I would start by telling you the definition of ‘one health’, but actually I can’t, and really that’s the point! It’s not that I’m forbidden from sharing such information, but more that no-one really seems to agree on the exact meaning of the term! It is essentially a collaboration between the human and veterinary medicine sectors; and the multidisciplinary agenda it promotes could have an application in all of our lives.
I was at the Society of Veterinary Epidemiology and Preventative Medicine (SVEPM) conference in Madrid last week, and ‘One Health on the Move’ was my workshop of choice, due to it being an exciting and relatively new concept. The problem regarding its definition was approached again and again, but due to its relevance to mental health, economic health and wellbeing (for example the effect on farmers’ health and livelihoods by livestock death) as well as both infectious and non-communicable disease (obesity in pet owners is associated with obesity in their pets, presumably through lack of exercise), any attempt to define it becomes prohibitive. It was decided that as a concept it works, but to attempt to define it defies its very nature.
Broadly speaking, one health encompasses both human and veterinary medicine, and other scientific health and environmental communities. Pathogens know no boundaries and can move between different species, with the result that focusing on just one can be a poor disease control strategy. Indeed many of our emerging diseases are zoonoses (present in both animal and human populations): anyone remember the swine flu epidemic? One health aims to promote a multi-disciplinary, collaborative, and holistic approach to public health, with a focus on community wellbeing as a whole (or at least this is how it was being interpreted by the one health workshop attendees on this particular day).
The session was mostly an informal and interactive exchange of opinion, although it began with a formal presentation by James Zingeser of FAO in Rome. He outlined a couple of good one health examples, including a UN collaboration between FAO, OIE and WHO (they have produced a tripartite position paper on zoonoses) and showed a moderately cringe-worthy video on World Rabies Day in Sierra Leone; where a carnival type atmosphere was achieved to raise awareness and encourage local people to vaccinate their dogs. Despite the cringe factor, this illustrated the use of one health approaches well (and woke up a jetlagged international audience!).
Human nature and society drives us to organise. For most of us the ability to categorise based on common features has its roots in early childhood. But compartmentalising academia, professional organisations and government into departments is the enemy of one health. Many problems span disciplines and departments and there is a real danger that if problems lie between sectors then no-one will take full responsibility and the problem will persist. In a public health context, these gaps can cost lives. Rabies is an excellent example: the problem lies in the human health sector, yet the solution lies in the veterinary sector.
A multigenerational change in thinking processes is required. Yes we can have specialists (the PhD wasn’t a waste of time!), but there is a requirement to train young scientists, and indeed all young specialists, to realise how their speciality fits into the broader societal sphere. Indeed, research in the area suggests that a more multidisciplinary approach may benefit us all: groups of diverse problem solvers were shown to outperform groups of high-ability problem solvers. Many of our current policy issues span several disciplines, and thus require a collaborative solution, namely climate change, anti-microbial resistance, chemical pollution and food sustainability. Perhaps the future of the planet requires an entirely holistic approach to problem solving? I suggest we all take a leaf from the one health example and de-compartmentalise!