EcoHealth 9, 107–110, 2012

DOI: 10.1007/s10393-012-0772-8

Ó 2012 The Author(s). This article is published with open access at Springerlink.com

Editorial

Mainstreaming One Health

Jakob Zinsstag,1,2 John S. Mackenzie,3,4 Martyn Jeggo,5 David L. Heymann,6,7 Jonathan A. Patz,8
and Peter Daszak9
1
Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, 4002 Basel, Switzerland
2
University of Basel, Petersplatz 1, 4003 Basel, Switzerland
3
Faculty of Health Sciences, Curtin University, P.O. Box U1987, Perth, WA 6845, Australia
4
The Burnet Institute, Melbourne, VIC 3004, Australia
5
Australian Animal Health Laboratory, P.O. Box 100, Geelong, VIC, Australia
6
Centre on Global Health Security, Chatham House, London, UK
7
Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
8
Global Health Institute, University of Wisconsin, 1710 University Avenue, Madison, WI 53726
9
EcoHealth Alliance, 460 West 34th Street, 17th Floor, New York, NY 10001

The term ‘One Medicine’ was coined by Schwabe (1984) Consideration of ‘One health’ calls for a reflection on
and focuses attention on the commonality of human and the human–animal relationship from its natural history to
animal health. The underlying concept is traceable to the cultural influences. Molecular genetics suggests that the
late nineteenth century, in contributions of the German human genome is 99 % similar to great apes and 95 % to
pathologist and architect of social medicine Rudolf Vir- pigs. Genetically, humans can be seen as only slightly
chow (Saunders 2000; Zinsstag and Weiss 2001). Schwabe remodelled chimpanzee-like apes (Wildman et al. 2003).
states that there is no difference in paradigm between hu- From a biological perspective, humans should consider
man and veterinary medicine and that both medicines have such domesticated animals and wildlife as close relatives,
the same scientific foundations. Yet, human and animal with similar capacity to transmit infectious organisms to us
health developed during the nineteenth and twentieth as members of our human family. We should therefore
centuries into fairly segregated disciplines or ‘silos’, sepa- treat our relationship with other animal species as part of a
rated at the academic, governance and application levels. In continuum across which pathogens can emerge and spread,
recent decades, the concept of ‘One Medicine’ evolving to exploiting new niches as we change our interactions, and
‘One Health’ has gained momentum worldwide after the moving into and out of erstwhile distinct species, regions or
SARS outbreak in 2003, and then driven by fears of a communities (Daszak et al. 2000).
possible pandemic of H5N1 avian influenza (Zinsstag et al. Nevertheless, the contemporary human–animal rela-
2005; Worldbank 2010). One Health now encompasses a tionship is complex and profound, ranging from exploita-
broad agenda from zoonotic infections (Roth et al. 2003), tion of livestock for food and anthropomorphisation of
food safety, to health services delivery (Schelling et al. animals as pets, to live ‘wet markets’ and international
2005), and beyond. trade in animal species; these processes, which are highly
culturally determined, create interfaces between animals
and humans, which lead in some instances, to disease
Published online: July 10, 2012 emergence. Additional driving mechanisms of potential
disease emergence or resurgence stem from: indiscriminate
Correspondence to: Jakob Zinsstag, e-mail: [email protected]
108 Editorial

destruction of native habitats for economic or agricultural cooperation and communication between human and ani-
development; biodiversity loss and niche invasions; in- mal health. There are obstacles, many of which are eco-
duced genetic changes (e.g. antibiotic-resistant bacteria or nomic, to broad transdisciplinary acceptance of the benefits
pesticide-resistant mosquitoes); and environmental con- gained from a One Health approach. These range from
tamination (Patz et al. 2005). understanding and mitigating the determinants of zoonoses
Of these activities, probably the primary factor driving and emerging infections to the prevention, detection and
human and animal interaction is globalised livestock pro- response when they occur in animal and/or human out-
duction, which tends to focus on maximising profit, breaks. To overcome these obstacles, we urgently need
sometimes with ethical implication. This leads to compet- stronger international leadership from the major interna-
ing agendas as, ironically, moderate intensification of tional organizations—the World Health Organization
livestock production is the way out of poverty for millions (WHO), the Food and Agriculture Organization (FAO) and
of smallholder farmers. Similarly, naturalist movements the World Animal Health Organization. The Office of the
sometimes claim that human rights extend to primates, United Nations Secretary General’s Special Representative
whales or other species, yet these are not widely held beliefs. for Food Security and Nutrition may also play a crucial role.
It is these dilemmas of aspiration for economic gain in a A tripartite agreement has been signed by WHO, FAO and
globalised economy, desire for social development and OIE for sharing responsibilities and coordinating global
concern over animal welfare that largely determines the activities to address health risks at the animal–human–
human–animal relationship. Intercultural work on the ecosystems interface (Anonymous 2010). Stronger imple-
human–animal relationship requires a clarification of one’s mentation of this agreement and associated advocacy is
own perspective in a self-reflective way. ‘What is my per- essential to give credibility and support to the One Health
sonal cultural/and ethical background that determines my concept, and to ensure national One Health planning that
relationship with animals and my concept of one health?’ can better respond to zoonoses and food safety.
Answers critically determine the emotional or financial Working together under this agreement, these three
value assigned to animals. Could this lead to a new sub- international organisations could provide the evidence
jectivism in Science? ‘One health’, for example, can be and rational answers to questions such as: What are the
influenced by philosophical ramifications, that determine direct benefits of joint human and animal communicable
the method of economic analyses of the cost of infections disease surveillance, along with environmental monitor-
that are transmissible between humans and animals (Nar- ing, for time to detection and response, the number of
rod et al. 2012). lives saved, and associated financial savings? How is power
How can we benefit most from ‘One health’? Firstly, most effectively shared in leadership and chain of com-
through the broad implications of closer cooperation mand that leads to effective and nimble implementation
between human and animal health sectors and recognising of integrated disease surveillance and control? What are
the linkages among humans, animals and the environ- potential benefits of joint antibiotic resistance surveillance,
ment. This broad vision means that One Health solutions as in the Canadian Integrated Programme for Antimi-
will benefit health, conservation and development. Sec- crobial Resistance Surveillance (CIPARS)? What are ben-
ondly, mainstreaming a ‘One Health’ approach should efits of joint laboratory facilities for human and animal
lead to better health for humans and animals and finan- communicable diseases, modelled after Canada’s National
cial savings to society from such a closer cooperation Microbiology Laboratory? What might be the benefits if
between the sectors which could not be obtained if they cancer registries for humans and animals were joined
worked in separation. Recently, ‘One health’ conceptual (O’Brien et al. 2000)? How could the Performance of
thinking has evolved towards systemic approaches that Veterinary Services (PVS) and the International Health
consider health as an outcome of social–ecological sys- Regulations (IHR), be linked in order to enhance their
tems. This includes concerns about social equity and the performance?
‘integrity’ of the environment (Zinsstag et al. 2011). ‘One Answers to these and other such questions may not
Health’ is clearly part of the broader consideration of necessarily lead to new structures, new governance or even
ecology and health. a ‘One Health’ society. Rather, the existing international
There is, however, a large unfinished agenda in the organizations, by providing the scientific evidence and
‘mainstreaming’ of one health that requires enhanced guidance based on this evidence, could provide what is
 Editorial 109

needed to change current siloed practices that are our approach to diseases at the human–animal–ecosytems
normal way of doing business. Let us continue to work in interface.
our disciplines and institutions to bring them closer by
improved communication, greater collaboration and better
information sharing. Fostering mutual respect amongst OPEN ACCESS
doctors and veterinarians and recognising and acknowl-
This article is distributed under the terms of the Creative
edging the interdependence of health in humans and ani-
Commons Attribution License which permits any use,
mals is a necessity. At the same time, new evidence is
distribution, and reproduction in any medium, provided
expanding on the dependence of both human and animal
the original author(s) and the source are credited.
health on ecosystem functioning, generally termed as
‘ecosystem services.’ According to a 2011 US report of the
President’s Council of Advisors on Science and Technology
(PCAST), ‘Ecosystems and the biodiversity they embody
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