A One Health Approach:- Need of the Hour
Sayan Bhattacharyya
Associate Professor, Microbiology, AIIH&PH, Kolkata
Abstract:- One health envisages the interconnectedness of human, animal and environmental well-being. Continuous human-animal clashes have ushered in new zoonoses, which need management by a concerted one health approach. Organizations need to get their act together and coordinate in order to build a safer and healthier world. These things have been discussed here.
Keywords:- Zoonoses, one health, emerging
Introduction:- The term One health was coined by Calvin Schwabe in his book, Veterinary Medicine and Human Health, in 1964. Prior to this, it was called ‘ One Medicine’. One health involves human health, animal health and environmental health, since all three are related intricately. The concept of One Health has firmly entered local and global political and professional narratives. The COVID-19 pandemic has opened up perspectives which allow a wider understanding of what health is. The complex interface of factors which decide health at many levels, from geosphere and biosphere to microbiological interactions, has acquired many formal names like planetary health, eco-health and others.
The intersections of human, animal and ecosystem health lie at the heart of these public and policy concerns involving one health, but these interactions are very poorly understood and little researched(1).
In the last few decades, increased man- animal conflict has led to emergence of new zoonoses like MERS- Coronavirus and COVID. Also, endemic zoonoses ljke Brucellosis and Q fever ae maintained by continuing man-animal conflict and impose a lot of burden on poor people(2).They can be managed well by a successfully carried-out One health approach.
Need and relevance of one health with respect to Public Health:-
- One health is also particularly important for the control of zoonoses like Rabies and Bird flu. Veterinary professionals, medical professionals and environmentalists need to work in tandem to mitigate the burden of zoonotic diseases. About 60 % of known infectious diseases and up to 75 % of new or emerging infectious diseases are zoonotic in origin and hence need a well-sorted One health policy for effective management.
- Antimicrobial-resistant microbes can quickly spread through communities, and enter the food supply. It can affect the healthcare facilities, and the environment , i.e. soil and water. This makes it harder to treat certain infections in animals and man. For managing this, one health may assume a very important role.
- Vector-borne diseases are also on the rise with warmer temperatures and expanded mosquito and tick habitats(3). One health becomes important in this context, too.
- Many newly emerged zoonoses have actually come into existence due to destruction of environment by man. Plasmodium knowlesimalaria is a good example of this.
- Also, environment plays a role in transmission and maintenance of infections. For instance, stepwells help in survival of cyclops that helps transmit Guineaworm ( Dracunculusmedinensis) infections. Water of ponds at foothills may be able to transmit Rhinosporidium seeberi infection ( Rhinosporidiosis) thast causes polypoidal lesions in mucosa of eyes and nose.
One health approach in managing outbreaks:-
In managing outbreaks, epidemics and pandemics, a one health approach is strongly advocated now. They are listed as under:-
- In bird flu outbreak, veterinarians and medical professionals work together in culling birds, monitoring acute respiratory infection in human contacts, advocating against consumption of egg and chicken in epicentre and safely burying the carcass. Burial pit should be covered with lime to prevent retrieval and consumption of dead birds by people. The carcass burial site should be fenced off and access of all people in that site should be restricted. An example of burial site is appended in Figure 1 below.
Fig. 1: Carcass burial site for bird flu. (source: authors)
- In managing Nipah virus outbreaks, putting a net on wells prevents contamination by fruit bats.
- Reducing vector breeding sites ( water collections) can help mitigate Dengue and malaria cases.
Table 1 below highlights some areas or infections where One health can be methodically applied to improve overall health outcomes.
Infection/condition | Agent | How one health policy can work |
Bird flu | H5N1 virus | Safe carcass disposal, safe culling of birds, monitoring ARI(acute respiratory infection) of man |
Brucellosis | B. abortus, B. melitensis | Mandatory pasteurization of milk and milk products, monitoring and detection of suspected cases |
Rabies | Rabies virus | Preventing and treating dog bites, managing population of stray dogs and dog vaccination |
Table 1:- Thrust areas where One health can be applied to improve overall health outcomes
One health can also help prevent and manage potential bioweapon or bioterrorism attack. Early detection, mitigation of effect, and the response will be enhanced by a One Health approach, It recognizes the link between human, animal, and plant health and the effect of biothreat on food supplies and the economy. Safe biomedical waste disposal will also go a long way in implementing one health and saving environment.
Newer techniques:-
- Remote sensing can be used to predict areas prone to deforestation and vector abundance, which can assist in putting in place the One health strategies.
- Artificial intelligence-driven algorithms can help detect and manage zoonoses better and faster. Artificial intelligence can also help in increasing data security for overall better management of one health and disseminating related information.
Steps that can be taken to implement and popularize One health can be as follows:-
- Formulating one health plans of action.
- Including one health in curricula and thematically including the topic in conferences..
- Promulgating intersectoral coordination between organizations. Institutes like the Indian Council of Medical Research (ICMR) and the Indian Council of Agricultural Research (ICAR) are collaborating for joint research priorities in One health(3)
Discussion:- One Health is an approach that recognizes the fact that the health of people is closely connected to the health of animals and it is , in fact, a shared environment. One Health is not a new concept, but has become more important in recent years(4). To address and emphasize the growing importance of one health, the Government of India has also launched One health mission. In today’s interconnected world, the health of man, animals, and the environment are intricately linked with each other. The concept of “One Health” tries to recognize this interdependence and hence strives for a holistic approach for addressing global health issues. One Health encompasses the understanding that the well-being of man, animals, and ecosystems are interconnected and that interventions must be collaborative, transdisciplinary, and multisectoral so as to effectively tackle complex health challenges(5). One Health approach needs coordinated efforts to promote the responsible usage of antibiotics in humans and animals. We also need enhanced surveillance and research on AMR. The excessive use of antibiotics in both clinical settings and agriculture leads to the selection and dissemination of drug-resistant pathogens, and this respects no geographical boundaries. In this regard, One Health serves as a unifying platform for healthcare professionals, veterinarians, researchers, policymakers, and environmentalists to collectively address AMR’s multifaceted nature. The One Health perspective has been adopted by the Quadripartite ( which is an alliance of four global organizations:- FAO, UNEP, WHO, and WOAH, set up in 2022) and urged a wide range of organizations to take action at all levels of governance(6). They are trying to address issues pertaining to one health, like prioritizing One Health in the international political agenda, increasing understanding and advocacy for the adoption and promotion of the enhanced intersectoral health governance for one health, strengthening national One Health policies, strategies and plans, and accelerate the implementation of One Health plans and strategies, and build intersectoral One Health workforces.
Conclusion:- One health should be stressed upon to manage emerging zoonoses. Separate sections and departments of one health need to be created to serve the purpose of one health.
References:-
1.https://royalsocietypublishing.org/doi/10.1098/rstb.2016.0162#:~:text=The%20concept%20of%20One%20Health,been%20successfully%20put%20into%20practice.
2.Cunningham AA, Scoones I, Wood JLN. One Health for a changing world: new perspectives from Africa. Philos Trans R Soc Lond B Biol Sci 2017 ;372(1725):20160162. Doi: 10.1098/rstb.2016.0162. PMID: 28584170; PMCID: PMC5468687.
- https://www.downtoearth.org.in/health/one-health-what-it-is-how-it-can-be-implemented-in-india-83673. Last accessed 06/8/24.
- About One Health. https://www.cdc.gov/one-health/about/index.html. Last accessed 06/8/24.
5.Danasekaran R. One Health: A Holistic Approach to Tackling Global Health Issues.
Indian J Community Med 2024; 49(2): 260-263 DOI: 10.4103/ijcm.ijcm_521_23.
- https://www.unep.org/news-and-stories/statements/quadripartite-call-action-one-health-safer-world#:~:text=The%20Quadripartite%20aims%20to%20achieve,for%20Animal%20Health%20(WOAH). Last accessed 06.8.24.