ONE HEALTH APPROACH : THE NEED OF THE HOUR
Dr. M.Nithya Quintoil*
*Assistant Professor, Department of Veterinary Public Health and Epidemiology, Rajiv Gandhi Institute of Veterinary Education and Research, Puducherry-9
Introduction:
One Health is a collaborative, multisectoral, and transdisciplinary approach which works at local, regional, national, and global levels with the goal of achieving optimal health outcomes recognizing the interconnection between people, animals, plants, and their shared environment. The concept of OH is as old as human culture (Veterinarians Without Borders 2010). Over 2,500 years ago Hippocrates urged physicians that all aspects of their patients including their environment. However, the concept has been more commonly associated with physician Rudolf Virchow,who acknowledged the similarities between human and animal medicine, and who first used the term ‘zoonosis’ for infections acquired from animals. In the mid-1960s, the eminent American veterinary epidemiologist, Calvin Schwabe, also recognized that the health of humans, animals and ecosystems are interconnected, which he referred to as “One Medicine” in his textbook “Veterinary Medicine and Human Health” (Schwabe 1984).
They events that led to the development of and defining of the OH paradigm have been listed in Table 1. The current momentum associated with the OH concept during the past decadewas driven initially by a series of strategic goals, know n as the ‘Manhattan Principles’ which were derived during a ‘One World, One Health™’ meeting ofthe Wildlife Conservation Society entitled Building Interdisciplinary Bridges toHealth in a “Globalized World” held in September 2004 in New York (WildlifeConservation Society 2004). These goals, developed for combating threats to lifeon Earth, clearly recognized the link between human health and animal health, and the threats that diseases pose to food supplies and economies, and called for the milestones.
The present momentum gained in the OH concept was driven by a series of strategic goals, known as the ‘Manhattan Principles’ which were derived during a ‘One World, One Health™’ meeting of the Wildlife Conservation Society entitled Building Interdisciplinary Bridges to Health in a “Globalized World” held in September 2004 in New York (Wildlife Conservation Society 2004). These goals, developed for combating threats to life on Earth by recognizing the link between human and animal health, and the threats food supplies and economies, and called for the inclusion of wildlife health as an essential component of global disease prevention, surveillance, monitoring, control and mitigation.
Figure.1 One Health Umbrella
One Health Concept
The One Health concept clearly focusses on consequences, responses, and actions at the animal–human–ecosystems interfaces, and especially on emerging zoonoses and endemic zoonoses which is responsible for a much greater burden of disease in the developing world, with a major societal impact in resource-poor settings, antimicrobial resistance (AMR), as resistance can arise in humans, animals, or the environment, and may spread from one country to another and food safety. However, the scope of One Health as envisaged by the international organizations like WHO, FAO, OIE, UNICEF, the World Bank and any national organisations also clearly embraces other disciplines 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 than any other sector. Engaging the medical community more fully in the future may require the incorporation of the One Health concept into the medical school curricula so that medical students can understand it an essential component in the context of public health and infectious diseases .
Table 1: One Health Timeline
| TIME | EVENTS |
| 460BC-370 BC | Hippocrates recognized the link between human health and the environment. |
| 1768 | Smallpox immunity from cowpox Dr. John Fewster variolating farmers and found that some were immune to small pox |
| 1947 | James H. Steele, founded the Veterinary Public Health Division at CDC.
Division played an important role in the public health response to diseases such as rabies, brucellosis, salmonellosis, Q fever, bovine tuberculosis, and leptospirosis |
| 1971 | An international group,wildlife Trust,formed by naturalist Gerald Durrel.
The wildlife trust is now known as Ecohealth Alliance. |
| 1984 | Calvin Schwabe, veterinary epidemiologist coined the term One Medicine. |
| 2007 | The American Medical Association Passes the One Health Resolution Promoting pandemic preparedness and human security Partnership Between Human and Veterinary Medical professions |
| 2008 | FAO, OIE, and WHO Collaborate with UNICEF, UNSIC, and the World Bank to develop a Joint Strategic Framework in Response to the Evolving Risk of Emerging and Re-emerging Infectious Diseases |
| 2009 | The One Health Office is Established at CDC.
The One Health Commission (OHC), a non-profit organization that is the collaboration between the AMVA and the AMA, is officially chartered |
| 2010 | The United Nations and the World Bank Recommend Adoption of One Health Approaches. And released the “Fifth Global Progress Report on Animal and Pandemic Influenza |
| 2011 | The High Level Technical Meeting to Address Health Risks at the Human-Animal-Ecosystem Interface Builds Political Will for The One Health Movement.The First International One Health Congress is Held in Melbourne, Australia. |
| 2012 | The Global Risk Forum sponsors the first One Health Summit. The Summit presented the One Health concept as a way to manage health threats, focusing on food safety and security |
| 2013 | The second International One Health Congress was held in conjunction with the Prince Mahidol Award Conference |
| 2015 | The OHC pens a letter to President Barack Obama, requesting that One Health platforms be chartered at federal and state levels in the US, and in the United Nations |
| 2016 | Senator Al Franken of the Senate Health Committee introduces the National One Health Act of 2016, which calls for a “national, interagency One Health Program |
| 2017 | A feature page for One Health was included on the WHO website, defining One Health and highlighting important topic areas such as food safety, zoonotic disease, and antimicrobial resistance |
| 2019 | The FAO works closely with the OIE and WHO, referred to all together as the Tripartite organizations, and published a new guide to approaching zoonotic disease with a One Health framework |
| 21st c. | One health” in the 21st century – Disease outbreaks including avian influenza have triggered the realization that animal health profoundly impacts human health |
One Health Definitions/ Basics
The Definition for One Health was developed in 2021 by the One Health High Level Expert Panel, an advisory panel to the One Health (now) Quadripartite made up of the FAO, WHO, WOAH, and UNEP
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 changes and contributing to sustainable development. (A)
There are a few areas that urgently need the One Health approach, at all levels of the sectors like academia, government, industry, policy and research, because of the inextricable interconnectedness of animal, environmental, human, plant and planet health.
- Agricultural production and land use
- Animals as Sentinels for Environmental agent and contaminants detection and response
- Antimicrobial resistance mitigation
- Biodiversity / Conservation Medicine
- Climate change and impacts of climate on health of animals, ecosystems, and humans
- Clinical medicine needs for interrelationship between the health professions
- Communications and outreach
- Comparative Medicine: commonality of diseases among people and animals such as cancer, obesity, and diabetes
- Disaster preparedness and response
- Disease surveillance, prevention and response, both infectious (zoonotic) and chronic / non-communicable diseases
- Economics / Complex Systems, Civil Society
- Environmental Health
- Food Safety and Security
- Global trade, commerce and security
- Human – Animal bond
- Natural Resources Conservation
- Occupational Health Risks
- Plant / Soil health
- Professional education and training of the Next Generation of One Health professionals
- Public policy and regulation
- Research, both basic and translational
- Vector-Borne Diseases
- Water Safety and Security
- Welfare / Well-being of animals, humans, ecosystems and planet
Common One Health Issues
The common One Health issues include zoonotic diseases, antimicrobial resistance, food safety and food security, vector-borne diseases, environmental contamination, and other health threats shared by people, animals, and the environment of earth. For example:
- Antibiotic-resistant organisms can quickly spread through communities, the food supply, healthcare facilities, and the environment (soil, water), making it harder to treat certain infections in animals and people.
- Vector-borne diseases are on high occurrence with warmer temperatures and expanded mosquito and tick habitats.
- Diseases in food animals can threaten supplies, livelihoods, and economies of nation.
- The human-animal bond can help improve mental well-being.
- Contamination of water used for drinking, recreation, and more can make people and animals sick.
Fig 2: One Health Issues
Application of the One Health Concept in Advocacy and Interventions
Zoonotic diseases. Ex: Rabies as an Example of Possible Application of the Operational Concept of One Health.
| Components | ||
| Human | Animal | Environment |
| People bitten with the risk of contracting the disease and that require care in the health care system | Infected dogs and cases in livestock, with economic losses | · Areas with abundant stray dogs and abundant food for stray dogs that helps to increase their population
· Areas where changes are occurring in the environment such as rural, periurban, urban activities like construction, laying of road and t, which remove animals and facilitates change in feeding habits. |
| Integrated vision and approaches | ||
| · Exchange of information on monitoring at local level both in human and animals
· Support the authorities to forecast / identification of risk areas. · In risky areas, environmatal sector would be able to report on the occurrence of events such as construction works and deforestation to predict increase in stray dog movements. · Jointly identify the areas of social vulnerability and difficlut access to services where people are being attacked by dogs and frame the intersectoral preventive measures before the occurrence of an outbreak · For risk areas, develop information materials, conduct trainings for staff members at different levels, orienting coordinated surveillance , research of possible outbreaks and actions for prevention and control |
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Fig. 3 one health approach in Antimicrobial Resistance
Fig 4 : One Health approach for Food Safety
One Health Tool
OneHealth Tool is a software tool designed to inform national strategic health planning in low- and middle-income countries. The objective of the OneHealth Tool is to link strategic objectives and targets of disease control and prevention programmes to the required investments in health systems. The tool provides planners with a single framework for scenario analysis, costing, health impact analysis, budgeting and financing of strategies for all major diseases and health system components. WHO provides technical oversight to the development of the tool, facilitates capacity building and provides technical support to policy makers to inform national planning and resource needs estimates. The first official version of the OneHealth Tool was released in May 2012. Since then the tool has been applied in over 55 countries to date, most of which in sub-Saharan Africa.The OneHealth Tool can be downloaded from the Avenir Health website.
One Health Day
To generate increased global awareness of the One Health concept, November 3rd is designated as One Health Day which was initiated in 2016 by the One Health Commission, the One Health Platform Foundation, and the One Health Initiative. One Health Day is celebrated through One Health educational and awareness events held around the world.
Conclusion:
One Health is basically a recognition of inextricable linkage of human, livestock, companion animals and wildlife health. The prominent one health issues like tackling of zoonotic disease, food safety, antimicrobial resistance, vector control etc. are the current important issues facing by the world . So, it can be concluded that One Health is a concept for 21th century which paves way for betterment of every lives on this planet and it is a need of the hour for our earth.
References:
- Mackenzie, John & McKinnon, Moira & Jeggo, Martyn. (2014). One Health: From Concept to Practice. Confronting Emerging Zoonoses: The One Health Paradigm. 163-189. 10.1007/978-4-431-55120-1_8.
- Mackenzie JS, Jeggo M. The One Health Approach-Why Is It So Important? Trop Med Infect Dis. 2019 May 31;4(2):88. doi: 10.3390/tropicalmed4020088. PMID: 31159338; PMCID: PMC6630404.
- (A)One Health High-Level Expert Panel (OHHLEP), Adisasmito WB, Almuhairi S, Behravesh CB, Bilivogui P, Bukachi SA, et al. (2022) One Health: A new definition for a sustainable and healthy future. PLoS Pathog 18(6): e1010537. https://doi.org/10.1371/journal.ppat.1010537
- Schneider, M., Munoz-Zanzi, C., Min, K., & Aldighieri, S. “One Health” From Concept to Application in the Global World. Oxford Research Encyclopedia of Global Public Health.Retrieved 24 Sep. 2022, from https://oxfordre.com/publichealth/view/10.1093/acrefore/9780190632366.001.0001/acrefore-9780190632366-e-29.
