Why preparing for the next pandemic requires implementing the One Health approach in letter and spirit

COVID-19 is not the last pandemic, and the next ones are very likely, unless we unite to prevent it

Healthcare worker takes nasal swab sample from woman for COVID-19 test – ANI

One Health is one of many expressions that have now entered common parlance after the COVID-19 pandemic. This used to be a niche area, primarily where veterinarians brought attention to the importance of animal health and its significance in the wider health agenda, albeit with limited interest from the rest of the sectors. The increased awareness in the public consciousness of how wildlife, domestic animals and human health are intertwined in this biosphere is encouraging.

For any movement to gain momentum, the first step is to raise awareness. Next comes acceptance, then the urgency as a society to resolve the challenges it faces. The problem of climate change has gone through these transitions and now we are entering the frantic phase of “searching for solutions”. It is therefore significant that the field of One Health is now entering the very first stage of public awareness.

While increased awareness is a good outcome, the very definition of One Health needs to be clarified. Commonly offered descriptions of “humans, animals, and the planet” sound like it’s all about it. When a concept is about everything, it may not be about anything specific. Therefore, we need clear problem definitions of what “One Health” is.

The second issue arises from the vagueness mentioned above. One Health in the current construct comes across as a set of wellness statements that are hard to disagree with, but that’s where it ends. As the concept of “world peace” is generally attractive, but it is difficult to build specific strategies and solutions around it. Repeating phrases such as ‘multi-sector collaborations’ and not going deeper into ‘what’ and ‘how’ of this concept will be implemented on the ground can risk losing momentum.

The third and final challenge is missing integrated thinking. If we take the example of disease surveillance, many efforts are underway today. Some are vertically funded global priorities, such as malaria. Others are current national priorities such as the control of foot-and-mouth disease in cattle. These efforts are often limited to a single compartment among wildlife, livestock, and humans, even though diseases transcend two or all three compartments. Even cross-cutting topics such as rabies control are often implemented in silos without the context of the underlying operating systems in those silos.

What we need instead is a holistic understanding of the three compartments, their complexities, and the incentives that drive certain behaviors within and through. Based on such a broad understanding, we need to solve specific problems, whether it is rabies, tuberculosis, foot and mouth disease or covid. When these are built on existing systems, be it forestry and wildlife professionals, veterinarians and technicians, and the range of medical and paramedical staff who deal with routine issues, they tend to better integrate and maintain themselves. We need programs that bring together the full range of those stakeholders in the fight against rabies or tuberculosis that span all three compartments, each of which has its own mandates and incentives so as to complement each other instead to work against each other.

Equally, and more importantly, pandemic preparedness requires real collaboration at all levels to be successful. In this case, we are dealing not only with diseases such as avian flu, which we know something about and know what to look for, but also potentially with a new class of disease which we know very little about. Additionally, for this preparedness system to work over the long term, it must be built on existing systems and linked to routine monitoring programs. If implemented as a stand-alone initiative, as the current crisis passes, it risks losing the attention and resources needed to keep the system in an active form of preparedness.

In addition to the intellectual understanding of these issues, we need real pilots with this integrated reflection as a strategy. In fact, many such drivers in various contexts are needed. Indeed, we don’t yet know how to do it sustainably, what works on the ground, and how complementary or opposing incentives play out in the real world. In this context, it is important to note the “One Health” program recently launched in Uttarakhand by the Department of Livestock and Dairy Husbandry (DAHD) (https://www.ohsu.in/). The approach includes wildlife, animal and human surveillance, workforce development, laboratory strengthening and networking, outbreak detection, notification and response, biosecurity in animal production systems and community awareness.

The country looks forward to the successful implementation of this ambitious agenda, with lessons emerging on what works and what does not. In the end, we learn as much if not more about what doesn’t work than about what ends up succeeding in predicting, preventing and controlling the diseases that afflict our biosphere.

The author is a Visiting PSA Researcher at the Office of Chief Scientific Adviser, Government of India and a Senior Visiting Researcher at Huck Institutes, PennState. He is also a member of the Project Steering Committee for the One Health Program of the Department of Animal Husbandry and Dairy Industry, Government of India.

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