"One Health" or Three? Publication Silos Among the One Health Disciplines

One Health preparedness and response for mosquito-borne viruses: a stakeholder- and social network-analysis in the Netherlands

BACKGROUND

The emergence of mosquito-borne viruses (MBVs) in Europe emphasizes the need for preparedness and response plans. This requires knowledge integration and collaboration across the human, animal, vector, and environmental health domains, aligning with the One Health approach. Despite the importance of a One Health approach, engaging stakeholders from each domain remains challenging. This study aims to identify stakeholders in the field of preparedness and response to MBVs in the Netherlands and map collaborations, knowledge- and information-sharing between these stakeholders, their domains and governance levels. In addition, we aim to identify bottlenecks in these networks and uncover underlying reasons.

METHODS

This study combined stakeholder- and social network analysis. Stakeholders were identified through document analysis and snowballing. Semi-structured interviews were conducted with eligible stakeholders. Stakeholders' collaborations, dependencies, and their roles in MBV preparedness and response were discussed. Interviewees not currently active in MBV policy were given the opportunity to share their experiences regarding 'zoonotic infectious diseases' or 'healthy living environments'. Interview transcripts were coded to identify collaborations and information- and knowledge sharing between stakeholders. Stakeholders were categorized into domains (animal, vector, human, environment, other) and governance levels (international, national, regional, local, other). Networks were visualized and analysed using Cytoscape and R.

RESULTS

Stakeholder analysis identified 87 stakeholders who influence or are (likely to be) influenced by MBV preparedness and response, of whom 47 were identified as having an active role in the MBV interaction network. Network visualisation unveiled 153 connections among these 47 stakeholders, encompassing all domains and governance levels but showed underrepresentation of regional, local and environmental stakeholders. Transcript analysis revealed low urgency for MBVs among these stakeholders as an underlying reason for their underrepresentation in the MBV interaction network. Analysis and visualisation of the networks for the other two themes ("healthy living environment" and "(zoonotic) infectious diseases") did show multiple connections with environmental and regional/local stakeholders.

CONCLUSIONS

The underrepresentation of the environment domain, regional and local stakeholders in the MBV preparedness and response network underlines the remaining challenge of including all relevant stakeholders. We recommend utilising existing collaborations, identified in this study, and central stakeholders to overcome these bottlenecks.

How studies on zoonotic risks in wildlife implement the one health approach - A systematic review

Background

The recent COVID-19 pandemic and the emergence of infectious diseases at the human-animal interface highlight the global challenge of mitigating zoonotic risks. The One Health approach emphasizes the interconnectedness of human, animal, and environmental health, urging for holistic and interdisciplinary strategies in disease prevention. Despite growing interest, the attention to wildlife in pandemic prevention remains limited. This systematic literature review aims to evaluate recent One Health research on zoonotic diseases and wildlife in terms of study design, interdisciplinary collaboration, and participatory approaches. Key questions addressed include the consideration of One Health domains, disciplinary involvement, and the inclusion of non-academic stakeholders.

Methods

Following PRISMA guidelines, PubMed and Web of Science were searched for primary research papers on zoonotic diseases and wildlife from 2018 to 2023. Eligibility criteria included a focus on wildlife, zoonotic diseases, and adoption of the One Health approach.

Results

A total of 228 primary research papers were retrieved. Out of these, 105 studies were included in the review. Few studies integrated human, animal, and environmental domains simultaneously in data collection (4.8 %) and knowledge generation (29.5 %). While extensive knowledge was generated for animal health (97.1 %) and human health (84.8 %), environmental health (34.3 %) remained underrepresented. Laboratory methods predominated (82.9 %), with limited integration of social science methodologies (19 %). The majority were epidemiological studies (86.7 %), yet analytical design within these was sparse (17.1 %). Participation of non-academic stakeholders was limited (36.2 % included non-academics; 3.8 % encompassed participative approaches).

Conclusions

The synthesis of the domains human, animal and environmental health remained fragmentary in the studies reviewed. Environmental health is underrepresented and the interdisciplinary involvement of social sciences lacks. Neglecting these fields of competence impedes comprehensive understanding of disease dynamics and hampers effective zoonosis prevention strategies. In result, greater inter- and transdisciplinary collaboration, along with participatory approaches, are still needed for advancing One Health research.

A bibliometric analysis of One Health approach in research on antimicrobial resistance

Background

Antimicrobial resistance (AMR) is a global public health threat that requires actions through One Health intervention. This study aims to trace the historical development of One Health research on AMR to provide evidence supporting future research and actions.

Methods

A bibliometric analysis is conducted with One Health articles in the field of antimicrobial resistance (AMR-OH articles) retrieved from the Web of Science Core Collection (WoSCC). AMR-OH articles refer to articles in the field of AMR that simultaneously involve elements from human health and at least one other domain, including animals, environment, or plants. Three research periods were identified based on the development of global actions in combating AMR. Descriptive analysis of publications, keyword cluster analysis, annual trending topic analysis, and co-authorship analysis were conducted using R software, V OSV iewer, and Pajek.

Results

The results indicated that the percentage of AMR-OH articles among all AMR articles increased from 5.21% in 1990 to 20.01% in 2023. Key topics in the current AMR-OH articles included the mechanism of AMR, AMR epidemiology, and public health control strategies. Epidemiological research initially focused on human and animal health and then shifted to environmental factors in the third period. Research at the molecular level focused on the mechanisms of AMR transmission in various domains, along with the dynamics and diversity of antibiotic resistance genes (ARGs). The co-authorship analysis suggested a significant increase in cooperation among low- and middle-income countries in the third period.

Conclusion

The scope of epidemiological research on AMR has expanded by including human, animal, and environmental areas. Moreover, genetic and molecular level research represents the forefront of this field, offering innovative tools to combat AMR in the future. This study suggests further research to translate existing findings into practical implementation of the One Health strategy, and to support globally consistent action in combating AMR.

Using one health training for interprofessional team building: implications for research, policy, and practice in Nigeria

In recent years, the concept of One Health (OH) has arisen as an approach that helps to catalyze the creation of transdisciplinary teams needed for surveillance and investigation of emerging disease dynamics. Besides a wealth of descriptions of what the OH approach encompasses, a dearth of information is available regarding the training of individuals in OH competencies. In 2019, the Nigerian Center for Disease Control developed an OH strategic plan to meet the country's human, animal, and environmental health challenges. In response to the demand for clinicians, scientists, climatologists, conservationists, and environmentalists, who have expertise in environment, human, plant, and animal health to work collaboratively in addressing OH challenges in Nigeria. An interprofessional group of faculty from the University of Texas Medical Branch, the University of Jos, and the National Veterinary Research Institute convened to develop a novel OH course 'entitled 'One Health for Translational Team Science. The objective of the course was to explore the evolution of an emerging epidemic, capitalizing on various learning environments, including animal, environmental, human, and public health perspectives. The 6-week course comprised of three parts: 2-weeks virtual part of case-based group discussions focusing on animal and environmental aspects, 2 weeks of individual field experiences, and a final virtual part focusing on human health. Pedagogical tools used were: case-based group discussions, breakout group presentations, role-play activities, field project write-up, peer evaluation, group writing assignments, and weekly reflections with the goal of working in teams to develop and practice the fundamental leadership and management skills in addressing emerging public health challenges. Post-course evaluations showed that all participants felt more confident identifying and practicing the necessary attitudes and skills to participate effectively in the evaluation of an outbreak. Furthermore, the roles, responsibilities, and "One Health ways of thinking" for the various disciplines and professions involved in improving global health were articulated and identified.

Reflective practice is a prerequisite for One Health development

One Health is being promoted as a transformative approach in health, conservation, and environmental sustainability. The polycrisis of climate change, pandemics, food insecurity, biodiversity loss, pollution and inequity is creating an urgency to evolve the epistemology and methods of One Health. However, the amount of effort placed into critical and systematic reflection on One Health is outweighed by advocacy for its use, or for expanding its scope of practice. This paper advocates for reflective One Health practice to foster new ways of knowing and doing that are helpful in the face of a rapidly narrowing window of opportunity to preserve the social and environmental factors that secure health and resilience for all species and generations. We propose six areas for reflection; (1) how to moderate conformity so that One Health does not become its own silo; (2) finding the moral purpose of One Health to align actions with desired outcomes; (3) coping with the problem of too many interacting problems; (4) the strategic trajectory of growth to accelerate action on root causes and ensure One Health is future-ready; (5) how to identify priorities across a vast array of problems, values, and needs and (6) how to know if we are making the world healthier and safer and for whom. Reflective practice requires investment in ongoing conversation to guard against over-confidence that we have captured the "one right way" to meet changing expectations and circumstances in a fair and effective way. Our intention is to stimulate thinking and discussion within the One Health community to ensure that "doing is shaped by knowing". We hope One Health will continue to be an emergent and highly variable set of ever more effective practices that constantly changes in response to the complex, interconnected and changing problems facing the health of people, animals, and the environment.

From theory to practice: Analyzing factors that foster the successful implementation of the one health approach for enhancing health security in Cameroon

Background

Multisectoral collaboration is crucial in effectively managing public health emergencies. The One Health approach, which emphasizes the interconnectedness of human, animal, and environmental health, has gained recognition as an effective strategy. This study analysis the factors influencing the implementation of the One Health approach in Cameroon and examines its effects on public health emergency management.

Method

A survey was conducted among 44 stakeholders from key sectors involved in implementing the "One Health approach" in Cameroon. Data were collected with a structured questionnaire using a self-administered approach. Statistical analysis using the Ki Square test was conducted to identify associations between variables.

Results

The findings revealed that stakeholders in Cameroon lacked prior training on the One Health approach, primarily due to its absence in their academic programs. However, ad hoc trainings during public health emergencies were effective in involving various sectors. Limited communication and collaboration between different sectors, often operating in silos, posed significant challenges. Stakeholders with previous collaborative experiences and existing relationships demonstrated a greater propensity for multisectoral collaboration. The involvement of environmental health professionals in collaboration activities was limited, highlighting the need for improved engagement. Strong leadership, supported by coordination structures and platforms, played a critical role in facilitating collaboration during public health emergencies. Communication channels, such as regular multisectoral meetings, were essential in fostering relationships and trust among stakeholders. However, financial constraints hindered cross-sector cooperation.

Conclusion

To enhance multisectoral collaboration in public health emergency management, there is a need to prioritize training on the One Health approach and promote cross-sector communication and collaboration. Strengthening coordination structures and platforms, improving resource allocation, and fostering a culture of accountability and trust are crucial for effective implementation. This study provides insights into the challenges and opportunities in implementing the One Health approach in Cameroon and offers valuable lessons for other countries seeking to enhance their multisectoral response to public health emergencies.

Steps towards operationalizing One Health approaches

One Health recognizes the health of humans, agriculture, wildlife, and the environment are interrelated. The concept has been embraced by international health and environmental authorities such as WHO, WOAH, FAO, and UNEP, but One Health approaches have been more practiced by researchers than national or international authorities. To identify priorities for operationalizing One Health beyond research contexts, we conducted 41 semi-structured interviews with professionals across One Health sectors (public health, environment, agriculture, wildlife) and institutional contexts, who focus on national-scale and international applications. We identify important challenges, solutions, and priorities for delivering the One Health agenda through government action. Participants said One Health has made progress with motivating stakeholders to attempt One Health approaches, but achieving implementation needs more guidance (action plans for how to leverage or change current government infrastructure to accommodate cross-sector policy and strategic mission planning) and facilitation (behavioral change, dedicated personnel, new training model).

One Health Education Nexus: enhancing synergy among science-, school-, and teacher education beyond academic silos

Introduction

The fact that the daily lives of billions of people were affected by the medical, social, and political aspects of the SARS-CoV-2 pandemic shows the need to anchor the understanding of One Health in society. Hence, promoting awareness and deepening the understanding of the interrelation between human health, animal health, and ecosystems must be accomplished through quality education, as advocated by UN Sustainable Development Goal 4. The often-questioned and discussed measures taken by governments to control the global pandemic between 2020 and 2023 can be seen as an opportunity to meet the educational needs of civil society solutions in multi-stakeholder settings between public, universities, and schools.

Methods

This paper focuses on the integration of One Health principles in educational frameworks, particularly within the context of the higher education teaching framework "Teaching Clinic." This master-level course in the domain of pre-service teacher education serves as a potent vehicle for facilitating One Health Education, bridging the gap between research, higher education, and schools. Through the presentation of two case studies, this article demonstrates how the Teaching Clinic approach fosters interdisciplinary perspectives and provides a dynamic learning environment for pre-service teachers, as well as for pupils involved in the educational process.

Results

In both cases, the integration of educational One Health school teaching-learning settings effectively enhanced pupils' understanding of complex topics and engaged them in active learning experiences. Pre-service teachers played a crucial role in developing, implementing, and evaluating these interventions. In Case I, pupils demonstrated proficiency in analyzing data and evaluating mathematical models, while in Case II, the chosen instructional approach facilitated One Health knowledge acquisition and enjoyment among pupils. These results underscore the potential of the One Health Teaching Clinic as a valuable educational framework for enhancing teaching and learning outcomes for pre-service teachers and fostering pupil engagement in socio-scientific One Health-related topics.

Discussion

The discussion delves into the significance of breaking down disciplinary silos and the crucial role of teacher education in promoting a holistic approach to education, emphasizing the intersectionality of One Health Education and Education for Sustainable Development. This article underpins the significance of collaborative efforts across multiple (scientific) disciplines and across secondary and tertiary education levels to reach a nexus. Moreover, it emphasizes the alignment of this approach with the 2030 Agenda, Education for Sustainable Development, and Sustainable Development Goals, highlighting the potential for collective action toward a more sustainable future.

Is the commercial determinants conversation confined to the health sciences? Potentially, and that's a problem

The commercial determinants of health (CDoH) are attracting increased interest and are of great importance when discussing how trade affects health. Through a citation analysis of recent foundational CDoH documents (a Lancet paper series and an Oxford University textbook), we find that fully 71% of all citations reference the health sciences. The health sciences may be well suited to documenting the specific pathways of how commercial (by)products and practices harm human health. However, to operationalize upstream solutions for mitigating these harms, our citation analysis suggests that the field can engage political scientists, economists, sociologists, the trade law and business, as well as advocates in civil society and journalism, more so than it currently does. With CDoH explicitly referring to the interaction between commerce and health, CDoH researchers might be uniquely positioned to get health on the agenda of others, which requires that CDoH methods, datasets, evidence reviews, and proposed interventions are drawn from the widest possible range of sources.

Poxviruses from the Concept of One Health

In the last 4 years, the world has experienced two pandemics of bat-borne viruses. Firstly, in 2019 the SARS-CoV-2 pandemic started and has been causing millions of deaths around the world. In 2022, a Monkeypox pandemic rose in various countries of the world. Those pandemics have witnessed movements and initiatives from healthcare and research institutions to establish a worldwide understanding to battle any future pandemics and biological threats. One Health concept is a modern, comprehensive, unifying ways to improve humans, animals, and ecosystems' health. This concept shows how much they are intertwined and related to one another, whether it is an environmental, or a pathological relation. This review aims to describe Poxviridae and its impact on the One Health concept, by studying the underlying causes of how poxviruses can affect the health of animals, humans, and environments. Reviewing the effect of disease transmission between animal to human, human to human, and animal to animal with pox viruses as a third party to achieve a total understanding of infection and viral transmission. Thus, contributing to enhance detection, diagnosis, research, and treatments regarding the application of One Health.

One Health High-Level Expert Panel (OHHLEP), Hayman DT, Adisasmito WB, Almuhairi S, Behravesh CB, Bilivogui P, Bukachi SA, Casas N, Becerra NC, Charron DF, Chaudhary A, Ciacci Zanella JR, Cunningham AA, Dar O, Debnath N, Dungu B, Farag E, Gao GF, Khaitsa M, Machalaba C, Mackenzie JS, Markotter W, Mettenleiter TC, Morand S, Smolenskiy V, Zhou L, Koopmans M. Developing One Health surveillance systems

The health of humans, domestic and wild animals, plants, and the environment are inter-dependent. Global anthropogenic change is a key driver of disease emergence and spread and leads to biodiversity loss and ecosystem function degradation, which are themselves drivers of disease emergence. Pathogen spill-over events and subsequent disease outbreaks, including pandemics, in humans, animals and plants may arise when factors driving disease emergence and spread converge. One Health is an integrated approach that aims to sustainably balance and optimize human, animal and ecosystem health. Conventional disease surveillance has been siloed by sectors, with separate systems addressing the health of humans, domestic animals, cultivated plants, wildlife and the environment. One Health surveillance should include integrated surveillance for known and unknown pathogens, but combined with this more traditional disease-based surveillance, it also must include surveillance of drivers of disease emergence to improve prevention and mitigation of spill-over events. Here, we outline such an approach, including the characteristics and components required to overcome barriers and to optimize an integrated One Health surveillance system.

Evolution and expansion of the One Health approach to promote sustainable and resilient health and well-being: A call to action

One Health is a transdisciplinary approach used to address complex concerns related to human, animal, plant, and ecosystem health. One Health frameworks and operational tools are available to support countries and communities, particularly for the prevention and control of zoonotic diseases and antimicrobial resistance and the protection of food safety. However, One Health has yet to be implemented in a manner that fully considers the complexities and interconnectedness of the diverse influences that have impacts at a larger system level. This lack of consideration can undermine the sustainability of any positive outcomes. To ensure the One Health approach can function effectively within the new global context of converging and escalating health, social, economic, and ecological crises, it must evolve and expand in three overlapping dimensions: (1) Scope: the partners, knowledge, and knowledge systems included, (2) Approach: the techniques, methodologies, and scholarship considered, and (3) Worldview inclusivity: the interweaving of other worldviews together with the mainstream scientific worldview that currently predominates. Diverse partners and knowledge from outside the mainstream health and scientific sectors, including Indigenous peoples and representatives of local communities, and traditionally generated knowledge, must be included. These systems of knowledge can then be braided together with mainstream science to comprise a holistic framework for decision-making. Scholarship and methodologies being applied in other fields and contexts to solve complex challenges and manage uncertainty, such as collaborative governance, social-ecologic systems theory, and complexity science, must be recognized and incorporated. The spectrum of considered worldviews must also expand to authentically integrate the expanded scope and approach into action and sustainable impact. By increasing community and social engagement and by recognizing and entwining different worldviews, the plurality of disciplines, and traditional and scientific ways of knowing to address community concerns in the contexts in which they exist, we can ensure that One Health remains effective and true to its paradigm in our rapidly changing and complex world.

Floristic Diversity as an Indicator in Low and High Endemic Buruli Ulcer Areas in Côte d'Ivoire

Mycobacterium ulcerans is an environmental bacterium responsible for Buruli ulcer. This disease has a high frequency index in humid tropical regions, with a high incidence in Sub-Saharan Africa. The ecology and mode of transmission of this disease is not well established. Based on dilution effect hypothesis, acting as lowering disease transmission due to greater biodiversity, floristic inventory was carried out in the Health Districts of Daloa and Bouaké in Côte d'Ivoire. In each district, high and low endemic sites were investigated. A total of 169 plant species were inventoried for both low and high endemicity of Buruli ulcer sites in the districts. The Indval index revealed that 13 plant species were good indicators for Buruli ulcer highly endemic areas. The plants which correlate with high endemicity area were Leersia hexandra, Panicum laxum, Mimosa pudica, Paspalum distichum, Persicaria senegalensis, Calopogonium mucunoides, Echinochloa colona, Ipomoea sagittata, and Eichhornia crassipes. For low endemic sites, a strong relationship was recorded for 37 plants. The indices revealed low similarity between high and low endemicity sites. Low endemicity sites expressed the highest plant species diversity. These results suggest the hypothesis that floristic richness is more important in sites of low endemicity than in those of high endemicity. Moreover, we observed a co-occurrence of some plant species and Buruli ulcer endemicity. This finding may lead to the fact that it is important to care about the biodiversity to prevent outbreak of Buruli ulcer cases.

Supplementary Information

The online version contains supplementary material available at 10.1007/s41742-023-00520-2.

Self-assessment: With all its limitations, why are we still measuring and teaching it? Lessons from a scoping review

INTRODUCTION

Self-Assessment (SA) is often assumed to be essential for learning, however, this assumption has been extensively rebutted. Research shows SA has significant limitations, including its lack of correlation with competence.

METHOD

We undertook a scoping review of SA in medical education (2011-2021) and surprisingly discovered substantial research where SA was erroneously assumed to be a valid measure of successful learning, or a skill needing to be taught. Although the initial intent of our scoping review was to explore where SA is being effectively used to advance lifelong learning, we paused to explore the extent of the problem of its misuse and resulting in wasted research, by examining excluded studies.

RESULTS

From 1151 articles, we identified 207 which ignored the documented limitations of SA. Thirty-nine studies explored SA of learning. This research has limited utility: increasing the accuracy of SA does not improve performance or lifelong learning. One hundred and sixty-eight used SA as an outcome measure to assess a program or intervention, including 63 where self-assessed improvement in knowledge/skills was the sole measure. SA of self-confidence was measured in 62 studies. When confidence was compared with an objective measure of performance, both invariably increased, but confidence did not always align with competence when measured.

DISCUSSION

Many researchers mistakenly assume the ability to accurately self-assess is essential for learning, so focus on teaching self-calibration rather than evidence-based methods of advancing learning. Other researchers incorrectly suppose that self-reported improvements in knowledge/skills provide evidence of the efficacy of a program/intervention. This is particularly troubling with regards to novices, who may believe that because they self-assess to have improved/gained confidence, they are now competent.

CONCLUSION

Our findings highlight the significant volume of research being done where SA is misunderstood and/or misused as a measurement. We posit reasons that such research continues to take place and suggest solutions moving forward.

One Health: a holistic approach for food safety in livestock

The food safety of livestock is a critical issue between animals and humans due to their complex interactions. Pathogens have the potential to spread at every stage of the animal food handling process, including breeding, processing, packaging, storage, transportation, marketing and consumption. In addition, application of the antibiotic usage in domestic animals is a controversial issue because, while they can combat food-borne zoonotic pathogens and promote animal growth and productivity, they can also lead to the transmission of antibiotic-resistant microorganisms and antibiotic-resistant genes across species and habitats. Coevolution of microbiomes may occur in humans and animals as well which may alter the structure of the human microbiome through animal food consumption. One Health is a holistic approach to systematically understand the complex relationships among humans, animals and environments which may provide effective countermeasures to solve food safety problems aforementioned. This paper depicts the main pathogen spectrum of livestock and animal products, summarizes the flow of antibiotic-resistant bacteria and genes between humans and livestock along the food-chain production, and the correlation of their microbiome is reviewed as well to advocate for deeper interdisciplinary communication and collaboration among researchers in medicine, epidemiology, veterinary medicine and ecology to promote One Health approaches to address the global food safety challenges.

Integration of Omics Approaches Enhances the Impact of Scientific Research in Environmental Applications

In the original article [...]

Examining the paradox of urban disease ecology by linking the perspectives of Urban One Health and Ecology with Cities

The ecology of zoonotic, including vector-borne, diseases in urban social-ecological systems is influenced by complex interactions among human and environmental factors. Several characteristics contribute to the emergence and spread of infectious diseases in urban places, such as high human population densities, favorable habitat for vectors, and humans' close proximity to animals and their pathogens. On the other hand, urban living can contribute to the improvement of public health through better access to health services and creation of ecological and technological infrastructure that reduces disease burdens. Therefore, urbanization creates a disease ecology paradox through the interplay of urban health penalties and advantages for individual and community outcomes. To address this contradiction, we advocate a holistic Urban One Health perspective for managing urban systems, especially their green spaces and animal populations, in ways that more effectively control the spread of zoonotic diseases. This view should be coupled with an Ecology with Cities approach which emphasizes actionable science needed for urban planning, management and policymaking; developing disease and vector surveillance programs using citizen and community science methods; and improving education and communication actions that help diverse stakeholders understand the complexities of urban disease ecology. Such measures will enable scholars from many disciplines to collaborate with professionals, government officials, and others to tackle challenges of the urban disease paradox and create more sustainable, health-promoting environments.

A SCOPING REVIEW OF THE RANGIFER TARANDUS INFECTIOUS DISEASE LITERATURE: GAP BETWEEN INFORMATION AND APPLICATION

The role and impact of infectious diseases in wildlife population dynamics are increasingly recognized, yet disease information is variably incorporated into wildlife management frameworks. This discrepancy is particularly relevant for Rangifer tarandus (caribou or reindeer), a keystone circumarctic species experiencing widespread population declines. The primary objective of this review was to characterize the available peer-reviewed literature on infectious diseases of Rangifer by using a scoping review methodology. Three databases of peer-reviewed literature-Web of Science, BIOSIS previews, and Scopus-were searched and 695 articles met the criteria for initial review. After screening for relevance and language, 349 articles, published between 1967 and 2020, remained. More than half of the excluded articles (181/346; 52%) were left out because they were not published in English; the majority of these excluded articles (120) were in Russian. From the 349 included articles, 137 (39%) pertained to wild (as opposed to semidomesticated or captive) Rangifer populations. Articles on infectious disease in wild Rangifer were published in 40 different journals across various disciplines; the most common journals were disease and parasitology oriented, accounting for 55% of included articles. Most studies were descriptive (87%), followed by experimental (9%). Of the pathogen taxa investigated, helminths were the most common, comprising 35% of articles. Rangifer subspecies were not equally represented in the literature, with barren-ground caribou (R. t. groenlandicus; n=40) and woodland caribou (R. t. caribou; n=39) having the greatest abundance and diversity of infectious disease information available. Few studies explicitly examined individual or population-level impacts of disease, or related disease to vital population rates, and only 27 articles explicitly related results to management or conservation. Findings from this review highlight an unbalanced distribution of studies across Rangifer ecotypes, a preference for dissemination in disease-specialized publication venues, and an opportunity for investigating population-level impacts that may be more readily integrated into caribou conservation frameworks.

Snakebite Management and One Health in Asia Using an Integrated Historical, Social, And Ecological Framework

Snakebite envenomation continues to contribute to high fatality and morbidity rates across Asia. Yet snake bite is one of many outcomes due to human-snake conflicts, which themselves are only one type of human-snake relationship among the diversity of such interactions. We propose that human-snake relationships need to be explored from a perspective integrative of history, ecology, and culture in order to adequately and holistically address snake bite. In order to contextualize this concept within a language already understood in conservation research, we characterize and develop four interconnected themes defining human-snake relationships as a social ecological system. By breaking down the multifaceted nature of human-snake relationships under a social ecological systems framework, we explore its applicability in contributing to a unified strategy, drawing from both social and natural sciences for ending the snakebite crisis.

A need for null models in understanding disease transmission: the example of Mycobacterium ulcerans (Buruli ulcer disease)

Understanding the interactions of ecosystems, humans and pathogens is important for disease risk estimation. This is particularly true for neglected and newly emerging diseases where modes and efficiencies of transmission leading to epidemics are not well understood. Using a model for other emerging diseases, the neglected tropical skin disease Buruli ulcer (BU), we systematically review the literature on transmission of the etiologic agent, Mycobacterium ulcerans (MU), within a One Health/EcoHealth framework and against Hill's nine criteria and Koch's postulates for making strong inference in disease systems. Using this strong inference approach, we advocate a null hypothesis for MU transmission and other understudied disease systems. The null should be tested against alternative vector or host roles in pathogen transmission to better inform disease management. We propose a re-evaluation of what is necessary to identify and confirm hosts, reservoirs and vectors associated with environmental pathogen replication, dispersal and transmission; critically review alternative environmental sources of MU that may be important for transmission, including invertebrate and vertebrate species, plants and biofilms on aquatic substrates; and conclude with placing BU within the context of other neglected and emerging infectious diseases with intricate ecological relationships that lead to disease in humans, wildlife and domestic animals.

The one health landscape in Sub-Saharan African countries

OBJECTIVES

One Health is transiting from multidisciplinary to transdisciplinary concepts and its viewpoints should move from 'proxy for zoonoses', to include other topics (climate change, nutrition and food safety, policy and planning, welfare and well-being, antimicrobial resistance (AMR), vector-borne diseases, toxicosis and pesticides issues) and thematic fields (social sciences, geography and economics). This work was conducted to map the One Health landscape in Africa.

METHODS

An assessment of existing One Health initiatives in Sub-Saharan African (SSA) countries was conducted among selected stakeholders using a multi-method approach. Strengths, weaknesses, opportunities and threats to One Health initiatives were identified, and their influence, interest and impacts were semi-quantitatively evaluated using literature reviews, questionnaire survey and statistical analysis.

RESULTS

One Health Networks and identified initiatives were spatiotemporally spread across SSA and identified stakeholders were classified into four quadrants. It was observed that imbalance in stakeholders' representations led to hesitation in buying-in into One Health approach by stakeholders who are outside the main networks like stakeholders from the policy, budgeting, geography and sometimes, the environment sectors.

CONCLUSION

Inclusion of theory of change, monitoring and evaluation frameworks, and tools for standardized evaluation of One Health policies are needed for a sustained future of One Health and future engagements should be outputs- and outcomes-driven and not activity-driven. National roadmaps for One Health implementation and institutionalization are necessary, and proofs of concepts in One Health should be validated and scaled-up. Dependence on external funding is unsustainable and must be addressed in the medium to long-term. Necessary policy and legal instruments to support One Health nationally and sub-nationally should be implemented taking cognizance of contemporary issues like urbanization, endemic poverty and other emerging issues. The utilization of current technologies and One Health approach in addressing the ongoing pandemic of COVID-19 and other emerging diseases are desirable. Finally, One Health implementation should be anticipatory and preemptive, and not reactive in containing disease outbreaks, especially those from the animal sources or the environment before the risk of spillover to human.

A Survey on One Health Approach in Colombia and Some Latin American Countries: From a Fragmented Health Organization to an Integrated Health Response to Global Challenges

The “One Health” (OH) approach has been recognized by world health authorities such as FAO/OIE/WHO, advocating for effective, multi-sectoral, and transdisciplinary collaboration. However, there is a lack of published evidence of the awareness of the OH concept in Colombia and other countries in the Latin American Region. In order to explore existing collaboration amongst the animal health, human-public health, environmental health sectors, and to describe the perception, knowledge, and barriers on OH in Colombia and other countries of Latin America, an online questionnaire-based survey was distributed among key professionals representing the three OH pillars (August 2018–August 2020). Overall, 76 key respondents from 13 countries (Colombia, México, Chile, Brazil, Argentina, Bolivia, Costa Rica, Ecuador, Perú, Guatemala, Nicaragua Uruguay, and Venezuela) completed the questionnaire. Respondents worked in institutions of animal (59%), public (20%), human (7%), and environmental health (7%); they mainly belonged to higher academic institutions (59%), followed by ministries (11%), and research organizations (9%). Most participants (92%) were familiar with the OH term and 68% were aware of the formal cooperation among sectors in their countries, mostly on zoonoses; in 46% of the cases, such connections were established in the last 5 years. The main reported limiting factors to intersectorality were the lack of commitment of policy-makers, resources, and budget for OH (38%) and the “siloed approach” of sectors and disciplines (34%). Respondents ranked a median score of 3.0 (1–5 scoring) in how good OH activities are implemented in their countries, and a median score of 2.0 in the citizen awareness on OH as regards their countries. The most important OH issues were identified in vector-borne diseases, rabies, wrong and/or improper use of antimicrobials, emerging viral diseases, food-borne diseases, neglected parasitic diseases, deforestation, and ecosystem fragmentation. Although there is a high-perceived importance on conjoint cooperation, OH implementation, and operationalization remain weak, and the environmental component is not well-integrated. We consider that integration and implementation of the OH Approach can support countries to improve their health policies and health governance as well as to advocate the social, economic, and environmental sustainability of the Region.

Strategies for Implementing a One Welfare Framework into Emergency Management

Simple Summary

During emergencies, people’s decision-making and actions are strongly influenced by their relationship with their animals. In emergency management, a holistic approach is needed which recognises the important interrelationships between animal welfare, human well-being, and the physical and social environment. It is also vital to break down barriers of collaboration between individuals, organisations, and the community. One Welfare, a concept with human–animal-environment interdependencies at its core, provides a framework to achieve this. Successful implementation of a transformative change will require positive strategies to deal with challenges and to ensure that animals are truly integrated into emergency management, not just included as an aside.

Abstract

Responding to emergencies requires many different individuals and organisations to work well together under extraordinary circumstances. Unfortunately, the management of animal welfare in emergencies remains largely disconnected from emergency management overall. This is due predominately to professional silos and a failure to understand the importance of human–animal-environment (h-a-e) interdependencies. One Welfare (OW) is a concept with these interrelationships at its core. This paper argues that by adopting an OW framework it will be possible to achieve a transdisciplinary approach to emergency management in which all stakeholders acknowledge the importance of the h-a-e interdependencies and work to implement a framework to support this. Acknowledging that such a transformational change will not be easy, this paper proposes several strategies to overcome the challenges and optimise the outcomes for animal welfare emergency management (AWEM). These include legislation and policy changes including h-a-e interface interactions as business as usual, improving knowledge through interprofessional education and training, incorporating One Welfare champions, and recognising the role of animals as vital conduits into communities.

Vector-borne zoonotic blood parasites in wildlife from Ecuador: A report and systematic review

Background and Aim:

Ecuador is a hugely diverse country, but information on infectious diseases in local wild animals is scarce. The aim of this study was to screen the presence of blood parasites in free-ranging wild animals admitted to the Wildlife Hospital at Universidad San Francisco de Quito, from April 2012 to January 2019.

Materials and Methods:

We identified blood parasites by microscopic observation of blood smears from free-ranging wildlife species that attended the Wildlife Hospital of Universidad San Francisco de Quito (Ecuador) from April 2012 to January 2019.

Results:

The microscopic evaluations of animals as potential reservoirs for vector-borne zoonotic blood parasites revealed the presence of Anaplasma spp., Babesia spp., Ehrlichia spp., Hepatozoon spp., microfilaria, Mycoplasma spp., and Trypanosoma spp. in previously unreported wildlife species. In addition, we performed a systematic review to understand the current knowledge gaps in the context of these findings.

Conclusion:

Our data contribute to the knowledge of blood parasites in wildlife from Ecuador. Furthermore, the potential transmission of these parasites to humans and domestic animals, current anthropogenic environmental changes in the region, and the lack of information on this suggest the importance of our results and warrant further investigations on infectious diseases in animals and humans and their relationship with environmental health as key domains of the One Health concept.

Stamping Out Animal Culling: From Anthropocentrism to One Health Ethics

Culling is used in traditional public health policies to control animal populations. These policies aim primarily to protect human interests but often fail to provide scientific evidence of effectiveness. In this article, we defend the need to move from a strictly anthropocentric approach to disease control towards a One Health ethics, using culling practices as an example. We focus on the recent badger culls in the UK, claiming that, based on data provided by the English Government, these culls may be unjustified, all thing considered. We highlight the relevance of ethical reasoning rooted in One Health for this discussion, and make several suggestions including a moratorium on culling until data are provided to support the effectiveness of culling; to conduct a randomized trial to compare proactive culling with alternative methods; to apply deliberative democratic methods to assess public opinion towards the culls, and to find in Brexit an opportunity for aiming for more effective control measures.

Setting the Terms for Zoonotic Diseases: Effective Communication for Research, Conservation, and Public Policy

Many of the world's most pressing issues, such as the emergence of zoonotic diseases, can only be addressed through interdisciplinary research. However, the findings of interdisciplinary research are susceptible to miscommunication among both professional and non-professional audiences due to differences in training, language, experience, and understanding. Such miscommunication contributes to the misunderstanding of key concepts or processes and hinders the development of effective research agendas and public policy. These misunderstandings can also provoke unnecessary fear in the public and have devastating effects for wildlife conservation. For example, inaccurate communication and subsequent misunderstanding of the potential associations between certain bats and zoonoses has led to persecution of diverse bats worldwide and even government calls to cull them. Here, we identify four types of miscommunication driven by the use of terminology regarding bats and the emergence of zoonotic diseases that we have categorized based on their root causes: (1) incorrect or overly broad use of terms; (2) terms that have unstable usage within a discipline, or different usages among disciplines; (3) terms that are used correctly but spark incorrect inferences about biological processes or significance in the audience; (4) incorrect inference drawn from the evidence presented. We illustrate each type of miscommunication with commonly misused or misinterpreted terms, providing a definition, caveats and common misconceptions, and suggest alternatives as appropriate. While we focus on terms specific to bats and disease ecology, we present a more general framework for addressing miscommunication that can be applied to other topics and disciplines to facilitate more effective research, problem-solving, and public policy.

One Health practices across key agencies in Sweden - Uncovering barriers to cooperation, communication and coordination

AIM

This study examined the barriers and opportunities in Sweden for integrating One Health practices. Sweden's long tradition of working with One Health was used as a case to analyse persistent barriers as well as opportunities.

METHOD

Thirteen semi-structured interviews with experts from the Swedish Veterinary Agency, Food Agency, Public Health Agency, and Environmental Protection Agency were carried out. A thematic content analysis was conducted on the interviews using inductive coding in NVivo.

RESULTS

The study revealed that while collaboration is the general aspiration across the Swedish agencies, barriers persist regarding the understanding of One Health, the integration of the environment sector and awareness of the different terminologies employed within the disciplines. There are legislative challenges and barriers to science to policy translation. Disease outbreak was identified as an opportunity for One Health integration.

CONCLUSIONS

A One Health strategy needs to be developed at agency level to define One Health and clarify the roles and responsibilities. To overcome practical challenges, experts need to be aware of different terminologies and practices when collaborating. Further prospects for One Health integration include employing policy entrepreneurs to push One Health onto the political agenda. Preparations for disease outbreaks need to focus on reducing barriers to effectively integrate One Health. Experiences of One Health projects must be disseminated, and to raise awareness, education programmes must integrate One Health into curricula.

Crop protection practices and viral zoonotic risks within a One Health framework

Recent viral zoonotic epidemics have been attributed partially to the negative impact of human activities on ecosystem biodiversity. Agricultural activities, particularly conventional crop protection (CP) practices, are a major threat to global biodiversity, ecosystem health and human health. Here we review interactions between CP practices and viral zoonoses (VZs), the first time this has been done. It should be noted that a) VZs stand at the interface between human, animal and ecosystem health; b) some VZs involve arthropod vectors that are affected by CP practices; and c) some crop pests, or their natural enemies are vertebrate reservoirs/carriers of certain VZs, and their contact with humans or domestic animals is affected by CP practices. Our review encompasses examples highlighting interactions between VZs and CP practices, both efficiency improvement-based (i.e. conventional with agrochemical insecticides and rodenticides), substitution-based (i.e. mainly with physical/mechanical or biopesticidal pest control), and redesign-based (i.e. mainly with conservation biological pest control, including some forms of crop-livestock integration). These CP practices mainly target arthropod and vertebrate pests. They also target, to a lesser extent, weeds and plant pathogens. Conventional and some physical/mechanical control methods and some forms of biopesticidal and crop-livestock integration practices were found to have mixed outcomes in terms of VZ risk management. Conversely, practices based on biological control by habitat conservation of arthropod or vertebrate natural enemies, falling within the Agroecological Crop Protection (ACP) framework, result in VZ prevention at various scales (local to global, and short-term to long-term). ACP addresses major global challenges including climate resilience, biodiversity conservation and animal welfare, and helps integrate plant health within the extended "One Health" concept.

Practices in research, surveillance and control of neglected tropical diseases by One Health approaches: A survey targeting scientists from French-speaking countries

One health (OH) approaches have increasingly been used in the last decade in the fight against zoonotic neglected tropical diseases (NTDs). However, descriptions of such collaborations between the human, animal and environmental health sectors are still limited for French-speaking tropical countries. The objective of the current survey was to explore the diversity of OH experiences applied to research, surveillance and control of NTDs by scientists from French-speaking countries, and discuss their constraints and benefits. Six zoonotic NTDs were targeted: echinococcoses, trypanosomiases, leishmaniases, rabies, Taenia solium cysticercosis and leptospiroses. Invitations to fill in an online questionnaire were sent to members of francophone networks on NTDs and other tropical diseases. Results from the questionnaire were discussed during an international workshop in October 2019. The vast majority (98%) of the 171 respondents considered OH approaches relevant although only 64% had implemented them. Among respondents with OH experience, 58% had encountered difficulties mainly related to a lack of knowledge, interest and support for OH approaches by funding agencies, policy-makers, communities and researchers. Silos between disciplines and health sectors were still strong at both scientific and operational levels. Benefits were reported by 94% of respondents with OH experience, including increased intellectual stimulation, stronger collaborations, higher impact and cost-efficiency of interventions. Recommendations for OH uptake included advocacy, capacity-building, dedicated funding, and higher communities' involvement. Improved research coordination by NTD networks, production of combined human-animal health NTD impact indicators, and transversal research projects on diagnostic and reservoirs were also considered essential.

Preparing for Emerging Zoonotic Viruses

The risk of emergence and spread of novel human pathogens originating from an animal reservoir has increased in the past decades. However, the unpredictable nature of disease emergence makes surveillance and preparedness challenging. Knowledge of general risk factors for emergence and spread, combined with local level data is needed to develop a risk-based methodology for early detection. This involves the implementation of the One Health approach, integrating human, animal and environmental health sectors, as well as social sciences, bioinformatics and more. Recent technical advances, such as metagenomic sequencing, will aid the rapid detection of novel pathogens on the human-animal interface.

Application of one health approach in training at Makerere University: experiences from the one health workforce project in Uganda

The interconnections of humans, domestic animals, wildlife and the environment have increasingly become complex, requiring innovative and collaborative approaches (One Health approach) for addressing global health challenges. One Health is a multidisciplinary and multi-sectoral collaborative approach to human, animal, plant and environmental health. The role of academia in training professionals oriented in One Health is critical in building a global workforce capable of enhancing synergies of various sectors in improving health. Makerere University, Uganda has implemented pre-service capacity building initiatives aimed to foster One Health competencies among students who are future practitioners. In addition to incorporating the One Health concept in didactic curricula, Student One Health Innovation Clubs, undergraduate field placements in 11 demonstration sites, graduate fellowships, small grants to support research and innovations, and cross-college collaborative training approaches have greatly aided the assimilation of One Health into the fabric of university offerings. Partnerships with government ministries, private sector and international agencies were initiated to benefit the students, as well as chart a path for experiential learning and in-service offerings in the future. One major challenge, however, has been the tendency to focus on infectious diseases, especially zoonoses, with less consideration of other health issues. The opportunity for improvement, nonetheless, lies in the increasing emerging and re-emerging health concerns including epidemics, environmental pollution and related challenges which justify the need for countries and institutions to focus on building and strengthening multidisciplinary health systems.

An ethical investigation into the microbiome: the intersection of agriculture, genetics, and the obesity epidemic

There is growing evidence of the interconnectivity between animals, humans, and the environment, which has manifested in the One Health perspective that takes all three into account for a more comprehensive vision of health. Over the past century, agriculture has become increasingly industrialized with a particular rise in the amount of livestock raised and meat produced. In order to fulfill such market demands, livestock farmers and agricultural corporations have artificially selected for and bred their cash animals to be more and more metabolically efficient via genetic and human-driven means. However, by selecting for more metabolically efficient animals, we may have inadvertently been selecting for obesogenic gut microbiota. This is further compounded by the potential obesogenic and microbiome-altering role antibiotics play in livestock. Evidence suggests that there is the potential for interspecies gut microbe transmissibility. It is notable that there has been a concurrent multispecies obesity epidemic across the same timeframe, which raises questions about potential connections between these epidemics. If it is the case that humans have inadvertently influenced their own obesity epidemic via the artificial selection of and antibiotic administration to livestock, then this holds significant ethical implications. This analysis considers current meat consumption trends, the impacts of livestock on climate change, and animal ethics. The paper concludes that due to the potential significant impact yet tenuous nature of the evidence on this subject stemming from research silos, there is a definitive ethical impetus for researchers to bridge these silos to better understand the true nature of the issue. This case is emblematic of an overarching ethics-driven need for deeper collaboration between isolated but related research disciplines to better characterize issues of public health relevance. It also raises concerns regarding inherent value-driven strife that may arise between competing One Health domains.

Common ground: The foundation of interdisciplinary research on bat disease emergence

Human perturbation of natural systems is accelerating the emergence of infectious diseases, mandating integration of disease and ecological research. Bats have been associated with recent zoonoses, but our bibliometric analysis of coauthor relationships identified a separation of bat ecologists and infectious disease researchers with few cross-disciplinary relationships. Of 5,645 papers, true interdisciplinary collaborations occurred primarily in research focused on White Nose Syndrome (WNS). This finding is important because it illustrates how research with outcomes favoring both bat conservation and disease mitigation promotes domain integration and network connectivity. We advocate for increased engagement between ecology and infectious researchers to address such common causes and suggest that efforts focus on leveraging existing activities, building interdisciplinary projects, and networking individuals and networks to integrate domains and coordinate resources. We provide specific opportunities for pursuing these strategies through the Bat One Health Research Network (BOHRN).

Limited collaboration between bat ecologists and disease researchers has precluded integrative research on disease emergence. These historical silos are now challenged by the emergence of SARS-CoV-2, which threatens both human and bat health. This Perspective article maintains that interdisciplinary research can be accelerated when disparate domains address common, foundational causes.

Accounting for One Health: Insights from the social sciences

This paper discusses the relationship between One Health (OH) and the social sciences. Using a comparison between three narratives of the history of OH, it is argued that OH can be studied as a social phenomenon. The narrative of OH by its promoters (folk narratives) emphasizes two dimensions: OH as a renewal of veterinary medicine and OH as an institutional response to global health crises. Narratives from empirical social science work explore similar dimensions, but make them more complex. For political sociology, OH is the result of negotiations between the three international organisations (WHO, OIE and FAO), in a context of a global health crisis, which led to the reconfiguration of their respective mandates and scope of action: OH is a response to an institutional crisis. For the sociology of science, OH testifies to the evolution of the profession and veterinary science, enabling it to position itself as a promoter of interdisciplinarity, in a context of convergence between research and policy. In the Discussion section, I propose an approach to OH as an “epistemic watchword”: a concept whose objective is to make several actors work together (watchword), in a particular direction, that of the production of knowledge (epistemic).

Scoping Review and Bibliometric Analysis of the Term "Planetary Health" in the Peer-Reviewed Literature

Background: Planetary health is an emerging holistic health field to foster interdisciplinary collaborations, integrate Indigenous knowledge, facilitate education, and drive public and policy engagement. To understand to what extent the field has successfully met these goals, we conducted a scoping review and bibliometric analysis. Methods: We searched 15 databases from 2005 to 2019 for peer-reviewed publications with the term "planetary health" in the title, abstract and/or keywords, with no language or geographical location limitations. We classified results into four categories (commentaries, comprehensive syntheses, educational material, and original research) and categorized original research according to expert-derived planetary health themes. Our bibliometric analysis highlighted publications over time, collaborations, and networks of keywords. Findings: Only 8.1% (n = 22) were research articles. Publications rose rapidly from 8 to 64 publications per year in 2015-2018. The top five author affiliation countries for most publications were the US, UK, Australia, Canada, and New Zealand, and the top five collaborations were a subset of pairwise combinations between the US, UK, Australia, and Canada. The most common author keywords were the following: planetary health, climate change, ecology, and non-communicable diseases. Keyword co-occurrences clustered around high-level concepts (e.g., Anthropocene) and food system-related topics; two clusters lacked a theme. Interpretation: We show that the term planetary health is used mainly in commentary-like publications, not original research. Additionally, more global collaborations are lacking. Interdisciplinary work, as represented by keyword co-occurrence networks, is developing but could potentially be extended. The planetary health community should promote more worldwide research and interdisciplinary collaborations.

The state of One Health research across disciplines and sectors - a bibliometric analysis

There is a growing interest in One Health, reflected by the rising number of publications relating to One Health literature, but also through zoonotic disease outbreaks becoming more frequent, such as Ebola, Zika virus and COVID-19.

This paper uses bibliometric analysis to explore the state of One Health in academic literature, to visualise the characteristics and trends within the field through a network analysis of citation patterns and bibliographic links. The analysis focuses on publication trends, co-citation network of scientific journals, co-citation network of authors, and co-occurrence of keywords.

The bibliometric analysis showed an increasing interest for One Health in academic research. However, it revealed some thematic and disciplinary shortcomings, in particular with respect to the inclusion of environmental themes and social science insights pertaining to the implementation of One Health policies. The analysis indicated that there is a need for more applicable approaches to strengthen intersectoral collaboration and knowledge sharing. Silos between the disciplines of human medicine, veterinary medicine and environment still persist. Engaging researchers with different expertise and disciplinary backgrounds will facilitate a more comprehensive perspective where the human-animal-environment interface is not researched as separate entities but as a coherent whole. Further, journals dedicated to One Health or interdisciplinary research provide scholars the possibility to publish multifaceted research. These journals are uniquely positioned to bridge between fields, strengthen interdisciplinary research and create room for social science approaches alongside of medical and natural sciences.

Lessons Learned From the Stakeholder Engagement in Research: Application of Spatial Analytical Tools in One Health Problems

Stakeholder engagement in research is widely advocated as a tool to integrate diverse knowledge and perspectives in the management of health threats while addressing potential conflicts of interest. Although guidelines for stakeholder engagement exist in public health and environmental sciences, the feasibility of actionable decisions based on scientific analyses and the lessons learned from the stakeholder engagement in the process co-creation of knowledge have been rarely discussed in One Health literature and veterinary sciences. Risk maps and risk regionalization using spatiotemporal epidemiological/analytical tools are known to improve risk perception and communication. Risk maps are useful when informing policy and management decisions on quarantine, vaccination, and surveillance intended to prevent or control threats to human, animal, or environmental health interface (i.e., One Health). We hypothesized that researcher-stakeholder engagement throughout the research process could enhance the utility of risk maps; while identifying opportunities to improve data collection, analysis, interpretation, and, ultimately, implementation of scientific/evidence-based management and policy measures. Three case studies were conducted to test this process of co-creation of scientific knowledge, using spatiotemporal epidemiological approaches, all related to One Health problems affecting Minnesota. Our interpretation of the opportunities, challenges, and lessons learned from the process are summarized from both researcher and stakeholder perspectives. By sharing our experience we intend to provide an understanding of the expectations, realizations, and “good practices” we learned through this slow-moving iterative process of co-creation of knowledge. We hope this contribution benefits the planning of future transdisciplinary research related to risk map-based management of One Health problems.

Integrative concepts and practices of health in transdisciplinary social ecology

Increasing recognition of interdependencies of the health of humans, other organisms and ecosystems, and of their importance to socio-ecological systems, necessitates application of integrative concepts such as One Health and EcoHealth. These concepts open new perspectives for research and practice but also generate confusion and divergent opinion, prompting new theories, and call for empirical clarification and evaluation. Through a semi-systematic evaluation of knowledge generation in scientific publications (comprised of literature reviews, conceptual models and analyses of communities of practice), we show how integrative concepts and approaches to health evolve and are adopted. Our findings indicate that while their contexts, goals and rationales vary, integrative concepts of health essentially arise from shared interests in living systems. Despite recent increased attention to ecological and societal aspects of health including broader sustainability issues, the focus remains anthropocentric and oriented towards biomedicine. Practices reflect and in turn transform these concepts, which together with practices also influence ways of integration. Overarching narratives vary between optimism and pessimism towards integrated health and knowledge. We conclude that there is an urgent need for better, coherent and more deeply integrative health concepts, approaches and practices to foster the well-being of humans, other animals and ecosystems. Consideration of these concepts and practices has methodological and political importance, as it will transform thinking and action on both society and nature and specifically can enrich science and practice, expanding their scope and linking them better. Transdisciplinary efforts are crucial to developing such concepts and practices to properly address the multiple facets of health and to achieve their appropriate integration for the socio-ecological systems at stake. We propose the term “transdisciplinary health” to denote the new approaches needed.

EcoHealth and One Health: A theory-focused review in response to calls for convergence

BACKGROUND

EcoHealth and One Health are two major approaches broadly aimed at understanding the links between human, animal, and environment health. There have been increasing calls for convergence between the two. If convergence is desired, greater clarity regarding the underlying theoretical assumptions of both approaches is required. This would also support integrated research to effectively address complex health issues at the human, animal and environment interface. To better understand the areas of overlap and alignment, we systematically compared and contrasted the theoretical assumptions of both approaches.

OBJECTIVES

We aimed to gain a more in-depth understanding of the ontological, epistemological and methodological underpinnings of EcoHealth and One Health in order to identify areas of difference and overlap, and consider the extent to which closer convergence between the two may be possible.

METHODS

We undertook a scoping review of literature about the ontological, epistemological and methodological positions of EcoHealth and One Health, and analyzed these according to Lincoln, Lynham and Guba's paradigm framework.

RESULTS

EcoHealth and One Health are both collaborative, systems-focused approaches at the human, animal, and ecosystem health interface. EcoHealth typically leans towards constructivist-leaning assumptions. Many consider this a necessary aspiration for One Health. However, in practice One Health remains dominated by the veterinary and medical disciplines that emphasize positivist-leaning assumptions.

DISCUSSION

The aspirations of EcoHealth and One Health appear to overlap at the conceptual level, and may well warrant closer convergence. However, further shared discussions about their epistemological and ontological assumptions are needed to reconcile important theoretical differences, and to better guide scopes of practice. Critical realism may be a crucial theoretical meeting point. Systems thinking methods (with critical realist underpinnings), such as system dynamics modelling, are potentially useful methodologies for supporting convergent practice.

BOARD INVITED REVIEW: Prospects for improving management of animal disease introductions using disease-dynamic models

Management and policy decisions are continually made to mitigate disease introductions in animal populations despite often limited surveillance data or knowledge of disease transmission processes. Science-based management is broadly recognized as leading to more effective decisions yet application of models to actively guide disease surveillance and mitigate risks remains limited. Disease-dynamic models are an efficient method of providing information for management decisions because of their ability to integrate and evaluate multiple, complex processes simultaneously while accounting for uncertainty common in animal diseases. Here we review disease introduction pathways and transmission processes crucial for informing disease management and models at the interface of domestic animals and wildlife. We describe how disease transmission models can improve disease management and present a conceptual framework for integrating disease models into the decision process using adaptive management principles. We apply our framework to a case study of African swine fever virus in wild and domestic swine to demonstrate how disease-dynamic models can improve mitigation of introduction risk. We also identify opportunities to improve the application of disease models to support decision-making to manage disease at the interface of domestic and wild animals. First, scientists must focus on objective-driven models providing practical predictions that are useful to those managing disease. In order for practical model predictions to be incorporated into disease management a recognition that modeling is a means to improve management and outcomes is important. This will be most successful when done in a cross-disciplinary environment that includes scientists and decision-makers representing wildlife and domestic animal health. Lastly, including economic principles of value-of-information and cost-benefit analysis in disease-dynamic models can facilitate more efficient management decisions and improve communication of model forecasts. Integration of disease-dynamic models into management and decision-making processes is expected to improve surveillance systems, risk mitigations, outbreak preparedness, and outbreak response activities.

Operationalizing One Health Employing Social-Ecological Systems Theory: Lessons From the Greater Mekong Sub-region

The idea of the interdependency of the health of humans, animals, and ecosystems emerged from the interplay of theory and concepts from medicine, public health and ecology among leading thinkers in these fields during the last century. The rationale for One Health and its focus on the “human, animal, and environmental interface” stems from this legacy and points to transdisciplinary, ecological and complex systems approaches as central to One Health practice. Demonstration of One Health's efficacy, its wider adoption and continual improvement require explicit operational criteria and evaluation metrics on this basis. Social-Ecological Systems Theory with its unique conception of resilience (SESR) currently offers the most well-developed framework for understanding these approaches and development of performance standards. This paper describes operational criteria for One Health developed accordingly, including a protocol currently being tested for vector borne disease interventions. Wider adoption of One Health is most likely to occur as One Health practitioners gain an increasing familiarity with ecological and complex systems concepts in practice employing a transdisciplinary process. Two areas in which this inevitably will be required for significant further progress, and where the beginnings of a foundation for building upon exist, include: (1) Emerging and re-emerging zoonotic diseases, and (2) successful implementation of the United Nations (UN) Sustainable Development Goals (SDGs). The former includes the challenge of stemming the threat of new microbial pathogens, anti-microbial resistant variants of existing pathogens, as well as resurgence of malaria and other recalcitrant diseases. The applicability of SESR in this regard is illustrated with two case examples from the Greater Mekong Subregion, Avian Influenza (H5N1) and Liver Fluke (Opisthorchis viverrini). Each is shown to represent a science and policy challenge suggestive of an avoidable social-ecological system pathology that similarly has challenged sustainable development. Thus, SESR framing arguably is highly applicable to the SDGs, which, to a large extent, require consideration of human-animal-environmental health linkages. Further elaboration of these One Health operational criteria and metrics could contribute to the achievement of many of the SDGs.

Faster and safer: Research priorities in water and health

The United Nations' Sustainable Development Goals initiated in 2016 reiterated the need for safe water and healthy lives across the globe. The tenth anniversary meeting of the International Water and Health Seminar in 2018 brought together experts, students, and practitioners, setting the stage for development of an inclusive and evidence-based research agenda on water and health. Data collection relied on a nominal group technique gathering perceived research priorities as well as underlying drivers and adaptation needs. Under a common driver of public health protection, primary research priorities included the socioeconomy of water, risk assessment and management, and improved monitoring methods and intelligence. Adaptations stemming from these drivers included translating existing knowledge to providing safe and timely services to support the diversity of human water needs. Our findings present a comprehensive agenda of topics at the forefront of water and health research. This information can frame and inform collective efforts of water and health researchers over the coming decades, contributing to improved water services, public health, and socioeconomic outcomes.

Policy and Science for Global Health Security: Shaping the Course of International Health

The global burden of infectious diseases and the increased attention to natural, accidental, and deliberate biological threats has resulted in significant investment in infectious disease research. Translating the results of these studies to inform prevention, detection, and response efforts often can be challenging, especially if prior relationships and communications have not been established with decision-makers. Whatever scientific information is shared with decision-makers before, during, and after public health emergencies is highly dependent on the individuals or organizations who are communicating with policy-makers. This article briefly describes the landscape of stakeholders involved in information-sharing before and during emergencies. We identify critical gaps in translation of scientific expertise and results, and biosafety and biosecurity measures to public health policy and practice with a focus on One Health and zoonotic diseases. Finally, we conclude by exploring ways of improving communication and funding, both of which help to address the identified gaps. By leveraging existing scientific information (from both the natural and social sciences) in the public health decision-making process, large-scale outbreaks may be averted even in low-income countries.

Reaching for the low hanging fruits: One health benefits of joint crop-livestock services for small-scale farmers

The benefits of joint health service delivery remain under-explored in One Health. Plant clinics are known to provide ad hoc, undocumented advice on animal health and production to farmers. To understand the scope of this activity, 180 plant doctors (extension workers) in Uganda, Kenya, Zambia, Peru and Costa Rica were surveyed and a workshop involving key stakeholders was organized in Uganda. Most (81%) plant doctors regularly received queries from farmers on livestock topics. This shows that the single sectoral approach to service delivery often does not match small-scale farmers' needs. There is growing interest among service providers, ministry officials and researchers to improve integration of farmer services to reduce operational costs and make better use of existing capacities. The workshop supported the proposal for the first ‘crop-livestock clinics’ to be trialled and evaluated in Uganda. This will inform other countries on the potential of joint services to mixed crop-livestock farming communities.

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81% of the interviewed plant doctors had received animal queries from farmers.

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The potential for creating health synergies by integrating farmer services is vast.

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There is a favourable environment in Uganda for trialling ‘crop-livestock clinics’.

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New joint crop-livestock services should be designed and evaluated with inputs from key stakeholders.

Transdisciplinary and social-ecological health frameworks-Novel approaches to emerging parasitic and vector-borne diseases

Ecosystem Health, Conservation Medicine, EcoHealth, One Health, Planetary Health and GeoHealth are inter-related disciplines that underpin a shared understanding of the functional prerequisites of health, sustainable vitality and wellbeing. All of these are based on recognition that health interconnects species across the planet, and they offer ways to more effectively tackle complex real-world challenges. Herein we present a bibliometric analysis to document usage of a subset of such terms by journals over time. We also provide examples of parasitic and vector-borne diseases, including malaria, toxoplasmosis, baylisascariasis, and Lyme disease. These and many other diseases have persisted, emerged or re-emerged, and caused great harm to human and animal populations in developed and low income, biodiverse nations around the world, largely because of societal drivers that undermined natural processes of disease prevention and control, which had developed through co-evolution over millennia. Shortcomings in addressing drivers has arisen from a lack or coordinated efforts among researchers, health stewards, societies at large, and governments. Fortunately, specialists collaborating under transdisciplinary and socio-ecological health umbrellas are increasingly integrating established and new techniques for disease modeling, prediction, diagnosis, treatment, control, and prevention. Such approaches often emphasize conservation of biodiversity for health protection, and they provide novel opportunities to increase the efficiency and probability of success.