“One health” for the world

As the health, economic, and now diplomatic fallout of the COVID-19 pandemic continues without abatement, the need for a united international effort to mitigate the devastation of COVID-19 is being widely discussed.

Soon, however, attention will shift to averting another pandemic of this kind.  As the saying goes, “prevention is better than cure.” In seeking an approach to achieve such ends, governments and multilateral institutions would do well to strengthen health security, particularly through “One Health” approaches, which bring together animal, environmental, and human health sciences to illumine our understanding of disease emergence and transmission cycles.

Indeed, the recently adopted World Health Assembly resolution, which calls for a “lessons learned” response, will likely incorporate a One Health approach. To avoid a catastrophe like this occurring again, the international community must bolster One Health capabilities in and amongst countries as a strategic priority.

More than half of the infectious diseases that affect humans have a non-human animal source. Diseases transmitted from animals to humans, among them Ebola, rabies, SARS, tetanus, and of course COVID-19, are termed zoonotic diseases or zoonoses.

Protecting humans from infectious diseases, then, requires an understanding of human-animal-environment interactions in a variety of settings, such as on farms, at the wildland-urban interface, or in a wet market.

Compounding this challenge is the fact that animals have no regard for political borders and, as such, the diseases they transmit can travel with them into various jurisdictions (though it should be said that most zoonotic disease outbreaks are accelerated by human-to-human transmission).

Recognising the interconnectedness of environmental, animal, and human health, professionals from a range of disciplines collaborate within a holistic approach, termed “One Health.”

One Health has been variously defined for decades and conceptions of it can even be found in the works of Hippocrates, Aristotle, and the Persian polymath Avicenna (Abu Ali Sina). Today, One Health essentially holds that environmental conditions, animal health, and human health are inextricably linked.

Operating in this multidisciplinary space are veterinarians, medical researchers, public health practitioners, environmental scientists, doctors, public servants, urban planners, and an array of other professionals, all mindful of the pitfalls of siloing their disciplines in combating One Health challenges.

Yet despite its utility and potential to mitigate the devastating impacts of pandemics, One Health is a neglected and poorly understood concept in both broader society and security discourse.

In a recent Analysis piece for the Australian Institute of International Affairs’ Australian Outlook, cultural analyst Diego Bolchini asks us to rethink “traditional conceptions of security” in the context of the current pandemic.

He argues for a broader vision, beyond “a political-military conception of a conventional security threat” in order to combat the COVID-19 pandemic. Part of this reconceptualisation of security, and international efforts to maintain it, should include a consideration of One Health as a key paradigm in preventing crippling disease outbreaks.

Historical examples demonstrate the power of One Health approaches, and the dangers of not implementing them. For both the SARS outbreak in the early 2000s and the 2014–2016 Ebola outbreak in West Africa, One Health approaches were crucial in stemming the ramifications of the disease and preventing a pandemic.

More importantly, rigorous implementation of the disease surveillance, environmental monitoring, urban planning, and health infrastructure that coalesces in One Health could have prevented or quickly quashed the outbreaks at the outset.

Both outbreaks posed a threat to national and regional stability and, particularly in the case of the Ebola outbreak, stressed already fragile political, social, economic, and health systems in West Africa. COVID-19 is today challenging these structures everywhere and it serves as another reminder of the need to strengthen strategies to protect people and the economies that support us.

While the securitisation of health poses a danger in elevating the importance of some health challenges over others and tends to conceive of matters as significant only if they threaten security, the integration of One Health into a less militarised conception of security reshapes it as a proactive, peace-building practice that protects human life and livelihoods, rather than the reactive practice of militarily posturing or responding to threats with arms. Clearly the systems of security currently in place need strengthening.

While the shock and awe of war, the political motivations that underlie it, and the psychological trauma it causes cannot be downplayed, the COVID-19 pandemic impacts society in some of the ways that armed conflict does: loss of life, perturbations to human health, disruption of commerce and trade, shifts in the international order, diplomatic disputes, reorienting of scientific priorities, mental health challenges, and so on.

As such, a reimagined definition of security should embrace strategies to prevent pandemics and combat climate change just as much as it seeks to promote political stability and defend populations against violent adversaries.

An expansion of our conception of security strategy, then, should be reflected in the tools used to safeguard human life and the environmental, cultural, social, and economic assets which our communities are organised around. There is an important place for One Health here.

From an Australian perspective, the country is well positioned to contribute to the development of stronger One Health capacities at the international level.

Australia’s strong scientific and technical capacity, underscored by a community of researchers and practitioners with extensive expertise in One Health-related disciplines, lends itself to regional and international endeavours aimed at preventing pandemics as part of a global system of holistic security.

Efforts that Australian governments and institutions have already made in this regard are admirable. The Indo–Pacific Centre for Health Security, launched in October 2018, seeks to address the threat of infectious diseases with a variety of programs across the Indo-Pacific region.

Disease surveillance of migratory birds and the establishment of sentinel cattle herds in Northern Australia and Papua New Guinea also contribute to animal but also human biosecurity in Australia, as does the work of biosecurity authorities at airports and various maritime points of entry.

Promising as such initiatives may be, without a regional or international system for preventing or containing zoonotic disease outbreaks, the effectiveness of these efforts is limited.

As the rapid, international travel-facilitated spread of COVID-19 has so far demonstrated, the world is today inextricably linked in ways it has not been before. A disease outbreak in one corner of the world threatens the health of millions and the resulting economic shocks jeopardise the livelihoods of hundreds of millions of others.

Given the global reach and influence of these zoonotic diseases, One Health approaches must be coupled with cooperation between national and subnational governments together with international institutions like the World Health Organisation, the World Organisation for Animal Health and the Food and Agriculture Organisation.

Preventing crises calls for the adoption of practices, policies and systems like One Health which address the challenges confronted by an evolving global society. COVID-19 has contributed to perhaps the biggest social and economic disruption humanity has faced since the end of the Second World War.

And just as the world sought to prevent another calamity of that scale by erecting international institutions to foster peace and justice then, so too must we revaluate the nature of this system now and adapt it for today’s challenges.

The One Health paradigm necessitates cooperation and an approach to security and safety in which people work together against a non-human threat. The international community should welcome a One Health approach to understanding and, importantly, preventing pandemics like this occurring again.

At its heart, a multidisciplinary approach like One Health demonstrates the efficacy of unity – that we are stronger and more secure when we work together. We reject this reality at our own peril.

This article was published by The Australian Institute for International Affairs.