Amalgamation of disciplines

The COVID-19 pandemic has renewed interest among scientists and policymakers in building an integrated approach for prevention, early detection and instituting appropriate responses to control such public health emergencies.

'Pandemic-preparedness plans' are already under consideration among major international bodies to thwart the pandemic in the future. The multi-disciplinary approaches of 'One Health' are central to these plans.

The core of the One Health approach is rooted in acknowledging and understanding the interdependence of human and natural systems to obtain optimal health for people, animals and the environment.

About 60 per cent of the known infectious diseases in humans and 75 per cent of all emerging infectious diseases are caused by pathogens that originate in animals, according to the Centers for Diseases Control and Prevention.

Antibiotic-resistant microbes also can effectively be transmitted from animals to humans and cause diseases in humans which may not respond to affordable antibiotics.

Extensive and irrational use of antibiotics, especially in the livestock sector for increasing yield and preventing diseases, causes the emergence and selection of resistant pathogens. These spread through animal-human interaction or the food chain.

One Health can have the following benefits:

• Reduce potential threats at the human-animal-environment interface to control diseases that spread between animals and humans

• Tackle anti-microbial resistance (AMR)

• Ensure food safety

• Prevent environment-related health threats to humans and animals

• Protect biodiversity

The One Health concept is not new but it is important to address the complex health and environmental challenges that have become more prominent in recent years. This is because a potential solution to these problems can only be understood when the human, animal, and environmental health questions are evaluated in an integrated and holistic manner rather than in siloed approaches.

An important aspect of such an integrated approach is the systematic collection of data on the occurrence of infectious diseases and related behaviours in both humans and animals. Improved collaboration, coordination and commitment of relevant sectors to minimise the impact of these diseases on human health is also a salient feature.

The Food and Agriculture Organization of the United Nations (FAO), the World Organization for Animal Health (OIE) and the World Health Organization (WHO), under their tripartite agreement and in collaboration with the United Nations Children's Fund (UNICEF) and the World Bank, have developed a joint strategic framework to implement the One Health approach.

The framework aims to assist national authorities in initiating steps to strengthen efforts towards the control of zoonoses and AMR in a comprehensive manner through collaborative activities among various sectors for a healthier and more productive human and animal population co-existing in a safe environment.

The implementation of One Health can be driven by policies (legislations and regulations, financing), knowledge sharing, institutional collaboration, joint programmes and operational plans, advocacy and awareness amongst policymakers and professionals, engagement of civil society and active community participation.

In India, efforts have been made to bring human and animal health together. There have been instances of collaboration at national and state levels to combat specific diseases or to overcome disease outbreaks such as the national influenza pandemic committee to control avian influenza and rabies in Tamil Nadu and other states.

Institutes like the Indian Council of Medical Research (ICMR) and the Indian Council of Agricultural Research (ICAR) have collaborated on joint research priorities, mostly to control disease outbreaks and also at individual levels between human and animal health researchers as well as practitioners.

The Integrated Disease Surveillance Project, launched in 2004 for disease outbreak detection and rapid response functions, has generated various information on the flow of certain disease outbreaks but the programme has been unable to integrate human and animal (livestock and wildlife) surveillance.

A multi-disciplinary Road Map to Combat Zoonoses (2008) was laid out to create an integrated mechanism for surveillance, detection and treatment of zoonoses. It identified several strategies for research and actions, but integrated surveillance, involving human, domestic and wildlife for long-term monitoring on a large scale has failed to materialise. As a result, the burden and dynamics of emerging and re-emerging infectious diseases are yet to be understood.

But recently, there have been several proactive steps which acknowledge the relationships between biodiversity loss, changing land-use patterns and zoonotic diseases.

The National Mission on Biodiversity and Human well-being is built on a framework that integrates biodiversity, ecosystem services, climate change, agriculture, health, bio-economy and capacity-building in the realm of biodiversity science has one mission component that explicitly links biodiversity to human health through the One Health approach.

The Government of India decided to set up a dedicated centre under ICMR to contain zoonotic diseases — the Centre for One Health at Nagpur, and also constituted a 'National Expert Group on One Health' to promote multi-sectoral, transdisciplinary, collaboration and cooperation to adopt and implement a One Health framework in India.

In the past, India has combatted several zoonotic diseases and has a robust institutional network for biomedical research, which can lead and operationalise the One Health approach.

For One Health science, it is important to develop databases and models with a consolidated approach of ecologists, field biologists, epidemiologists and other scientists. The Kyasanur Forest Disease Model is one such example.

Also, the core strategies put forward by the National Framework for One Health, 2021 by FAO can guide towards overcoming the systemic barriers to implementing the One Health approach.

The strategy element involves:

• Improving the capacity for public health actions in major stakeholders human health, animal health and environment management

• Understanding and responding to the drivers that threaten health; optimising the effectiveness of public health systems in achieving these goals within each sector

• Institutionalise strong, continuous and mutually beneficial coordination and collaboration between all stakeholders through multi-disciplinary and multi-institutional joint planning and implementation

Therefore, a nexus of science, social science, indigenous knowledge and policy at national, state and local levels can put forward strategies and institutions for the implementation of One Health. DTE

Views expressed are personal