One Health. Группа авторов
a master’s degree in public health and a PhD in parasitology and tropical medicine (1956). For 10 years, Schwabe worked at the American University in Beirut. His main interests were parasitic diseases, mainly echinococcosis. He initiated control programmes and led the WHO expert committee on veterinary public health in Geneva. In 1966, he became a full professor in veterinary epidemiology at UC Davis (California). Schwabe’s interests reached far beyond health issues towards more integrated approaches to science. His overarching views on health of all species influenced modern concepts of veterinary public health, One Health and ecosystem health. His vast bibliography is accessible at: https://oculus.nlm.nih.gov/cgi/f/findaid/findaid-idx?c=nlmfindaid;idno=schwabe (accessed 27 March 2020).
Collaborations between veterinarians and physicians should produce benefits that are broader than merely additive. The beyond-additive value-added benefits are related to direct positive outcomes not just in reduced risks and improved health and well-being of animals and humans, but also in financial savings, reduced time to detection of disease outbreaks and subsequent public health actions, as well as improved environmental services (Zinsstag et al., Chapter 31, this volume). For example, a mixed team of doctors and veterinarians examining human and animal health in mobile pastoralist communities in Chad found that more cattle were vaccinated than children. None of the children were fully vaccinated against childhood diseases. Recognition of this fact enabled subsequent joint human and animal vaccination campaigns providing preventive vaccination to children who would otherwise not have had access to health services. Clearly, a closer cooperation of veterinarians and doctors generated a better health status than what could have been achieved by working in isolation (Schelling et al., 2007a; Häsler et al., Chapter 10, this volume; Danielsen and Schelling, Chapter 14, this volume). Such joint services are scalable to national and regional level by adopting a systems strengthening perspective leading to an extension from Calvin Schwabe’s concept of ‘one medicine’ to One Health (Zinsstag et al., 2005). This has been clearly validated as a public health concept in different areas of the world, ranging from Africa to Asia (Zinsstag et al., 2011).
Today, One Health has become a broad international movement supported by the World Health Organization (WHO), the Food and Agriculture Organization of the United Nations (FAO) and the World Organisation for Animal Health (OIE). The World Bank produced a first account of economic aspects of One Health (World-Bank, 2010, 2012), which can include health consequences of structural aspects such as political change (Roth et al., 2003) or globalized agriculture (Wallace et al., 2015). In the USA, a One Health commission coordinates and assembles many of the activities (‘www.onehealthcommission.org’ (accessed 27 March 2020)).The European Cooperation in Science and Technology (COST) funded the creation of a Network for Evaluation of One Health (NEOH), which developed an evaluation framework (Rüegg et al., 2017) and coined the term ‘One Health-ness’. One Health-ness is expressed as a mixed method index of quantitative and qualitative operational and infrastructural aspects of One Health. NEOH includes environmental, ecosystem and structural elements of health, and connects to the Sustainable Development Goals (SDGs) of the United Nations (Rüegg et al., 2017, 2018; Hitziger et al., 2018).
One Health has thus gained broad recognition as an integrated approach to health when compared with mainstream reductionist approaches in the health sciences. Yet, by expanding the integration of health towards broad social-ecological issues like antimicrobial resistance or deforestation, complex interactions can become ‘wicked’ and hardly tractable.
Rüegg and co-workers state: ‘There is a need to provide evidence on the added value of these integrated and transdisciplinary approaches to governments, researchers, funding bodies and stakeholders’ (Rüegg et al., 2018). We thus recall the foundational principles of One Health:
1. One Health is about cooperation between different academic disciplines underlying human and veterinary medicine in the first place, but without any barrier to natural and social sciences and the humanities. One Health also engages with non-academic actors in the co-production of knowledge (Berger-González et al., Chapter 6, this volume).
2. Cooperating partners will seek a benefit of working together sooner or later. To fully understand the range of potential benefits of a closer cooperation implies a deeper and comprehensive recognition and understanding of how humans and animals and their environment are interrelated at all scales. This is a necessary requirement of One Health but still not sufficient.
A sufficient requirement for One Health is demonstrating the benefits and added values resulting from the crosstalk and closer cooperation between human and animal health and all related disciplines and stakeholders.
We thus define One Health as any added value in terms of health of humans and animals, financial savings, social resilience and environmental sustainability achievable by the cooperation of human and veterinary medicine and other disciplines when compared to the two medicines and other disciplines working separately.
The equal focus on the health of people and animals is one of the characteristics that has differentiated the organization, strategy and practice of One Health from several other related fields, such as veterinary public health, resilience, ecohealth, and most recently, planetary health (Horton et al., 2014; Pongsiri et al., 2019). The latter two consider ecological resilience and sustainability more prominently (see more discussion on this below; also Bunch and Waltner-Toews, Chapter 4, this volume; Lerner and Zinsstag, Chapter 5, this volume).
Based on these characteristics, the challenge is to show how, through highly iterative processes and actions, both directly and indirectly, physicians serve animal health and veterinarians serve public health. We need methods that are capable of quantitatively and qualitatively measuring interactions at the interface of human and animal health. Such methods have been developed for survey design (Schelling and Hattendorf, Chapter 8, this volume), integrated surveillance and response (Aenishaenslin et al., Chapter 9, this volume), economics (Häsler et al., Chapter 10, this volume), animal-to-human transmission of infectious diseases (Chitnis et al., Chapter 12, this volume) and integrated health services (Danielsen and Schelling, Chapter 14, this volume). The postulate of an added value of such a closer cooperation is summarized in Zinsstag et al. (Chapter 31, this volume).
Cultural Differences in Human–Animal Relations and their