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Health with Humanity

HPHR Fellow Joanna Burke-Bajaj

By Joanna Burke-Bajaj


One Health: An emerging public health field with 
the opportunity to build systems change

Screenshot 2021 08 18 At 11.19.17 PM

The new and burgeoning field of One Health (OH) grew from the long-known concept of connection between living things, but took on new meaning in the growing knowledge of connectivity between health-related disciplines and major events in the emergence of infectious disease (Mackenzie, McKinnon & Jeggo 2014). The term One Health was first popularized in the early 2000’s in relation to the coronavirus outbreak causing SARS, when wildlife sources were found to be associated with the creation of this novel virus (Mackenzie & Jeggo 2019). From the time of SARS to the current age of a global pandemic from yet another novel coronavirus, the One Health approach has gained urgency as public health practitioners become ever more aware of the interconnected nature of health, particularly through infectious disease. One Health is, in essence, a public health response to the globalisation of health threats across three areas: in humans, in animals, and in the planetary environment as a whole. Due to the intersectional nature of these health concerns, One Health focuses on the building of interdisciplinary collaborations to track and address diseases that overlap between these triad areas, and to provide planning and solutions for these diseases from multiple perspectives. One definition suggested by the One Health Global Network described the goal of One Health being to “address potential or existing risks that originate at the animal-human-ecosystems interface” (Mackenzie & Jeggo 2019). The definition offered by the WHO states that One Health is  “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,” which seems appropriately broad for a field which covers all life on Earth, however the second part of the definition narrows to clarify, “the areas of work in which a One Health approach is particularly relevant include food safety, the control of zoonoses, and combatting antibiotic resistance,” (WHO 2017). 

 

The problem with the infectious disease focus of much of the One Health field is that if a majority of the field is limited to discussions only of zoonotic disease control, scholars and practitioners miss the opportunity for OH to become a beacon of advocacy against the wider systemic and structural threats to all three levels of health for humans, animals, and the planet – the upstream causes of not only increasing novel infectious diseases but also the increasing lack of healthy environments for humans and wildlife alike. These root causes of structural harm are major global health threats that are also producing harm at similar levels to pandemic diseases. One example is the unregulated or lightly regulated production industries whose practices can pollute local ecosystems and contribute to the global climate change crisis causing harm to the health of humans, animals, and the planet as a whole, but who choose to continue expanding these practices in the capitalistic pursuit of profits over widespread health and welfare. In the same way, major swells in the past few decades in the destruction of natural habitats through urbanisation, deforestation, and intensification of agriculture, places humans and animals in close proximity leading to potential for mixing and creations of new disease. The industries and governing bodies choosing to continue land use change through habitat destruction, without evidence-based planning for conservation and environmental health practices, should be a key target of One Health advocacy and public policy change in the interest of stamping out this threat, as widespread and irreversible harm is being done to the living environment of humans and animals.

There is a momentous opportunity for the One Health community at large to become more active in discussions of systems change in public policy, economics, justice, sustainability, and other areas that exhibit the vast intersectionality of health concerns in the world today. 

Not all within the One Health field have remained focused only on zoonotic disease, and in fact some have passionately spoken out for a systems view of health threats that affect all life. For example, veterinary scholars have publicly called for academic veterinary institutions working with the One Health Consortium to go “beyond disease control”, and address “not only improved animal and human health as captured under the banner of one health, but also the broad issues of poverty, hunger, sustainability, food systems, and food security,” (Kelly et al. 2013). This includes discussions on the global policy and public health implications of the call for sustainable food security, the structural and social needs of farmers and those who work in agriculture related to animals, and the requirements of expanding sustainable agriculture to combat deforestation, desertification, and environmental change (Kelly et al. 2013). In a further example, Canadian researchers evaluating the role that the One Health approach filled in response to the COVID-19 pandemic emphasised that OH opened understanding of health equity concerns as well, stating “OH thinking emphasizes the need for equitable solutions to infectious disease challenges, suggesting that policy response mechanisms and interventions need to be reflective of the disproportionate disease burdens borne by vulnerable and marginalized populations,” (Ruckert et al. 2020). The group also noted that an OH approach to health equity requires reassessing ideas in social justice “through a multi-species lens,” (Ruckert et al. 2020). In this way there is both a great need and a momentous opportunity for the One Health community at large to become more active in discussions of systems change in public policy, economics, justice, sustainability, and other areas that exhibit the vast intersectionality of health concerns in the world today. 

 

The key piece of the One Health approach that must be adopted in all disciplines of Public Health to combat the health concerns of the future, is the understanding that the crises we face are global, intersectional and multidisciplinary, and the health of humans does not exist independent of the animals, ecosystems, and wider world around us. This is a truth that many Indigenous communities have known and alerted others to for centuries, but it is also a concept that global health leaders are only just beginning to account for, and thus concentrated efforts must be made to reframe public health systems to act quickly upon the upstream sources of harm to humans and all life on the planet. The interdisciplinary approach of One Health is ultimately an opportunity for public health to move into a deeper role of advocacy and activism to address and prevent global harm and threats to all life, but it will take a shift in mindset to exploring structural and systemic harm, and a willingness to push beyond traditional tracking and response to disease. 

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References

Kelly A, Ferguson J, Galligan D, et al. (2013). One health, food security, and veterinary medicine. J Am Vet Assoc. 2013;242:739–743. doi: 10.2460/javma.242.6.739. 

 

Mackenzie J., & Jeggo M. (2019). The One Health Approach-Why Is It So Important?. Tropical medicine and infectious disease4(2), 88. https://doi.org/10.3390/tropicalmed4020088

 

Mackenzie, J., McKinnon, M., & Jeggo, M. (2014). One Health: From Concept to Practice. Confronting Emerging Zoonoses: The One Health Paradigm, 163–189. https://doi.org/10.1007/978-4-431-55120-1_8

 

Ruckert A., Zinszer K., Zarowsky C., et al. (2020). What role for One Health in the COVID-19 pandemic?. Can J Public Health 111:641–644. https://doi.org/10.17269/s41997-020-00409-z

 

WHO. (2017). One Health. WHO Newsroom Q&A, World Health Organization. Website. Accessed online at https://www.who.int/news-room/q-a-detail/one-health

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