Author: Ms Michele Mayuba

The interconnectedness of human and animal health was first recognized and described in the 19th century by scientists studying disease patterns in populations. Yet, it was in the early 21st century that human and animal medicine was practised together (CDC, 2022).

Over the last decade, there has been notable progress in the recognition, conceptualisation, and understanding of the One Health Approach, particularly during the COVID-19 pandemic. One Health works towards an integrated approach to restore and optimize the health of humans, animals, and their shared ecosystems (WHO, 2023). Here, it creates new methods of surveillance and disease control with the help of the close and interdependent links among these fields including, zoonotic diseases, antimicrobial resistance, vector-borne diseases, food safety, and food-borne disease & environmental health. As the world is working towards preventing Disease X, the One Health approach is viewed as the core to secure populations and economies (Mackenzie & Jeggo, 2019).

The core of the One Health Approach lies in a well-coordinated surveillance system. Spearheaded by the One Health High-Level Expert Panel, the One Health Surveillance System was launched to support and complement all efforts towards Pandemic Preparedness and Response. The Integrated system is the key to pinpointing risk factors and predicting, diagnosing, and responding to emerging infectious disease outbreaks before they explode into pandemics (OHHLEP, 2023).

Recognising the threats to public health across all regions in the world, the One Health Surveillance System is anticipated to be flexible and comprehensive enough to secure healthcare taking into account the One Health issues global. Some countries, mainly in the Global North, have already implemented the One Health Surveillance System successfully. Nevertheless, inequalities pose real challenges for the Global South, and if these inequalities are not dealt with appropriately, the scalability of the System in low- and middle-income countries (LMICs) will be very limited (Mwatondo et al., 2023). This raises the question of whether the urgency of finding solutions to public health risks and global health issues is done with the consideration of the practicability in the Global South.

These problems are further compounded by some country-specific challenges particularly when there are weak national One Health coordination mechanisms and insufficient higher government commitment. Furthermore, there is a lack of comprehensive One Health programmes that engage critical ministries such as environment, wildlife and natural resource management. This limited collaboration between sectors and responsibilities of stakeholders in addition to limited technical expertise such as diagnostic capacities among research and public health laboratories remains a problem for the effective implementation of the One Health Approach (Yopa et. al., 2023; FAO, 2021).

The present challenges with One Health initiatives in LMICs can be attributed to varying government priorities that make it difficult for the authorities to allocate required funding to human, animal, and environmental health and the poor coordination of resources in these sectors. One Health governance is often approached in sectoral, professional and institutional silos, leading to fragmented stakeholder engagement and limiting the application and integration of the three main foundations of One Health - communication, coordination & collaboration. This siloed approach further limits One Health interventions due to difficulty in prioritization of intervention areas in One Health. Furthermore, colonial and donor-controlled funding prevents LMICs from investing in critical areas needed to strengthen health systems. Regrettably, these factors also impede the slow development of the One Health Surveillance System in the Global South, resulting in most current efforts being project-based, not integrated into the existing systems, and fully donor-funded. The Policy initiatives also fall behind and do not address the complexity of factors such as production practices, and the “ground zero” where human activities cause more risks of spreading infections (Yopa et al., 2023).

An ideal One Health Surveillance System requires equal involvement of all sectors, social and political parity, accountable leadership and stewardship, and sufficient financial and human capital investment. The fact that the health systems have gaps makes it essential to prioritize strengthening the health system while establishing a One Health Surveillance system. Furthermore, global financing and cooperation that take into account the priorities of the different countries will speed up this paradigm shift.

Despite these challenges, numerous milestones have been achieved in setting and consolidating the One Health Surveillance Systems across the Global South. The joint work of governments, international organizations, civil society, and local communities has led to these improvements. In recent times, dedicated One Health offices have been established in the agriculture and health ministries of Thailand, Ghana, & Indonesia to foster inter-sectoral collaboration. This has enabled more coordination and data integration in common risk analysis due to issues like antimicrobial resistance, Salmonella transmission, and high-risk zoonotic disease hotspots. Regional networks such as Africa One Health University Network & Southeast Asia One Health University Network and Regional bodies such as Africa Centres for Disease Control and Prevention (CDC) play a critical role in coordinating and promoting One Health initiatives in LMICs through providing support in building One Health Workforce and providing technical support in establishing the One Health strategies. Additionally, the Integrated Strategic Health Surveillance System of Brazil is a tool that integrates epidemiological data from public, animal health, environmental, and agricultural agencies to set priorities (Ingrid et al., 2015).

Additionally, the implementation of One Health initiatives and strategies in the Global South have been successful due to best practices such as policy support from the government and good coordination & collaboration in for example, India and West Africa respectively. India’s key approach in disease prevention and control following the avian influenza and Ebola virus outbreaks has been the One Health approach. India’s government has established One Health framework policies and programs with reflections, orientations and planning steps as they approach One Health issues. The Economic Community of West African States (ECOWAS) Regional One Health Coordination Mechanism (ROHCM) highlights the importance of good coordination and collaboration. Through good coordination and collaboration in ECOWAS, the ROHCM was established and has gained political commitment after having regional One Health meetings and workshops with key stakeholders (Virgil et al., 2021).

The future of the Global South calls for the adoption of the One Health Approach and installing the One Health Surveillance Systems. A robust System guarantees the health and welfare of present and future generations by protecting health through early detection and tracking of diseases, promoting food safety by monitoring the safety of food production systems and facilitating data sharing and collaboration to promote health protection. What we are aiming at is to bridge the systemic gaps so that we can make a sustainable One Health Surveillance System. Translating the impact of the One Health approach which reflects the social, economic and developmental short-term and long-term benefits is crucial. Institutional, sectorial and professional silos can be broken by highlighting the interdisciplinary and transdisciplinary nature of One Health issues and fostering multi-stakeholder engagements in all discussions. Additionally, there is a need to have an autonomous and sustainable investment that focuses on capacity development, infrastructure development, and research collaboration.

Learning from the successes of countries in the Global South, our efforts must be an integrative and collaborative approach to succeed. Data sharing, transparency, and equitable access to surveillance resources will be central to fostering trust and reciprocal partnerships among the stakeholders.

References

1. Centers for Disease Control and Prevention (CDC) (2022) National Center for Emerging and Zoonotic Infectious Diseases (NCEZID). https://www.cdc.gov/onehealth/basics/history/index.html

2. FAO (2021) FAO Regional Conference for Asia and The Pacific. https://www.fao.org/3/nh652en/nh652en.pdf

3. Folorunso O. Fasina, Olubunmi G. Fasanmi, Yilma J. Makonnen, Charles Bebay, Bernard Bett, Kristina Roesel (2021) The one health landscape in Sub-Saharan African countries, One Health, Volume 13, 2021, 100325, ISSN 2352-7714, https://doi.org/10.1016/j.onehlt.2021.100325

4. Ingrid Vargas, Amparo Susana Mogollón-Pérez, Jean-Pierre Unger, Maria Rejane Ferreira da-Silva, Pierre De Paepe, María-Luisa Vázquez, Regional-based Integrated Healthcare Network policy in Brazil: from formulation to practice, Health Policy and Planning, Volume 30, Issue 6, July 2015, Pages 705–717 https://doi.org/10.1093/heapol/czu048

5. Mackenzie, J. S., & Jeggo, M. (2019). The One Health Approach-Why Is It So Important? Tropical medicine and infectious disease, 4(2), 88. https://doi.org/10.3390/tropicalmed4020088

6. Mwatondo, A., Rahman-Shepherd, A., Hollmann, L., Chiossi, S., Maina, J., Kurup, K. K., Hassan, O. A., Coates, B., Khan, M., Spencer, J., Mutono, N., Thumbi, S. M., Muturi, M., Mutunga, M., Arruda, L. B., Akhbari, M., Ettehad, D., Ntoumi, F., Scott, T. P., Nel, L. H., … Dar, O. (2023). A global analysis of One Health Networks and the proliferation of One Health collaborations. Lancet (London, England), 401(10376), 605–616. https://doi.org/10.1016/S0140-6736(22)01596-3

7. One Health High-Level Expert Panel (OHHLEP), Hayman, D. T. S., Adisasmito, W. B., Almuhairi, S., Behravesh, C. B., Bilivogui, P., Bukachi, S. A., Casas, N., Becerra, N. C., Charron, D. F., Chaudhary, A., Ciacci Zanella, J. R., Cunningham, A. A., Dar, O., Debnath, N., Dungu, B., Farag, E., Gao, G. F., Khaitsa, M., Machalaba, C., … Koopmans, M. (2023). Developing One Health Surveillance Systems. One Health (Amsterdam, Netherlands), 17, 100617. https://doi.org/10.1016/j.onehlt.2023.100617

8. Virgil Kuassi Lokossou, Nnomzie Charles Atama, Serge Nzietchueng, Bernard Yao Koffi, Vivian Iwar, Nadia Oussayef, Chukwuma David Umeokonkwo, Casey Barton Behravesh, Issiaka Sombie, Stanley Okolo, Edgard-Marius Ouendo (2021) Operationalizing the ECOWAS regional one health coordination mechanism (2016–2019): Scoping review on progress, challenges and way forward, One Health, Volume 13, 100291, ISSN 2352-7714,https://doi.org/10.1016/j.onehlt.2021.100291

9. World Health Organization (WHO) (2023) One Health. https://www.who.int/news-room/fact-sheets/detail/one-health

10. Yopa, D. S., Massom, D. M., Kiki, G. M., Sophie, R. W., Fasine, S., Thiam, O., Zinaba, L., & Ngangue, P. (2023). Barriers and enablers to the implementation of one health strategies in developing countries: a systematic review. Frontiers in public health, 11, 1252428. https://doi.org/10.3389/fpubh.2023.1252428