative opportunities with UC Davis, Colorado State University and other veterinary schools to allow Stanford medical students to rotate or attend rounds with veterinary students and vice versa. We are also exploring the feasibility of establishing or expanding current bioinformatics fellowships to provide training opportunities for veterinarians within the Department of Biomedical Data Science. Currently, under the direction of Paul Buckmaster in Comparative Medicine, a total of 102 veterinary students from many schools around the country have completed summer research internships at Stanford through the T35 program. As of 2017, 21% of former Stanford T35 trainees that have graduated from vet school have entered PhD programs. Also, to date, four veterinarians have completed PhDs at Stanford in our current T32 program, with an additional seven veterinarians currently in the program. The Comparative Medicine Department’s ACLAM-recognized Residency Training Program has matriculated seven residents and currently has four residents enrolled. These students and trainees represent a pool of veterinarians trained in a high-quality research environment that will improve the quality of veterinary research programs across the country and these programs should be supported and expanded.
Project Benefits and Ultimate Goals
Stanford One Health has the following goals:
- Work closely with the Center for Innovation in Global Health (CIGH) and the Wood’s Institute to collaborate on research projects centered on human-animal-environment interactions and Planetary Health initiatives.
- Leverage animal disease models, animal disease epidemiology and knowledge of shared risk factors to better predict, prevent, treat and cure human disease, in alignment with the School of Medicine’s Precision Health Initiative.
- Continue and expand support of Stanford scientists who are developing and characterizing critical human diseases in novel animal models (cancer, diabetes, heart disease, allergies, asthma and others).
- Fund collaborative, inter-disciplinary research efforts that bring together basic researchers, physicians, veterinarians, ecologists, economics and computational researchers.
- Promote stronger collaborations with veterinary schools to enhance interdisciplinary research initiatives, including recognized world-wide leaders in animal and human health research.
The benefits of the SOH Center include the improvement of our current outstanding research programs by the inclusion of key veterinary collaborators. This enables medical researchers to investigate novel means to achieve their project goals and more quickly translate their basic research discoveries into actual therapeutics that can benefit patients. Additionally, SOH will educate a new generation of physician scientists and biomedical researchers of the benefit of considering not just human diseases, but the whole spectrum of disease presentations in various species as well as the interconnections between humans and animals for a wide variety of infectious and non-infectious diseases.
Institutional Capacity Building
This project will build capacity for Stanford to compete on the global stage as a leader in One Health programs. It is the opportunity to combine Stanford’s leading research programs and expertise across a broad range of fields with top-notch veterinary researchers. Several Stanford faculty have already expressed interest in research programs that would benefit from these types of collaborations (link to potential One Health Research programs). These collaborations have the potential to produce novel insights into the pathophysiology of not just zoonotic infectious diseases, but diseases with broad societal impact, including cancer, diabetes, obesity and others. The Stanford community will be actively involved through seminars as well as advising research projects supported through this initiative. SOH will involve students at many levels of training, including undergraduate, graduate, medical and veterinary students to encourage them to develop a broader view of health research at early stages of their careers.
In line with the School of Medicine’s Precision Health Initiative, SOH will leverage information on disease genetic and environmental predisposing factors in animals to support efforts to better predict and prevent human disease. We are in the process of building infrastructure and pipelines to integrate and analyze large amounts of veterinary clinical data to better identify appropriate animal models and clinical phenotypes that are relevant for human disease. Additionally, by improving collaborations with both academic and private veterinary clinical trials centers, SOH can provide Stanford researchers access to more predictive and more accurate translational models to provide faster routes for treating and curing patients.
The initial phase of this initiative will take three years. The first year will be establishing the leadership of Stanford One Health as well as recruiting research proposals from collaborative research teams for seed funding. Awards will be provided during the second year and into the third year. By the end of the second year and into the third year, we anticipate applying for larger grant support from NIH and other sources (e.g., NSF, Gates Foundation, etc) based on proof-of-concept data from the seed grants awarded in year one. We also will provide opportunities for Stanford medical students and undergraduates to work with partner veterinary institutions as well as veterinary research mentors.
Potential Funding Sources
- Stanford funding: Skippy Frank Foundation has pledged $25K as a seed grant for research performed through the center. Collaborations with CIGH and Monash University may provide funds for a veterinary postdoctoral scholar with a focus on Global Health.
- Outside funding: NIH funding through several mechanisms, including R01 for specific projects, K- and T- awards for trainees, U24 and P30 awards for collaborative, interdisciplinary research programs. Morris Animal Foundation and other research foundations focused on animal and human health, including the National Cancer Institute Comparative Oncology program, the Wellcome Trust. MARS corporation (parent company of >1800 veterinary practices through ownership of VCA, Banfield and Blue Pearl) through Dept. of Biomedical Data Science. Partnerships with veterinary schools providing matching research funds for shared projects. Partnerships through drug companies and medical device companies to support research into better animal models for testing therapeutics and diagnostics. Philanthropic donations from individuals interested in advancing translation of basic science research to therapies and advancing global health goals.
Current Stanford One Supporters: (Listed alphabetically within each department)
- Donna Bouley, DVM, PhD, DACVP (Comp Med, Co-leader, One Health)*
- Paul Buckmaster, DVM, PhD (Comp Med/Neurology)*
- Stephen Felt, DVM, MPH, DACLAM, DACVPM, (Assoc. Director, VSC)*
- Sherril Green, DVM, PhD, DACVIM (Chair, Comp Med)
- Jose Vilches-Moure, DVM, PhD, DACVP (Comp Med)*
- Manuel Amieva, MD (Pediatrics, Microbiology/Immunology)*
- John Boothroyd, PhD (Microbiology/Immunology, Assoc. Vice-Provost for Graduate Education)
- Mark Davis, PhD (Dir, Ins. for Immunity, Transplantation and Infection)
- Stan Derensinki, MD (Medicine/Infectious Diseases)
- Stanley Falkow, PhD (Prof Emeritus, Microbiology/ Immunology)
- Jeffrey Glenn, MD, PhD (Dir, Ctr Hepatitis and Liver Tissue Engineering)
- Desiree LaBeaud, MD, MS (Pediatrics/Health Research/Policy)
- Jose Montoya, MD (Infectious Disease/Geographic Medicine)*
- Benjamin Pinsky, MD, PhD (Pathology/Infectious Diseases)
- Lucy Tompkins, MD, PhD (Co-Director, Inf. Dis. Fellowship)
Cancer, Pathology and Non-infectious disease:
- Matthew Frank (Scholar in Residence, Immunology and Cancer Biology; Skippy Frank Foundation)
- Stephen J. Galli, MD (Pathology, Microbiology and Immunology)
- Amato Giaccia, PhD (Radiation Oncology, Dir. Basic Science, Stanford Cancer Institute)
- Kevin Grimes, MD (Chemical, Systems Biology, Co-Dir SPARK)
- Susan Knox, MD (Radiation Oncology, Stanford Cancer Institute)*
- Mark Krasnow, MD, PhD (Director, Wall Center for Pulmonary Vascular Disease)
- Sara Michie, MD (Pathology and Laboratory Medicine)*
- Emmanuel Mignot, MD (Psychiatry, Dir. Ctr for Sleep Sciences and Med)
- Beverly Mitchell, MD (Director, Stanford Cancer Institute)
- Julien Sage, PhD (Pediatrics/Genetics, Co-Dir Cancer Biology PhD program
- Lawrence Steinman, MD (Pediatrics/Neurology)
- PJ Utz, MD (Immunology/ Rhuematology)
- Sam Gambhir, MD, PhD (Director, Molecular Imaging Program (MIPS)
- Tarik Massoud, MD, PhD (Radiology, MIPS
- Avnesh Thakor, MD, PhD (Radiology, MIPS)
Engineering and BioEngineering:
- Chaitan Khosla, PhD (Engineering/Chemistry/Biochemistry)
- David Lentink, PhD (Mechanical Engineering)
- Krishna Shenoy, PhD (Engineering/Neurobiology/Bioengineering)
Global Health and Security:
- Michele Barry, MD, FACP (Director for the Ctr for Innovation in Global Health)*
- Ami Bhatt, MD, PhD (Dir. Global Oncology, Stanford Ctr for Innovation in Global Health)
- Milana Boukhman Trounce, MD (Emergency Medicine, Biosecurity)
- Steve Luby, MD (Dir. Research, Stanford Ctr for Innovation in Global Health)
- David Relman, MD (Co-Director, Center for Intl Security, Cooperation)
Modeling, Informatics and Economics:
- Carlos Bustamante, PhD (Chair, Department of Biomedical Data Science)
- Liran Einav, PhD (Economics)
- Purvesh Khatri, PhD (Biomedical Informatics/Biomedical Data Science)
- Manuel Rivas, DPhil (Biomedical Data Science)
- Ashley Zehnder, DVM, PhD, DABVP (Biomedical Data Science, Co-leader of One Health)*
- Eran Bendavid, MD (Health Policy; Affiliate Wood’s Insitute)
- Guilio de Leo, PhD (Program in Disease Ecology, Health and the Environment)
- Robert Dunbar, PhD (School of Earth, Energy and Environmental Sciences, Woods Institute)*
- Chris Field, PhD (Director, Stanford Wood’s Institute)
- Lynne Gaffikin, DrPH (Consulting Associate Professor, School of Medicine and Fellow, Stanford Center for Innovation in Global Health)
- Pamela Matson, PhD (Dean, School of Earth, Energy and Environmental Sciences)
- Harold Mooney, PhD (Professor Emeritus, Environmental Biology)
- Krish Seetah, PhD (Anthropology)
- Sanna Sokolow, DVM, PhD (Disease Ecology, Health and the Environment)