ONE HEALTH APPROACH: THE NEED OF THE HOUR
By-COL (Dr) ASHOK SINGH RATHOR
1 UK R&V, SQN, NCC, GBPUA &T, Pantnagar (U.S. Nagar), Pin- 263 145
Introduction:
People, animals and the environment – healthy together
The health of humans, animals and the environment is closely linked. In order to prevent new diseases and improve global health, correlations and dependencies must therefore be understood. This is what the One Health approach stands for. Infectious diseases are among the greatest threats to global health. Many of these diseases arise in the animal kingdom , and then jump over to humans. Increasing human intervention in animal habitats, global mobility and international trade flows promote the rapid spread of pathogens such as bacteria, viruses and parasites. In many cases, intensive livestock farming accelerates this process. Another challenge is that more and more pathogens worldwide are developing resistance to drugs. This means that drugs can no longer harm the pathogens. For example, numerous bacterial strains are already immune to several antibiotics and infections with them are therefore difficult to treat.
The One Health concept is not new but its importance to address the complex health and environmental challenges has become more prominent in recent years. This is because potential solution to these problems can only be understood when human, animal, and environmental health questions are evaluated in an integrated and holistic manner .An important aspect of such an integrated approach is the systematic collection of data on the occurrence of infectious diseases and related behaviours in both humans and animals. Improved collaboration, coordination and commitment of relevant sectors to minimise the impact of these diseases on human health is also a salient feature.
The Food and Agriculture Organization of the United Nations (FAO), the World Organization for Animal Health (OIE) and the World Health Organization (WHO), under their tripartite agreement and in collaboration with the United Nations Children’s Fund (UNICEF) and the World Bank, have developed a joint strategic framework to implement the One Health approach.
It has become increasingly clear over the past three decades that the majority of novel, emergent zoonotic infectious diseases originate in animals, especially wildlife, and that the principal drivers of their emergence are associated with human activities, including changes in ecosystems and land use, intensification of agriculture, urbanisation, and international travel and trade. A collaborative and multi-disciplinary approach, cutting across boundaries of animal, human, and environmental health, is needed to understand the ecology of each emerging zoonotic disease in order to undertake a risk assessment, and to develop plans for response and control.
The term ‘One Health’ was first used in 2003–2004, and was associated with the emergence of severe acute respiratory disease (SARS) in early 2003 and subsequently by the spread of highly pathogenic avian influenza H5N1, and by the series of strategic goals known as the ‘Manhattan Principles’ derived at a meeting of the Wildlife Conservation Society in 2004, which clearly recognised the link between human and animal health and the threats that diseases pose to food supplies and economies. These principles were a vital step in recognising the critical importance of collaborative, cross-disciplinary approaches for responding to emerging and resurging diseases, and in particular, for the inclusion of wildlife health as an essential component of global disease prevention, surveillance, control, and mitigation .There is a clear need for countries to have the capability and capacity to maintain an effective alert and response system to detect and quickly react to outbreaks of international concern, and to share information about such outbreaks rapidly and transparently. Responding to large multi-country outbreaks or pandemics requires global cooperation and global participation using the basic principles enshrined in One Health. The spread of influenza H5N1 and its prevention has been another excellent example of the importance of global cooperation. It also served as a catalyst for the United Nations Secretary General to appoint a UN Systems Coordinator for Avian and Animal Influenza (UNSIC), and to form a major collaboration with a number of international and national organizations, including the World Health Organization(WHO), Food and Agriculture Organization (FAO), World Organization for Animal Health (OIE),United Nations Children’s Fund (UNICEF), and World Bank and various national heath ministries, to develop the International Ministerial Conferences on Avian and Pandemic Influenza (IMCAPI). IMCAPI was a major driver in the surveillance and responses to influenza H5N1 and subsequently in the development of a strategic framework built around a One Health approach that focussed on diminishing the risk and minimizing the global impact of epidemics and pandemics due to emerging infectious diseases.
Concept –The One Health concept clearly focuses on consequences, responses, and actions at the animal–human–ecosystems interfaces, and especially emerging and endemic zoonosis, antimicrobial resistance (AMR), which can arise in humans, animals, or the environment, and may spread from one to the other, and from one country to another .However, the scope of One Health as envisaged by the international organizations (WHO, FAO, OIE, UNICEF), the World Bank, and many national organisations also clearly embraces other disciplines and domains, including environmental and ecosystem health, social sciences, ecology, wildlife, land use, and biodiversity. Interdisciplinary collaboration is at the heart of the One Health concept, but while the veterinarian community has embraced the One Health concept, the medical community has been much slower to fully engage,
Importance
It helps to reduce potential threats at the human-animal-environment interface to control diseases that spread between animals and humans
- Tackle anti-microbial resistance (AMR)
- Ensure food safety
- Prevent environment-related health threats to humans and animals
- Protect biodiversity
Strategy-
A multi-disciplinary Road Map to Combat Zoonosis (2008) was laid to create an integrated mechanism for surveillance, detection and treatment of zoonosis. It identified several strategies for research and actions, but an integrated surveillance, involving human, domestic and wildlife for long-term monitoring on a large scale have failed to materialise. As a result, the burden and dynamics of emerging and re-emerging infectious diseases is yet to be understood.
- The implementation of One Health can be driven by policies (legislations and regulations, financing), knowledge sharing, institutional collaboration, joint programmes and operational plans, advocacy and awareness amongst policy makers and professionals, engagement of civil society and active community
- In India, efforts have been made to bring human and animal health together. There have been instances of collaboration at national and state levels to combat specific diseases or to overcome disease outbreaks such as the national influenza pandemic committee to control avian influenza, rabies in the Tamil Nadu and other
- Institutes like the Indian Council of Medical Research (ICMR) and the Indian Council of Agricultural Research (ICAR) have collaborated for joint research priorities, mostly to control disease outbreaks and also at individual levels between human and animal health researchers as well as practitioners.
- The Integrated Disease Surveillance Project, launched in 2004 for disease outbreak detection and rapid response functions, has generated several information on flow of certain disease outbreaks but the programme has been unable to integrate human and animal (livestock and wildlife) surveillance.
The National Mission on Biodiversity and Human Well-being built on a framework that integrates biodiversity, ecosystem services, climate change, agriculture, health, bio- economy and capacity-building in the realm of biodiversity science has one mission component that explicitly links biodiversity to human health through the One Health approach.
The Government of India decided to set up a dedicated centre under ICMR to contain zoonotic diseases — the Centre for One Health at Nagpur, and also constituted a ‘National Expert Group on One Health’ to promote multi-sectorial, Trans disciplinary, collaboration and co-operation to adopt and implement a One Health framework in India.
In the past, India has combatted several zoonotic diseases and has a robust institutional network for biomedical research, which can lead and operationalize the One Health approach. For One Health science, it is important to develop databases and models with a consolidated approach of ecologists, field biologists, epidemiologists and other scientists. The Kyasanur Forest Disease Model is one such example.
Also, the core strategies put forward by the National Framework for One Health, 2021 by FAO can guide towards overcoming the systemic barriers to implement the One Health approach.Therefore, a nexus of science, social science, indigenous knowledge and policy at national, state and local levels can put forward strategies and institutions for implementation of One Health.
Recent emergence of infectious diseases-
The corona pandemic has shown, how closely our health is linked to that of our environment and how the relationship between humans, animals and the environment has become unbalanced.
Living in harmony with nature is what everyone desires, and yet today it remains (mostly) an idealistic dream. Our behaviour harms nature. Increasingly, we are exceeding the limits of the Earth’s resilience. This is manifested by species extinction, climate crisis and most recently the corona pandemic, triggered by a virus transmitted from animals to humans, a so-called zoonosis. These develop especially when animals live in unnatural conditions and come into contact with humans. An obvious example of this is factory farming. A very large number of animals are confined to very little space in non-species-appropriate stables, which weakens their immune system. At the same time, the animals or their excretions come into contact with humans. Such living conditions for animals and working conditions for humans favour the development of zoonosis.
How do we find our way back to a balanced relationship?
One Health starts exactly at this point and calls for the complex synergies between humans, animals and the environment to be taken into account in our actions. One Health is an approach that looks at the overall health of the ecosystem and does not necessarily focus on people, but can ultimately improve human health. For example, projects aimed at protecting forests can simultaneously preserve the forest as a habitat for wildlife and include the land rights of indigenous populations.
Many rural populations and indigenous groups have been living by the idea of One Health for a long time. The approach is closely linked to agro ecology, which makes agricultural ecosystems more resilient, including through diversity in cultivation. Agro ecology is based on local and traditional knowledge and represents an alternative to conventional, industrialized agriculture. By implementing agro ecological principles, the income and health situation of small holder family farms can be improved in the long term. This type of agriculture also has a positive effect on nature, as it contributes to improved soil quality and biodiversity. Properly implemented, agro ecology can also sequester carbon back into the soil.
As a result, One Health has a strong human rights dimension. If we want to reconcile humans, animals and the environment, we must allow each other to coexist peacefully, to preserve creation together.
Challenges-
However, the implementation of the One Health approach so far falls short and focuses almost exclusively on zoonosis and the prevention of pandemics. As a result, there is a risk that One Health will become an empty phrase, similar to the inflationary use of the term sustainability. One Health is so much more than crisis management! And only a consistent implementation of the One Health approach can have an effect to prevent pandemics.
The fact is that the knowledge and solutions for the complex problems are known but political will to implement it is lacking. That is why One Health must be implemented as the holistic approach in order to help people, animals and the environment to harmonize. Experts from many fields work closely together – from human and veterinary medicine, environmental and agricultural sciences to food technology and public health services. Together, they must look for ways to maintain and improve the health of people, animals and their ecosystems. This also means that health research must take greater account of the One Health approach.
The corona pandemic and the presumed origin of SARS-CoV-2 from an animal host have shown us how closely linked human and animal health is. Research and development in international cooperation plays a central role in coping with pandemics, combating antimicrobial resistance and dealing with infectious diseases. These challenges cannot be solved by individual countries alone. The need to act in the sense of the One Health approach therefore has to be a high political priority internationally at several levels, including at the UN/WHO, the European Union,
Conclusion-
Close contacts between humans and animals, as well as industrial animal husbandry; increase the risk of new zoonosis being created. The situation is critical in view of a growing world population, the advance of humans into untouched habitats and industrial agriculture. Climate change, global mobility, biodiversity loss and, last but not least, antimicrobial resistance also promote the spread of pathogens. Our health is closely linked to the health of our environment. Health protection is a complex task in which, in addition to human medicine, veterinary medicine and environmental sciences must also work together in an interdisciplinary manner. This is where the holistic One Health approach comes in, with the aim of preventing diseases and preserving health while taking into account the inter relationships between humans, animals and the environment.
For prevention to succeed in the sense of the One Health approach, one thing is needed above all: cooperation across the boundaries of the disciplines. Human and veterinary health, environment, economics and social sciences belong together. Such a coordinated approach requires significant investment in preventive measures. In order to successfully implement the One Health approach, the involvement of the private sector and politics is needed in addition to various branches of science. Continuous dialogue, transparent project communication and a mindful, culturally and gender-sensitive approach are fundamental in every One Health project. The veterinary community is saying that the introduction of One Health is particularly powerful? “Calvin Schwabe, who first referred to One Health as ‘one medicine,’ was also a veterinary epidemiologist.
