One Health. Группа авторов

One Health

One Health - Группа авторов

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are encouraging low- and middle-income countries to set up processes of public participation in health-sector priority setting. A recent review, however, showed that to date there is little evidence on how to do this in a less costly way. The authors of the review propose that some of the substantial resources needed for a nationwide public engagement could be used to strengthen the evidence for what works within the realities, using small-scale, community-driven trials (Alderman et al., 2013).

      Transdisciplinarity in ecohealth

      Transdisciplinarity is well embedded in ecohealth to tackle the non-linear systems dynamics (Bunch and Waltner-Toews, Chapter 4, this volume). The International Development Research Centre framework implies not only a transcendence of disciplines, but also the participation of scientists, communities and policy makers in research (Lebel, 2004). Particular attention is given to gender and social equity and putting knowledge into action through policy change, interventions and improvement of practices (Charron, 2012). Examples of transdisciplinary processes are presented in Charron (2012), Veterinarians Without Borders/Vétérinaires Sans Frontières Canada (VWB/VSF Canada, 2010) and in Bunch and Waltner-Toews (Chapter 4, this volume). Parkes et al. (2005) exemplified the value of transdisciplinarity for emerging infectious diseases. They concluded that with transdisciplinary integration and innovation for infectious diseases it may be possible to harness the good will and teamwork established during an emergency in order to address health issues that develop more slowly. With emerging health threats, the social-ecological and political contexts of global health foster integrated conceptual frameworks and disease control measures (see also Gallagher et al., Chapter 24, this volume). Although complex understandings of social and ecological systems may be informative and better reflect the uncertainty of real life, such approaches may be challenged on the basis that they often do not lend themselves to straightforward, rapidly implemented policies or interventions.

      Disciplines and Approaches are Not Static: Intermediary Conclusions

      Transdisciplinarity emerged as a form of research at the end of the 20th century because separated disciplines could not grasp the complexity of, for example, the impact of new technologies and natural resource depletion. Such issues could not be tackled from the sphere of individual disciplines. We see health as a life-world problem and believe that transdisciplinarity should be at the heart of One Health studies leading to improved health of people, animals and the environment. The examples in this chapter show that the engagement of other than academic knowledge can lead to problem solving and innovation, as well as unexpected outcomes. For enabling this, efficient project communication including multilingualism is mandatory and needs to be planned from the outset for every phase of the project. Taking a One Health approach can promote development of good partnerships between government agencies as well as engage the public and industry stakeholders in the development and delivery of policy (Rinchen et al., Chapter 29, this volume). It can further increase equity and effectiveness of interventions at national and sub-national levels, because equity can only be defined within a broad transdisciplinary partnership between communities and authorities governed by mutual trust and security. This is similar to what is promoted in the 2008 Report of the WHO Commission on Social Determinants in Health that recognizes civil society as a champion of equity (Jackson et al., 2013). Health equity, in turn, is part of sustainable development and hence directly linked to environmental sustainability and social justice (Zinsstag et al., 2011a).

      Participatory stakeholder processes, as discussed above, seemingly have huge potential for practical problem solving but also bear risks. These include raising expectations too high for outcomes of the process and choosing certain health-related outcomes over others such as poverty alleviation (which implies ethical considerations), the stakeholders engaged are not representative for the relevant problem area, and there may be biases in the process due to power relationships, such as dominance of academia and gender issues. These few examples show how important it is to involve social scientists and communication specialists in stakeholder processes and to carefully document the process right from the outset.

      Complexity, uncertainty and ambiguity in health and other life-world problems are obviously challenges. How do we deal with corruption or the discrepancy between investments in development of sophisticated, new technological tools, when we do not manage to effectively deliver existing adequate tools, such as measles vaccination? We can deal with complexity by interdisciplinary expert inputs, although we may invite a suboptimal panel of disciplinary experts. Each researcher and actor may locate the problem in an alternative ‘world of relevance’. Validation and quality control may help. Validation of non-scientific knowledge and explanations is a crucial and challenging aspect of knowledge integration within transdisciplinary research. Because different types of explanation play a role, different validation criteria have to be met, both through problem formulations and solutions found. Sometimes a non-scientific explanation can be tested as a hypothesis in a further research process. A continuous dialogue between the parties involved is required, with feedback loops for cross checking previous assumptions, insights and demands (Flinterman et al., 2001). Social scientists appear best situated to monitor the process and identify possible shortfalls that need corrective actions.

      Researchers are challenged to cross the boundaries between human and natural sciences to generate results that could not have been attained using a disciplinary or sectoral approach alone. Scientists trained for many years in one discipline must first learn to acknowledge the strengths of other approaches. University curricula, however, rarely enable scientists to communicate with other disciplines, and researchers first need to acquire their own experiences and skills (Conrad et al., 2009; Min et al., 2013). Max-Neef (2005) wrote that this should not represent a problem as long as the higher education received was coherent with the challenge. This is, unfortunately, not the case, since monodisciplinary education is still widely predominant in all universities.

      It is encouraging to see that donors explicitly ask for inter- and transdisciplinary research. However, the establishment of these processes requires some additional investments, and donors do not yet readily give more time or money. In any case, transdisciplinary research with its iterative cycles between innovation, application and validation is an integral part of One Health approaches.

      References

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