Should “One Health” be the government’s priority?
With the human health care infrastructure deeply strained and unable to meet demand, particularly in the context of the additional burden of the COVID-19 pandemic, the broader topic of ‘One Health’ is expected it be a priority?
This is an important issue, especially in light of the growing number of global and Indian leaders and institutions urging the need to adopt One Health as a key focus area.
The US CDC describes One Health as “a collaborative, multisectoral and transdisciplinary approach, working at local, regional, national and global levels, with the goal of achieving optimal health outcomes by recognizing the interconnection between people, animals, plants and their shared environment. ”
A One Health approach recognizes that the health and well-being of animals, humans and the environment are deeply and increasingly interdependent, driven by growing population, increasing travel and connections across the planet , and the proximity of human contact with animals and the environment.
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These interconnections have led to an increase in chronic zoonotic as well as multifactorial diseases. Compounded by antimicrobial resistance and environmental pollution, tackling these diseases in a holistic manner requires a collaborative approach involving multiple stakeholders and experts among providers and systems in health, public health, forestry, veterinary medicine, the environment and other related disciplines.
Historically, difficult times have fostered increased global collaboration. Over the past few months, we have seen such collaborative partnerships and networks across the world and in India benefit millions of people medically, economically and socially affected by COVID-19. This has helped accelerate the momentum of One Health.
One Health in India, although nascent, is taking more and more root. The government has launched initiatives to tackle issues such as antimicrobial resistance, zoonotic diseases and food security using a One Health approach, which is multidisciplinary in nature, involving interdepartmental work and navigating networks and institutional hierarchies.
This represents a great opportunity to improve and further strengthen this approach and to seamlessly integrate several aspects of the ecosystem and prepare our health systems for the future.
The implementation of one health will need to resolve several priorities, including three key intervention areas: (1) a holistic approach to health care, (2) a strong network of qualified professionals and (3) partnerships and infrastructure.
Holistic health care
Holistic health is becoming increasingly important as the links between different zoonotic, infectious and chronic diseases become clearer, with one disease impacting the risk of vulnerability or complications from others.
In response, therapeutic interventions focus on targeting multiple indications and / or complications. Prevention is increasingly seen as a key priority and a key pillar of holistic health and well-being.
Additionally, we are learning that humans’ relationship with animals and nature in regards to health and well-being is more nuanced than is traditionally thought.
The benefits of animal assisted therapy (AAT) for humans have been well documented not only in companion animals, but also in farm animals.
The use of agricultural farms as a base to promote human mental and physical health in cooperation with health authorities is growing in several countries in Europe and the United States.
In some countries this is called Green care, a concept that is not limited to the use of animals but also includes plants, gardens, forests and the landscape. In India, clinician-led, institutionally strengthened advocacy and support for green care, along with well-coordinated command, can be part of a “green recovery” and increased sustainability of health care.
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Given the magnitude of the demand posed by the large population, capacity building and capacity building is essential. This requires bringing together a network of qualified and specialized professionals in a wide range of disciplines, such as medicine, veterinary medicine, life sciences, mathematics, physics, chemistry, social sciences, and human sciences. environment, etc.
One Health workers should have both a solid disciplinary background and training to work in multidisciplinary environments. Few countries can cite their interdisciplinary leadership and management training programs and graduates with the same ease as they follow graduates of specific disciplinary programs such as medicine.
It is important to change. One Health education has been successfully integrated into secondary schools in some countries, while many countries offer university and postgraduate level programs. Indian schools and universities should consider incorporating One Health as a curriculum not only in medical courses but also in other programs.
Partnerships and infrastructures
Coordination mechanisms are needed to support One Health approaches, for example working groups and interpersonal relationships that encompass government agencies and jurisdictions, public-private partnerships, networks and community working groups.
These can be based on informal relationships driven by a shared vision, or formal mechanisms governed by laws. The need for coordination also applies to surveillance efforts. For example, we have human and animal disease surveillance programs.
It is worth considering whether these systems could be integrated to help establish a roadmap towards creating a unified One Health surveillance system in the country. A key role of One Health governance is to maintain and nurture long-term relationships. Productive, trustworthy and mutually rewarding partnerships take time to build and require support.
One Health has the potential to drive an ecosystem approach to healthcare, with the various components of the system working in their areas of expertise, respectively, but learning from and collaborating with each other to make available to humans. and animals cohesive health and care solutions.
(The author is Managing Director, Boehringer Ingelheim India.)