One Health+: Integrated Control and Elimination of Zoonoses
Deputy Head of Department Epidemiology and Public Health, Swiss Tropical and Public Health Institute and University of Basel, Basel, Switzerland
Emerging diseases generate media and public interest in industrialized countries, yet this interest does not accurately reflect the type of infectious diseases where attention is globally most needed. It can be argued that in less-affluent nations and countries in transition, the burden of re-emerging and endemic zoonoses outweighs the burden and associated costs of emerging zoonoses. Less-affluent nations and countries in transition often have inadequate surveillance-response systems. Factors that influence the emergence and persistence of zoonoses are more fully understood at the molecular level, but there is much to be learned about the determinants of transmission at the population level in specific settings. There is currently a lack of understanding regarding intervention effectiveness across all biological, environmental, social, and psychological determinants. “One Health” has no well-defined theoretical framework. In particular, it lacks a socioeconomic perspective and is poorly implemented at the international level. My colleagues and I contend that recognition of inextricable linkages between humans, livestock, companion animals, and wildlife is a necessary requirement for One Health, but it is not sufficient. The success of One Health is dependent on the demonstration of an added value of health and well-being of humans and animals and/or financial savings from closer cooperation of human and animal health initiatives. We propose a concept built on the theory of effectiveness of interventions, combining scientific disciplines that usually work separately, and extending the theory to the animal-human interface at the population level. Understanding the determinants of the effectiveness of surveillance and interventions at different scales, ranging from the household to the government level, can then provide convincing evidence for policy and practice.