What is One Health?
One Health is a collaborative concept/approach that its proponents suggest seeks to address imminent and fundamental threats facing humanity, the ecosystem and animals at a local, regional and global scale. It is a platform for improving health in the broadest sense in a cost effective fashion. This requires inter and cross disciplinary partnerships and cooperation among a diverse arena of professionals such as veterinarians, physicians, ecologists, sociologists, economists and public health professionals.
Current historical knowledge suggests that in the early days of the practice of healing, there was little differentiation made between the healers of people and the healers of animals. Indeed, treatment of humans and animals has continued to be closely aligned for much of early history. Several notable scientists recognized the advantages of a more integrated approach between the human and animal health sciences such as Rudolf Virchow (1821-1902) who coined the term “zoonosis” and stated that “Between animal and human medicine there is no dividing line-nor should there be…”. Calvin Schwabe (1927-2006) is also widely accredited with reviving the one medicine approach to human and animal health. Other scientists who have contributed to the One Health concept are Hippocrates of Cos, William Osler, Louis Pasteur, Robert Koch, Rachel Carson, General James Steele and many others.
Dr. Abigail Woods (a historian from King’s College London) acknowledges the historical synopsis above but at the same time asserts that it is a highly selective account, that is deliberately designed to advance the case of One Health today. She and her colleagues have developed a more critical, in-depth and evidence-based account of its history, published as: Bresalier, M, Cassidy, A, and Woods, A, ‘One Health in history’, in J Zinsstag, E Schelling, D Waltner-Toews, M Whittaker and M Tanner (eds.) One Health: The theory and practice of integrated health approaches (CAB International, 2015), 1-15.
How is it being propagated?
The One Health concept has also been promoted by a series of local, regional and international meetings/organisations:
- Meetings e.g. 2011 Expert meeting on One Health governance and global network
- Congresses e.g. 2015 3rd International One health congress in the Netherlands
- Summits e.g. One Health Summit in Davos
- Training programmes e.g. MSc One Health (University of Edinburgh & Royal Veterinary College)
- Surveillance systems such as ProMED, GLEWS
- One Health Clubs worldwide e.g. One Health student online portal
- International organizations e.g. One health Initiative and One Health Commission
- Joint One Health offices/departments e.g. ZDU in Kenya
- The ZED group through a number of its projects e.g. PAZ project featured in veterinary record
- One Health research centres & institutes e.g. University of Washington, COHEART, UC Davis One Health Institute
Why is it important in the 21st century and beyond?
Ecosystem & climatic changes, socio-cultural & economic changes, population & demographic changes, technological & development changes and increasing contact between humans and animals have acted and will continue to act as drivers of the One Health concept as a result of their impact on:
- Emerging and reemerging infectious diseases (75% of which are zoonotic e.g. Avian influenza)
- Neglected and zoonotic diseases (affecting mainly poor and marginalized populations in low-resource settings e.g. cysticercosis, trypanosomiasis etc.)
- Drug resistance (which is currently a global public health concern e.g. XDR-TB, MRSA)
- Climate change as a result of human influence e.g. burning fossil fuels
- Biodiversity loss e.g. due to deforestation, overfishing
- Ecological change and disease emergency e.g. Ebola at the wildlife-human interface
- Water and food security and safety
- Chronic diseases and mental health
One Health in perspective
Drive into a shamba, a smallholding, and you observe first hand the close relationship rural citizens have with their animals. Young men plough the fields with their team of cattle; women milk their cows and goats by hand and use fresh cow dung to floor their houses; a medley of poultry, cats, dogs and young children play happily together on the dusty ground. Pigs, goats and sheep wander in and out of houses, latrines and kitchens, picking at anything remotely edible, all categories of household wastes included.
You are also aware of the trappings of poverty: the road you came in on is likely to be unpaved, highly pot-holed and probably inaccessible by anything other than a bicycle or 4×4. Running water is a rarity, electricity even more so. Children, as happy as they are, often bear the telltale pot belly of a high worm burden, and it may have been years since any member of their household had contact with a healthcare professional. The livestock, mainly of indigenous breeding, often show overt signs of disease, ill thrift and anaemia being particularly common.
A stereotypical view of Africa, maybe, but one that is nonetheless a reality and which, when you stop to look, can give an insight into the diseases encountered by those living in such communities.
The very process of investigating disease simultaneously in human and animal populations involves putting the idea of one health into daily practice and the results will add weight to the argument for more integrated health surveillance and control for zoonotic diseases. Featured in the veterinary record.