Why preparation for the next pandemic needs One Health approach implementation in letter and spirit
COVID-19 is not the last pandemic, and the next ones are quite likely, unless we come together to prevent it
One Health is one of the many phrases that has now entered the common parlance after the COVID-19 pandemic. This was once a niche area, mostly where veterinarians called attention to the importance of animal health and its significance in the broader health agenda, though with limited interest from the rest of the sectors. The increased awareness in the public consciousness of how the wildlife, domestic animals and human health are intertwined in this biosphere is encouraging.
For any movement to gather momentum, the first step is spreading awareness. This is followed by acceptance and then an urgency as a society to solve the challenges facing it. The problem of climate change went through these transitions and now we are entering the frantic phase of ‘solution finding’. It is significant therefore that the area of One Health is now entering the very first stage of public awareness.
While increased awareness is a good outcome, the very definition of One Health needs clarity. The commonly offered descriptions of it being about ‘humans, animals and the planet’ makes it seem about everything. When a concept is about everything, it has the risk of being about nothing specific. Therefore, we need clear problem definitions of what ‘One Health’ is.
The second issue follows from the vagueness mentioned above. One Health in the current construct comes across as a set of feel-good statements that is hard to disagree with, but it stops there. As the concept of ‘world peace’ is broadly appealing but challenging to build specific strategies and solutions around. Repeating phrases such as ‘multisectoral collaborations’ and not moving further on ‘what’ and ‘how’ of this concept will be implemented on the ground may risk losing the momentum.
Third and the final challenge is the missing integrated thinking. If we take the example of disease surveillance, there are many efforts that are ongoing today. Some are vertically funded global priorities such as malaria. Others are routine national priorities such as foot and mouth disease control in cattle. These efforts are often limited to one single compartment among the wildlife, livestock, and humans, even though diseases transcend two or all the three compartments. Even the cross-compartmental topics such as rabies control are often implemented on a siloed basis without the context of underlying operating systems across these compartments.
What we need instead is a comprehensive understanding of all the three compartments, their intricacies, and the incentives that drive certain behaviours within and across. Built on top of such broad-based understanding, we need specific issues to be solved, be it rabies, tuberculosis, foot, and mouth disease or covid. When these are built on existing systems, be it the forestry and wildlife professionals, veterinarians and technicians, and the spectrum of medical and paramedical workforce that handle routine issues, they tend to integrate and sustain better. We need programmes that bring the full spectrum of these stakeholders together in rabies or tuberculosis control that spans across the three compartments, each of them has its own mandates and incentives in such a way that complements instead of working against each other.
Similarly, and even more importantly, pandemic preparedness requires real collaboration across the spectrum to be successful. In this case, we are dealing with not only diseases such as Avian Influenza, about which we know something about and know what to look for, but also potentially a new class of disease about which we don’t understand much about. Also, for this system of preparedness to work in the long term, it needs to be built on the existing systems and linked to routine surveillance programs. If implemented as a standalone initiative, as the present crisis passes, it risks losing the attention and resources that are required to keep the system in an active form of readiness.
In addition to the intellectual understanding of these issues, we need real pilots with this integrated thinking as a strategy. In fact, many such pilots in diverse contexts are needed. This is because we don’t yet know how to do this sustainably, what works on the ground and how complementary or opposing incentives play out in the real world. In this context, it is significant to note the recently launched ‘One Health’ programme in Uttarakhand by Department of Animal Husbandry and Dairying (DAHD) (https://www.ohsu.in/). The approach includes wildlife, animal and human surveillance, workforce development, laboratory strengthening and networking, outbreak detection, reporting and response, biosecurity in animal production systems and community awareness.
The country looks forward to the successful implementation of this ambitious programme, with lessons coming out of these on what is working and what is not. In the end, we learn just as much if not more from what doesn’t work, as what ends up succeeding in predicting, preventing, and controlling the diseases that afflict our biosphere.
The author is a Visiting PSA Fellow at the Office of Principal Scientific Advisor to the Government of India and a Senior Visiting Scholar at Huck Institutes, PennState. He is also a member of the Project Steering Committee for the One Health programme of the Department of Animal Husbandry and Dairying, Government of India.
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