One Health gets a new update at the World Health Summit

“One Health,” the transdisciplinary attempt to address the nexus of human, animal, and ecosystem health that first emerged nearly two decades ago, has gained renewed attention during the COVID-19 pandemic. The concept got an update at the World Health Summit that began Sunday in Berlin. A One Health High Level Expert Panel, or OHHLEP, first convened in May of this year, used the summit to unveil its definition of the concept amid a broader focus on how to actually jumpstart One Health approaches that integrate the entire global community. Conceptualized as an “integrated, unifying approach” across the tightly interlinked areas of human, animal, and ecosystem health, OHHLEP’s definition conceives a mobilization “at all levels of society to work together to tackle threats to health and ecosystems, while addressing our collective needs for healthy foods, energy and air, taking action on climate change and promoting sustainable development.” “As we go forward, we have to start thinking not just from the human perspective, but think from the eco-nature-centered perspective.” --— Wanda Markotter, co-chair, One Health High Level Expert Panel “This is a much more overarching definition of One Health than we have had in the past,” explained Thomas Mettenleiter, OHHLEP's co-chair. Amongst the updates is a focus on sociopolitical parity and equity between sectors and disciplines. It builds on the last update, which also came in Berlin, just months ahead of the onset of the COVID-19 pandemic. Beyond infectious diseases The rapid spread of a virus likely originating in animals underscored the importance of One Health and the need to take preventive action to reduce the likelihood of that kind of zoonotic spillover in the future. But experts at WHS were quick to caution against viewing One Health only through the lens of infectious diseases. "COVID-19 is only one of many striking examples of our collective, systemic failure to make the connection between the natural world, wildlife, livestock and our political and socio-economic and financial structures," said Cristina Romanelli, a One Health expert at the World Health Organization. That integration that takes on additional significance ahead of the climate change conference in Glasgow beginning later this month. For the first time, there will be a health pavilion at the annual meeting as part of an effort to highlight how changes in the ecosystem also affect nutrition and spur non-communicable diseases, or how actions that deepen the climate crisis, including deforestation, also bring humans into closer contact with animals and raise the risk of future infectious disease outbreaks. "Pandemic today. Impending climate disaster tomorrow. It wakes us up to the links between human, animal, and environmental health," said Runa Khan, the founder of Friendship, a Bangladeshi NGO. "One Health needs to be done in a sustainable, continuous way incorporating sustainable, holistic, and realistic solutions." But overriding the implementation of One Health is the question of how to begin to integrate comprehensive solutions cutting across sectors and departments that are more conditioned to compete for resources than to collaborate. It begins with the work of reaching an agreement on exactly what One Health means, beginning with OHHLEP's efforts to draft a definition. Because the panel was convened by four global institutions — WHO, the Food and Agriculture Organization, the World Organisation for Animal Health, and the United Nations Environment Programme — Mettenleiter suggested it could have the authority to help consolidate the global One Health agenda. The scope of the definition could help efforts to broaden the focus of who and what is at risk, experts suggested. "As we go forward, we have to start thinking not just from the human perspective, but think from the eco-nature-centered perspective," said Wanda Markotter, OHHLEP's other co-chair. Achieving that perspective will necessitate new partnerships that cut across ministries and organizations — both vertically and horizontally — by spotlighting the ways in which their goals are interlinked. It will also likely require convincing siloed departments that working together is likely to help them achieve their goals faster. "All these crises are interlinked, tightly interlinked," said Dr. Christian Walzer of the Wildlife Conservation Society. "We have to think in co-benefits and how that helps us cut the costs." Focus on communities In line with the emphasis on equity, that also means broadening who is included in these efforts, including the communities who are at the frontlines of emerging infectious diseases or the impacts of climate change on food systems. "We have to stop talking about local communities as data sources," said Marisa Peyre, an epidemiologist with the French Agricultural Research Centre for International Development. "There has to be a change in paradigm in thinking about prevention at a local level." That means "finding solutions to reduce human imprint on the local environment and protection by the community and for the community." It is, speakers at WHS acknowledged, a massive task whose scope could prove overwhelming. "It's going to take quite some time and will be quite painful," said Dr. John Amuasi, who co-chairs The Lancet One Health Commission. "We need a fundamental change in the global economic system." At the same time, experts acknowledged that it doesn't have to be everything all at once. Maria Flachsbarth, an official with Germany's Ministry for Economic Cooperation and Development, said her department is attempting to anchor One Health into its individual policies with partner countries, including efforts to prevent the future spread of infectious diseases. The idea is that there might be incremental immediate returns, but also the inculcation of a long-term One Health approach to addressing interlinked problems. "The COVID-19 pandemic has opened a window of opportunity for One Health, for a holistic view of health and development and for the importance of being prepared and prevention," she said.