One Health showcase from Asia: the Lawa model—a community-based approach to liver fluke control in Thailand

Abstract

Liver fluke infection caused by Opisthorchis viverrini is a significant public health challenge in the Lower Mekong Basin, affecting over 10 million people and leading to cholangiocarcinoma, a fatal bile duct cancer. Traditional control efforts often fail due to complex socio-cultural and ecological factors. The Lawa model, implemented in the Lawa Lake region of Khon Kaen, Thailand, adopts a One Health framework to integrate human health interventions, environmental modifications, and animal reservoir management, addressing the transmission cycle comprehensively. This approach respects the cultural context of Isan communities and leverages evidence-based, community-driven strategies. Over 15 years, the model has achieved remarkable success, reducing human infection rates from 60 % to below 5 % and eliminating infections in intermediate hosts. Key lessons include the importance of systems thinking, transdisciplinary collaboration, and community engagement in achieving sustainable health outcomes, despite challenges like cultural dietary practices and environmental disruptions such as flooding.