One Health. Группа авторов
example that can provide valuable insights for addressing serious infectious diseases that affect production animals, economic value, and transmission to humans. The ‘reverse zoonosis’ pathway, that is of animals being infected by humans is also under-addressed. Yet it could have major economic, animal (including wildlife) and human consequences (e.g. production pigs being infected by ‘flu’ from human carriers working in the industry, and the rarer and fascinating cases of elephant tuberculosis coming from humans) (Laine, 2018). The emerging field of multispecies ethnography provides an opportunity to reorientate social science approaches to better examine human–animal–environment entanglement and ‘revisit theorizations’ of central topics in medical anthropology’ (Brown and Nading, 2019, p. 5; see also Kirksey and Heimreich, 2010).
Designing and Implementing One Health Approaches with Social Science Integration
There remain few descriptions of integrating social science in the planning, implementation, monitoring and evaluation of One Health interventions in the published literature, especially beyond pilot research projects. Case study 2 adds another valuable contribution to address this knowledge gap. In Chad, deliberative integration of social science research in the design phrase enabled the findings to be utilized to develop health-care programmes for nomadic pastoralists (Schelling and Zinsstag, 2015). In Fiji, social science was one of the disciplines engaged in the transdisciplinary process to develop the National One Health Control Programme (Reid and Kama, 2015). One of the barriers to integration remains lack of appreciation of the value that social science can add to the design and implementation of interventions, and their outcomes and impact. Beyond having baseline and endline KAP, there are few descriptions of a fully integrated transdisciplinary approach to a One Health problem. One example is in Nunavik, Canada where the Inuit people, anthropologists and veterinarians started working together to develop more culturally suitable and respectful dog management practices. The aim is for more effective implementation for rabies control and to address other common health issues (Levesque, 2018). Additional examples are included in Chapters 18–27, this volume.
It should be noted that there are also limited published quality evaluations of any One Health intervention around the issue of the integration of social science. However, a review of ‘proof of concept for the One Health approach to emerging disease threats provides evidence that transdisciplinary integration among the sectors of human, animal, and environmental health is feasible’ (Rabinowitz et al., 2013, p. 6).
Rwanda has developed a One Health strategic plan to ‘streamline cross-sectoral and institutional interventions, minimize duplication of efforts, and maximize the use of public resources’ (Nyatanyi et al., 2017, p. 3). Included in this plan is the promotion of interprofessional collaboration in research and innovation and its linkages to programme development and implementation. However, it is early days yet, and although they hope for a broad approach to problems like food security, antimicrobial resistance, animal and human infectious disease outbreaks, it will take time. Some newly announced projects, such as Operationalizing One Health Interventions in Tanzania (UK Research and Innovation, 2018), are designed to incorporate social science into the design, and may provide valuable insights to address this knowledge and practice gap. In Switzerland, One Health plans have been developed by the local government in some cantons to address some priority health issues of non-communicable diseases, mental health and health hazard surveillance (Meisser and Goldblum, 2015).
One way to increase appreciation of and integration of social science into One Health approaches is through engagement and dialogue across disciplines and professions. Rock et al. (2017) discussed how, in order to have rabies and dog bite research enhance policy alignment and task integration between animal control and public health services, they developed a forum to share the results of their research with animal control officers and public health officials in a variety of settings. Many anthropologists have advocated for ‘greater social science involvement in One Health initiatives, seeing possibilities to attend to new dimensions of inequalities revealed at human–animal interfaces within enlarged understandings of pathology’ (Craddock and Hinchliffe, 2015, p.1) and ‘others have identified opportunities for “critical and constructive social science engagement with One Health” ’ (Brown and Nading, 2019, p. 9). (For further discussions see also Rock et al. (2009) and Dzingirai et al. (2017).) There is a need for better documentation of how social science has made changes to the effectiveness of joint and integrative identification of problems, design of interventions and their implementation, including their success in being relevant to, culturally appropriate for and meeting the requirements of those in greatest need.
Discussion
Discussing the added value of integrated approaches in One Health strikes at the core of complexity studies, where we acknowledge that the interconnectedness of the human–animal–environment interface requires a multiplicity of lenses to capture enough information to make syntheses typical of academic research a reasonable endeavour. Social scientists, trained to understand emic models of self and other, are well positioned to address the interpretative nature of paradigms shaping particular knowledge systems within the professions and disciplines (e.g. the diverse interpretations of veterinary doctors or epidemiologists as to what variables need to be addressed in One Health), facilitating intra-team dialogues to better represent the human–animal–environment subsystems.
Going beyond state-of-the art scientific production, One Health claims include the dimension of producing socially robust approaches contributing to public health. The role of social sciences then becomes evident as foundational for the co-production of interdisciplinary understandings of One Health by linking disciplinary experts in relevant approaches to particular complex health problems and various societal contexts. As the case studies show, a socially robust orientation requires contextualized thinking, an approach sensitive to cultural, historical and gender aspects shaping determinants of human, animal and environmental health. Additionally needed are mechanisms to see the linkages and feedback loops of human behaviour and observable disease, with the animal world and environments, and a capacity to address and integrate multiple ontologies and epistemologies of diverse stakeholders. The social sciences can provide evidence around power relationships, and the differential positions of various groups of people in social settings and economic markets, which support addressing the inequities often seen in accessing health interventions (Craddock and Hinchcliffe, 2015). Craddock and Hinchcliffe (2015, p. 2) note that social science brings to the One Health agenda an ability to ‘foreground uneven geographies, uneven power relations, discrepant risks and variable access to resources’.
Social science also fosters participatory approaches that recognize multiple epistemologies and join academic disciplines, engaging partners, including communities, in mutual understanding of practices and explanatory models. It assists in examining the ‘myriad configurations, textures and dynamics of human and non-human relations’ (Craddock and Hinchcliffe, 2015, p. 3; see also Fuentes,