One Planet, One Health
If we take Oscar Wilde’s notion that Life imitates Art into the scientific realm, then before the COVID pandemic, we had its blueprint, the movie Contagion. In this 2011 thriller, a highly contagious virus of unknown origin not only wreaks havoc on the world’s population; the resultant attempts by medical researchers and public health officials to identify and contain the disease highlight the detrimental effects of misinformation and loss of social order as the virus turns into a worldwide pandemic.
Although a work of fiction, the movie underscores the scientific principle of zoonosis, an infectious disease that has jumped from non-human animals to humans. Over 200 zoonoses currently exist, representing a large portion of newly infectious diseases. The pathogen—that which causes illness--may be a direct viral, bacterial, or parasitic transfer, or take a more unconventional route through food, water, or the environment.
Estimates indicate zoonoses cause approximately 2.5 billion illnesses and 2.7 million deaths around the world annually. Because agricultural practices will consistently require intimate interaction between humans and animals, the risk for a zoonotic disease is always in the foreground. Hence, One Health—a global approach to maximize the health and sustainability of humans, animals, and ecosystems.
While the formalized organizational efforts of One Health have only been in existence for the past few decades, the recognized risks of interrelated ecosystems have been well documented since the mid-1800s. The nineteenth century physician Rudolf Virchow first coined the term zoonosis to describe the similarities between human and animal medical practices.
Jump to the mid-20th century, where the noted veterinary epidemiologist, Calvin Schwabe, also documented the interconnected health of humans, animals, and ecosystems. He coined this as One Medicine in his textbook Veterinary Medicine and Human Health.
While increasingly discussed in various scientific journals, the global danger of a zoonotic infection was not fully embraced until the 2003 outbreak of the Severe Acute Respiratory Syndrome (SARS). Caused by a previously unrecognized virus associated with animal markets (in this case, bats), the readily transmissible airborne pathogen quickly spread to 29 countries on five continents. The speed with which SARS took hold demonstrated a new era in global infectious diseases:
• a previously unknown disease could emerge from a wildlife source at any time and in any place;
• a clear need exists for countries to maintain an effective alert and response system to detect and quickly react to outbreaks; and,
• global cooperation and global participation are required to mitigate the spread of new infectious diseases.
To meet these challenges, over the years One Health international consortiums have developed evolving core competencies that focus not only on cross-disciplinary collaboration, but also strategic analysis skills to foster program development at the local, national, and international levels. In addition, as individual relevant disciplinary fields attempt to better understand zoonotic infections, the One Health cross-pollination concept has gained traction in research. Such cross-collaborative research has led to a more mechanistic vs functional understanding of a specific problem.
COVID-19 provided a devastating illustration of the criticality of the One Health approach to a healthy planet. No event in modern history has resulted in such worldwide disruption. Even after close to three years, the world is still coping with the health, societal, and economic consequences, requiring innovative solutions for full recovery.
COVID exposed the disconnect between governmental promotion of the One Health-like approach in international arenas (e.g., conferences and consortiums) and the reality outside of government spaces. The absence of an efficient global early warning system and early collaboration among stakeholders resulted in disjointed governmental efforts worldwide, resulting in unnecessary deaths and prolonged economic discord. Yet regional examples of the One Health concept to manage the pandemic through a shared resource base, interdisciplinary engagement and communication networks, and global answers to address local needs resulted in less adverse impacts in those regions.
Human activity remains the catalyst behind new, emerging, and re-emerging diseases. The crossover of ecosystems will only occur with greater speed and frequency over time. The world population is anticipated to increase by another 2 billion by 2050. In addition, more individuals globally are living in urban centers, with higher density and more economic disparity. This resultant demand for adequate healthcare, food, water, and sanitation may affect human and animal health through contamination, pollution, and changing climate conditions that could lead to the emergence of newer, unanticipated infectious agents. One Health has a proven roadmap to mitigate these opportunistic infections and provide for a more holistic and healthier planet. ▼
More information on One Health is available at cdc.gov, WHO.int, and onehealthcommission.org.
Sharon A. Morgan is a retired advanced practice nurse with over 30 years of clinical and healthcare policy background.