From “one medicine” to “one health” and systemic approaches to health and well-being

Abstract

Faced with complex patterns of global change, the inextricable interconnection of humans, pet animals, livestock and wildlife and their social and ecological environment is evident and requires integrated approaches to human and animal health and their respective social and environmental contexts. The history of integrative thinking of human and animal health is briefly reviewed from early historical times, to the foundation of universities in Europe, up to the beginning of comparative medicine at the end of the 19th century. In the 20th century, Calvin Schwabe coined the concept of “one medicine”. It recognises that there is no difference of paradigm between human and veterinary medicine and both disciplines can contribute to the development of each other. Considering a broader approach to health and well-being of societies, the original concept of “one medicine” was extended to “one health” through practical implementations and careful validations in different settings. Given the global health thinking in recent decades, ecosystem approaches to health have emerged. Based on complex ecological thinking that goes beyond humans and animals, these approaches consider inextricable linkages between ecosystems and health, known as “ecosystem health”. Despite these integrative conceptual and methodological developments, large portions of human and animal health thinking and actions still remain in separate disciplinary silos. Evidence for added value of a coherent application of “one health” compared to separated sectorial thinking is, however, now growing. Integrative thinking is increasingly being considered in academic curricula, clinical practice, ministries of health and livestock/agriculture and international organizations. Challenges remain, focusing around key questions such as how does “one health” evolve and what are the elements of a modern theory of health? The close interdependence of humans and animals in their social and ecological context relates to the concept of “human-environmental systems”, also called “social-ecological systems”. The theory and practice of understanding and managing human activities in the context of social-ecological systems has been well-developed by members of The Resilience Alliance and was used extensively in the Millennium Ecosystem Assessment, including its work on human well-being outcomes. This in turn entails systems theory applied to human and animal health. Examples of successful systems approaches to public health show unexpected results. Analogous to “systems biology” which focuses mostly on the interplay of proteins and molecules at a sub-cellular level, a systemic approach to health in social-ecological systems (HSES) is an inter- and trans-disciplinary study of complex interactions in all health-related fields. HSES moves beyond “one health” and “eco-health”, expecting to identify emerging properties and determinants of health that may arise from a systemic view ranging across scales from molecules to the ecological and socio-cultural context, as well from the comp...

Public health ethics and more-than-human solidarity

“…Research and practice in relation to One Health is shifting towards concern with shared causes of disease burden across non-human and human populations (Rock et al, 2009;Zinsstag et al, 2011). This shift follows from recognising that there can be no public health without animal health and ecosystem health.…”

A survey of zoonotic diseases in trade cattle slaughtered at Tanga city abattoir: a cause of public health concern

“…Conclusions: The study findings suggest that brucellosis, toxoplasmosis and leptospirosis are prevalent in Tanga and provide definitive evidence of slaughtered stock exposure to these zoonotic agents with concurrent public health consequences. and indirectly from infected farm environments [3,4] . However, most meat-borne zoonoses are acquired through the consumption of infected and under cooked blood and meat [5] .…”

Posthumanist critique and human health: how nonhumans (could) figure in public health research

“…The discourse analysis thus mapped onto the bibliometric analysis, wherein One-health links public health research on zoonotic diseases with research using animal models. The former set of articles could be subdivided in terms of focus, where characterising and classifying pathogens was the goal of some (Cleaveland, Laurenson, & Taylor, 2001;Taylor, et al, 2001), understanding the transmission of diseases and its contexts the focus of others (Epstein, 2001;Jones, et al, 2008;Mangili & Gendreau, 2005;Nicholson & Mather, 1996), while a third subset of articles were more programmatic or calls to action (Jackson, 2003;Spellberg, et al, 2008;Zinsstag, Schelling, Waltner-Toews, & Tanner, 2011).…”