Roadmap to a One Health agenda 2030.

Abstract

The current fragmented framework of health governance for humans, animals and environment, together with the conventional linear approach to solving current health problems, is failing to meet today's health challenges and is proving unsustainable. Advances in healthcare depend increasingly on intensive interventions, technological developments and expensive pharmaceuticals. The disconnect grows between human health, animal health and environmental and ecosystems health. Human development gains have come with often unrecognized negative externalities affecting ecosystems. Deterioration in biodiversity and ecosystem services threatens to reverse the health gains of the last century. A paradigm shift is urgently required to de-sectoralize human, animal, plant and ecosystem health and to take a more integrated approach to health, One Health (OH). The Sustainable Development Goals (SDGs) offer a framework and unique opportunity for this. Through analysing individual SDGs, we argue the feasibility of an OH approach towards achieving them. Feasibility assessments and outcome evaluations are often constrained by sectoral politics within a national framework, historic possession of expertise, as well as tried and tested metrics. OH calls for a better understanding, acceptance and use of a broader and transdisciplinary set of assessment metrics. Key objectives of OH are presented: that humans reconnect with our natural past and accept our place in, and dependence on our planet's ecosystems; and that we recognize our dependence on ecosystem services, the impact of our development thereon and accept our responsibility towards future generations to address this. Several action points are proposed to meet these objectives.Keywords: One Health, Health governance, Health policy, Sustainable development goals, Ecosystems health, Global health, Planetary Health Review Methodology: We reviewed academic papers and on line resources for definitions of health for each sector (human, animal, wildlife, plant and ecosystem health). The 17 Sustainable Development Goals (SDGs) and the official lists of diseases published by WHO and the OIE were collated and analysed for their suitability for an integrated approach to management. Selected SDGs were chosen as examples to demonstrate the feasibility of an integrated or one Health approach, which was supported by reviewing the relevant literature for each.

A scoping review on the prevalence of Shiga‐toxigenic Escherichia coli in wild animal species

“…The “One Health” initiative recommends multidiscipline collaboration for an increase in sustainable and cost‐effective approaches in preventing infectious diseases as well as other public health interventions (Queenan et al, ). Likewise, the new Sustainable Development Goals published by WHO in 2015 (World Health Organization, ), stresses the necessity of an integrated approach across environmental, economic and social pillars to address all infectious diseases.…”

Knowledge integration in One Health policy formulation, implementation and evaluation

“…Potentially, therefore, as a decisive element in policy development, knowledge integration could help resolve the main shortcomings of the current global framework for health governance, by managing complexity and shaping interactions between actors and institutions towards joint learning 17 , 18 . Knowledge integration could also be used to complement educational and institutional measures for improving the implementation of the One Health approach 14 . We therefore propose that policy cycles relevant to One Health should aim at knowledge integration and make the best possible use of multicriteria analyses, systems thinking and transdisciplinary approaches.…”

“…It has been suggested that some of the current framework’s shortcomings could be overcome by the development of coordinated supranational bodies, the promotion of specialized training and career opportunities and the creation of dedicated funding mechanisms 9 , 12 – 14 . We suggest that the framework may also be strengthened by improving the integration of its management 4 , 7 , 15 and by integrating knowledge at all stages of any related policy development 16 – 18 .…”

Global Crisis Leadership for Disease‐Induced Threats: One Health and Urbanisation

“…Despite the ‘good’ intentions the SDGs, there have been questions about their level of complexity, including the political and governance capacities for them to be realised (Liverman, 2018). The ‘SDGs provide a key entry point for the OH approach to drive a paradigm shift in policy and practice towards a fully integrated approach’ (Queenan et al, 2017, p. 6). However, Waage et al (2015) cited in Queenan et al (2017, p. 5) ‘criticises the SDGs for being developed within different sectors and presented by the UN without recognizing the interactions’.…”

“…The ‘SDGs provide a key entry point for the OH approach to drive a paradigm shift in policy and practice towards a fully integrated approach’ (Queenan et al, 2017, p. 6). However, Waage et al (2015) cited in Queenan et al (2017, p. 5) ‘criticises the SDGs for being developed within different sectors and presented by the UN without recognizing the interactions’. Urbanization, and risks of urban animals producing health threats, risk being lost within the web of SDGs given that health and the environment‐related SDGs cover a broad range of areas.…”