The notion of One Health – the combined and connected health of humans, animals, plants, and the environment – is both simple and ancient. The Egyptians were famously holistic in their approach to medicine and remain equated with a One Health Approach to this day. Hippocrates taught his students to assess not only the patient, but also his or her surroundings: where they lived, what they did, where they went, what they ate and drank. This concept regained its momentum throughout the 1600 and 1700s.
In today’s Public Health and Veterinary circles, epidemiologist Calvin Schwabe gets the credit for coining the phrase One Health – a 1980s evolution of his “One Medicine” concept from the 1960s. Schwabe’s promotion of an integrated human and veterinary approach for zoonotic disease control has long been part of the Veterinary mantra and continues to form the foundation of today’s One Health strategy.
A still amorphous One Health following started to take shape in international circles after the SARS outbreak of 2002-2003:
2004 – Following the 2002 SARS outbreak, the World Wildlife Conservation Society hosted a September symposium that purposefully brought a group of international human and animal health experts together for the first time. The outcome became the 12 Manhattan Principles, a list of recommendations for establishing a more holistic approach to preventing epidemic / zoonotic disease and for maintaining an ecosystem with high integrity for humans, their domesticated animals, and biodiversity.
2005 – The Lancet published its first reference to One Health.
2007 – The American Veterinary Medical Association and American Medical Association formed the One Health Initiative Task Force.
2008 – FAO, WHO, OEI, the United Nations Children’s Fund (UNICEF), World Bank, and the United Nations System Influenza Coordination (UNSIC) published their collaborative “Contributing to One World, One Health” document.
2009 – The US Centers for Disease Control and Prevention (CDC) established its One Health Office.
2011 – The 1st International One Health Congress was held in Melbourne, Australia.
2012 – The 1st One Health Summit was held in Davos, Switzerland.
2016 – The One Health Act of 2016 was introduced in the US Senate by Senator Al Franken (D-MN). It called for collaboration between the US Centers for Disease Control and Prevention (CDC) and the Department of Homeland Security as well as the US Department of Agriculture to “develop and implement a federal One Health framework for emergency preparedness.” The bill died without the necessary support when Franken resigned his seat in 2017.1
2020 – WHO made the assessment that COVID-19 can be characterized as a pandemic.
There’s nothing like a global pandemic to act as a ruthless litmus test of your plans and preparedness. COVID-19 turned our world upside down in 2020. How well we responded to the outbreak of Disease X is one matter, but avoiding outbreaks entirely remains the other. Outbreaks may prove unavoidable in general terms, but the depth of an outbreak’s impact will define its relative importance. As we look to the future, then, let us consider our current situation:
- Vector-borne disease is on the rise
- Antibiotic resistance and insecticide resistance are significantly undermining the effectiveness of our drug and vector control investments
- Significant changes in land use have driven wild animals from their natural habitats, leading to zoonotic spillover and conditions for infectious disease outbreaks
- Efforts to coordinate management systems across borders in a One Health Approach have been largely, but not entirely, unsuccessful
“How to achieve, in policy and practice, one health in an inter-connected world has lagged behind our intuitive recognition and scientific evidence that this should be the right way to proceed.”
~ Ruth M. Gibson, University of British Columbia – Vancouver, 2010 2
The Global Zoonotic Disease Challenge
Human disease can be classified by two forms – Noncommunicable Diseases (NCDs) and Infectious Diseases. According to the World Health Organization and CDC:
- NCDs include diseases such as heart disease, cancer, chronic respiratory disease, and diabetes
- NCDs are the leading cause of death among humans, accounting for 71% of all deaths
- 41 million people die from NCDs annually
Infectious diseases are caused by organisms such as bacteria, viruses, fungi, or parasites that can be spread from one organism to another. WHO and CDC report that:
- 60% of existing human infectious diseases are zoonotic (shared by humans and animals)
- 75% of emerging infectious diseases (EIDs) are zoonotic (shared by humans and animals)
- zoonoses account for 2.5 billion infections and 2.7 million deaths per year
This is where One Health straddles the human-animal-environment horizon. Two important drivers currently dominate the discussion: Antimicrobial Resistance (AMR) and zoonotic disease. There are two distinct commonalities between these drivers: they both dramatically threaten human health and they both concern large sums of money. Zoonotic disease can be expensive to control, and our medicines are inexorably linked not only to health, but the vast economic implications of disease (see The Economics of Resistance).
Antimicrobials are critical to the health of humans, animals, plants, and food security. Experts agree that the loss of antimicrobials for medical, veterinary, agricultural, or public health applications would be no less than catastrophic. Zoonotic diseases are most often transmitted by vectors such as mosquitoes, midges, sand flies, fleas, and ticks, often with animal reservoirs in the transmission cycle. Endemic zoonotic diseases, such as dengue and chikungunya, are often considered neglected diseases because they do not spread fast or widely, yet exact a great disease burden toll on society.
There are several reasons why zoonotic disease transmission happens. Apart from the obvious vector-borne interaction – an insect bite from a tick, mosquito, or flea, for example – zoonotic diseases can also be spread by direct contact with an infected animal or body fluids. Zoonotic transmission can also take place through indirect contact with contaminated surfaces in areas where infected animals live or have been. In addition to the wild, this includes pet or livestock habitats, on plants, and in soil.
Foodborne illnesses arise from eating or drinking a contaminated substance. This could be raw vegetables or fruit, undercooked meat or poultry, contaminated water, or unpasteurized beverages. Livestock are also susceptible to disease causing agents of these types in feed and water, undermining productivity and food security.
It is worth noting that not only are pandemics increasing in frequency, but every pandemic since 2000 has zoonotic origins.
Pandemics Since 2000
|
Pandemic |
Etiology |
Origin/ |
Outbreak Year/ |
Country/ |
Total Infected |
Total Deaths |
| COVID-19 | SARS-CoV-2 virus | Possibly Bats, Pangolins/Minks |
December 2019 onward |
From Wuhan, China to 216 countries/territories around the world | *191 million | *4.12 million |
| Zika Outbreak | Zika Virus |
Mosquito-borne |
2015-2016 | From Micronesia, across the Pacific, to the Americas: more than 34 countries or territories | No conclusive data available, 2400 confirmed cases in Brazil | No conclusive data available, 29 confirmed deaths in Brazil |
| Ebola Outbreak | Ebola Virus | Wild Animals (Fruit Bats, Porcupines, non-human Primates) | 2014-2016 | Emerged in Central and West Africa, then spread to the US and UK |
28,652 | 11,325 |
| Middle East Respiratory Syndrome (MERS) |
Middle East Respiratory Syndrome Coronaviris | Bats, Camels | 2012 | Emerged in Saudi Arabia and subsequently spread to more than 27 countries | More than 2500 | 866 |
| 2009 H1N1 (Swine Flu) pandemic |
H1N1 strain of influenza A virus | Pigs | 2009-2010 | Started in Mexico and spread to the whole world | 10% of the global population | 151,700-575,400 |
| Severe Acute Respiratory Syndrome (SARS) |
SARS Corona Virus (SARS-CoV) |
Bats, Civets | 2002-2003 | Emerged in Shunde, China then spread to 29 countries | 8,098 | 774 |
Source: onehealthjournal.org: Hoque MN, Faisal GM, Chowdhury FR, Haque A, Islam T (2022) The urgency of wider adoption of one health approach for the prevention of a future pandemic, International Journal of One Health, 8(1): 20-33.
* table data through July 23, 2021
External factors may also contribute to the spread of disease including resistant genes or pests, limited access to health services, sanitation and waste management challenges, and insufficient housing. But clearly an underlying cause of this rise is our encroachment onto lands and habitats once or currently occupied by wild animals.
Spillover is an event when a pathogen crosses the species boundary and moves from one species to another. Zoonotic spillover can result in an outbreak because the receiving species often exhibits poor defenses against the disease. Examples of zoonotic spillover include COVID 19, SARS, Nipah Virus, HINI, Zika, Ebola, and MERS.
Spillover is also an unintended result of human activities such as deforestation and urbanization. The proliferation of tick-borne illness is a good example, as forest fragmentation from changing land use patterns has brought humans and ticks closer together. These activities create conditions that promote spillover.
In related news, debate surrounding the origins of COVID-19 still hovers over two possibilities: laboratory escape or a zoonotic event. There have been 376 million confirmed cases of COVID-19, resulting in 5.6 million deaths, through the end of February 2022. One cannot say with any surety what happened, but it is worth noting some facts.
In nearby Yunnan Province, China’s climate has changed so dramatically over the past century that the landscape has been completely altered. Over the course of that time, 40 invasive species of bat have migrated into the area to take advantage of the hospitable surroundings3 These animals are thought to host some 100 types of bat coronavirus.
Other interesting facts:
- Lyme disease is the most reported vector-borne illness in the U.S. – the CDC estimates 300,000 Lyme infections per year
- Bubonic plague killed somewhere between 200 and 750 million people
- Rhinolophus affinis (horseshoe bat) Coronavirus shares a 96.2% sequence similarity with the genome sequence of the COVID-19 coronavirus
- It is estimated that around 1.7 million undiscovered viruses exist in mammals and birds, of which up to 827,000 could have the ability to infect people4
The Benefits of a One Health Approach to Zoonotic Disease
Zoonotic disease dynamics exist across all sectors (human, animal, environment) at all times. This means the range of optimal One Health coverage can be as challenging as it is massive. One Health advocates caution against shying away from this challenge because of its magnitude. Even if not 100% successful, distinct benefits can be gained immediately from a well implemented, multisectoral One Health approach for zoonotic diseases:
- Response to zoonotic disease events and emergencies is timelier and more effective.
- All sectors have the information they need.
- Decisions are based on accurate and shared assessments of the situation.
- Accountability to each other and to decision makers ensures action by all sectors.
- Regulations, policies, and guidelines are realistic, acceptable, and implementable by all sectors.
- All sectors understand their specific roles and responsibilities in the collaboration.
- Technical, human, and financial resources are effectively used and equitably shared.
- Gaps in infrastructure, capacity, and information are identified and filled.
- Advocacy for funds, policies, and programmes is more effective.5
Forests and One Health
It is easy to focus on just the human and animal intersection in the One Health equation, but the environment plays a pivotal role as well. Forests have a dramatic effect on both human and animal health with something as simple as tree cover.6 According to World Wildlife Fund and World Bank, an estimated 750 million people inhabit forests and 1.6 billion people depend directly on forests for their livelihood. Forests are home to more than 75% of all the life that exists on land.
“A 2015 study found that nearly one in three outbreaks of new and emerging diseases is linked to land use change, including deforestation.”
The Vitality of Forests, World Wildlife Fund
Trees play a critical role not only in respiration, but also in preserving air and drinking water quality by filtering out pollutants and pathogens. Forests can lower ambient temperature and protect people from harsh impacts of natural hazards such as flooding and landslides. Forests have a positive impact on nutrition and food security, particularly in areas with indigenous residents.
Importantly, forests have also been shown to reduce risks associated with some important NCDs. This ability stems from their potential to drive improved fitness and to bolster one’s immune system. While not all of these mechanisms are understood, changing behavior such as the altering of diet and activity preferences may result from interaction with the forest.
Forests also provide an important harbor for pathogens that helps mitigate the emergence and spread of zoonotic infectious disease among humans. However, this benefit disappears quickly when deforestation occurs.
Between 1976 and 2010, about 15% of the Brazilian Amazon was deforested and according to the FAO, we have lost 420 million hectares of forest since 1990 – the size of India and Portugal combined.7
There are significant financial incentives behind deforestation, most founded in the growing human population. It is profitable for landowners to sell off or develop land to construct new places for people to live or to raise profitable crops or animals. As the value of land and the lure of financial gain continues to rise, deforestation will continue, forest fragmentation will continue, and the pump will be primed for spillover.
In April of 2021, a group of 15 like-minded international organizations gathered in New York to issue a joint statement highlighting our need to halt the destruction of the world’s forests. Chaired by the Food and Agriculture Organization of the United Nations (FAO), the Collaborative Partnership on Forests (CPF) comprises UN agencies, four conventions, and other organizations with substantial programs on forests.
Putting One Health into Practice
So, what has happened? What have we done? Pandemic aside, if we considered a list of accomplishments that One Health proponents might offer us, we’d find it to be legitimate. And yet, without taking away from the accomplishments of many, what remains lacking are projects of major impact or projects that span a broad range of countries that demonstrate a strong commitment to local One Health governance. There are numerous reasons for this, but in essence our impeded progress is tied to resourcing. At the end of the day, dedicated resources of both monetary and human capital are the ultimate drivers behind the success, or failure, of One Health Programs.
And it isn’t for a lack of trying that we don’t have fully functioning systems in place. Amazing plans have been written that we can use to get there, but plans are only as good as the commitments behind them. While the One Health scoreboard may not always show the big wins people are hoping for, there are projects that have demonstrated the power and potential of One Health in a meaningful way. Many of today’s disease responses are counted on as victories among One Health leadership.
The Interactions between forests and human health
Forests Provide
They supply food and help define the cultures of indigenous people and local communities. They provide habitat and refuge for wildlife including pollinators. They recycle the solid and sustain the water cycle. They provide medicinal plants and can have a positive behavioral impact on NCDs.
Forests Prevent
Forests mediate the emergence and spread of zoonotic infectious disease. Forests provide a buffer against many pathogens and may dilute the effect of disease transmission. Forests also protect people from natural hazards and can stem damage from flooding and landslides.
Forests Heal
Human interaction with forests reduces risks associated with NCDs and can have a positive impact on mental health, obesity, and physical fitness.
Source: World Wildlife Fund
- Thailand became an early adopter of a One Health Approach (OHA) after suffering significant losses to the H5N1 and H1N1 outbreaks. One Health also has long been a part of Egyptian culture and Egypt, as well as Kenya, who is near institutionalizing One Health.
- The Global Response to the H1N1 outbreak in 2009 was another a good example in the principles of One Health. Strong coordination among Ministers of Health and outstanding communication and collaboration brought about quick results and prevented what could have been a much more severe outbreak. Particularly strong coordination was demonstrated by the United States.
- Cryptococcosis is a fungal microbe that likes decaying wood and bird droppings and was found during a 2021 Canadian porpoise autopsy. Porpoises are not typically known to host Cyrptococcus gatti infections, but through their respective One Health networks, researchers quickly learned of an usually high number of C. gatti cases in dog, cats, and people, too. The relationships forged through their One Health collaborations enabled superior execution of a zoonotic disease outbreak program they had practiced in collaborative simulations numerous times.
- In Africa, USAID contributes to One Health by teaching local farmers about agroforestry. Trees and shrubs provide African growers with fruit, timber, resins, fuelwood, and livestock fodder. They also improve soil fertility, regulate the water cycle, and help farmers regulate challenging climatic conditions. If agroforestry brings so many benefits, why don’t we see lots of trees on every farm? Valuable land still needs to be used to grow food, but the program helps small holding farmers plant trees near crop areas to improve food security, nutrition, and replenish natural resources.
- In Thailand, an application called E-Smart allows users to monitor swine health on their own and neighboring pig farms to avoid influenza outbreaks among the animals. Influenza can spread from sick animals to humans. An estimated 140,000 Thai pig farms are now using the E-Smart app.
How will we get it done?
That, as they say, is the million-dollar question. One Health requires dedicated resources. Where and when it fails, it fails because it does not get the attention it requires. Anyone who has worked in this area knows that dedicated and sustainable resources are hard to come by. Hard to come by, perhaps, but not impossible.
It all comes down to money and people. Success requires the proper allocation of financial and human resources required to make things happen, and these commitments must come from a very high level. Unless the One Health owner is someone with power and influence, the entire program and all its efforts are at risk.
As with other dynamics in the same sphere, behavioral change is not easy. Consider this perspective with an excerpt from a 2021 open letter from Alejandro Gaviria Uribe, Minister of Health and Social Protection of Colombia from 2012 to 2018. In the letter, Gaviria expressed his frustration with the lack of cohesion around One Health at the national level.
“I remember I tried to explain in congress that these epidemics were related to environmental problems well beyond our policy space”, Gaviria wrote. “It sounded as if I were making excuses. My efforts of coordination and cooperation with other ministers were not very successful. We created an intersectoral commission for health. The environmental minister attended the first session, but then delegated to other people. In six years, I had only one bilateral meeting with the environmental minister. Public policy in practice takes place in silos. It is difficult to change this. Probably, it needs a commitment from the top … One Health needs a longer horizon, a type of structural thinking that is sometimes at odds with the impatience of everyday policy making.” 9
Soliciting and acquiring allocated resources—and identifying how those resources should be used to identify gaps in existing strategy—remains a daunting task. As noble as the One Health aspirations remain, the concept runs the risk of falling into the black box of unsecured funding from which many movements never return.
“The dearth of real-world evidence has hindered the identification of gaps in the human animal environment health nexus, which hampers the application of a One Health approach in shaping policies and practice.”
~Xiao‑Xi Zhang, School of Global Health, Chinese Center for Tropical Diseases Research11
Navigating Today’s One Health Barriers
Despite the elegant nature of the One Health vision, competing demands represent ever-present barriers to One Health implementation. With a growing population comes growing responsibility, and funding is tough to come by.
A fascinating study recently published by Zhang involved the creation of a Global One Health Index where each country could be assessed on a level playing field. It gauged each country or region against what are termed the five core drivers index (CDI) dimensions of One Health. These are:
- Zoonoses
- Antimicrobial Resistance
- Food Security
- Governance
- Climate Change
The assessment began with three (3) first level indicators then moved onto 13 and ended with 57 third level indicators with data on more than 200 countries. In general, performance was low with the highest country scoring only 65 out of a possible 100. The worst country scored 31. There is a long way to go.
As part of the assessment, each country was evaluated against the five indicators to revealing its composite as well as the distribution of competence and competence density between countries. Even the best scoring category, preparedness against zoonotic disease, fell well below the 70% level. Three of the five CDIs had a mean value of less than 50%. 10
It should be no surprise that Governance, upon which any strong One Health program must be built, lags far behind the other indicators.
From the Ground Up to the Highest Level
Still, other significant One Health efforts continue to emerge. The One Health Joint Plan of Action (OH JPA) is a draft form of a technical document that establishes a clear and practical set of One Health actions for 2022-2026. The OH JPA represents the collective thinking for self-governance and assistance to others by the quadripartite of WHO, FAO, and the IOC, and UNEP. The document exudes a “next-gen” feel that benefits from experiential knowledge and our desire and ability to learn from the past.
The OH JPA uses a model that utilizes three pathways for organizations to establish the capacity by joining forces and bringing about change. These include:
Pathway 1: Policy, legislation, advocacy, and financing
Encompasses all aspects related to policy development, political will, enabling regulatory frameworks, investment, and institutionalization of inter-sectoral governance.
Pathway 2: Organizational development, implementation, and sectoral integration
Encompasses all aspects related to the implementation of One Health including scaling up of capacity development at regional and country levels, community engagement and mobilization for action, multisectoral coordination, collaboration and communication, and equitable integration of sectors.
Pathway 3: Data, evidence, and knowledge
Encompasses strengthening the scientific evidence base, knowledge translation into data for evidence, technical tools, protocols and guidelines.
For leadership, the OH JPA strongly advocates that the top One Health stakeholder occupies a high-level country or ministry position including prime minister or governor. One Health aspires to become a system that does not require more, but rather a system in alignment. One aligns his own efforts better and aligns his efforts with the efforts of others with common goals. Thinking with a One Health mindset means always evaluating outcomes not only on the benefit but also potential negative impacts to other stakeholders.
Who will fill in all the blanks and keep the train moving? What is needed to succeed in a One Health program?
Leadership in other sectors must be willing to collaborate and help to build advocacy for a successful, evidence based One Health program, for one. Since One Health is designed to break down silos, it requires multisectoral participation. A strong leadership team can accomplish great feats, but a weak leadership team is a non-starter.
Collaborators are also necessary as direct tools in the process of improving coordination, communication, and capacity building. These activities may include research, education, technical support, or planning.
One will also need a strong technical team including surveillance systems and access to accurate information. One will need to leverage today’s powerful computing and communications technologies that integrate data and assist in decision making.
To achieve these lofty goals, the quadripartite has launched a methodical, stepwise approach that began with the creation of an Expert Advisory Committee to help shape the process. In March 2021, the tripartite named 26 international experts from a pool of 700 applicants to serve on the One Health High Level Expert Panel (OHHLEP). The Panel displays an impressive array of multidisciplinary and technical knowledge skills and One Health experience. The initial focus of the Panel will be to establish a scientific assessment of One Health and to provide guidance on development of a long-term strategic plan.
A historic Memorandum of Understanding (MoU) was signed in March 2022 between FAO, WHO, OIE, and UN Environment Program (UNEP). The MoU established a new quadripartite legal and formal framework for One Health, with particular emphasis on AMR.
Initial areas of cooperation will be 1) AMR; 2) emerging and endemic zoonotic diseases; 3) strengthening of health systems.
On December 1, 2021, the OHHLEP (which has since grown to 29 members) released its new definition of One Health:
“One Health is an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals, and ecosystems. It recognizes the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and inter-dependent. The approach mobilizes multiple sectors, disciplines, and communities at varying levels of society to work together to foster well-being and tackle threats to health and ecosystems, while addressing the collective need for clean water, energy and air; safe and nutritious food; taking action on climate change; and contributing to sustainable development.”
Leveraging the OH JPA
The operational objectives of the OH JPA seek to provide a framework for coordinated action at global, regional, and local levels; but it also establishes a framework for upstream policy advice and technical assistance for development of OH legislation initiatives. These activities may include collaborative learning and knowledge sharing sessions within and across nations, sectors, and disciplines; and taking stock of existing initiatives to advise OH on potential synergies to make better use of resources.
The OH JPA “Theory of Change” asserts that One Health as an integrated, multisectoral, holistic, and transdisciplinary approach that has the potential to solve the pressing health challenges described here. Effective implementation of One Health would help us to achieve the desired long-term outcome of improved human, animal, plant, and environmental health with reduced risk.
To develop a successful plan, the JPA cautions that the organization must identify stakeholders that represent all interests and levels early in the process. This helps establish trust and promote sustainability at a personal level. Once stakeholders are identified, the process of establishing roles and responsibilities should proceed immediately and thus becomes a driver toward accountability.
One Health Multisectoral Coordination Mechanisms, or OH MCMs, establish a common denominator that can drive communication and One Health Activities across all relevant sectors. Specific programs may involve exploiting unique, context-specific benefits or may involve making required modifications to current operations to improve it. This will all be driven by the level of interest and stakeholder commitment.
The guidance also urges an immediate self-assessment to establish a baseline for future evaluation. With the information gathered, a multisectoral strategic plan looking out five to ten years should be developed, ensuring equal endorsement from all sectors. By collaborating in the planning process, stakeholder groups are more strongly bound to their objectives.
Societal costs of zoonotic disease control efforts must be established – along with a benefits analysis that is easy to understand. Monitoring and evaluation – while not fulfilled until later in the process – should be well thought through during the planning phase in order to be able to track implementation outputs and systematically evaluate progress
Resources are often not adequate for zoonotic disease control, which will likely necessitate a prioritization process for resource allocation. An objective and formalized prioritization process will assist collaborative prioritization, ownership, and uptake. Resource and information sharing will be a priority for all stakeholders, along with achievable goals and objectives.
Planning for the Future
Strategic planning and emergency preparedness are complementary mechanisms. Planning is used to think through everything needed to do an effective job, while preparedness ensures that all of those elements wind up in place and at the ready. Planning focuses on management of a system while preparedness focuses on being trained and ready to act.
Preparedness also means that activities are not disjointed and that no time is lost. Collaboration and experience we gain in the planning process improves collaboration when it comes time to execute. But once again, that takes people and money. Both in planning and in preparedness, all sectors must be accounted for. In both areas, communication ensures collaboration, and a network ensures communication.
Ten Policy Recommendations
Leveraging a One Health Approach to Prevent Future Pandemics
Ten science-based policy recommendations that can help prevent future zoonotic outbreaks:
- AWARENESS: Raise awareness and increase understanding (knowledge) of zoonotic and emerging disease risks and prevention (where appropriate), at all levels of society to build widespread support for risk-reduction strategies.
- GOVERNANCE: Increase investments in interdisciplinary approaches including the One Health perspective; strengthen the integration of environmental considerations in the World Health Organization (WHO)/Food and Agriculture Organization (FAO)/World Organization for Animal Health (OIE) Tripartite Collaboration.
- SCIENCE: Expand scientific enquiry into the complex social, economic and ecological dimensions of emerging diseases, including zoonoses, to assess risks and develop interventions at the interface of the environment, animal health and human health.
- FINANCE: Improve cost-benefit analyses of emerging diseases prevention interventions to include full cost accounting of societal impacts of disease (including the cost of unintended consequences of interventions) so as to optimize investments and reduce trade-offs. Ensure ongoing and well resourced preparedness and response mechanisms.
- MONITORING AND REGULATION: Develop effective means of monitoring and regulating practices associated with zoonotic disease, including food systems from farm to fork (particularly for removing structural drivers of emergence) and improving sanitary measures, taking into account the nutritional, cultural and socio-economic benefits of these food systems.
- INCENTIVES: Include health considerations in incentives for (sustainable) food systems, including wildlife source foods. Augment and incentivize management practices to control unsustainable agricultural practice, wildlife consumption and trade (including illegal activities). Develop alternatives for food security and livelihoods that do not rely on the destruction and unsustainable exploitation of habitats and biodiversity.
- BIOSECURITY AND CONTROL: Identify key drivers of emerging diseases in animal husbandry, both in industrialized agriculture (intensive husbandry systems) and smallholder production. Include proper accounting of biosecurity measures in production driven animal husbandry/livestock production to the overall cost of One Health. Incentivize proven and under-used animal husbandry management, biosecurity and zoonotic disease control measures for industrial and disadvantaged smallholder farmers and herders (e.g. through the removal of subsidies and perverse incentives of industrialized agriculture), and develop practices that strengthen the health, opportunity and sustainability of diverse smallholder systems.
- AGRICULTURE AND WILDLIFE HABITATS: Support integrated management of landscapes and seascapes that enhance sustainable co-existence of agriculture and wildlife, including through investment in agroecological methods of food production that mitigate waste and pollution while reducing risk of zoonotic disease transmission. Reduce further destruction and fragmentation of wildlife habitat by strengthening the implementation of existing commitments on habitat conservation and restoration, the maintenance of ecological connectivity, reduction of habitat loss, and incorporating biodiversity values in governmental and private sector decision-making and planning processes.
- CAPACITY BUILDING: Strengthen existing and build new capacities among health stakeholders in all countries to improve outcomes and to help them understand the human, animal and environment health dimensions of zoonotic and other diseases.
- OPERATIONALIZING THE ONE HEALTH APPROACH: Adequately mainstream and implement the One Health approach in land-use and sustainable development planning, implementation and monitoring, among other fields
Source: United Nations Environment Programme and International Livestock Research Institute (2020): Preventing the Next Pandemic: Zoonotic diseases and how to break the chain of transmission. Nairobi, Kenya.
Despite the ill fate of the One Health Act of 2016, the draft of a new Bill is expected to be introduced in the Senate in September by Senator Kirsten Gillibrand (D-NY). Named the One Health Security Act, the Bill aims to better integrate One Health Security including a strong link to our national biodefense mechanisms.
The One Health Security Act will endeavor to prevent, detect, and counter natural disease as well as accidental and deliberate threats to humans, animals, and the environment. The Bill calls for an integrated, unifying approach to sustainably balance and optimize the health of people, plants, animals, and ecosystems following a One Health model.
A key part of the Bill includes the creation of the One Health Security Council to advise the President directly on the integration of domestic, foreign, and military policies relating to One Health Security and to enable Federal agencies to cooperate more effectively. The One Health Security & Pandemic Preparedness Network will support global efforts to develop a prevention, early detection, and warning system for zoonotic and vector-borne disease.
A One Health Security Council would also make recommendations on allocations for new funding as well as activities that would be critical to improving our biodefense systems. The Deputy National Security Advisor would likely chair the Council along with up to three Vice Chairs.
Perhaps more importantly, the Bill establishes that the Council would be composed of the heads of—
- the Department of State
- the Department of Health and Human Services
- the Environmental Protection Agency
- the Department of Agriculture
- the Department of Commerce
- the Department of Defense
- the Department of the Treasury
- the Department of Homeland Security
- the Office of the Director of National Intelligence
- the National Science Foundation
- the Department of Energy
- the Federal Bureau of Investigation
- the Department of the Interior; and
- such other offices of the United States Government as the President may designate.
Now that’s getting the right people to the table.
Footnotes
- https://www.aphis.usda.gov/
- Borders, Veterinarians & Waltner-Toews, David & Gibson, Ruth. (2010). Veterinarians without Borders. One Health for One World: A Compendium of Case Studies.
- https://www.usaid.gov/
- Source Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES)
- Tripartite Zoonosis Guide, WHO 2019
- Beatty, C.R., Stevenson, M., Pacheco, P., Terrana, A., Folse, M., and Cody, A. 2022. The Vitality of Forests: Illustrating the Evidence Connecting Forests and Human Health. World Wildlife Fund, Washington, DC, United States.
- https://fao.org
- Beatty
- Gaviria A. My experience with One Health: between realism and optimism. One Health Implement Res 2021;1:14-6
- Zhang et al. Infectious Diseases of Poverty (2022) 11:57
- Zhang, XX., Liu, JS., Han, LF. et al. Towards a global One Health index: a potential assessment tool for One Health performance. Infect Dis Poverty 11, 57 (2022). https://doi.org/10.1186/s40249-022-00979-9
