‘One Health’

Imlisanen Jamir

Indigenous communities have long recognized the connection between the wellbeing of people and the land. Today, the concept of One Health has gained importance in global health. According to the World Health Organisation’s (WHO) One Health High-Level Expert Panel, ‘One Health’ is an integrated approach that aims to sustainably balance and optimize the health of people, animals, and ecosystems. This approach recognizes that human health, animal health, plant health, and environmental health are closely linked and interdependent.

Earlier this year, a new four-part series on ‘One Health’ and global health security was published online. The series analyzed the current understanding of potential public health emergencies and explored how effective adoption of ‘One Health’ could improve global health security. ‘One Health’ is the foundation for understanding and addressing the most critical threats to society, including antimicrobial resistance, food and nutrition insecurity, and climate change.

‘One Health’ challenges the purely anthropocentric view of human health that is prevalent in modern attitudes. It places humans in an interconnected and interdependent relationship with animals and the environment. This shift in perspective means that all life is of equal concern, which is crucial for addressing pressing health issues at the human-animal-environment interface.

The COVID-19 pandemic highlights the need for a One Health approach. The pandemic's successes and failures have prioritized health systems and vaccines and antivirals. However, understanding the causes of the pandemic requires a broader ecological perspective. The involvement of more environmental health organizations could better integrate environmental, wildlife, and farming issues to help address challenges relating to disease spillover.

One Health also requires reducing human pressure on the environment, which is an essential medical intervention in itself. Antimicrobial resistance is driven by antimicrobial use and misuse in human, animal, and environmental sectors, and the spread of resistant bacteria and resistance genes within and between these sectors. AMR causes significant global damage, with an estimated 1.2 million people dying from antibiotic-resistant bacterial infections in 2019 and another 4.95 million deaths associated with bacterial AMR globally.

The current ‘One Health’ architecture of institutions, processes, regulatory frameworks, and legal instruments has led to a fragmented, multilateral health security landscape. To address this issue, a more egalitarian approach is needed, one that is not paternalistic or colonial in telling low-income and middle-income countries what to do. For example, closing wet markets to stop emerging zoonoses might be technically correct, but it does not account for those who make their livelihoods from such markets. Decolonization requires listening to countries' needs and demands.

‘One Health’ will be delivered in countries, not by concordats between multilateral organizations, but by taking a fundamentally different approach to the natural world. This approach should be concerned about the welfare of non-human animals and the environment as much as human health. In its truest sense, ‘One Health’ is a call for ecological, not just health, equity.

‘One Health’ is a critical concept in global health that recognizes the interconnectedness of human health, animal health, plant health, and environmental health. The COVID-19 pandemic highlights the importance of taking a ‘One Health’ approach to address public health emergencies effectively. However, ‘One Health’ must be implemented sensitively, taking into account the needs and demands of different countries and avoiding paternalistic or colonial approaches. In its truest sense, ‘One Health’ calls for ecological equity, where the welfare of non-human animals and the environment is just as important as human health.

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