The concept of ‘One Health’ is currently gaining popularity worldwide; India has of late been taking significant strides to deploy concepts and strategies rooted in this idea to bolster the way it responds to health crises. However, One Health is not a new concept.
One Health is a holistic approach to problems that recognises the interconnections between the health of humans, animals, plants, and their shared environment. An early articulation can be found in the writings of Hippocrates (460-367 BC), who contemplated the relationships between public health and clean environments.
The 19th-century German physician and pathologist Rudolf Virchow (1821-1863) later wrote: “Between animal and human medicines there are no dividing lines – nor should there be.” More recently, the eminent veterinarians James Steele (1913-2013) and Calvin Schwabe (1927-2006) have championed the value of ecology for both animal and human health.
Why is One Health special?
Human population growth, urbanisation, and industrialisation have compounded the damage to biodiversity and ecosystems. These harmful environmental changes are linked to zoonoses – diseases shared between animals and humans. Researchers have estimated that 60% of emerging diseases that can infect humans are zoonotic in nature. They include bird flu, Ebola, rabies, and Japanese encephalitis.
In addition, humankind has also become beset by major issues of antimicrobial resistance, food safety and security, and the control of vector-borne diseases. Taken together, these issues warrant both the intersectoral management and the efficiency that characterises the One Health strategy.
One Health minimises resource requirements across sectors. An important way it does this is by encouraging coordination across governmental units, including the Ministries of Health and Family Welfare, Fisheries, Animal Husbandry and Dairying, Environment, and Science and Technology. Taking a One Health approach allows researchers to, for example, share their laboratories and findings, and ultimately make decisions that lead to resilient, sustainable, and predictable policies.
The economic benefits of One Health are understood in contrast to the cost of managing a pandemic with a non-One-Health approach. An assessment of the G20 Joint Finance and Health Taskforce estimated the latter to be around $30 billion a year. On the other hand, estimates by the World Bank have indicated that the former would cost $10.3 billion to $11.5 billion annually.
Recent One Health initiatives
The COVID-19 pandemic of 2020-2023 highlighted the importance of adopting a One Health approach. Since COVID-19, many interventions based on the One Health model have been launched worldwide.
The Government of India established its ‘Standing Committee on Zoonoses’ in 2006 under the Ministry of Health and Family Welfare (MoHFW). The purpose of this committee was to provide the Union and the State governments guidance and recommendations on challenges related to zoonoses. But the pandemic provided the real boost to this topic; India has also floated a number of initiatives in this direction since then.
The Department of Biotechnology launched India’s first consortium on One Health in October 2021. It brings together 27 organisations from several ministries and plans to assess the burden of five transboundary animal diseases and 10 select zoonotic diseases. The government has allocated ₹ 31 crore for three years to the consortium, especially for its promise of improving cross-cutting collaborations between the animal, human, and wildlife sectors.
In June 2022, the Department of Animal Husbandry and Dairy (DAHD) – in partnership with the Bill & Melinda Gates Foundation and the Confederation of Indian Industry – launched a One Health pilot project in Karnataka and Uttarakhand. This initiative intends to strengthen intersectoral collaborations through capacity-building, with the goal of improving livestock health, human health, wildlife health, and environmental health.
India is also currently preparing for a wider ‘National One Health Mission’ to be spearheaded by the Office of the Principal Scientific Advisor.
The idea behind this mission is to coordinate, support and integrate all existing One Health initiatives in the country.
How can we switch?
While dealing with human, animal and environmental health together makes immediate sense on paper, what does it entail on the ground, in terms of things to be implemented? The transformation process can be broken down into four major stages. Each stage requires consistent political will and sustainable financing structures.
Stage 1: Communication
In this stage, the basic mechanisms for communication between various ministries and/or sectors are set up. The focus is on keeping the important stakeholders informed and engaged throughout the One Health transformation, and to help them meet regularly and review progress.
An example of this stage is the National Standing Committee on Zoonoses under the MoHFW.
Stage 2: Collaboration
After initiating communication between the relevant sectors, sector members need to exchange their knowledge and expertise in order to translate ideas into short-term interventions.
Clarifying the roles and responsibilities of different sectors in zoonoses management is crucial in this stage. For example, to manage a zoonotic disease, collaboration means assessing and lowering disease risk, surveillance, building capacity at different institutions, research, and public outreach.
The DAHD’s One Health pilot project in Karnataka and Uttarakhand is a good example of a public undertaking that strengthens just these ties.
Stage 3: Coordination
The activities carried out during this stage are usually routine and long-term. Initiatives to achieve One Health in this stage are spearheaded by a national or a subnational agency (so that it has the authority and the resources to coordinate several ministries). Ideally, the agency should have been established specifically to achieve One Health outcomes.
Typical ‘situations’ that call for long-term coordination include routine environmental and disease surveillance, monitoring trade across borders with respect to animals and animal products, and conducting regular awareness campaigns.
India’s forthcoming ‘National One Health Mission’ would be an appropriate example of this stage.
Stage 4: Integration
By default, government sectors and their units are designed to function vertically – and this is good for managing individual programmes. However, One Health is implicitly intersectoral, and existing system can’t accommodate One Health’s goals and mechanisms if it doesn’t ‘horizontalise’: i.e. it needs to integrate and develop synergies between programmes undertaken across various sectors.So for this stage, a policy framework that helps the relevant sectors to efficiently share resources and streamline their current programmes is essential. India’s national and subnational programmes – such as MoHFW’s Integrated Disease Surveillance Programme and DAHD’s Livestock Health and Disease Control scheme – are currently not integrated with other sectors, resulting in uncoordinated, ad hoc initiatives.
To reap all the advantages of a One Health approach, India should move beyond short-term collaborations and create an integrated, science-based environment. This is a prerequisite for platforms to not just share office space but to also provide access to laboratories and biological samples to the relevant researchers.
Certain samples like blood, tissue, faecal matter, and effluent water are also expensive and come with ethical implications, and an integrated system that deals with them can prove especially beneficial. In such a system, researchers from various disciplines should be able to use laboratories as necessary and generate the requisite inputs will go a long way to meeting major challenges with the One Health approach.
Source : The Hindu Aug 24th 2023
(Irfan Shakeer-The author is a senior research associate at Ashoka Trust for Research in Ecology and the Environment. He is associated with the IndiaZooRisk+ project, which is and India-UK joint initiative.)