One Health Points the Way to More Effective and Equitable Development

The One Health initiative is gaining momentum to address complex health and development challenges. Photo credit: ADB.

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Human, animal, plant, and ecological health challenges are all interconnected; solutions should be too.

Introduction

One Health is an approach to overcoming human, animal, plant, and ecological health challenges that start from a simple premise: all these are interconnected, and solutions demand communication, coordination, and collaboration across multiple sectors, disciplines, and levels of government.

Gains in human development have often come at an unrecognized and high price for ecosystems. We have now reached a tipping point where ecosystem degradation and deterioration in biodiversity threaten to reverse the human health gains of the last century. One Health offers a way to address these by taking a multidisciplinary and transdisciplinary approach.

Intertwined and Interdependent

The essence of One Health is interdependence. While the interests of human, animal, agricultural, and ecological sectors may seem at times to be in conflict, the reality is that the needs of one are impossible to address in a sustainable way without considering the needs of the others. The simplest way to express the aspirations of One Health is a healthy ecosystem, a healthy community, and healthy people with sustainable livelihood.

One Health is not simply a theoretical model for understanding the interconnection between development problems. It is also an operational framework for addressing them.  Conceptualizing human, animal, and ecological health together leads to development based on harmony, rather than pitting the interests of one against the others.

Figure 1: What is the One Health Approach?

Source: Asian Development Bank

Beyond its technical function, One Health also advocates for a change of mindset, encouraging people to take a broader, systems-based approach to problem-solving. Integrating knowledge from different disciplines opens options for novel and innovative starting points. It is a way of identifying more efficient and equitable interventions to achieve greater outcomes than are possible when working in a single sector.

The need for such a transformational approach has never been greater as our region looks to post-COVID-19 pandemic recovery. One Health is a green development approach that can support “building back better” as economies and the region emerge from COVID-19 and seek to create a sustainable, equitable future. Examples of nature-positive initiatives range from large-scale (i.e., effective spatial planning that locate infrastructure in ways that minimize damage to primary ecosystems) to the local level (i.e., improved drainage initiatives that reduce habitat for disease vectors while creating better water quality and sanitation).

Admittedly, One Health has its challenges. Collaboration and integration are not easy, and the benefits of taking this approach requires creating incentives for collaboration and may require a longer timeframe to measure success.

Stakeholders often need to approach development issues from a high-level perspective from the problem they are trying to solve because this is where sustainable, long-term solutions are found. 

Until recently, One Health’s utility has been hampered by lack of financing for research and development that links it with tangible projects. The concept is now fast gaining traction in the development space. Parts of developing Asia are already exploring One Health to address their development challenges, and such initiatives are actively supported by the Asian Development Bank, United States Agency for International Development, and World Bank.

Successful Case in India

How India is tackling its rabies problem is a good illustration of the One Health approach. In October 2021, it launched a national action plan to eliminate rabies from dogs by 2030. It’s an exemplar of One Health in action because it builds in cross-sectoral coordination between the worlds of human and animal health to tackle what has long been an intractable problem for both sectors.

India’s rabies elimination plan incorporates both post-exposure vaccination of humans and prophylactic vaccination and sterilization of dogs with incidence surveillance and public engagement to push for prevention. Vaccination and sterilization of dogs have been proven to be more cost-effective in terms of human health than simply treating rabies bites after the fact. 

Rabies is just one of the diseases that a One Health approach can help address. It can be used for diseases ranging from acquired immunodeficiency syndrome (AIDS) to Zika virus, COVID-19, Ebola, and malaria.

Two-thirds of communicable diseases have jumped the species barrier from animal to human, and the accelerating human encroachment on animal habitat only increases the risk of more diseases in the future.

The World Health Organization has argued that future pandemics can only be prevented with a One Health approach. Antimicrobial resistance, food security, ecological security, pollution, and climate change are all areas that can benefit from this approach.

In South Asia there is high-level support for One Health to tackle zoonoses, antimicrobial resistance, and other health issues, such as avian influenza. In the Greater Mekong Subregion (GMS), all country governments have officially adopted the concept of One Health to varying degrees. Some GMS countries have established technical collaborations, such as the Southeast Asia One Health University Network, Viet Nam One Health Partnership for Zoonoses, and Mekong Basin Disease Surveillance Network.

With the 2030 deadline for the SDGs on the horizon, there is a pressing need for trans-disciplinary collaboration, including incorporation of One Health into most or all of the SDGs. One Health offers a framework to break down the silos between human, animal, plant, and ecosystem health and support efforts to reach SDG targets in all these domains. From preventing the personal calamity of a rabid dog bite to meeting national challenges of sustainable development and climate change resilience, the One Health framework is an idea whose time has come.

Resources

Food and Agriculture Organization of the United Nations, World Organisation for Animal Health, and World Health Organization. 2019. Taking a Multisectoral, One Health Approach: A Tripartite Guide to Addressing Zoonotic Diseases in Countries.

United Nations Environment Programme. 2021. Making Peace with Nature: A Scientific Blueprint to Tackle the Climate, Biodiversity and Pollution Emergencies. Nairobi.

US Centers for Disease Control and Prevention. One Health Basics.

World Bank. 2018.  Operational Framework for Strengthening Human, Animal and Environmental Public Health Systems at their Interface. Washington, DC.

World Health Organization. 2015. Operational Framework for Building Climate Resilient Health Systems. Geneva.

Najibullah Habib
Senior Health Specialist, Human and Social Development Sector Office, Sectors Group, Asian Development Bank

Najibullah Habib is a senior health specialist in ADB. He has more than 20 years of international experience in international public health and development with global institutions. He is a physician with a doctorate degree in Public Health.

Jane Parry
Senior Public Health and Development Writer

Jane Parry is a senior public health and development writer. Based in Hong Kong, China for more than 2 decades, she writes for international organizations including ADB, WHO, and UNAIDS, as well as international NGOs and publications such as the BMJ and The Guardian.

Rikard Elfving
Principal Social Sector Specialist, Human and Social Development Sector Office, Sectors Group, Asian Development Bank

Rikard Elfving is leading the work on regional health cooperation in the Greater Mekong Subregion. He also manages health projects in Cambodia, Lao People’s Democratic Republic, Myanmar, Philippines, Timor-Leste, and Viet Nam. He has worked on social sector development for over 20 years across Africa, Asia, and Eastern Europe with both bilateral and multilateral agencies.

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