Operationalizing One Health Employing Social-Ecological Systems Theory: Lessons From the Greater Mekong Sub-region

Abstract

The idea of the interdependency of the health of humans, animals, and ecosystems emerged from the interplay of theory and concepts from medicine, public health and ecology among leading thinkers in these fields during the last century. The rationale for One Health and its focus on the “human, animal, and environmental interface” stems from this legacy and points to transdisciplinary, ecological and complex systems approaches as central to One Health practice. Demonstration of One Health's efficacy, its wider adoption and continual improvement require explicit operational criteria and evaluation metrics on this basis. Social-Ecological Systems Theory with its unique conception of resilience (SESR) currently offers the most well-developed framework for understanding these approaches and development of performance standards. This paper describes operational criteria for One Health developed accordingly, including a protocol currently being tested for vector borne disease interventions. Wider adoption of One Health is most likely to occur as One Health practitioners gain an increasing familiarity with ecological and complex systems concepts in practice employing a transdisciplinary process. Two areas in which this inevitably will be required for significant further progress, and where the beginnings of a foundation for building upon exist, include: (1) Emerging and re-emerging zoonotic diseases, and (2) successful implementation of the United Nations (UN) Sustainable Development Goals (SDGs). The former includes the challenge of stemming the threat of new microbial pathogens, anti-microbial resistant variants of existing pathogens, as well as resurgence of malaria and other recalcitrant diseases. The applicability of SESR in this regard is illustrated with two case examples from the Greater Mekong Subregion, Avian Influenza (H5N1) and Liver Fluke ( Opisthorchis viverrini) . Each is shown to represent a science and policy challenge suggestive of an avoidable social-ecological system pathology that similarly has challenged sustainable development. Thus, SESR framing arguably is highly applicable to the SDGs, which, to a large extent, require consideration of human-animal-environmental health linkages. Further elaboration of these One Health operational criteria and metrics could contribute to the achievement of many of the SDGs.

Illicit Wildlife Trade, Wet Markets, and COVID‐19: Preventing Future Pandemics

“…Future research by the health, medical, and environmental community must be combined with research on illicit trade and corruption. A transdisciplinary approach has been taken in the One Health perspective but this approach has not gone outside the scientific perspective (Aguirre et al, 2019; Wilcox, Aguirre, De Padua, Siriaroonrat, & Echaubard, 2019). Going forward, these barriers among academic disciplines must be bridged to consider all the risks to public health.…”

Fostering social innovation and building adaptive capacity for dengue control in Cambodia: a case study

“…There is a strong crossover between the SDGs and the social determinants of health, as elaborated in the Alma Ata declaration and later strengthened by the launch of the Commision on Social Determinant of Heath [1]. There are also significant cross-overs with the Social ecological systems theory and its unique conception of resilience applied to health emphasizing the interdependence of human society and nature and supporting adaptive governance in this regard [2,3].…”

Will the COVID-19 crisis trigger a One Health coming-of-age?

“…2 We concur, however, we warn that conceptual and institutional ambiguities that preclude the practical implementation and evaluation of One Health remain to be resolved. 3,4 One Health was initially adopted by major health agencies more than a decade ago to promote interdisciplinary collaborations among biomedical scholars and practitioners, and then progressively with workers in the environmental and social sciences, with the aim of establishing a more society-wide responsibility for the health of humans and the whole planetary ecosystem. One Health is embedded within the concept of EcoHealth, which further extends the scope to complex human-environment systems.…”

“…Overcoming the fundamental ambiguities in the framing of One Health-ie, whether it addresses the resilience of social-ecological systems or the health of humans, animals, and the bio-physical environment in the context of social-ecological systems-is essential to overcoming a number of challenges to its practical implementation as a transdisciplinary concept. 3,7 Without more explicit framing as complex systems, the ambitions of One Health are likely to fail most of the time at the implementation phase due to functional mismatches between the scale of management and the scale of the processes being managed. 8 Public health and veterinary services are not usually organised or equipped to operate according to how ecosystems are hierarchically organised.…”

“…We suggest that the UN Environment Program (UNEP), which hosts the secretariats of several international environmental conventions, such as the Convention on Biological Diversity, should be included in the One Health coalition with WHO, OIE, and FAO. Through its mandate on international environmental governance, UNEP could facilitate the much-needed articulation of health challenges with the Sustainable Development Goals, 3 anchoring the One Health approach within a wider inititiave to achieve a healthy planet for all.…”