ONE HEALTH APPROACH: THE NEED OF THE HOUR

   ONE HEALTH APPROACH: THE NEED OF THE HOUR

DR ANJU POONIA

 anjupooniavas@gmail.com

LALA LAJPAT RAI UNIVERSITY OF VETERINARY AND ANIMAL SCIENCES, HISAR (HARYANA) – 125 004

“Without livestock sustainability, economic stability and social cohesion cannot be achieved”- Phil Harding

In developing countries, demand for animal products is predicted to rise by around 70% in the next 30 years, owing to population and economic growth. In comparison to land, livestock wealth is more evenly distributed, and the growing demand for animal food products creates enormous opportunities for the poor to overcome poverty through diversifying and intensifying livestock production. The livestock sector helps in resolving these issues by fostering sustained economic growth, social inclusion and efficient natural resource management. Animal health and welfare can be improved by minimizing the economic impact of animal diseases, improving food safety and reducing the possibility of antibiotic resistance. Thus, the livestock industry must invest in veterinary services and animal disease surveillance. Zoonotic diseases can be controlled by preventing animal diseases thus emphasizing on “One Health” concept, which aims to enhance human, animal, and world health, includes better livestock management (Garcia et al., 2019).

Although the term “One Health” is relatively new, the idea has long been understood on a national and international level. Animal and human illness processes are comparable, according to scientists, but until the 20th century, human and animal medicine were treated differently. One of the most famous doctors of the 19th century was Rudolf Virchow, MD. German pathologist Dr. Virchow became intrigued by the connections between veterinary and human medicine while researching the roundworm Trichinella spiralis in pigs. He came up with the term “zoonosis” to describe an infectious disease that is spread from animals to people. He insisted that there should be no distinction between human and animal medicine. The object is different but the experience obtained constitutes the basis of all medicine.” The term ‘One Health’ was first used in 2003–2004, and was brought on by the development of severe acute respiratory syndrome (SARS) in early 2003, followed by the spread of highly pathogenic avian influenza H5N1, as well as by a set of strategic objectives known as the “Manhattan Principles,” which were developed at a meeting of the Wildlife Conservation Society in 2004. These principles recognised the connection between human and animal health and the dangers that illnesses represent to food supply and economies. These principles were a crucial first step in recognising the critical significance of collaborative, cross-disciplinary approaches for combating emerging and resurgent diseases, and in particular, for the inclusion of wildlife health as a crucial component of global disease prevention, surveillance, control, and mitigation (Parkes et al., 2020). Over the course of his career, Calvin Schwabe made numerous significant contributions to veterinary epidemiology. In his articles, Dr. Schwabe made it clear that he was in favour of One Health. He suggested that veterinary and human health experts work together to fight zoonotic infections in the 1964 edition of his monograph. Dr. Schwabe first used the term “One Medicine” in his textbook, Veterinary Medicine and Human Health. The phrase highlights the parallels between veterinary and human care as well as the necessity of working together to successfully treat, prevent, and manage illnesses that affect both humans and animals.

The World Health Organization defines One Health as “an approach to designing and implementing programmes, policies, legislation and research in which multiple sectors communicate and work together to achieve better public health outcomes”. ‘One Health’ is an integrated, unifying approach to balance and optimize the health of people, animals and the environment. It is particularly important to prevent, predict, detect and respond to global health threats such as the COVID-19 pandemic.

According to Mackenzie et al. (2014), the SARS outbreak—the first serious and easily spreadable novel disease to appear in the twenty-first century—led to the realisation that (a) a pathogen that had not yet been discovered could appear from a wildlife source at any time and in any location and, without warning, threaten the health, well-being, and economies of all societies; (b) there was a clear need for countries to have the capability and capacity to maintain an effective alert and response; and (c) responding to large multi-country outbreaks or pandemics requires global cooperation and global participation using the basic principles enshrined in One Health. The emergence and spread of influenza H5N1 has been another excellent example of the importance of global cooperation and the widespread worry that it could become the next influenza pandemic strain led to a One Health approach. As a result, the World Health Organization (WHO), Food and Agriculture Organization (FAO), World Organization for Animal Health (OIE), United Nations Children’s Fund (UNICEF), World Bank, and numerous national health ministries formed a significant collaboration to develop the UN Systems Coordinator for Avian and Animal Influenza (UNSIC) (IMCAPI). IMCAPI played a significant role in influenza H5N1 surveillance and response (Singer, 2011) 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 ( Singer, 1995).

In accordance with Khan et al. (2018) One Health is also prominent in several global commitments and political declarations such as the Sustainable Development Goals, the International Health Regulations, the Global Health Security Agenda, the UN Paris Agreement on climate change, and the UN Political Declaration on Antimicrobial Resistance.  The three pillars of One Health are human health, animal health, and environmental health. However, the environment is frequently overlooked, as is clear from its lack or brief mention in the majority of the programmes cited. This disregard for the environment was a crucial conclusion of Mishal Khan and colleagues’ systematic research of One Health Networks (OHNs), which was published in The Lancet Planetary Health.

According to Cleaveland et al. (2016), government representatives, academics, and employees from various industries should coordinate their efforts to address health hazards at the local, national, regional, and international levels. This entails creating shared databases and surveillance systems across many industries as well as coming up with fresh approaches that deal with the underlying issues and connections between risks and impacts. In order to enhance early detection and containment of disease threats and to promote risk-reducing behaviours and attitudes, community engagement is also essential. Understanding the illness and halting its spread are made possible by the social sciences. Using COVID-19 as an example once more, it is clear how social awareness, other people’s support, and self-isolation can help people lessen the effects of pandemics. The recognition of November 3rd as One Health Day is one recent move that may aid in raising global awareness of the One Health concept, particularly among students but also more widely. One Health Day is observed by holding educational and awareness-raising activities all across the world. It is especially encouraged for students to develop One Health projects, put them into action, and submit them to an annual competition for the top student-led projects in each of the four global areas.

To coordinate efforts on human, animal, and environmental health across the Organization, WHO established the One Health Initiative. In addition, as part of the One Health Quadripartite, WHO collaborates with the Food and Agriculture Organization of the United Nations (FAO), the United Nations Environment Programme (UNEP), and the World Organisation for Animal Health (WOAH). The Quadripartite is supporting multi-sectoral strategies to lessen health risks at the interface between humans, animals, and ecosystems. The Quadripartite One Health Joint Plan of Action outlines the changes needed to avoid and lessen the effects of existing and future health concerns at the global, regional, and national levels (OH-JPA). To provide one health-related advice to FAO, UNEP, WHO, and WOAH, the One Health High-Level Expert Panel (OHHLEP) was formed in May 2021. In order to prevent the spread of diseases such the H5N1 avian influenza, MERS, COVID-19, Ebola, and Zika, it is suggested that research be done on the hazards posed by emerging diseases.

The panel will also look into how disease dangers are influenced by human activity’s effects on the environment and wildlife habitats. Health issues such as zoonotic infections, antibiotic resistance, food safety and security, vector-borne diseases, environmental contamination, and other health risks have an impact on people, animals, and the environment. According to Boqvist et al. (2018), critical areas include food production and distribution, urbanisation and infrastructure development, international travel and trade, activities that contribute to biodiversity loss and climate change, as well as those that put more strain on the natural resource base and can all result in the emergence of zoonotic diseases. Three components provide a stable framework for One Health:

Scientists may monitor the behaviour and mutations of microbiological strains of bacteria that have an impact on both human and animal health as well as create fresh approaches to disease prevention. Over the past three decades, it has become increasingly evident that the majority of novel, emerging zoonotic infectious diseases originate in animals, especially wildlife, and that human activities, such as changes to ecosystems and land use, intensification of agriculture, urbanisation, and international travel and trade, are the main drivers of their emergence (Khan et al., 2018; Mackenzie et al., 2014). Studies of interactions between people and animals, particularly wild animals, help scientists foresee potential risks to biodiversity or the introduction of new viruses. Understanding the ecology of each emerging zoonotic disease is essential for conducting risk assessments, developing plans for response and control, and working across boundaries of animal, human, and environmental health (Jones et al., 2013).

Observations of ecosystem health provide early signs of potential dangers to human and animal health. This also gives people a chance to conserve the biodiversity of ecosystems, which is required for mutual survival between animals and humans (Osterhaus et al., 2020). In accordance with findings of Parkes et al. (2020) it was found that the environment is the most dynamic and, as a result, the most perplexing sector of the One Health triad. Since it affects all three areas, antibiotic resistance has been called the “quintessential One Health issue.” However, there is a lack of knowledge regarding the relative contributions made by the three sectors to the emergence, spread, and durability of antibiotic resistance. Hoelzer et al. (2017) stated that the selection pressure from justified and indiscriminate antibiotic usage in human and animal health as well as antibiotic exposure in the environment leads directly to antibiotic resistance. Antibiotic resistance genes can get entrenched in bacteria when antibiotics are used at sub-therapeutic levels over extended periods of time in animal production systems. These genes are then passed from humans, tainted food, or the environment to human diseases or commensals. There is rising evidence that links antibiotic intake in cattle to antibiotic resistance in the clinic. Antibiotics used in humans and animals typically have analogues of one another, which may contribute to the transmission of resistance between humans and animals. Ceric et al. (2019) stated that in the environment, the impact of antibiotic resistance is least clearly understood. Environmental bacteria, which are the most common bacteria in terms of quantity, serves as a reservoir for resistance genes that can eventually be absorbed into human and animal infections. The input of resistance genes from livestock and human waste into the environment increases these reservoirs of resistance genes. They are made worse by the introduction of antibiotic residues from pharmaceutical companies, intensive animal husbandry, and hospitals. These residues alter the soil and water microflora and also act as a selection pressure for the emergence of resistance. The environment is subject to erratic weather patterns, particularly shifts in temperature, humidity, and precipitation that have an impact on bacterial ecosystems (not the least of which is due to climate change). As a result, the environment is a shaky component of the One Health antibiotic resistance triad.

As per findings of One Health Initiative Task Force, American Veterinary Association (2008) climate change and its detrimental impacts on the health of people, animals, and the ecosystem are what have given environmental issues the most attention. By causing changes in the lifecycles of pathogens, vectors, and reservoirs as well as new and emerging diseases of food-producing plants as well as domestic and wild animals, trophic cascades, interfering with the synchrony between interacting species in a given habitat, and modifying or destroying habitats, climate change endangers the ecological and environmental integrity of living systems. Singer et al. (2011) termed it as the “threat multiplier” in that it adversely affects infectious diseases, zoonosis, food security, food safety, and local, regional, and global responses to them. Callicott (1989) stated that the environmental sector may become more integrated into the One Health triad if it is aligned with climate change. One Health must be approached from a systems perspective due to the interconnectedness of human, animal, and environmental health. This method recognises that complex molecular, biological, ecological, economic, social, policy, and political systems play a role in the occurrence of both health and sickness. In terms of their dynamic relationships, feedback loops, interactions, and dependencies, the method focuses on understanding how systems function, both individually and collectively. Countries can contribute vital information about the state of the environment and the issues that need to be prioritised for people to protect the health of all species by taking part in the One Health Initiative. Diseases are more likely to spread as humans and animals become more connected, therefore international collaboration is essential to maintaining healthy populations (Osterhaus et al., 2020). An example of this would be COVID-19 and its studies that will help in the prevention of further corona viruses emergence. The One Health Institute, CA, currently works on compiling an open source FAQ with thorough information on the topic provided by many countries and organizations that aim to raise pandemic preparedness.

Although plant health is currently part of the definition of One Health, plants have typically not been well integrated into discussions of One Health approaches (Destoumieux, 2018; Fletcher et al., 2009). Nevertheless, maintaining plant health is essential for maintaining human and animal health and is a crucial part of the intricate connections between the environment, people, and animals. The United Nations designated 2020 as the International Year of Plant Health in recognition of the significant contribution plants provide to human health (IYPH). The main goal of the IYPH was to increase public knowledge of plant health issues and their impacts on society. Maintaining plant health is crucial for food security and safety, livelihood in plant-based agriculture, pharmaceutical production, and the creation of healthy ecosystems, all of which have a significant impact on human and animal health (Boa et al., 2015; Scholthof, 2003; Strange and Scott, 2005). Plants provide over 80% of the food consumed by humans and are the primary source of nutrition for livestock. Food security—the state of having reliable access to sufficient, safe, affordable, and nutritious food at all times—is necessary to have healthy and productive societies (Savary et al., 2019). Food security is also a crucial aspect of One Health and is a pillar of the United Nations Sustainable Development Goals (SDGs) (Choffness et al., 2012). As per the reports of World summit on Food Security, FAO (2009) According to the UN definition, there are four main pillars of food security: availability, access (both economically and culturally), use, including food preparation and safety, and stability of these three pillars. As a result, food security represents a complicated value chain of food production, distribution, and access, starting with plant health in the field. Public health will be improved and protected by using a One Health strategy to guarantee the security and continuity of this value chain. Plant diseases and pests affect the availability and safety of plants for consumption by humans and animals, as well as crop productivity and quality (Savary et al., 2017; Strange and Scott, 2005). Application of pesticides as part of disease prevention or treatment strategies has the potential to have a negative influence on agricultural workers’ and consumers’ health as well as promote the emergence of infections resistant to antimicrobials and antifungals (Fisher et al., 2018; Ramakrishnan et al., 2019).

As per estimates of the Global Burden of Foodborne Diseases, WHO (2015) food plants may serve as carriers of human pathogens and harmful microbial-based toxins. For example, foodborne illnesses pose a serious global burden on human health, reportedly affecting 600 million people or 33 million Disability Adjusted Life Years (DALYs) in a single year. Although international food standards, such as the Codex Alimentarius, are implemented to protect consumers’ health and fair trade, foodborne illnesses continue to affect high-, middle-, and low-income countries around the world. In accordance with Painter et al. (2013) plants are important origins of foodborne outbreaks, including fresh vegetables and fruits irrigated with, washed with, or exposed to water and soil contaminated with pathogens of animal or human origin. Over a ten-year period, plant-based foods were linked to more outbreak-associated illnesses in the US (51%), more than any other dietary item, including meat, fish, and dairy products. Fresh produce can also be contaminated by bacteria resistant to antibiotics and genes for resistance that come from animal faeces, both of which pose health risks for people. Therefore, early and efficient control of plant diseases, pests, and other microorganisms associated with plants is essential for ensuring food security since these organisms frequently disproportionately affect the most vulnerable and health-disparate populations locally and internationally. Global population health, productivity, and prosperity are all threatened by threats to plant health. In addition to boosting food security and safety to ensure healthy lives, efforts to protect plants against new and endemic pathogens and pests also support efforts to reduce poverty, advance equity, address the effects of climate change, safeguard the environment, foster economic development, and fortify international alliances. Promoting a secure, sustainable, and nourishing diet for families around the world will be made possible by forging a far stronger alliance between One Health proponents, including sustainable agricultural specialists, and public health professionals.

Rabinowitz et al. (2017) stated that 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. The One Health model places interdisciplinary collaboration at its core, but despite backing from organisations like the American Medical Association, Public Health England, and WHO, the medical community has been far slower to fully integrate. The One Health idea may need to be incorporated into the curricula of medical schools so that medical students perceive it as a crucial component in the context of public health and infectious diseases in order to engage the medical community more completely in the future.

As per Osterhaus et al. (2020) if today’s health issues are solely approached from a medical, veterinary, or ecological point of view, it is unlikely that effective mitigation strategies will be developed. Today’s health issues are frequently complex, transboundary, multifactorial, and cross-species. A revolutionary approach to enhancing health is called One Health. It creatively questions long-held presumptions about happiness and is now regarded as the “best solution” for reducing human health issues, including pandemic zoonotic diseases. Without major changes to the status quo, there will be a lot of suffering and ill health, so One Health’s success is crucial. One Health is not radical enough, though, even in its more ambitious guises. For example, it has not embraced the emerging philosophical view that historical anthropocentrism is an unfounded ethical prejudice against other animals. It must expand the circle of moral concern beyond a narrow focus on human interests to include nonhuman beings and the environment. On this bolder agenda, progressive ethical and practical thinking converge for the benefit of the planet and its diverse inhabitants—human and nonhuman.

Successful public health interventions require the cooperation of human, animal, and environmental health partners. Professionals in human health (doctors, nurses, public health practitioners, epidemiologists), animal health (veterinarians, paraprofessionals, agricultural workers), environment (ecologists, wildlife experts), and other areas of expertise need to communicate, collaborate on, and coordinate activities. Other relevant players in a One Health approach could include law enforcement, policymakers, agriculture, communities, and even pet owners. No one person, organization, or sector can address issues at the animal-human-environment interface alone. By promoting collaboration across all sectors, a One Health approach can achieve the best health outcomes for people, animals, and plants in a shared environment.

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