SciTech Europa explores how the One Health Initiative has pioneered a cross-species approach to healthcare.
The One Health approach encompasses a range of programmes, policies, legislation and research which enable improved communication and health outcomes across healthcare for animals, humans and the environment. Forging professional bonds between physicians, veterinarians, dentists, nurses and other scientific and health- and environment-related disciplines, One Health has become pertinent in key issues such as food safety, the control of zoonoses, and the battle against antibiotic resistance.
By synergising disciplines, it is anticipated that the outcome will lead to advances for health care beyond the 21st century – accelerating biomedical research, improving public health efficacy, building on the scientific knowledge base, whilst increasing the standard of medical education and clinical care offered.
As such, the One Health Initiative was formed in 2007 under the objective of promoting the One Health concept. Its founders include Laura Kahn, MD, MPH, MPP, veterinarian Bruce Kaplan, DVON, and physician Thomas Monath, MD. SciTech Europa explores how a One Health approach seeks to mitigate some of the most prevalent health risks today, and how the One Health Initiative has pioneered the approach to healthcare for all.
What risks are there to health today?
Owing to the fact that many of the same microbes infect animals and humans, a one-sided clinical approach to prevention and elimination of infection and disease will fail to be successful. Effectively, a co-ordinated, collaborative approach is needed from physicians and veterinarians in order to combat the close proximities by which humans and animals live in. The close relationship between animals and humans allows drug-resistant microbes to be transmitted through direct contact or contaminated food.
Zoonotic diseases represent a large part of the burden of infectious disease in humans, whereby around 60% of all human pathogens and 75% of new or emerging infectious diseases are spread from animals. As a result, transmission is hastening on an international scale and is only worsened by an increasing population, insufficient sanitation, limited public health infrastructure, as well as rapid increases to international travel and trade. Moreover, animal farming practices across the globe have an effect on both the quality and safety of the food consumed, of which has direct implications on human health.
On the other hand, as human activity makes detrimental impacts upon the natural environment, population growth and increasing levels of consumption become areas of concern. With evolving patterns of land and water use, desolation of habitats, intensive farming, pesticide use, and the prevalence of greenhouse gases in the air, a One Health approach seeks to limit the impact of these changes on the health of all.
What is the One Health Initiative?
The One Health Initiative states that a One Health approach works towards promoting, improving and defending the health and wellbeing of all through enhanced co-operation and collaboration between healthcare and environmental professionals. Moreover, through enhancing strengths in both leadership and management, it is believed that these goals can be reached. Moreover, the One Health Initiative promotes the integration of human and veterinary medicine, and environmental science, in order to pioneer One Health.
As a result, the integrated approach to a species-devoid healthcare system will be made possible through:
- Collaborative efforts towards education in human and veterinary medicine schools, public health schools and environmental professionals
- Reciprocal communication through journals, conferences and through allied health networks
- Collaborative efforts towards clinical care – from assessment through to prevention of cross-species disease transmission
- Collaborative cross-species disease surveillance, alongside shared control efforts in public health
- Joint efforts to achieve a depth of understanding of cross-species disease transmission, through the means of comparative medicine and environmental research
- Shared efforts in the development and evaluation of new diagnostic methods, medicines and vaccines in order to control and/or prevent diseases crossing between species and
- A collaborative effort to both inform and educate political leaders, and the public sector, through accurate media publication.
The One Health Initiative outlines four key concerns – zoonotic infection, animal allergies, the human-animal bond and animals as sentinels – whereby the One Health approach can assist in gaining greater understanding through research, whilst developing an approach to combatting the associated risks.
Animal contact can leave humans vulnerable to a risk of zoonotic infectious diseases, whereby this risk increases in vulnerable groups such as infants, the elderly, or immunocompromised individuals. Therefore, disease control of animals is seen as the most effective means by which patient exposure to infectious pathogens can be reduced.
In instances where humans begin to develop allergies to household animals, consultations with a veterinarian are deemed the most appropriate method of action in order to help identify alternatives to removing the pet from the household.
As humans develop bonds with animals, a therapeutic value can be of benefit to both, leading to implications on medical care from shifts in behaviour. Humans may alter their behaviour and habits, should they recognise that these changes will benefit their pets. One example of this is tobacco cessation.
Animals as sentinels
Some animals may be capable of identifying and raising the alarm for signs of exposure to a toxic substance or infectious hazard in an environment. Therefore, reciprocal communication between healthcare providers and veterinarians is necessary in order to share and relay such information.
The benefits of a One Health approach
Under the synergised approach, many benefits are expected which will not only alleviate the risk to species but assist in combatting global concerns and issues. These benefits include:
- More efficient diagnosis and prevention of infectious disease transmissions between animals and humans
- More efficient management of allergic reactions to animals
- Improvement in the psychosocial status of human patients
- Early detection in regard to health hazards in the environment and
- Increased patient satisfaction.
How will the One Health approach be successful?
By shared collaboration and co-operation between professionals with a range of expertise and discipline, the One Health approach should oversee public health, animal health, plant health and environmental sectors co-operate to mitigate some of the most pressing species-wide concerns today.
In order to effectively detect, respond and prevent zoonosis outbreaks and food safety issues, epidemiological data, alongside laboratory information, should be shared amongst sectors. Meanwhile, international government officials, researchers and other professionals should work towards producing a joint response to health threats.
In the UK, both the NHS and the Department for Environment, Food and Rural Affairs (Defra) have acknowledged the importance of One Health and established frameworks which seek to focus on surveillance and control of resistant strains, prevention of infection, a reduction in the dependency on antibiotics and its prescription to patients, as well as education of professionals, patients and the public.
This article will appear in SciTech Europa Quarterly issue 28, which will be published in September, 2018.