One Health. Группа авторов
not be ignored. In the case of trypanosomiasis during the first half of the century, a highly ecological set of investigations resulted which drew on entomology, medicine, veterinary medicine and agricultural science to generate a dynamic picture of the disease (Tilley, 2011).
The elevation of development as an economic and political priority made colonial and post-colonial settings important to the integration of human and livestock health and nutrition (Staples, 2006). In 1948, as part of an international drive to improve human health through disease control and better nutrition, the WHO set up a VPH unit within its Division of Communicable Diseases (WHO, 1958). Headed by the American Martin Kaplan, who had degrees in veterinary medicine and public health, it developed close relations with the Food and Agriculture Organization of the United Nations (FAO), other UN agencies, and the Office International des Epizooties (OIE) (Kaplan, 1953). A series of joint WHO/FAO meetings in the 1950s led to collaborative programmes on zoonoses, meat hygiene and veterinary education. It also brought a working definition of VPH as comprising ‘all the community efforts influencing and influenced by the veterinary medical arts and sciences applied to the prevention of diseases, protection of life, and promotion of the wellbeing and efficiency of man’ (WHO/FAO, 1951).
In framing animal health as a crucial problem of human health and development, the FAO and WHO positioned veterinarians, trained and working within public health, as vital to realizing these goals (Bresalier, 2018). However, most countries lacked such personnel (WHO/FAO, 1956), therefore establishing new education and training programmes became a key focus. Through the 1950s and 1960s, the WHO and FAO acted to support and fund veterinary and VPH education in the developing world. These activities relied on expertise drawn from the USA, which led the post-war development of VPH at national, state and local levels, as well as internationally through the Pan-American Health Bureau (PAHB). The leading figure in these initiatives was James H. Steele (Steele, 2008). Trained in both veterinary medicine and public health, he was a prodigy of the Swiss-American veterinary pathologist Karl M. Meyer, himself a vocal proponent of the integration of human and animal medicine. It was Meyer who established the Hooper Foundation as a world-leading research centre on zoonoses and food safety.
As is evident from the above, post-colonial and international health contexts were very important in shaping the careers and ideas of many of the key figures who aligned themselves with a ‘One Medicine’ agenda. Their work within developing countries also enabled them to engage in cross-cultural encounters and exchanges with pastoral and agricultural peoples, which informed their thinking about the relationship between human and animal health, disease and medicine (Kaplan, 1966; Green, 1998; Beinart and Brown, 2013). The influence of these experiences and contexts can, for example, be detected in Calvin Schwabe’s frequently cited work, Veterinary Medicine and Human Health (Schwabe, 1964, 1969, 1984). More generally, this history indicates that many of the roots of present-day One Health lie in earlier currents of veterinary thought and practice that were deeply entangled with projects of development, international health, aid and post-colonial reconstruction.
Conclusion: From One Medicine to One Health
In analysing the changing relations between the health of humans, animals and the environment, this chapter demonstrates the many and varied links between them. Human medicine, in particular, has a rich history of engagement with animals, their diseases, and the people and institutions dedicated to animal health. Correspondingly, since the late 18th-century creation of their profession, vets have supported, collaborated and sometimes competed with this medical programme. These interconnections can be explained, in part, by reference to prevailing scientific ideas, practices and disease problems, but they can only be fully understood by examining the people involved, their institutional settings, and the wider professional, political, economic and environmental contexts. The historical specificity of these factors, as well as the variability of the health activities they influenced, makes it impossible to construct a simple, linear narrative linking past to present. Nor is it possible to draw direct lessons from history, or to claim – as do many existing histories – that the work of certain historical figures demonstrates the importance of pursuing One Health today.
This does not mean, however, that the past is irrelevant to the present. One key finding to emerge from this account is that links between the health of humans, animals and the environment were often investigated at grass-roots levels in the course of everyday veterinary and medical science and practice. For the most part, these activities were not articulated into a definite agenda of ‘comparative pathology’, ‘comparative medicine’, ‘veterinary public health’ or ‘One Medicine’. Only at certain historical junctures did practitioners choose to adopt these terms, usually in order to validate or win wider support for operationalizing their activities. Pushing beyond these labels and the rhetoric that surrounded them and looking at what was actually happening on the ground reveals that integrated approaches to health were much more widespread and more significant than previously realized. It is no understatement to say that health and medicine today are heavily shaped and underpinned by the many precursors to One Health.
One Health itself, as a self-consciously labelled set of activities and agendas, has emerged very recently out of a complex and rapidly shifting coalition of international health bodies, veterinary associations, academic advocates, environmental organizations and pharmaceutical companies. While its history has been fully explored elsewhere (e.g. Lebouf, 2011; Chien, 2013; A. Cassidy, 2019, unpublished), this chapter concludes by sketching out the broad contours of these developments in order to put the rest of this volume into context.
During the 2000s, elements of the ongoing traditions of comparative medicine and VPH came together into a rearticulated vision of ‘One Medicine, One Health’. This involved the alliance or convergence of veterinary and human medical research and/or clinical practice, including collaborative research, and shared clinics, vaccination strategies, equipment and drug development (e.g. King et al., 2008). In parallel, a different (albeit overlapping) set of actors and agendas came together around the term ‘One World, One Health’TM (OWOH). In contrast to the veterinary–medical focus of One Medicine, OWOH tended to address a broader range of disciplines across the life and environmental sciences while maintaining a relatively tight focus on issues such as ‘emerging infectious diseases’. The idea of ‘One World’ (OW) has its origins in mid-20th-century debates about international relations and the formation of the United Nations Educational, Scientific and Cultural Organization (UNESCO) (Sluga, 2010). It was significantly taken up by health actors during the 1990s, when the global scale and potential wildlife origins of the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) pandemic were recognized (Whiteside, 1996; King, 2004). In 2004, the first of a series of meetings between human public health, conservation and infectious disease experts was organized by the US-based Wildlife Conservation Society on the theme of OWOH. The idea then found strong purchase in international responses to the outbreak of highly pathogenic avian influenza (HPAI), and was adopted by the WHO, FAO, OIE and others in a shared statement of cooperative intent (FAO et al., 2008) following the HPAI crisis (