Developing framework toward one health approach: Relevance and future implications

Suraj Kapoor

doi:10.4103/jphpc.jphpc_15_22

EDITORIAL

Year : 2023 | Volume : 4 | Issue : 1 | Page : 1-3

Developing framework toward one health approach: Relevance and future implications

Suraj Kapoor
Department of Community Medicine, Armed Forces Medical College, Pune, Maharashtra, India

Date of Submission	09-Apr-2022
Date of Acceptance	29-May-2022
Date of Web Publication	19-Oct-2022

Correspondence Address:
Dr. Suraj Kapoor
Department of Community Medicine, Armed Forces Medical College, Solapur Road, Wanowrie, Pune - 411 040, Maharashtra
India

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jphpc.jphpc_15_22

Abstract

Against a constant background of recognized infections, epidemics of new and old infectious diseases periodically emerge, greatly magnifying the global burden of emerging and re-emerging diseases. The emergence/re-emergence of these diseases is related to multifaceted factors, such as viral recombination and mutation, leading to more infectious and adaptive strains, industrialization and urbanization, and human activities such as deforestation creating a more permissive environment for vector-host interaction. A better knowledge of the causes and consequences of certain human activities, lifestyles, and behaviors in ecosystems is crucial for a rigorous interpretation of disease dynamics and to drive public policies. This article highlights the factors associated with emergence and re-emergence and in turn the importance and implementation of the One Health approach. Health-care professionals can prevent and control antimicrobial resistance by prescribing and dispensing antibiotics as per the laid down guidelines and indications. Sentinel surveillance at the point of entry should be strengthened. Successful One Health approaches require intersectoral coordination, with a team approach despite functioning in different sectors or domains. It is proposed that government and policy-makers should take scientific decisions about the creation of epidemiological surveillance centers at the district level on the concept of One Health. It should have facilities and infrastructure for ecosystem surveillance, namely air, water, soil, flora, and fauna, monitoring as well as investigation of the outbreak. Equally important is to empower the community and family members about the One Health concept and the matters concerned.

Keywords: One Health, emerging, and re-emerging diseases, surveillance

How to cite this article:
Kapoor S. Developing framework toward one health approach: Relevance and future implications. J Public Health Prim Care 2023;4:1-3

How to cite this URL:
Kapoor S. Developing framework toward one health approach: Relevance and future implications. J Public Health Prim Care [serial online] 2023 [cited 2023 Jun 5];4:1-3. Available from: http://www.jphpc.org/text.asp?2023/4/1/1/358585

Introduction

World Health Day theme 2022 is centered on the connection between the health of our planet and the health of humans, animals, plants, and all other living things. Sustainable development goals (SDGs) 3.8 also aim at universal health coverage which signifies that preventive, promotive, and curable services should be made available to all.^[1] However, infectious diseases have for eras ranked with wars and famine and as a major barrier to human progress and survival. They still exist as the most important causes of mortality and morbidity worldwide. Against a constant background of recognized infections, epidemics of new and old infectious diseases periodically emerge, greatly magnifying the global burden of emerging and re-emerging diseases.^[2]

Highly communicable arboviral disease, the Crimean–Congo hemorrhagic fever virus has claimed many lives in the Gujarat state of India during the 2010–12 period.^[3] A similar disease outbreak was seen in the Shimoga district of Karnataka affecting about 80 villages due to Kyasanur forest disease transmitted by a tick. The ongoing pandemic of COVID-19 is another example of infectious diseases disrupting the entire ecosystem throughout the globe.

The emergence/re-emergence of these diseases is related to multifaceted factors, such as viral recombination and mutation, leading to more infectious and adaptive strains, industrialization and urbanization, and human activities such as deforestation creating a more permissive environment for vector-host interaction. Climate change such as global warming and the rising trend of air pollution are the major factors in defining the topographical and temporal distribution of various vector species, their lifecycle, and transmission to humans.

The One Health approach concept is particularly important in the times of pandemic with the emergence of the potential threat of biological warfare as well as rising trends and suitability for emerging and re-emerging diseases. A better knowledge of the causes and consequences of certain human activities, lifestyles, and behaviors in ecosystems is crucial for a rigorous interpretation of disease dynamics and to drive public policies.^[4] This article highlights the factors associated with emergence and re-emergence and in turn the importance and implementation of the One Health approach.

Methodology

The aecondary data from government official sites, press information, latest articles, and newspapers were extracted and discussed in the article.

Discussion

There is an evolution of the “One Medicine” concept^[5] that promotes a blend of human medicine and veterinary sciences in reaction to zoonotic diseases,^[6] the present “One World – One Health” concept was conceived in 2004. The uniqueness was the amalgamation of the entire ecosystem's health, including that of wild flora and fauna. The “One Health” proposal consequently establishes a worldwide strategy emphasizing the requirement for a strategy that is integrative and multi-disciplinary which incorporates multisector expertise with intersectoral coordination in dealing with the health of mankind, animals, and further of entire ecosystems.^[7]

Global climate change is no longer an ominous future threat but a drawing reality. It is already creating disturbing shifts in the natural and human environment and eroding the delicate balance of our planet's ecosystem and the species that depend on it. Further WHO has predicted that temperature shifts with global warming will encourage the spread of communicable diseases including vector-borne diseases such as malaria and dengue. Similarly, extreme weather may result in natural disasters like situations such as floods, droughts, and cyclones which may have a catastrophic impact on the health of the ecosystem, especially in the coastal islands and small island communities. While everyone on the earth will be touched by climatic change, it is clear that the effects will be calamitous than ever imagined.

Discussing the concept of One Health is often a neglected component in plant health.^[8] Plant health, or more in particular the reality that infected plants, can act as vectors for the transmission of infections to humans. In addition, some pathogens can negatively affect the health status of all three groups: plants, animals, and humans.^[9] The various factors associated with the emergence and re-emergence of diseases with possible solutions suggested are highlighted in [Table 1].

Table 1: Factors associated with emergence and reemergence of diseases

Click here to view

Way Ahead/Future Implications

The health sector can play a leadership role in mitigating climatic change that is reducing its magnitude and consequences. By doing so, the health sector will create a series of health, economic, and social co-benefits that improve the health of the entire ecosystem in addition to the traditional role of the health sector in the delivery of quality health care. Hospital settings are energy and resource-intensive enterprises that, as they operate today, contribute substantially to climate change. Procurement, resource use, transportation, biomedical waste management, and other policies and practices contribute to the health sector's significant climatic footprint. By effectively managing this footprint and moving toward carbon neutrality, the health sector can demonstrate the way forward in response to climatic change, thereby playing the leadership role in advocating for a healthy and sustainable future as visioned by SDGs. The use of alternative fuels, encouraging walking and cycling, and promoting the use of public transport are some of the simple but effective measures. Conservation of water, and electricity, adopting reduce, reuse, and recycle strategy are some of the other preventive measures.

Another big area of concern is antimicrobial resistance, especially in the context of emerging and re-emerging diseases, health-care professionals can prevent and control the antimicrobial resistance by prescribing and dispensing antibiotics as per the laid down guidelines and indications.

Another matter of concern is many of the diseases considered to be emerging and re-emerging are cross-border in nature and thus necessitate both national and international approaches for their effective surveillance.^[10] Sentinel surveillance at the point of entry should be thus strengthened.

Despite the significant development made in recent years, barriers to executing and supporting One Health initiatives remain. Successful One Health approaches require inter-sectoral coordination, with a team approach despite functioning in different sectors or domains.^[11] The public–private partnership and involvement of nongovernmental organizations also may help in strengthening the concept of one health.

It is proposed that government and policy-makers should take scientific decisions about the creation of epidemiological surveillance centers at the district level on the concept of One Health. It should have facilities and infrastructure for ecosystem surveillance, namely air, water, soil, flora, and fauna, monitoring as well as investigation of the outbreak. Rapid response teams should be created at the district level which should include epidemiologists/microbiologists/entomologists/veterinary specialists/botanists/statisticians and data entry operators. There should be capacity building such as equipment, laboratory, information technology support, and financial allocation for the creation of such centers based on the One Health concept. Training and employment of staff should also be given due importance. Surveillance systems strengthening by capturing real-time data, using modern tools such as artificial intelligence, big data technology, and geographical information system for the early warning system.

Complete and thorough evaluation of physiochemical fingerprints (BCI burden) of the environment and data triangulation with socioeconomic fingerprints (indices) of tested communities is necessary to completely support the One Health concept.^[12]

Equally important is to empower the community and family members about the One Health concept and the matters concerned. It is important to educate people about the prevailing diseases in the area and preventive, promotive, and curative measures which can be adopted. Imparting awareness about health promotion and lifestyle measures is an important strategy for the overall health of the community and in turn of the planet.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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