One Health

One Health is at the intersection of human health, animal health, and environmental health.

One Health is "the collaborative efforts of multiple disciplines working locally, nationally, and globally, to attain optimal health for people, animals and our environment", as defined by the One Health Initiative Task Force (OHITF).

History

The recognition that environmental factors can impact human health can be traced as far back as to the Greek physician Hippocrates (c. 460 BCE – c. 370 BCE) in his text "On Airs, Waters, and Places". He promoted the concept that public health depended on a clean environment. In the mid-1800s, Rudolf Virchow, a physician, recognized the link between animal and human medicine, came up with the term zoonosis to describe a disease that can be passed from animals to humans, and actively advocated for veterinary medical education. The founding of the Veterinary Public Health Division at the Centers for Disease Control and Prevention (CDC) in 1947 by James H. Steele, a veterinarian trained in public health, contributed to the understanding of how diseases are spread between animals and humans, or the epidemiology of zoonotic diseases. Calvin Schwabe, another veterinarian trained in public health, coined the term One Medicine in a veterinary medical textbook in 1964, which reflects the similarities between animal and human medicine and stresses the importance of collaboration between veterinarians and physicians to help solve global health problems. In 2004, The Wildlife Conservation Society held a conference at Rockefeller University in New York called One World, One Health, out of which the twelve Manhattan Principles were created. These principles highlighted links between humans, animals, and the environment, how these links are integral to understanding disease dynamics, and the importance of interdisciplinary approaches to prevention, education, investment, and policy development.

Due to global scares surrounding the H5N1 influenza outbreaks of the early-mid 2000s, the American Veterinary Medical Association established a One Health Initiative Task Force in 2006, the American Medical Association passed a One Health resolution to promote partnering between veterinary and human medical organizations in 2007, and a One Health approach was recommended for responses to global disease outbreaks in 2007. Building on these initiatives, the Food and Agriculture Organization (FAO), World Organization for Animal Health (OIE), and World Health Organization (WHO) came together with the United Nations Children's Fund (UNICEF), United Nations System Influenza Coordination, and the World Bank to develop a framework entitled "Contributing to One World, One Health-A Strategic Framework for Reducing Risks of Infectious Diseases at the Animal-Human-Ecosystems Interface” in 2008, reiterating recommendations for a One Health approach to global health. This framework was expanded and the aforementioned organizations moved into developing implementable policies surrounding One Health at the Stone Mountain Meeting, which was held in May 2010 in Georgia.

The first international meetings with the topic of One Health were held in 2011 in both Africa and Australia. In 2012, Barbara Natterson-Horowitz, a physician, and Kathryn Bowers, a science journalist, published the book Zoobiquity, which highlights case studies of parallels between animal and human health. This book has spear-headed interdisciplinary research initiatives as well as a Zoobiquity conference series which have been held both in the United States and internationally. In 2016, The One Health Commission, One Health Platform, and One Health Initiative Team deemed International One Health Day to be November 3. Organizations can submit event details for One Health Day through the One Health Commission's website for global recognition.

In 2019, Senator Tina Smith and Representative Kurt Schrader introduced the Advancing Emergency Preparedness Through One Health Act into the United States Senate and House of Representatives, respectively. This bi-partisan piece of legislation would require that the Department of Health and Human Services, Department of Agriculture, and other federal agencies develop a coordinated plan to create a One Health Framework to help prepare responses to zoonotic disease and prevent disease outbreaks.

Leading organizations

The One Health Commission (OHC) is a 501(c)3 non-profit organization with the mission to connect individuals and create relationships across human, animal, and environmental health sectors, as well as to educate the public about these issues with the intent to improve global health. In 2007, Roger K. Mahr from the American Veterinary Medical Association, Jay H. Glasser from the American Public Health Association, and Ronald M. Davis from the American Medical Association came together as liaisons with other health science professionals, academics, students, government workers, and industry scientists to create a task force and have teleconferences to discuss One Health. This One Health Initiative Task Force created a report in 2008 which outlined recommendations to create a joint steering committee, implement improved communications efforts, plan national One Health studies, develop a One Health Commission, create advisory teams, establish national meetings, and engage medical, veterinary, and public health students. The One Health Commission was officially chartered in Washington D.C. in 2009, with Roger Mahr as the founding CEO. A request for proposal for an institutional partner was put forth in 2010, and Iowa State University was selected to be the main site for operations. In 2013, Roger Mahr retired from the commission and the operations site moved to the Research Triangle of North Carolina, where it currently resides. The current executive director is Cheryl Stroud, a veterinarian, who has held the position since 2013.

The One Health Initiative is an interdisciplinary movement to create collaborations between animal, human, and environmental health organizations including the American Veterinary Medical Association, American Medical Association, Centers for Disease Control and Prevention, United States Department of Agriculture, Vétérinaires sans Frontières/ Tierärzte ohne Grenzen and the United States National Environmental Health Association, among others. The website was created by a pro bono team of Laura H. Kahn, Bruce Kaplan, Thomas P. Monath, Jack Woodall, and Lisa A. Conti to create an email distribution list as well as a repository for news and information pertaining to One Health. Currently, 1,252 individuals from 76 countries are on the email list, and 972 individuals are on their initiative supporter list.

The One Health Platform is a scientific reference network which unites researchers and experts of One Health to better understand and prepare for zoonotic disease outbreaks from animals to humans and antimicrobial resistance, including a better understanding of environmental factors that impact disease dynamics. The organization has nine objectives, which include disseminating research results at biennial meetings, identifying knowledge gaps in the field, engaging policy makers, establishing a Bio Threats Scanning Group to connect One Health and global health security, share data, serve as a reference network to the government, foster collaborations, and implement policies, and increase awareness during One Health Day. The management board is made up of Ab Osterhaus, John Mackenzie and Chris Vanlangendonck. The One Health Platform was responsible for organizing the World One Health Congress meeting each year 2015 - 2020. The One Health Platform closed its doors early in 2021 but the next World One Health Congress scheduled for 2022 continued in Singapore hosted by SingHealth Duke-NUS Global Health Institute.

The World Health Organization (WHO) was created on April 7, 1948 and has since expanded to include 150 country offices and six regional offices in addition to its headquarters in Geneva, Switzerland. The WHO is the main authority for global health within the United Nations. The WHO was a partner in the 2008 establishment of a strategic One Health framework for approaching global health problems. In September 2017, a feature page for One Health was included on the WHO website, defining One Health and highlighting important topic areas such as food safety, zoonotic disease, and antimicrobial resistance.

The World Organization for Animal Health was created as the Office International des Epizooties (OIE) via an international agreement signed on January 25, 1924 out of a need to combat animal disease outbreaks. It officially became the World Organization for Animal Health in 2003, but retained its old acronym, and is headquartered in Paris, France. The OIE has 182 member countries as of 2018 and is managed by a World Assembly of Delegates which includes representatives of each member country. It was also a partner in establishing a strategic One Health framework in 2008. The OIE works to maintain transparency surrounding global animal disease, collect and distribute veterinary information, publish international trade standards for animals/ animal products, improve veterinary services globally, and to promote animal welfare and food safety. Along with the WHO, the OIE hosts workshops about how to implement One Health networks and practices to improve health services in member countries.

The Food and Agriculture Organization of the United Nations (FAO) is an agency of the United Nations, founded in 1945, to address global food security needs. It is an organization that represents 194 member countries. In 2011, the FAO put forth a strategic action plan for One Health, which had the objective to strengthen food security by improving animal production systems and veterinary services and called for action in improving collaborations between animal, human, and environmental health sectors. The FAO works closely with the OIE and WHO, referred to all together as the Tripartite organizations, and published a new guide to approaching zoonotic disease with a One Health framework in 2019.

The Centers for Disease Control and Prevention (CDC), located in Atlanta, Georgia, is an agency within the United States Department of Health and Human Services. The CDC was founded in 1946 by Joseph Mountin to prevent the spread of malaria. The CDC created a One Health Office in 2009, becoming the first United States federal agency to have an office dedicated to this field. This office works alongside other animal, human, and environmental health organizations both within the United States and across the world in order to increase the awareness of One Health and develop tools to help strengthen One Health movements. The CDC One Health Office is involved with multiple initiatives, including working to implement a Zoonotic Disease Prioritization process, creating Global Health Security Agenda Action Packages, overseeing the Zoonoses Education Coalition, developing guidelines with the National Association of State Public Health Veterinarians, and helping educate youth involved with agriculture about influenza. Additionally, the CDC One Health Office hosts monthly webinars, entitled the Zoonoses and One Health Updates Calls, to educate audiences about One Health issues including food safety, antimicrobial resistance, and recent disease outbreaks.

International efforts

A global One Health Day, officially celebrated on November 3, was launched in 2016 in a collaborative partnership between the One Health Commission, the One Health Initiative, and the One Health Platform. Maps of One Health Day events held each year around the world provide a visual of where and how One Health is being embraced.

The One Health Commission began in 2014 compiling a Who's Who in One Health, a Directory of organizations around the world that are actively working to further the One Health paradigm shift. The OHC also oversees a Global One Health Community listserv and shares a One Health Happenings newsletter of international One Health news as a service to the international community of One Health supporters.

The One Health Zoonotic Disease Prioritization process is led by the CDC, holding workshops internationally to prioritize which zoonotic diseases are of the most concern and helping countries develop action plans to address those diseases. The process involves 3-6 neutral facilitators representing human, animal, and environmental health sectors, up to 12 voting members which represent human health/public health, agriculture/livestock, wildlife/fisheries, the environment and other relevant government sectors, and 10-15 advisors from international organizations such as the CDC, WHO, FAO or OIE, academic partners, NGOs or other government sectors not directly involved in zoonotic diseases. The CDC One Health Office trains facilitators and it takes months to prepare for a workshop to acquire resources, identify participants, review zoonotic diseases and confirm logistics. Completed workshops have been held in a variety of countries including Pakistan, Tanzania, Thailand, Uzbekistan, China, and the United States with more workshops upcoming. Diseases most commonly prioritized worldwide include rabies, brucellosis, influenza, Ebola virus, and Rift Valley fever.

Additional organizations promoting international One Health efforts include the World Health Organization, Food and Agriculture Organization, World Organization for Animal Health, The International Federation for Animal Health, Global Alliance for Rabies Control, New Zealand Centre for Conservation Medicine (NZCCM), Hubnet in Asia the One Health Global Network, the University of California One Health Center, Academic Hospital Utrecht and Utrecht Life Sciences and the Infection Ecology and Epidemiology Network, Uppsala, Sweden.

See also

• Conservation medicine
• EcoHealth
• Environmental health
• Planetary health
• Public health

Further reading

• Deem, Sharon L.; Lane-deGraaf, Kelly E.; Rayhel, Elizabeth A. (2019). Introduction to One Health : An Interdisciplinary Approach to Planetary Health (1st ed.). John Wiley & Sons, Inc. ISBN 9781119382867.