Introduction

to
One Health Approach
 One Health
Prepared by :
Prof. Adil M. A. Salman
Photos ;
Swiss Tropical Health Institute

Tuffts University
What is “Health”? PH
Health is a state of complete physical, mental and social well-being and not
merely the absence of disease or infirmity.
Includes the following interdependent systems:
Individual health
Population (community) health
Ecosystem health,
Societal health
Economic health

(WHO 1946)
Definition of health:-
Veterinary Public Health (VPH)
is that component of public health activities devoted to the application of
professional veterinary skills, knowledge and resources to the protection and
improvement of human health .
It is clear that modern Veterinary
e Public Health is oriented
a
towards healthy feed – t healthy animals – healthy
i
food – healthy humans n .
g
Environmental Health
Environmental health is the science and practice of preventing human
injury and illness and promoting well-being by

-identifying and evaluating environmental sources and hazardous agents

and –
limiting exposures to these hazardous materials in air, water, soil, food,
 Elements of the Environment
clean air
safe drinking water
Safe nutritious food
safe places to live.
 What is One Health?

• A concept that takes into account the relationship among

human health and animal health and the environment
• People, animals, and environment are closely connected
One to each other.
• Movement of diseases from animals to humans can be
Health influenced by changes in the environment they share.
• An approach to looking at new diseases and other adverse
health events by taking a holistic viewpoint that considers
human health, animal disease, and environmental changes
What is One Health?

• One Health is a return to simpler times when

most physicians were generalists rather than
specialists, and physicians and veterinarians
communicated regularly.
• One Health is especially important now
because we live in a time when there is an
increase in the number of new human
diseases that originate in animals.
One health approach

Team composition
Health professional, veterinarian,
nutritionist, ecologist, socio-economist
 One Health Approach

The One Health concept is a worldwide strategy for

expanding interdisciplinary collaborations and
communications in all aspects of health care for
humans, animals and the environment.
 Main Goal:

•Enhance cooperation and

expand interdisciplinary
collaborations between all
the fields to promote
health and well-being
Definition of One Health
One Health is a collaborative,
multisectoral, and trans-disciplinary
approach - working at local, national,
and global levels – to achieve optimal
health and well-being outcomes
recognizing the interconnections
between people, animals, plants, and
their shared environment.
 Worldwide, nearly 75 percent of all emerging human infectious
diseases in the past three decades originated in animals.

Why One The human-animal bond beneficially impacts the

Health? health of both people and animals.
To provide adequate healthcare, food and water for the growing
global population, the health professions, and their related
disciplines and institutions, must work together.

Environmental health may affect human and animal health through contamination,
pollution and poor conditions that may lead to new infectious agents.
Scope of One Health
•Convergence of human, animal, and plant health and
the health of the environment
•Human-animal bond
•Research, both basic and translational-Participatory
•Ensuring a safe food and water supply that is high
quality, available and affordable
•Agricultural production and land use
•Natural resources and conservation
•Scope of One Health
•Disease surveillance, prevention and response, both
infectious and chronic diseases
•Clinical medicine demand for interrelationship between the health
professions
•Environmental agent detection and response
•Disaster preparedness and response
•Public policy and regulation
•Global trade and commerce
•Communications and outreach
WHY OH
Interactions among people, animals, and the
environment continue to change due to.
A- The expansion of human and animal
populations,
B-changes in climate and land use, and
C-increased international travel and trade
provide opportunities for disease spread.
 1. Joint educational efforts between human
medical, veterinary medical schools,
schools of public health, Ecosystem health ,
According to the media , allied health networks and disease
One Health
Initiative; One surveillance
Health shall be
achieved through: 2. Joint efforts in the development and
evaluation of new diagnostic methods,
medicines and vaccines for the prevention
and control of diseases across species and;

3. Joint efforts to inform and educate

political leaders and the public sector
through accurate media publications.
OH Stake holders
One Health embraces the idea that complex
problems at the human-animal-environmental
interface can best be solved through
multidisciplinary communication,
cooperation, and collaboration. These
includes wildlife specialists, anthropologists,
economists, environmentalists, behavioral
scientists, and sociologists, among others.
 Boolean diagram of integrative health concepts

Social-Ecological System (SES)

Planetary Heatlh
EcoHealth
One
or Animal Health Health Public Health

HSES
Historical Background
Chou Dynasty in China (11-13th century):
integrated public health system including
medical doctors and veterinarians. “The
foundations of veterinary medicine are as
comprehensive and subtle as those of human
medicine and it is not possible to place one
above the other” Hsü Ta-ch’un 18th century

.
Rudolf Virchow in 1880, said, “Between
animal and human medicine there is no
dividing line—nor should there be. The object
is different but the experience obtained
constitutes the basis of all medicine.”
In the 1980’s, epidemiologist Calvin Schwabe
called for a unified human and veterinary
approach to combat zoonotic diseases,
providing the modern foundation for One
Health
The concept was advanced further when, in
2004, the Wildlife Conservation Society
hosted a symposium that brought together
an international group of human and animal
health experts to discuss shared diseases
among human, wild animal, and domestic
animal populations.
In 2007, The American Veterinary Medical
Association and the American Medical
Association adopted a vision supporting the
concept of One Health and formed the
One Health Initiative task force.
In 2008, the Food and Agriculture Organization
(FAO), the World Health Organization (WHO), the
World Organisation for Animal Health (OIE), the
United Nations Children's Fund (UNICEF), the
World Bank, and the United Nations System
Influenza Coordination (UNSIC) came together to
develop a document titled, "Contributing to One
World, One Health™-A Strategic Framework for
Reducing Risks of Infectious Diseases at the
Animal-Human Ecosystems Interface
In 2010, the United Nations and the World Bank
recommended adoption of One Health Approaches
in the document: "Fifth Global Progress Report on
Animal and Pandemic Influenza."
The 1st International One Health Congress was held
in Melbourne Australia in February 2011.
Representing a range of disciplines, more than 650
people from 60 countries gathered to discuss the
benefits of working together to promote a One
Health approach. The conference supported the
inclusion of disciplines such as economics, social
behavior, and food security and safety.
The first One Health Summit, sponsored
by the Global Risk Forum, was held in
Davos, Switzerland in February 2012.
Understanding the animal-human interface

Animals Humans

31
6. März 2023 32
One Health is An approach to looking at new diseases and other adverse health events by
taking a holistic viewpoint that considers human health, animal disease, and environmental
changes

OH focuses on
Emerging and new emerging diseases
zoonoses,
food and water safety and security,
antimicrobial resistance , and
vector-borne diseases, as well as the environmental and
ecological factors that drive and impact on these issues.
Successful public health interventions require the
cooperation of human, animal, and environmental
health partners.
Professionals in human health (doctors, nurses, public
health practitioners, epidemiologists),
animal health (veterinarians, paraprofessionals,
agricultural workers),
environment (ecologists, wildlife experts), and other
areas of expertise need to communicate, collaborate
on, and coordinate activities..
Other relevant players in a One Health approach
could include
law enforcement,
policymakers,
agriculture,
communities, and
even pet owners.
No one person, organization, or sector can
address issues at the animal-human-environment
interface alone
Emerging Infectious Diseases
1-Diseases that have recently increased in incidence or in
geographic or host range – e.g., tuberculosis, cholera,
malaria, dengue fever, Japanese encephalitis, West Nile
fever, and yellow fever.
2. Diseases caused by new variants assigned to known pathogens – e.g., HIV,
new strains of influenza virus, and SARS, drug resistant strains of bacteria,
Nipah virus, Ebola virus, hantavirus pulmonary syndrome, and avian influenza
virus.
3. Bacteria newly resistant to antibiotics, notably the multiple
antimicrobial resistant strains – e.g. E. coli 0157, MRSA (Methicillin
Resistant Staph. Aureus)…
Emerging and re-emerging animal diseases have in
recent years been associated with global outbreaks that
have serious consequences for animal and human
health.
The World Organisation for Animal Health (OIE) defines an emerging
disease as
“a new infection or infestation resulting from the
evolution or change of an existing pathogenic agent,
a known infection or infestation spreading to a new
geographic area or population, or a previously
unrecognised pathogenic agent or disease diagnosed
for the first time and which has a significant impact on
animal or public health.”
A known or endemic disease is considered to
be re-emerging if it shifts its geographical
setting, expands its host range, or significantly
increases its prevalence RVF
Why the disease emerges
The increases in human population and wealth have resulted in very
high demand for livestock products around the world.
Leading to the development of complex livestock systems and a
complex value chains in which the selection of animals is primarily
based on production traits rather than disease resistance.
 The associated increase in enhanced biosecurity measures on farms
has also contributed to the increased vulnerability of livestock to
disease threats, as regional or national eradication of infectious
diseases means that animals in these areas are immunologically
naïve and thus at increased risk from pathogen incursions.
With growing demands on land use, -intensified
farming practices, -increased transportation of
livestock for trade purposes, and the evolution and
mutation of pathogens themselves, the likelihood of
further serious epidemics will grow
In summary --Important factors leading to the emergence of
infectious diseases

• Overpopulation and urbanization

• Population movement and animal trade
• Water and sanitation
• Agriculture and changing land use
• Livestock production
• Climate
• Drug resistance
The result is existing health programs which
addressing some aspects of the complexity, are
insufficiently equipped to assess risks and
outcomes associated with their root causes.
 One Health is not a new concept, but it has become more important in recent years
because many factors have changed the interactions among humans, animals, and the
environment. These changes have caused the emergence and reemergence of many
diseases.
Factor (Cause) Change (Effect)

Human populations are growing and As a result, more people live in close
expanding into new geographic areas. contact with wild and domestic animals.
Close contact provides more opportunities
for diseases to pass between animals and
people.
The earth has experienced changes Disruptions in environmental conditions
in climate and land use, such as and habitats provide new opportunities for
diseases to pass to animals.
deforestation and intensive farming
practices.
International travel and trade have
increased. As a result, diseases can spread quickly
across the globe.
using the One Health will lead to,
 preventing many outbreaks before they
occur and/or
 greatly reducing their impact through
early detection and control.
 predicting
Challenges OH _EID
• Complex health issues need innovative, integrated
approaches.
• Strengthening the capacity of professionals working in the
human, animal and environmental health sectors to respond
to, control and prevent outbreaks of EID is vital.
• Gaps in knowledge, networking, field capacity
• Need to widen scope “Systems” approach vs. focus on
specific diseases Looking beyond animal health / human
health
• Need more coordination of research projects to make bigger
Zoonoses and OH
refer to diseases that pass between people and
animals.
Some of these diseases start in wildlife that is
being displaced by deforestation in remote areas
of the world.
Diseases can move around the globe quickly
because people and products, such as animals
and food supplies, are constantly crossing
borders..
Livestock and Zoonoses
 Is it profitable to mass vaccinate 25 million sheep, goat and cattle in Mongolia to
Prevent human brucellosis?

6. März 2023 Präsentationstitel 49

Courtesy: Dr. Jan Kolar, Prague
AMR and OH
Since antimicrobials were first commercially produced, initially
for use in human medicine and subsequently in veterinary
medicine, their use has been associated with the risk of
emergence of AMR. At the same time as the world has
observed accelerated emergence of resistance, the discovery
and development of new antimicrobial drugs has slowed
down. The effectiveness of the existing antimicrobials should
therefore be preserved as much as possible.
The need for a ‘One Health’ approach Addressing the
rising threat of AMR requires a holistic and multisectoral
(‘One Health’) approach because antimicrobials used to
treat various infectious diseases in animals may be the
same or be similar to those used in humans. Resistant
bacteria arising either in humans, animals or the
environment may spread from one to the other, and
from one country to another. AMR does not
recognize geographic or human/animal borders.
6. März 2023 52
The World Health Organization (WHO), the Food and
Agriculture Organization (FAO) and the World
Organisation for Animal Health (OIE) take collective
action to minimize the emergence and spread of AMR.
The aim is to:
– Ensure that antimicrobial agents continue to be
effective and useful to cure diseases in humans and
animals;
– Promote prudent and responsible use of antimicrobial
agents;
Climate change and OH
Climate change Affects the social and environmental
determinants of health
-clean air,
-safe drinking water,
-sufficient food and
-secure shelter.
One of the challenges is the spread of infectious diseases that emerge
or reemerge at the interfaces between animals, humans, and the
ecosystems in, which they live.
climatic conditions strongly affect water-borne
diseases and diseases transmitted through
insects, snails or other cold-blooded animals.
Changes in climate are likely to lengthen the
transmission seasons of important vector-borne
diseases and to alter their geographic range.
The Aedes mosquito vector of dengue and RVF is also
highly sensitive to climate conditions, and studies
suggest that climate change is likely to continue to
increase exposure to these diseases.
The cost of outbreaks of emerging vector-borne
zoonotic pathogens may be much lower if they
are detected early in the vector or in livestock
rather than later in humans. Therefore, integrated
community-based surveillance of zoonoses is a
promising avenue to reduce health effects of
climate change.
 Food Safety and One Health.

the food is an important vehicle for many, but not all, of

the zoonotic pathogens. One of the major issues in food
safety is the lack of cross-sectoral collaboration across
the food production and distribution chain,between the
animal health, the food control, and the human
health sector.
The OH approach formulates clearly both the need for
and the benefit of cross-sectoral collaboration.
Food related zoonoses can be separated in three major
classes:
 parasites often relate to very specific animal hosts and
contribute significantly to the human disease burden,
virus have often been related to major, well-published
global outbreaks, e.g. SARS and avian- and swine-
influenza.
The bacterial zoonoses on the other hand often result in
sporadic, but very wide-spread disease cases, resulting in a
major disease burden in all countries, e.g. Salmonella and
Campylobacter.
Control of FBD
The prime objective of 'One health' is to minimize the global impact
of diseases of animal origin, including zoonoses, especially those with
pandemic potential.
The control of food-borne diseases, and zoonoses require a
new interdisciplinary approach, as human health, animal
health, and ecosystem health are inextricably linked.
How to apply OH
 In third world countries with remote medical and
veterinary health centers, if at all existing, it should be
reconsidered to link human and animal systems (“one
medicine” concept). it should be normal to include
veterinarians in community health centers as
experts in zoonotic prevention, environmental
health, food and water safety issues.
 veterinary and medical monitoring and surveillance
systems should be linked and data used by either
party.
In such areas “life expectancy” will be changed in
“health expectancy”, where veterinary skills are widely
used in collective prevention programmes.
 Joint human and animal vaccinations improve access to health care for pastoralists

(Schelling et al. 2007 EID)

Costing study: public health sector could save up to 15% of infrastructure,

cold chain and staff costs
Private veterinarians’ interest in capitalising on transportation infrastructure
6. März 2023 62
62
Potential Outcomes from the One Health Approach
•More interdisciplinary programs in education,
training, research, and established policy
•More information sharing related to disease
detection and diagnosis as well as education and
research
•More prevention of diseases, both infectious
and chronic diseases
•New therapies and approaches to treatment for
unmet needs
• Improving animal and human health globally ➢
collaboration among all the health sciences
• Meeting new global challenges through collaboration
➢ veterinary medicine, human medicine,
environmental and social sciences, wildlife and public
health
• Developing centres of excellence for education and
training ➢ veterinary medicine, human medicine, and
public health
 Human

Animal Environment
With the growing globalization of health risks and the
importance of the human-animal ecosystem interface in the
evolution and emergence of pathogens, the best solution
appears to be One Health approach.; to design and
implement programs, policies, legislation and research in
which multiple sectors communicate and work together to
achieve better public health outcomes,
 What is Transdisciplinarity ?
•Considering academic and non-academic knowledge in the
research process
•Value contributions of all stakeholders in the generation of
knowledge

Society

transdisciplinary
Humanities
Medicine
interdisciplinary

Emerging career profile

Science
6. März 2023 68
 Transdisciplinary process
 Integrates the social and natural sciences in a common
approach (interdisciplinarity), and simultaneously…
 Includes non-academic knowledge systems

One Health

Nat. Sci. Tech. Sci. Econ. Sci. Soc. Sci.

Discipline 1 Discipline 2 Discipline 3 Discipline n

Non- academic
actors
Adapted from Herweg et al. (2011)
Non-academic actors become research partners:

Decision makers Scientists Concerned population

6. März 2023 Transdisciplinarity and Health 70

Health of mobile pastoralists

71
Mixed teams of medical doctors and veterinarians

72
Photo credit: Dawit Abebe [Link]/S73
Implémentation of OH May lead to
 Institutionnal challenges: acceptante, Policy
engagement. how to share credits, added values of One
Health among members, partners

 Capacity building: One Health workforce

 Deeper coordination between sectors on human and

animal (and wildlife) health and the environmental
agencies (also plant health)

 Improving the translation of evidence and research into

policy, more cases to show added values of One
Health/Ecohealth
The OH active institutions Globally

One Health is increasingly being acknowledged by

national and international institutions as the most
constructive approach to address complex issues at the
animal-human-environmental interface.
•The One Health Commission is a globally focused
organization dedicated to implementing One
Health and One Health actions around the world.
•The Commission seeks to ‘Connect’ One Health
Advocates and Stakeholders, to ‘Create’ networks
and teams that work together across disciplines to
‘Educate’ about One Health and One Health
issues.
Southeast Asia One Health Universities Network
The Southeast Asia One Health University Network
(SEAOHUN) is a network of 14 faculties and schools of
medicine, nursing, public health, and veterinary
medicine from 10 Southeast Asia universities in
Indonesia, Malaysia, Thailand, and Vietnam. SEAOHUN
serves as a dynamic partner for building One Health
capacity within the Southeast Asia region, another “hot
spot” for emerging infectious diseases.
SEAOHUN with activities focused on strengthening
Southeast Asia’s One Health workforce. Activities include
 developing innovative graduate and continuing
education programs,
 establishing field experience sites for students
and faculty, and
 embedding One Health Core Competencies into
the classroom.
These activities are preparing the healthcare
workforce to respond to emerging and re-emerging
infectious and zoonotic diseases in Southeast Asia.
Yo Regional related organizations
One Health Central and Eastern Africa (OHCEA), initiated by
Makerere University School of Public Health (MakSPH) in
Uganda, in collaboration with Muhimbili University of Health
and Allied Sciences (MUHAS), School of Public Health in
Tanzania since 2005; with schools of veterinary medicine in
the region joined hands in the formation of OHCEA, which
was inaugurated on 17th October 2010. It all started with
seven schools of public health and seven faculties of
veterinary medicine in DRC, Ethiopia, Kenya, Rwanda,
Tanzania and Uganda.
The work they have done, over the years, has positioned them as a
convening platform for institutions of higher education interested in
using the One Health approach in building the next generation
practitioner. The mandate has expanded. Their name has
changed. Africa One Health University Network
(AFROHUN).
AFROHUN is now taking on a bigger and expanded mandate to cover
the entire continent, reflecting the name. ave expanded. Our
name has changed. (AFROHUN).
Africa One Health University Network (AFROHUN).

Nine African countries , Sixteen universities and 25

institutions

Was able to train 4555 students till 2020

One Health education should be a mechanism to build One
Health capacity and academic partnerships between different
institutions. The overall goal is
to enhance One Health policy formation and implementation, to
contribute to improved capacity of different partners to respond to
any emerging pandemics in the country.
OH approach seeks to expand the human resource base
needed to prevent, detect and respond to potential pandemic
disease outbreaks, and increase integration of domestic animal,
wildlife and human disease surveillance and outbreak
response systems.
The Problem
There has been an outbreak of RVF virus in Marawi, North Sudan. A
group of people have to be identified to discuss response and
solutions to the problems created by the outbreak. The meeting will
be held at the Ministry of Health and chaired by an official from the
Ministry of Health.
Stakeholder meeting:
Roles & responsibilities
• Chairperson
• Secretary
• Stakeholders
Stakeholder meeting: Agenda
First fifteen minutes:
• Problems created by the outbreak
• Possible solutions
• Challenges the team will face

Next forty-five minutes

• Rank the problems