Presentation at 3rd GRF One Health Summit 2015 Session Case Studies of Integrative Health Risk Management

1. Risk Of Vector-Borne Diseases In
Relation To Rubber Plantations In
Lao PDR
COORDINATORS: DR. PAUL BREY AND JULIE-ANNE TANGENA
MEMBERS OF STAFF: PHOUTMANY THAMMAVONG, HONGLAKHONE XAIYASING AND PHOUVANNAMALEE
VILAYSOUK

2. Rubber plantations in SEA
• Monocultures of Hevea brasiliensis are hugely important 
>90% of the global demand for natural rubber from SEA
• In 2010 SEA had 9.2 million ha of rubber
plantations
• high demand = high rubber prices =
expansion of rubber plantations
 poverty alleviating crop

3. Rubber plantations in SEA
Sustainable development: balance between all Stakeholders
(industry, government, population)
• Decent income for local population (migrants)
• Access to healthcare
• Proper housing and access to water
• Food security and environmental protection
(loss of farm-land and deforestation)
• Ecosystem services (erosion and waterbalance)

4. The ECOMORE project
• Rubber plantations are good habitats for vector mosquitoes (adult and larvae)
• Close proximity to the natural forest (zoonosis)
• High vector exposure risk due to their behaviour
• High demand for labour; approximately 4.5-6 million people will work on rubber
plantations in SEA in the next decade
• Plantation workers are largely poor itinerant workers
This risk is further exasperated by plantation workers not interacting with official
health care providers due to difficult accessibility of health services, economic
factors, lack of local language skills, lack of knowledge on mosquito-borne diseases,
or for fear of deportation or a combination of these

5. The ECOMORE project
• SEA many countries towards elimination of malaria: are rubber
plantations a barrier?
• Dengue is the fastest spreading disease in the world: rubber
plantation workers facilitating this spread?
• Chikungunya is an emerging infectious disease: rubber plantations
facilitating spread?
 For the industry: estimated 20% commodity loss during malaria
outbreak in rubber plantations with non-immune migrant workers

6. Objectives
• Understand vector mosquito diversity and abundance in immature
rubber plantation and mature rubber plantation (i.e. tapped)
compared to secondary forest and villages
• Understand when and where rubber workers are exposed to
vectors of mosquito-borne diseases
• Establish the relative proportion of mosquitoes infected with
dengue and chikungunya
• Write public health advice for health workers, governments, and
those working in the rubber industries of Lao PDR and other
countries in SEA

7. Integration: International level
• Steering committee meetings; involving WHO, NGO’s, government
officials and researchers from Laos and neighboring countries in
the discussions; Vietnam, Cambodia and Myanmar
Challenge getting industries and agricultural organizations interested

8. Integration: National level
• Institut Pasteur du Laos from the Ministry of Health
• National Agriculture and Forestry Research Institute from the
Ministry of Agriculture and Forestry
Challenge Involve both parties in all activities conducted

9. Integration: National level
• National stakeholders; rubber industry, Ministry of Health, Ministry
of Agriculture and Forestry
• Meetings 2014 and 2015
• Local meeting with provincial departments of Health and
Agriculture 2013, 2014, 2015

10. Integration: Local level
Cultural aspects
• Involving rubber workers and villagers in collection of data
• Rapid Rural Appraisals
• Visit schools
• Live in the study area

11. Public health advice
We are currently updating the rubber plantation analysis book
published by the Ministry of Agriculture and Forestry for stakeholders
in the rubber industry
This book will have an additional chapter focusing on the health of
rubber workers (including mosquito-borne diseases)
Will be available both in Lao and English for national and
international distribution
Involved in the Strategic plan 2016-2020 of the Ministry of Health

12. Yersin project
• Mirror study of the ECOMORE study in Côte d’Ivoire
• South-south cooperation
• Working with both Ministry of Health and Ministry of Agriculture

13. Conclusions
• Stakeholders need to be involved from the beginning: sense of
ownership
international country  province local population
Government, Industry, NGO’s
• Budget and time for this integration

14. A big thank you to:
• Agence Française de Développement
• Institut Pasteur International Network
• Ministry of Health, Lao PDR
• Ministry of Agriculture and Forestry, Lao PDR
www.ecomore.org