One Health - a concept considered as the fundamental basis for society's health problems

One Health concept, a tool for policy makers

Currently, our planet is facing challenges that impact directly or indirectly health such as diet shifts, an increased contact between humans and animals, and climate change (Mwangi, 2016). According to the United Nations, multidisciplinary and intersectoral measures are essential to achieving the 2030 Agenda for Sustainable Development Goals (United Nation, 2020). Therefore, in 2008 the WHO, the WHOA, and FAO launched the One Health initiative to demonstrate the connection between human, animal, and environmental health (WHO, 2019). However, few public health policies include all pillars of the One Health approach and little importance is given to the institutional, political, and social factors associated with their implementation in a One Health approach (Woods, 2014).

A recent article (de Macedo Couto, 2020) reviewed the One Health concept, an essential knowledge tool for public health policymakers who seek strategies for more efficient public administration and better governance.

Environment and health : direct impacts and connections

Ecologically balanced environments impact the quality of life, wellbeing, and health of the population (Lafferty, 2009). While zoonoses are generally endemic and occur in natural areas, changes in the ecosystem and in weather and climate conditions can lead to epidemics, especially of vector-borne diseases (Campbell-Lendru, 2015). Moreover, the interference of human with natural areas leads to changes in the biodiversity and density of pathogen hosts (Hassell, 2017). Protecting these areas could therefore be a strategy for health promotion to prevent the evolution and adaptation of pathogens considered as a growing concern by policy makers who support a broader, integrated, and holistic health approach (Jones, 2008).

Other studies have showed the benefits of the presence of green and natural spaces in promoting human health such as reducing stress, noise, air pollution and excessive heat and improve immune system but also in encouraging physical activity (James, 2015; Li, 2008; Kaczyncki, 2007). In contrast, significant exposure to environmental carcinogens in urban areas was linked with little green space, which may be associated with new cancer cases (Ribeiro, 2018).

Our dietary patterns shift impacts human health as well as the environment health

Food choices link environmental sustainability to human health. Indeed, human diets are changing across the world due to incomes rising and urbanization. This global dietary transition is represented by a shift from traditional diets to patterns with potential impacts for the environment as well as public health by increasing the global incidence of non-communicable diseases, causing significant global impacts of greenhouse gas emissions, and contributing to deforestation. Alternative dietary choices with substantial health benefits could, if widely adopted, reduce global greenhouse gas emissions related to agriculture, reduce land clearing and resultant species extinctions, and help prevent non-communicable diseases. Implementing food strategies to address the interrelated issue of “Food-Environment-Health” is therefore a global challenge (Tilman, 2014).

Moreover, land use planning can mitigate some of the effects of agricultural expansion by preserving remaining natural areas and existing biodiversity and protecting surface water. New technologies and policies developed for ecologically sustainable agriculture could also minimise impacts and will allow sufficient supply and equitable food distribution (Tilman, 2001).

Putting science, trans-disciplinarity and joint action at the hearth of policy development and implementation

Faced with the challenges of our society and the objectives of sustainable development, there has been a growing awareness of the need to involve transdisciplinary teams in solving complex problems, leading to the One Health concept for policy development and implementation. The keys to this holistic approach: setting up links and joint actions between the human health, animal, and environmental sectors, and involving different actors and institutions (public and private). The response in one sector must incorporate impact assessment and mitigate adverse effects on downstream sectors, reducing redundancy, and the duplication of policy guidelines (Chatterjee, 2016).

The role of science is unavoidable and crucial to formulate One Health policies, as they should be based on scientific studies. Once the scientific community endorses the idea that animal and ecosystem health are umbilically linked to human health, the approach of national public health policies should follow accordingly. Such transdisciplinary approaches can be used both to improve the effectiveness of existing systems and to develop new networks for collective action (Zinsstag, 2015). Science can identify solutions to public health problems, but only policy can deliver most of these solutions into reality (Greer, 2017)

Figure 1- Pillars of One Health to formulate public health policies (Adapted from: de Macedo Couto R, 2020).

Four recommendations of practical steps to use widely the One Health approach

In order to have a One Health approach, the review suggests some practical steps to use widely the One Health approach as a tool for public health policymakers and practitioners:

1- Include curriculum guidelines based on One Health and sustainable development perspectives in different human resources training courses
2– Ensure a solid legal framework that legitimizes public health practices based on the One Health perspective
3– Create research networks to support the implementation of One Health-based public policies
4– Set up working groups between the government, private sector, and civil society to engage intersectoral dialogue and hence identify public health issues within the One Health perspective.

Key messages
  • Most health-related problems involve the same complex: human, animals and the environment. Therefore, government decision-making should be based on the pillars of the One Health concept.
  • The holistic view of health, combining efforts from public, private, and research agencies, will eliminate the existing organizational culture of fragmentation between sectors and political actors, which represents an obstacle to the implementation of integrated and intersectoral policies.
  • This will help ensuring a more efficient public administration and better governance.

Based on: de Macedo Couto R, Brandespim DF (2020) A review of the One Health concept and its application as a tool for policy-makers. Int. J. One Health, 6(1): 83-89.

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