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Recurring outbreaks of emerging and re-emerging zoonoses, such as Ebola virus disease, avian influenza, and Nipah virus, serve as a reminder that the health of humans, animals, and the environment are interconnected and that early response to emerging zoonotic pathogens requires a coordinated, interdisciplinary, cross-sectoral approach. As our world becomes increasingly connected, emerging diseases pose a greater threat, requiring coordination at local, regional, and global levels. One Health is a multisectoral, transdisciplinary, and collaborative approach promoted to more effectively address these complex health threats. Despite strong advocacy for One Health, challenges for practical implementation remain. Here we discuss the value of the One Health approach for addressing global health challenges. We also share strategies applied to achieve successful outcomes through the USAID Emerging Pandemic Threats Program PREDICT project, which serves as useful case studies for implementing One Health approaches. Lastly, we explore methods for promoting more formal One Health implementation to capitalize on the added value of shared knowledge and leveraged resources.
R E V I E W Open Access
Implementing One Health approaches to
confront emerging and re-emerging
zoonotic disease threats: lessons from
Terra R. Kelly
, Catherine Machalaba
, William B. Karesh
, Paulina Zielinska Crook
, Kirsten Gilardi
, Julius Nziza
Marcela M. Uhart
, Erika Alandia Robles
, Karen Saylors
, Damien O. Joly
, Corina Monagin
Prime Mulembakani Mangombo
, Placide Mbala Kingebeni
, Rudovick Kazwala
, David Wolking
, Woutrina Smith
PREDICT Consortium and Jonna A. K. Mazet
Recurring outbreaks of emerging and re-emerging zoonoses, such as Ebola virus disease, avian influenza, and
Nipah virus, serve as a reminder that the health of humans, animals, and the environment are interconnected
and that early response to emerging zoonotic pathogens requires a coordinated, interdisciplinary, cross-
sectoral approach. As our world becomes increasingly connected, emerging diseases pose a greater threat,
requiring coordination at local, regional, and global levels. One Health is a multisectoral, transdisciplinary, and
collaborative approach promoted to more effectively address these complex health threats. Despite strong
advocacy for One Health, challenges for practical implementation remain. Here we discuss the value of the
One Health approach for addressing global health challenges. We also share strategies applied to achieve
successful outcomes through the USAID Emerging Pandemic Threats Program PREDICT project, which serve as
useful case studies for implementing One Health approaches. Lastly, we explore methods for promoting more
formal One Health implementation to capitalize on the added value of shared knowledge and leveraged
Keywords: Emerging infectious diseases, Global health, One Health, Zoonotic diseases
Zoonoses lead to millions of deaths annually; the eco-
nomic losses from a single outbreak can amount to bil-
lions of dollars [1,2]. Recurring outbreaks of emerging
and re-emerging zoonotic infectious diseases, such as
Ebola virus disease (EVD), severe acute respiratory syn-
drome (SARS), avian influenza (e.g. H5N1, H7N9), and
Nipah virus disease underscore the need to consider the
interconnections among the health of humans, animals,
and the environment in disease prevention and control
measures. As trade and travel facilitate greater access
and connections across the world, these zoonoses pose
significant and growing global health threats.
Lessons learned from these disease outbreaks highlight
the need to shift to a more integrated, holistic, and pro-
active paradigm, such as can be achieved using the One
Health approach. One Health considers the linkages
among the health of humans, animals, plants, and their
shared environment. As such, the approach allows for a
deeper understanding and ability to address the complex
eco-social determinants of health and to more effectively
and efficiently tackle threats through coordination across
disciplines and sectors. One Health approaches are in-
creasingly recognized for their value in addressing emer-
ging infectious disease (EID) threats, as the majority of
EIDs arise from wild animal reservoirs in biodiverse
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International License (, which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
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( applies to the data made available in this article, unless otherwise stated.
* Correspondence:
One Health Institute, University of California, Davis, CA, USA
Full list of author information is available at the end of the article
Kelly et al. One Health Outlook (2020) 2:1
landscapes experiencing strong anthropogenic pressures,
including human population growth, land use change,
and natural resource extraction [3].
At a global level, there is broad support for the con-
cept, which has led to the establishment of several One
Health initiatives around the world, including designated
divisions within U.S. federal agencies (e.g., in the U.S.
the National Park Service One Health Initiative, Centers
for Disease Control and Prevention One Health Office,
and U.S. Department of Agriculture One Health Coord-
ination Center), interagency working groups and na-
tional multisectoral coordination mechanisms (such as
Bangladeshs One Health Secretariat and Liberias One
Health Coordination Platform) [46], international One
Health networks and consortia (e.g., the FAO/OIE/
WHO Tripartite collaboration, One Health Workforce,
One Health Alliance of South Asia, Southeast Asia One
Health University Network, One Health Central and
Eastern Africa) and One Health designated degree and
training programs [712]. Furthermore, nearly 50 coun-
tries have signed on to the Global Health Security
Agenda (GHSA), which was launched in 2014 to bring
countries together to promote One Health approaches
and strengthen capacities to prevent, detect, and respond
to disease threats [13].
Despite this broad support, implementing One Health
approaches in practice still proves challenging. For in-
stance, most countries lack formal mechanisms for co-
ordination and integration of activities across the human
health, agricultural, and environmental sectors, which
are traditionally based in separate ministries or govern-
ment agencies with different mandates on activities and
spending [4,14]. As a result, practical applications of
One Health approaches have largely been ad-hoc [4,15],
resulting in delayed or incomplete prevention and con-
trol measures. There is also a need for formal standard-
ized analyses showing the added benefits of One Health
over conventional approaches in disease prevention and
control [14,16]. A growing body of research, including
studies revealing the financial benefits of One Health in-
vestments in addressing emerging zoonoses, is building
the evidence base for One Health [17,18]. However,
additional case studies and formal assessments demon-
strating the social, health, and economic benefits are
needed to garner broader high-level support by decision
In 2009, the US Agency for International Development
(USAID) launched the Emerging Pandemic Threats
(EPT) Programs PREDICT Project. PREDICT utilizes a
One Health approach focused on early detection and re-
sponse to potentially zoonotic viral threats at their
source ideally before they emerge in people [19]. PRE-
DICTs efforts have focused on strengthening zoonotic
virus surveillance and laboratory capacity in hotspots
for EIDs. The project provided a platform for breaking
down barriers through development of cross-sectoral
surveillance and laboratory networks with open sharing
of data, coordination on disease outbreak response, and
contributions to extant or new national One Health plat-
forms. PREDICTs efforts to operationalize One Health
in collaboration with government and university part-
ners provide valuable examples and evidence for the im-
portance of One Health approaches in addressing
complex health challenges. Here we discuss the value of
One Health for addressing complex health threats at the
human-animal-environment interface and current hur-
dles for implementing One Health. We also share ap-
proaches used by PREDICT to achieve successful
outcomes, which serve as useful case studies for applying
the One Health approach.
Value of the One Health approach
The One Health approach builds on existing capacities
but is novel in bringing disciplines and sectors together
to provide broader health benefits. Increasing cross-
sectoral coordination can help promote science-based
decision making; reduce unnecessary duplication among
the sectors responsible for the health of humans, ani-
mals, and the environment; and more effectively address
outside factors influencing disease burdens [2,18].
Comparative medicine has long been acknowledged
for its benefits in scientific research, and One Health ex-
pands comparative medicines scope to surveillance in
animals and the environment for early detection and
better understanding of threats to mitigate risk and im-
pacts. For example, great ape die-offs associated with
Ebola virus have often been detected prior to outbreaks
in humans, providing a potential predictive value that
can help prevent human cases if paired with risk mitiga-
tion measures, such as hunter avoidance of carcasses
[20]. Weather conditions have also been used to forecast
Rift Valley fever and other outbreaks and can inform
vaccination and mosquito control campaigns to reduce
health and economic consequences of disease epidemics
[21]. Integrated human, animal, and environmental sur-
veillance can likewise elucidate pathways of pathogen
sharing and inform development of more comprehensive
solutions that emphasize prevention at the source.
The onset of encephalitis cases in people and birds
that were ultimately linked to the emergence of West
Nile virus in the U.S. in 1999 left public health author-
ities challenged with identifying its origin. Critical
insight into the cause of disease was gained from the
veterinary community investigating associated wild bird
mortalities. Currently, sentinel surveillance in mosquitos,
birds, and horses is used routinely to monitor risk to hu-
man health and trigger preventive measures. Parts of
North America and Western Europe have also made a
Kelly et al. One Health Outlook (2020) 2:1 Page 2 of 7
concerted effort to control rabies using a One Health ap-
proach. While effective rabies control efforts have re-
quired substantial investments, they have yielded high
public health benefits, with canine vaccination widely
considered the most cost-effective strategy [2224]. The
successful control of rabies in dogs through vaccination
has then allowed for a targeted approach to managing
wildlife reservoirs. Baseline surveillance data has enabled
managers to monitor risk and target control efforts in
these populations, as seen in response to the rise of rac-
coon rabies.
An economic optimization projection suggested that
investing in a One Health approach through mitiga-
tion of pandemic threats versus business-as-usual
adaptation could yield a savings of over $300 billion
globally over the next century [17]. Similarly, a World
Bank analysis suggested that upfront investments of
$3.4 billion per year globally in One Health capacity
through improved veterinary and public health ser-
vices could avoid over $30 billion in zoonotic disease
response annually worldwide [2].
While these scenarios reflect value for global public
good, countries are also increasingly endorsing health
security as a national priority given the potential for
rapid disease spread via trade and travel networks.
This necessitates improved prevention and control of
both endemic and emerging disease risks within and
beyond a nations borders. Climate and other eco-
logical changes are resulting in shifts in geographic
ranges of species and their pathogens with a wide
range of associated ongoing and novel health threats
ranging from vector-borne and zoonotic diseases to
impacts on food safety and security. For example, the
spread of Zika virus and CDCs request to the U.S.
government for $1.8 billion to respond demonstrate
the need for One Health approaches to implement
preventive measures prior to the emergence of novel
health threats.
Case studies: One Health contributions toward
more efficient and effective response to emerging
zoonotic disease threats
Over the past decade, PREDICT partnered with foreign
governments, universities, and other organizations to ad-
vance One Health initiatives [19]. In collaboration with
local partners, the PREDICT project strengthened
capacity for viral surveillance at high-risk animal-human
interfaces. Also, when requested by host country govern-
ment partners, PREDICT provided support during dis-
ease outbreaks by incorporating animal sampling into
investigations, expanding laboratory analyses to look for
novel viruses, and promoting the growth of a trained
One Health workforce.
Rapid outbreak response and containment
During the widespread EVD outbreak in West Africa in
2014, the Democratic Republic of Congo (DRC) experi-
enced its own separate and unique Ebola virus disease
outbreak. Unlike West Africa, DRC has a long history of
Ebola outbreaks and substantial capacity for response,
due in part to a long-running partnership between lIn-
stitut National de Recherche Biomédicale (INRB), the
national infectious disease reference laboratory, and
other partners like PREDICT. Many experts from the
Viral Hemorrhagic Fever Unit of the INRB were
deployed in West Africa when the outbreak in DRC oc-
curred. As a result, PREDICT was requested to support
laboratory testing. Suspect cases were sampled, speci-
mens were shipped to the PREDICT laboratory at INRB
for analyses, and Ebola virus was detected within 1 day
of receiving the specimens. Importantly, the strain of
Ebola virus detected was distinct from the strain causing
the West Africa epidemic, ruling out linkages between
the two outbreaks. Following the prompt testing and
pathogen identification, the DRC government was able
to access the affected area and respond rapidly with con-
tact tracing, dispatching a mobile laboratory, and quar-
antining suspected cases, leading to swift containment
with only 66 cases reported over the two-month dur-
ation of this outbreak.
The PREDICT team was also able to assist with collec-
tion of wildlife samples from the outbreak area. Contact
tracing later identified the likely source of the outbreak
as an infected wild animal that had been found dead and
butchered for food. This information was key to identify-
ing high-risk practices to target for disease prevention.
The rapid response and field investigations informing on
prevention measures illustrate what is achievable when
an in-country One Health workforce is trained,
employed, and ready to act. Such prevention arguably
becomes even more important when country capacity to
rapidly respond to outbreaks is lacking, especially in fra-
gile areas of high vulnerability to both disease threats
and their impacts (e.g. resulting from weak governance
structures). The impacts of the on-going EVD outbreak
in DRC, which began in Kivu DRC in August 2018,
highlight the challenge of responding to a disease out-
break in a remote location where access and control ef-
forts have been substantially impeded by violence and
insurgency. These reinforce the need for continued cap-
acity strengthening and integration of sectors at national
and sub-national levels, tailored to the local risk context
and stakeholders to promote relevance, sustainability,
and ownership.
Prevention of human disease outbreaks
Currently, response to outbreaks around the world is
highly reactive, with control measures employed once an
Kelly et al. One Health Outlook (2020) 2:1 Page 3 of 7
outbreak in humans has been detected. PREDICT activ-
ities in Bolivia demonstrated that monitoring for zoo-
notic viruses in wild animals can be a valuable early
detection tool for preventing disease outbreaks, particu-
larly in landscapes undergoing substantial alteration,
such as deforestation, where breakdown of natural bar-
riers leads to increased contact between wildlife and
Yellow fever (YF) is a zoonotic viral hemorrhagic dis-
ease [25] that is perpetuated in a transmission cycle in-
volving mosquitos and non-human primate hosts.
Because New World primate hosts are especially suscep-
tible to YFV infection, acute clusters of mortality in
these populations can signal YFV activity and alert au-
thorities to increased risk of human infection, thereby
serving as an early warning system.
In 2012, staff at a wildlife sanctuary in Bolivia, who
had received training in wildlife disease surveillance
through PREDICT, discovered six dead howler monkeys
(Alouatta sara) near the park. In collaboration with the
sanctuary, PREDICT investigated the mortality event.
Post-mortem examinations and diagnostic testing per-
formed at the University of San AndresInstitute of Mo-
lecular Biology and Biotechnology, PREDICTs partner
laboratory in Bolivia, indicated infection by a flavivirus,
the family of viruses to which YFV belongs. PREDICT
partners reported the results to the Ministry of Health,
while conducting further laboratory analyses to confirm
that infection was caused by YFV. The Ministry of
Health, Pan-American Health Organization, and PRE-
DICT conducted a joint risk assessment followed by a
prompt cross-sectoral, coordinated response in the af-
fected area. The response included preventive YF human
vaccination, public education and outreach, and mos-
quito control to reduce risk of infection.
Although YF outbreaks had never been documented in
Bolivian primates, authorities were able to implement
preventive measures in the surrounding area within 1
week of detection of the mortality event. No human
cases of YF were subsequently reported, suggesting the
value of early warning systems for increased zoonotic
disease risk, local pathogen detection capacity, effective
collaboration channels across sectors, and prompt im-
plementation of public health measures for preventing
pathogen spillover from animals into people.
Systematic coordinated data sharing and national One
Health platforms
PREDICT worked with foreign government partners to
establish a systematic One Health approach to commu-
nicating findings stemming from disease surveillance.
The process involved sharing laboratory results with des-
ignated points of contact in the ministries representing
public health, livestock/agriculture, and wildlife, which
facilitated discussions on coordinated solutions. It also
established open communication channels that enabled
more rapid coordinated responses to disease outbreaks.
In Rwanda and Tanzania, this collaborative approach
was the impetus for PREDICTs involvement in the de-
velopment of national One Health platforms in the
In Rwanda, PREDICT-trained personnel served on the
Government of Rwandas One Health Steering Commit-
tee. The committee, which is made up by representatives
from the animal and human health and environmental
sectors, applied a participatory and consensus building
processto develop an integrative framework for solving
problems at the animal-human-environmental interface
[26]. As part of the committee, PREDICT team members
aided in the development of a One Health Strategic Plan
in 2015 [26]. The plan references commitments to en-
hance cross-sectoral collaboration and increase One
Health workforce capacity in Rwanda. It outlines an im-
plementation strategy covering organizational structure
and pooling and mobilizing resources [27]. The Steering
Committee oversees the plan, including prioritization of
resource allocations, and coordinates the technical as-
pects of the strategy, which are integrated into the an-
nual action plans of the implementing partners. If
successfully operationalized, Rwandas One Health Stra-
tegic Plan will lead to more efficient and timely re-
sponses to disease threats [27].
For example, following the avian influenza (AI) out-
break in neighboring Uganda in 2017, the Rwanda Agri-
culture Board, in collaboration with representatives from
the National One Health Steering Committee, conducted
a field investigation of an avian mortality event in
Rwanda. In the process of their investigation, they con-
ducted public sensitization around AI risk through infor-
mal community meetings and radio broadcast. Although
AI was not confirmed in Rwanda, the collaborative ef-
forts initiated by the committee raised critical awareness
and led to improvements in Rwandas National Contin-
gency Plan against AI highlighting the benefits of this
plan to improving preparedness.
Alongside Rwanda, Tanzania also launched its One
Health Strategic Plan in 2015. This plan laid the ground-
work for multi-sectoral coordination and established a
One Health Coordination Unit overseen by a One
Health Steering Committee, comprised of secretaries of
participating ministries and supported by five technical
working groups. Tanzania was the first country to
undergo a self-assessment using the World Health
Organization (WHO) Joint External Evaluation (JEE)
tool, which is a voluntary, collaborative process to assess
a countrys capacity to prevent, detect, and rapidly re-
spond to public health threats [28]. PREDICT represen-
tatives served in one of the technical working groups
Kelly et al. One Health Outlook (2020) 2:1 Page 4 of 7
using the tool to evaluate strengths, gaps, and priority
actions for enhancing national health security. The as-
sessment was instrumental for encouraging cross-
sectoral communication and identifying activities in
which ministry partners could work together to combat
disease threats. The process paved the way for develop-
ing the Tanzania National Action Plan for Health Secur-
ity, which addresses gaps identified by the evaluation. As
a culmination of these efforts, Tanzania formally
launched the first national One Health Platform and
One Health Strategic Plan in 2018 [29].
The way forward: implementing One Health
While mechanisms for operationalizing One Health are
variable across contexts, case studies demonstrating suc-
cessful One Health outcomes can provide valuable
insight for implementing approaches elsewhere. These
can be leveraged as countries work toward multisectoral
coordination platforms with more sustainable ap-
proaches to One Health (such as through the establish-
ment of the Zoonotic Disease Unit in Kenya [30]). These
platforms often have high political will, with oversight
and support at prime minister or presidential levels
which promote country ownership and sustained atten-
tion and across sectors. Over the past 5 years, the GHSA
has been instrumental in creating an enabling environ-
ment and political will for strengthening global and na-
tional health securities through a One Health approach.
JEEs conducted in several countries around the world
have revealed weaknesses in coordination across health
sectors prompting the recommendation to develop na-
tional One Health platforms. To work towards this goal,
the World Bank, USAID EPT program, and United Na-
tions organization partners have compiled resources to as-
sist countries with formalizing a One Health strategy,
including tools for capacity assessments, resource map-
ping and prioritization, and One Health systems improve-
ment [24,3137]. These tools aid in identifying where
investments in One Health approaches and leveraged re-
sources could fill gaps, avoid unnecessary overlap, and re-
sult in more holistic, preventive approaches [18]. In
allocating resources, it is beneficial to conduct formal
standardized assessments to evaluate how best to optimize
investments to ensure added value gained by integrating
efforts across health sectors [32,33]. For example, One
Health approaches have yielded higher returns on invest-
ments through joint human-animal disease surveillance
and prevention and control measures, including vaccin-
ation campaigns [18,19,34]. Cross-sectoral exercises to
assess risk and economic impacts of zoonoses have also
brought stakeholders to the table to facilitate more sys-
tematic collaboration and communication and to identify
opportunities of mutual benefit [18,35,36]. Leveraging
the One Health approach to ensure the wider risk context
and relevant sectors, especially at sub-national levels, can
help boost countriesabilities to prepare for a suite of
current and evolving threats.
Finally, it is critical to continue to raise awareness of
One Health and foster leaders who are uniquely skilled
to work across disciplines and sectors. Around the
world, universities are progressively incorporating One
Health education into their curricula, including desig-
nated degree programs. These programs need to be de-
veloped around a set of core competencies with an
emphasis on practical skill-building [37] to provide stu-
dents with the knowledge and experience necessary to
address complex health threats.
While there is increasing commitment to One Health
across the world, implementing One Health approaches
in practice still proves challenging. Development of na-
tional One Health platforms and policies are critical for
improving coordination and integration of activities and
programs across sectors. In many countries, the GHSA
has provided a platform for coordination and served as
the impetus to initiate One Health strategic plans and to
develop national One Health policies. In addition, sup-
port from international organizations, such as the World
Bank, USAID (EPT Program), and UN partners has
aided several countries in designing and implementing
One Health strategies and in strengthening national One
Health systems [18,19]. While some programmatic ac-
tivities may not be feasible in the absence of external
funding, one route for sustainability is the application of
low-cost coordination systems that have been tested and
validated, including routine inter-ministry meetings to
share disease surveillance results and discuss coordi-
nated mitigation efforts. Country investments in human
and animal health systems, including through develop-
ment loans, illustrate the value that countries place on
enhancing capacity for disease preparedness. Further,
there is a need to continue to bring attention to the
value of One Health approaches and to invest in training
a workforce of One Health leaders who have the skills to
think critically and work collaboratively across sectors.
AI: Avian Influenza; CDC: Centers for Disease Control and Prevention;
DRC: Democratic Republic of Congo; EID: Emerging Infectious Disease;
EPT: Emerging Pandemic Threats; EVD: Ebola Virus Disease; GHSA: Global
Health Security Agenda; INRB: lInstitut National de Recherche Biomédicale;
JEE: Joint External Evaluation; UN: United Nations; USAID: US Agency for
International Development; WHO: World Health Organization; YF: Yellow
This work was made possible by the generous support of the American
people through the USAID. The contents are the responsibility of the
PREDICT authors and do not necessarily reflect the views of USAID or the
U.S. Government. We thank the governments and partners in PREDICT
Kelly et al. One Health Outlook (2020) 2:1 Page 5 of 7
TRK, CM, WBK, PZC, and JM conceived the study and were major
contributors in writing the manuscript. KG and JN led the PREDICT projects
activities in Rwanda and contributed to the writing of the manuscript. MMU
and EAR led the PREDICT projects activities in Bolivia and contributed to the
writing of the manuscript. KS, DOJ, CM, PMM, and PMK led the PREDICT
projects activities in the DRC and contributed to the writing of the
manuscript. RK, DW, JM, and WS led the projects activities in Tanzania and
contributed to the writing of the manuscript. The PREDICT Consortium is a
consortium of researchers who have made substantial contributions to the
design and implementation of the PREDICT project. All authors read and
approved the final manuscript.
This work was made possible by the generous support of the American
people through the USAID. The USAID did not play a role in conceiving or
writing this manuscript.
Availability of data and materials
Not applicable.
Ethics approval and consent to participate
Not applicable.
Consent for publication
Not applicable.
Competing interests
The authors declare that they have no competing interests.
Author details
One Health Institute, University of California, Davis, CA, USA.
Alliance, New York, NY, USA.
Gorilla Doctors, Mountain Gorilla Veterinary
Project and Karen C. Drayer Wildlife Health Center, University of California,
Davis, CA, USA.
Bolivian Network of Primatology, La Paz, Bolivia.
San Francisco, CA, USA.
Sokoine University of Agriculture, Morogoro,
Received: 24 May 2019 Accepted: 13 December 2019
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... Good leadership is a way to establish and maintain networks that bridge across ministries, sectors and countries. The employment of One Health leaders is mentioned in the literature, referring to abilities of performing strategic analysis, finding solutions, organising, and employing flexible and transparent approaches [18,19]. However, in relation to the complexity of One Health activities, more concrete characteristics of leaders must be discussed. ...
... There is no one-fit-for-all solution for catching political attention, as the allocation of services under ministries is different across states, and different government systems Humboldt-Dachroeden One Health Outlook (2023) 5:1 (like federal systems) affect how powers are distributed within a state [19]. Considering a governments structure is important for national One Health approaches, as it can facilitate but also impede the establishment of networks. ...
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Background Implementing a One Health approach is complex. It demands engaging different sectors and actors in the promotion and protection of human, animal and environmental health. A key challenge for successfully implementing the One Health approach are knowledge translation processes among scientists and policy-makers. Methods An online survey reached 104 experts from 23 European countries, working at national agencies or institutes, universities, ministries, non-governmental organisations (World Health Organization, World Organisation for Animal Health), and European Union (EU) agencies. Qualitative and quantitative analyses were conducted to describe experts’ perceptions. Results This study indicated a lack of networks among scientists and between scientists and policy-makers. Relations of scientists and policy-makers were perceived as challenging due to different interests and priorities, leading to difficulties in reaching political attention for One Health topics. It also highlighted a favoured attention to some One Health topics (e.g. antimicrobial resistance) as opposed to others (e.g. environmental issues). Important international actors to push One Health policies forward were the Quadripartite organisations and EU agencies. National actors (government agencies, national research institutes, universities) were on average perceived to be more important than international actors due to their roles and influences. Factors influencing the knowledge translation process were the different languages spoken by scientists as well as politicians, and an equivocal understanding of the One Health approach. Conclusion The study shows the importance of leadership to establish interdisciplinary networks and to problematise One Health issues with clear scope and targets. This will help to link knowledge to needs and capabilities of policy-makers. Establishing strong relationships among national and international actors can encourage networks and raise awareness of the One Health approach to policy-makers. Lastly, promoting research communication skills of scientists can provide a valuable tool to reach policy-makers to enhance attention to One Health topics.
... 16 We also included outbreak reports from a United States Agency for International Development (USAID)-funded project as a programmatic case study. 17 Within each reporting outlet, if there were multiple reports of the same outbreak event in any given year, only the last comprehensive report published on that outbreak was included in the analysis. If an outbreak spanned several years, the last report from each of those years was included in the final analysis. ...
... To understand how outbreak investigations occurring at a project level have reported timeliness metrics and how future projects can improve upon the use of these metrics, our scoping review included a case study of the USAID-funded 11-year global effort 17 aimed at building and strengthening One Health collaborations to detect, diagnose, and respond to epidemic threats. 17,19,20 These PREDICT Outbreak or Health Event Rapid Reports were deemed eligible for full review based on the same inclusion and exclusion criteria as all other reports. For purposes of consistency, we included and analysed reports written from 2017 onward, the year that the project developed a new reporting template for outbreak investigations. ...
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Background As the global population soars, human behaviours are increasing the risk of epidemics. Objective performance evaluation of outbreak responses requires that metrics of timeliness, or speed in response time, be recorded and reported. We sought to evaluate how timeliness data are being conveyed for multisectoral outbreaks and make recommendations on how One Health metrics can be used to improve response success. Methods We conducted a scoping review of outbreaks reported January 1, 2010– March 15, 2020, in organizational reports and peer-reviewed literature on PubMed and Embase databases. We tracked 11 outbreak milestones and calculated timeliness metrics, the median time in days, between the following: 1) Predict; 2) Prevent; 3) Start; 4) Detect; 5) Notify; 6) Verify; 7) Diagnostic; 8) Respond; 9) Communication; 10) End; and 11) After-Action Review. Findings We identified 26783 outbreak reports, 1014 of which involved more than just the human health sector. Only six of the eleven milestones were mentioned in >50% of reports. The time between most milestones was on average shorter for outbreaks reporting both Predict (alert of a potential outbreak) and Prevent (response to predictive alert) events. Interpretation Tracking progress in timeliness during outbreaks can focus efforts to prevent outbreaks from evolving into epidemics or pandemics. Response to predictive alerts demonstrated improved expediency in time to most milestones. We recommend the adoption of universally defined One Health outbreak milestones, including After Action Review, such that timeliness metrics can be used to assess outbreak response improvements over time. Funding This study was made possible by the United States Agency for International Development's One Health Workforce–Next Generation Project (Cooperative Agreement 7200AA19CA00018).
... "One Health is a collaborative, multisectoral, and transdisciplinary approach -working at the local, regional, national, and global levels -to achieve optimal health outcomes recognizing the interconnection between people, animals, plants, and their shared environment" [22]. In recent years, the One Health approach has been successfully practiced for the investigation and surveillance of emerging zoonotic diseases in several countries, including Qatar [23][24][25]. Such an approach is essential to understand the mpox virus and reducing its global health threat [26]. ...
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Monkeypox (Mpox) was mostly limited to Central and Western Africa, but recently it has been reported globally. The current review presents an update on the virus, including ecology and evolution, possible drivers of transmission, clinical features and management, knowledge gaps, and research priorities to reduce the disease transmission. The origin, reservoir(s) and the sylvatic cycle of the virus in the natural ecosystem are yet to be confirmed. Humans acquire the infection through contact with infected animals, humans, and natural hosts. The major drivers of disease transmission include trapping, hunting, bushmeat consumption, animal trade, and travel to endemic countries. However, in the 2022 epidemic, the majority of the infected humans in non-endemic countries had a history of direct contact with clinical or asymptomatic persons through sexual activity. The prevention and control strategies should include deterring misinformation and stigma, promoting appropriate social and behavioral changes, including healthy life practices, instituting contact tracing and management, and using the smallpox vaccine for high-risk people. Additionally, longer-term preparedness should be emphasized using the One Health approach, such as systems strengthening, surveillance and detection of the virus across regions, early case detection, and integrating measures to mitigate the socio-economic effects of outbreaks.
... Other important factors include urbanization, intensive animal production, altered management practices, interaction with wild animals, environmental changes, and pathogen acquisition of new virulence factors (11,12) . In summary, most factors are imposed by human intervention, which directly or indirectly disrupts the host-pathogen equilibrium (9,14) . In swine farming it was no different, most of the diseases Figure 1. ...
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The novel coronavirus pandemic highlighted the importance of discussing and monitoring emerging diseases to scientific society, particularly in the case of zoonotic diseases. Diseases emerge in nature and infect living beings current on all continents, even in the current scenario of biomedical research evolution. Among the most studied emerging animal diseases are the swine viral diseases, due to their high occurrence and severity. Added to this, is the economic impact on the health of pigs and in some cases on human health. The challenges of swine health include endemic diseases, foodborne and transboundary diseases. Idiopathic vesicular diseases and subclinical diseases have also been identified, either alone or in combination with other infections. Several factors have contributed to these phenomena, but failures in biosecurity, biocontainment, and herd immunity imbalances are critical and must be addressed. Viruses evolve naturally, through mutation, rearrangement, or recombination, either to become more virulent or more transmissible, or not. This review will discuss the broad field of emerging swine viral infections, how monitoring the evolution of these viral agents is of supreme importance. Also, when should a new disease or emerging agent is considered a risk to swine production? Although the evolution of pork production systems is admirable, animal diseases continue to account for 20% of the losses. Therefore, international organizations work with member countries to prevent animal diseases, ensure food supply, maintain household income, health, and preserve the future. One Health is not just a concept, but an action of surveillance and control that all countries must implement.
... Since 2009, there has been a substantial increase in One Health research and capacitybuilding funding via global programmes. For example, the US Agency for International Development (USAID)funded Emerging Pandemic Threats Program,48 the Global Health Security Agenda, and the UK Fleming Fund.49 Between 2014-18, the USAID Preparedness and Response Project supported the development and strengthening of One Health platforms in 16 countries in east Africa, west Africa, and southeast Asia,50 and the Fleming Fund has strengthened capacities of and the evidence base for anti microbial ...
There has been a renewed focus on threats to the human–animal–environment interface as a result of the COVID-19 pandemic, and investments in One Health collaborations are expected to increase. Efforts to monitor the development of One Health Networks (OHNs) are essential to avoid duplication or misalignment of investments. This Series paper shows the global distribution of existing OHNs and assesses their collective characteristics to identify potential deficits in the ways OHNs have formed and to help increase the effectiveness of investments. We searched PubMed, Google, Google Scholar, and relevant conference websites for potential OHNs and identified 184 worldwide for further analysis. We developed four case studies to show important findings from our research and exemplify best practices in One Health operationalisation. Our findings show that, although more OHNs were formed in the past 10 years than in the preceding decade, investment in OHNs has not been equitably distributed; more OHNs are formed and headquartered in Europe than in any other region, and emerging infections and novel pathogens were the priority focus area for most OHNs, with fewer OHNs focusing on other important hazards and pressing threats to health security. We found substantial deficits in the OHNs collaboration model regarding the diversity of stakeholder and sector representation, which we argue impedes effective and equitable OHN formation and contributes to other imbalances in OHN distribution and priorities. These findings are supported by previous evidence that shows the skewed investment in One Health thus far. The increased attention to One Health after the COVID-19 pandemic is an opportunity to focus efforts and resources to areas that need them most. Analyses, such as this Series paper, should be used to establish databases and repositories of OHNs worldwide. Increased attention should then be given to understanding existing resource allocation and distribution patterns, establish more egalitarian networks that encompass the breadth of One Health issues, and serve communities most affected by emerging, re-emerging, or endemic threats at the human–animal–environment interface.
... The US Agency for International Development (USAID) through the Emerging Pandemic Threats Program PREDICT project has discovered approximately 1,000 novel virus species from 145,000 samples of wildlife, cattle, and people (Carlson, 2020;Carroll et al., 2018). Some of these viruses have recently caused outbreaks, while others constantly pose a threat to global public health (Kelly et al., 2020). Recent estimates of virus diversity in mammals suggest that at least 40,000 viral species are associated with mammals, of which 25% can transmit zoonotic diseases (Carlson, Zipfel, Garnier, & Bansal, 2019). ...
Parasites impose high selection pressure on host fitness and are thought to be a major selective factor that promotes the evolution of resistance in host populations. Much of the resistance is determined by genetic factors, however, it is unclear what genetic factors promote resistance to parasites. In this thesis, I used Drosophila melanogaster as a model system to study the genetic basis of resistance against RNA viruses. To understand the genetic basis of infection between different viral and Drosophila genotypes, I investigated two classic models, gene-for-gene and matching-allele models. These models consider that the outcome of the infection depends on the specific compatibility between host and parasite genotypes. Here, I demonstrate that the genetic background of flies explained substantially the resistance against the viral pathogen, which represents an exception to the genotype-by-genotype interaction models. Additionally, I developed an accessible and reproducible protocol to isolate and characterize RNA viruses from wild population of Drosophila. As a result of the protocol, two novel positive-stranded RNA viruses were isolated, La Jolla virus (Iflaviriade) and Newfield virus (Permutotetraviridae). Using RNA sequencing and a customised bioinformatics pipeline, I recovered partial viral genomes which were used to reconstructed their phylogeny. Then, I experimentally explored the impact of the newly isolated viruses on Drosophila infected with Wolbachia, a mutualistic endosymbiotic bacterium that protects the flies against RNA viruses. Furthermore, I determined the host range of these viruses infecting several Drosophila species of the Sophora group. In particular, I evaluated the potential of the novel viruses as biological control agents on the invasive species D. suzukii, one of the most important invasive pests of ripening fruits and wine production worldwide. Finally, I performed a genome-wide association analysis to investigate the genetic variation of resistance to the novel viruses using the Drosophila Genetic Reference Panel. The genome-wide analysis revealed a substantial genetic variation in resistance to the virus isolates, providing new insights into the natural genetic variation in resistance to viruses in Drosophila, and antiviral response in insects.
... Evidence indicates issues in implementing these integrated approaches because of inadequacies in policy, funding, education, training, and surveillance, suggesting the need for cross-disciplinary knowledge, skills, and expertise, including practical experience from diverse fields [19][20][21]. Recent data estimate a global shortage of 12.9 million health workers, with approximately 83 countries facing major difficulties [22]. ...
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To sustain the health of humans, animals, and their shared environment, global advo-cacy in policy, funding, education, and training in multi-actor, multi-domain, and multi-level collaboration is required. Emerging interdisciplinary concepts such as One Health, Planetary Health, and Eco-Health (OH/PH/EH) have flagged opportunities to promote health across species; however, there is a lack of understanding about the extent and type of available education and training of professionals working in these disciplines. Therefore, this review aims to identify the ongoing efforts in the pedagogy of imparting OH/PH/EH education across the globe. We conducted a systematic Google database search between August and October 2021. The specific course types covered in this review were limited to degree programs and short courses. All courses using the terms "One Health," "Planetary Health," and "Eco health" were included. A descriptive analysis was conducted to understand the distribution of these courses based on the course type, geographic region, mode of delivery, duration, and course fees. A total of 61 courses delivered across the globe were identified in this review. Among these courses, there were three doctoral degrees, 31 master's degrees, two bachelor's degrees, and 25 short courses documented. The majority of the courses were related to OH (n = 43), followed by PH (n = 10), and EH (n = 08). Overall, there are still a limited number of courses or programs offered on OH/PH/EH, especially for PH and EH. There was geographic inequity as the reviewed courses were centered around the European region. There were also differences in the mode of delivery, as there was a preference for online delivery of courses, and many of them were diploma or certificate courses. Acknowledging the essence of these frameworks in tackling real-world issues, OH/PH/EH education should be made more available in higher education to help mould OH/PH/EH-oriented professionals.
... The in-depth interview guide elicited information on what makes it possible for the employee's organisation to apply a multidisciplinary approach in solving day to day programmatic challenges, whether the employee's organisational culture supports a multi-disciplinary approach to solving day to day challenges, steps taken by the employee's organisation to promote the one health approach, and what makes it difficult to promote a multidisciplinary approach to solving health challenges in the employee's workplace. The questions contained in the in-depth interview guide were developed after a critical review of literature on barriers and facilitators of effective implementation of the one health approach [27,[40][41][42]. After the development of the interview guide, it was pretested among 4 AFROHUN alumni of the 2019 cohort to ensure that the questions were clear and wellunderstood prior to the main data collection phase. ...
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Background The One Health (OH) approach integrates multiple competencies in the prevention and control of disease outbreaks. Through a range of OH competence-based activities, the Africa One Health University Network (AFROHUN) built the capacity of selected students at Makerere University and Mbarara University of Science and Technology. This study applied the Systems Theoretical Framework (STF) of career development to establish the employment status of AFROHUN-Uganda alumni, and the facilitators and barriers to application of the OH approach in their organisations. Methods We conducted an embedded mixed-methods study among a random sample of 182 AFROHUN-Uganda alumni of the 2013–2018 cohorts. For quantitative data, descriptive statistics were computed using Stata 14.0 statistical software. A total of 12 in-depth interviews were conducted, and NVivo 12 Pro was used to organise data during thematic analysis. Results While the majority, 87.4% were or got employed after participating in the AFROHUN Uganda capacity building programme, 68.1% were employed at the time of the survey, 57.7% had worked with their current employer for at least a year, and 39% held managerial positions. The facilitators of applying the OH approach into employing organisations included being knowledgeable about OH, the presence of a multidisciplinary workforce, the nature of activities implemented, and existing partnerships and collaborations between organisations. The barriers to the application of the OH approach included limited funding, a negative attitude towards working with people from other disciplines, and limited knowledge of the One Health approach. Conclusion Notably, more than two-thirds of the OH alumni were employed, and more than a third held managerial position. While these findings portray a fairly good absorption rate of the OH alumni into the workforce, they also highlight the facilitators of application of the OH approach that need to be promoted as well as the barriers that need to be addressed if the application of the OH approach is to be improved within the workforce.
... Some ID pathogens that manifested fully within the past half-century and have transcended into the disease arena to reap global attention include Ebola virus (1970)(1971)(1972)(1973)(1974)(1975)(1976)(1977)(1978)(1979)); hepatitis C virus, HIV, and Escherichia coli O157:H7 (1980)(1981)(1982)(1983)(1984)(1985)(1986)(1987)(1988)(1989); West Nile virus, Nipah virus, influenza A virus (H5N1), Hendra virus, and hantavirus (1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999); Zika virus, SARS-CoV, influenza A virus (H1N1), and Trypanosoma cruzi (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009); and Candida auris, Elizabethkingia anopheles (meningitis), chikungunya virus, MERS-CoV, and SARS-CoV-2 (2010-2020) [5,6]. e continuous threats posed by these changing disease patterns require local, regional, and global interdisciplinary coordination [7,8] to develop surveillance systems that can adapt to an increasingly transformed world. ...
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The current epidemiological transition makes us wonder how the parallel of infectious diseases (IDs) might be at the end of each passing year. Yet, the surveillance of these IDs continues to focus on high-profile diseases of public health importance without keeping track of the broad spectrum of the IDs we face. Here, we presented the prevalence of the broad spectrum of IDs in Ghana. Data from the annual reports on Gold Coast now Ghana, Global Infectious Diseases and Epidemiology Network (GIDEON), and the District Health Information Management System II (DHIMS2) databases were examined for records of ID prevalence in Ghana. Using the IDs from these databases, the paper assessed the epidemiological transition, pathogen-host interactions, spatiotemporal distribution, transmission routes, and their potential areas of impact in Ghana. The topmost ID recorded in health facilities in Ghana transitioned from yaws in the 1890s to malaria in the 1950s through 2020. We then presented the hosts of a pathogen and the pathogens of a host, the administrative districts where a pathogen was found, and the pathogens found in each district of Ghana. The highest modes of transmission routes were through direct contact for bacteria and airborne or droplet-borne for viral pathogens. From GIDEON, 226 IDs were identified as endemic or potentially endemic in Ghana, with 42% cited in peer-reviewed articles from 2000 to 2020. From the extent of risk of endemic or potentially endemic IDs, Ghana faces a high risk of ID burden that we should be mindful of their changing patterns and should keep track of the state of each of them.
... El programa PREDICT es una de las principales experiencias previas de vigilancia de amenazas pandémicas desarrollada globalmente. En dicho programa, financiado por la United States Agency for International Development (USAID), se trabajó con más de 60 países en el periodo 2009-2019 y se identificaron al menos 931 especies de virus nuevos a partir de 145.000 muestras de fauna silvestre, ganado y humanos 32 . ...
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Resumen La pandemia de COVID-19 ha hecho evidente la importancia de la interfaz animal-humano-medio ambiente en la emergencia de zoonosis. A pesar de que el salto de especie se considera un evento raro, el número de enfermedades infecciosas emergentes aumentó de manera significativa en la segunda mitad del siglo xx, siendo estas principalmente de carácter zoonótico y originadas en la fauna silvestre. Entre los determinantes asociados a la emergencia de zoonosis destacan la interacción humana con los ecosistemas, la pérdida de biodiversidad, los cambios en el uso del suelo, el cambio climático, el comercio y el consumo de fauna silvestre, etc. En el proceso del salto de especie existen diferentes fases de adaptación evolutiva entre el patógeno y la especie humana, variando desde su presencia en el reservorio animal sin infección humana hasta enfermedades exclusivamente humanas sin otros reservorios. El conocimiento de la evolución natural de las zoonosis permite identificar los puntos críticos para su control, al tiempo que posibilita identificar posibles candidatos para futuras pandemias. De forma específica, los avances en el conocimiento de los posibles reservorios del SARS-CoV-2 han contribuido a la toma de decisiones durante la pandemia. Por todo ello, y ante la variedad de escenarios que posibilitan el salto de especie y la evolución de los diferentes patógenos en un nuevo huésped, la vigilancia frente a la emergencia de zoonosis debe plantearse bajo la estrategia One Health.
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A One Health approach is critical to strengthening health security at country, regional, and global levels. However, operationally its uptake remains limited. Recent momentum in assessing capacity to effectively prevent, detect, and respond to disease threats has resulted in identification of gaps that require dedicated action. This article highlights relevant tools, standards, and guidance to assist countries and institutions in meeting the collective vision articulated at the 2018 Prince Mahidol Award Conference on "Making the World Safe from the Threats of Emerging Infectious Diseases." Taking stock of assessment findings, resources, priorities, and implementation initiatives across human and animal health, environment and disaster risk reduction sectors can help expand participation in global health security, target risk drivers, and form synergies for collective action and shared gains for both emerging and endemic disease challenges. In addition to health security gains, a multisectoral, One Health approach can drive benefits for wider health sector and global development goals.
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Infectious disease emergence and multidrug-resistant pathogens are among this century’s defining global health challenges. The magnitude of their present and potential impact is sobering. In addition to the disease burden and social impact on families and communities, economic losses due to epidemics and pandemics are often more significant than the direct immediate and longer-term medical expenses.
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Global economic impacts of epidemics suggest high return on investment in prevention and One Health capacity. However, such investments remain limited, contributing to persistent endemic diseases and vulnerability to emerging ones. An interdisciplinary workshop explored methods for country-level analysis of added value of One Health approaches to disease control. Key recommendations include: 1. systems thinking to identify risks and mitigation options for decision-making under uncertainty; 2. multisectoral economic impact assessment to identify wider relevance and possible resource-sharing, and 3. consistent integration of environmental considerations. Economic analysis offers a congruent measure of value complementing diverse impact metrics among sectors and contexts.
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It is increasingly clear that resolution of complex global health problems requires interdisciplinary, intersectoral expertise and cooperation from governmental, non-governmental and educational agencies. ‘One Health’ refers to the collaboration of multiple disciplines and sectors working locally, nationally and globally to attain optimal health for people, animals and the environment. One Health offers the opportunity to acknowledge shared interests, set common goals, and drive toward team work to benefit the overall health of a nation. As in most countries, the health of Rwanda's people and economy are highly dependent on the health of the environment. Recently, Rwanda has developed a One Health strategic plan to meet its human, animal and environmental health challenges. This approach drives innovations that are important to solve both acute and chronic health problems and offers synergy across systems, resulting in improved communication, evidence-based solutions, development of a new generation of systems-thinkers, improved surveillance, decreased lag time in response, and improved health and economic savings. Several factors have enabled the One Health movement in Rwanda including an elaborate network of community health workers, existing rapid response teams, international academic partnerships willing to look more broadly than at a single disease or population, and relative equity between female and male health professionals. Barriers to implementing this strategy include competition over budget, poor communication, and the need for improved technology. Given the interconnectedness of our global community, it may be time for countries and their neighbours to follow Rwanda's lead and consider incorporating One Health principles into their national strategic health plans.
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Over 20,000 rabies deaths occur annually in India, representing one-third of global human rabies. The Indian state of Tamil Nadu has pioneered a " One Health " committee to address the challenge of rabies in dogs and humans. Currently, rabies control in Tamil Nadu involves postexposure vaccination of humans after dog bites, whereas potential supplemental approaches include canine vaccination and sterilization. We developed a data-driven rabies transmission model fit to human rabies autopsy data and human rabies surveillance data from Tamil Nadu. Integrating local estimates for canine demography and costs, we predicted the impact of canine vaccination and sterilization on human health outcomes and evaluated cost-effectiveness according to the WHO criteria for India, which correspond to thresholds of $1,582 and $4,746 per disability-adjusted life-years (DALYs) for very cost-effective and cost-effective strategies, respectively. We found that highly feasible strategies focused on stray dogs, vaccinating as few as 7% of dogs annually, could very cost-effectively reduce human rabies deaths by 70% within 5 y, and a modest expansion to vaccinating 13% of stray dogs could cost-effectively reduce human rabies by almost 90%. Through integration over parameter uncertainty, we find that, for a cost-effectiveness threshold above $1,400 per DALY, canine interventions are at least 95% likely to be optimal. If owners are willing to bring dogs to central point campaigns at double the rate that campaign teams can capture strays, expanded annual targets become cost-effective. This case study of cost-effective canine interventions in Tamil Nadu may have applicability to other settings in India and beyond. mathematical modeling | cost-effectiveness | rabies | sterilization | vaccination
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The perceived benefits of a One Health approach are largely hinged on increasing public health efficiency and cost effectiveness through a better understanding of disease risk–through shared control and detection efforts, and results that benefit human, animal and ecosystem health. However, there have been few efforts to identify and systematize One Health metrics to assess these perceived efficiencies. Though emphasis on the evaluation of One Health has increased, widely cited benefits of One Health approaches have mainly been based on modeled projections, rather than outcomes of implemented interventions. We conducted a review of One Health literature to determine the current status of One Health frameworks and case studies reporting One Health metrics. Of 1839 unique papers, only 7 reported quantitative outcomes; these assessments did not follow shared methodology and several reviewed only intermediate outcomes. For others, the effectiveness of One Health approaches was often assumed without supporting evidence or determined subjectively. The absence of a standardized framework to capture metrics across disciplines, even in a generic format, may hinder the more widespread adoption of One Health among stakeholders. We review possible outcome metrics suitable for the future evaluation of One Health, noting the relevance of cost outcomes to the three main disciplines associated with One Health.
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Significance Emerging pandemics are increasing in frequency, threatening global health and economic growth. Global strategies to thwart pandemics can be classed as adaptive (reducing impact after a disease emerges) or mitigation (reducing the causes of pandemics). Our economic analysis shows that the optimal time to implement a globally coordinated adaptive policy is within 27 y and that given geopolitical challenges around pandemic control, these should be implemented urgently. Furthermore, we find that mitigation policies, those aimed at reducing the likelihood of an emerging disease originating, are more cost effective, saving between $344.0 billion and $360.8 billion over the next 100 y if implemented today.
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The One Health concept is gathering momentum and, over the next 12 months, Veterinary Record will be publishing a series of articles to help encourage that process. Written by specialists in a range of fields, the articles will consider the meaning of One Health, the interactions between animal and human health and how a collaborative and interdisciplinary approach could help to solve emerging global problems. To set the scene, Paul Gibbs outlines the recent history of One Health, discusses current challenges and muses on what the future might hold.
Competency in One Health (OH) leadership was emphasized in the Roadmap for Veterinary Medical Education in the 21st Century in 2011. Since then, several educational interventions have been aimed at increasing awareness and capacity for inter-professional collaboration. At the University of Saskatchewan, Canada, a 3-day event, the One Health Leadership Experience (OHLE), was initiated in 2012 and continues to the present. The event targets students entering their first year of a health professional program and consists of presentations by invited OH guest speakers, networking sessions, small-group case discussions of OH scenarios, and leadership development through panel discussions and interactive small-group dialogues. Post-conference surveys, a 5-year follow-up survey, and two focus groups were conducted to evaluate the impact of participation in the OHLE. After the event, the proportion of students who said they clearly understood OH and its goals was substantially higher than before: 86% versus 14% in 2012, 91% versus 23% in 2013, and 69% versus 24% in 2014. In the 5-year follow-up survey, most respondents (90%) indicated that attending the OHLE increased their interaction with other students from health sciences colleges or schools on campus. Also, most (81%) believed that OH should be formally taught in their program and 80% anticipated implementing, or had already implemented, OH practices after graduation. The OHLE increased participants' awareness of the importance of interdisciplinary approaches and is a successful educational model that can be adapted to health professional curricula at other institutions.