One Health, Shared Future: The Power of Connection in Medicine

In December 2019, the World Health Organization (WHO) was notified of a disease causing shortness of breath and fever in Wuhan, China. It wasn’t responding to treatment. By January, the CDC’s National Center for Immunization and Respiratory Disease (NCIRD) was mobilised and by March 2020, countries were initiating social distancing and shutdown measures [1]. COVID-19 changed the world. It also shone a light on the importance of the connection between human and animal health.

Factors such as reduced biodiversity, climate change, urbanisation, and travel are increasing the likelihood of another pandemic [2] , meaning zoonotic and reverse-zoonotic infectious diseases are likely to become even more common. The heat, floods and droughts caused by climate change have transitioned the narrative from what if to when? [3]

One Health: Multiple Disciplines

The interconnection between the health of humans and animals is central to the One Health concept.

The WHO defines One Health as ‘an integrated, unifying approach that aims to sustainably balance and optimise the health of people, animals and ecosystems’ [4]. Animals and humans have common exposures to similar viruses and bacteria, and our proximity to one another is only increasing. Pet ownership soared during the pandemic – it has risen by more than 50% since 2020 in countries such as the UK, France and Germany [5] – and these animals sleep on our beds, sit on our laps and are an integral part of our lives.

The One Health approach recognises the importance of understanding the entire ecosystem when it comes to global health – including the role of both veterinary professionals and medical teams in identifying, assessing and addressing disease. Veterinarians have a unique perspective on how outbreaks affect both human and animal health, and their skills and knowledge have proven essential when dealing with a pandemic.

We are trained in the undergraduate setting as well as post-graduate education to be on alert for notifiable diseases. If one of these viruses were to enter a naive country, it could devastate entire industries, so we as veterinarians have a responsibility to detect newly emerging diseases. I know I’m not alone in carrying the fear of being the person who misses the presentation of, for example, foot and mouth disease (FMD). In Australia, where I was most recently in practice, FMD would have a devastating impact on both the livestock industry and the Australian economy.

Veterinary expertise can make all the difference in mitigating the impact of these outbreak events. Another example of this is the Hendra virus which, thanks to a unique combination of environmental events, spreads on occasion from bats to horses, and from horses to humans. Rare but often fatal, its detection comes down to veterinary skills and awareness, which is particularly challenging as this virus presents in horses in a very vague and non-specific way.

We all have a responsibility – human medical practitioners, researchers, pharmaceutical and biotech organisations, leaders in academia, public and private institutions and veterinarians – because we are all operating in one environment.

Infectious Disease: An Animal Origin Story

There’s a growing consensus that many infectious diseases originate from animal sources. This means veterinary professionals have a huge responsibility to detect these diseases. Standing on the zoonotic front line, we are uniquely placed to notice unusual presentations, illnesses and symptoms.

We are trained not just to think about the animal in front of us but to look at the broader implications. Are these blisters on this cow an isolated incident, or are they indicative of something more serious? FMD for example? Or think about rabies: while prevalent in Africa and Asia, other countries such as Australia and the UK have no cases of the disease in terrestrial species, yet there is always the possibility of re-emergence. Veterinary professionals must be alert to these possibilities and vigilant to detection.

However, I’m not sure society fully appreciates the role veterinarians play. Without enough veterinary professionals (a current challenge around the world), there is the risk of missing diseases which could devastate entire industries and economies. We are at the forefront of surveillance, and a critical player in the One Health approach.

Collaborative Health

The many and varied roles that veterinarians have in the context of One Health are often under-recognised and potentially undervalued. While there is some collaboration between veterinary and human health, there isn’t enough.?

Adopting a One Health approach is vital to ensuring cross-discipline insights and knowledge are equally shared and respected across all professionals.

It also contributes to building an ecosystem of collaborative healthcare that provides veterinary and medical professionals with more support and training. For example, Zoetis has established alliances with infectious disease networks, uniting top experts and resources to tackle emerging health threats. This collaboration speeds up the development of solutions for diseases affecting humans and animals. A superb example was during the Hendra virus outbreak, where it was significantly faster and more cost-effective to produce a horse vaccine as opposed to a vaccine for humans, but the vaccine has now benefited both species [6]. It exemplifies the One Health philosophy and highlights the interconnectedness of human, animal, and environmental health. For example in this outbreak, there were calls for broad scale bat culling, despite their crucial role in pollination and insect control. This would have had huge implications for the environment as well as likely little to no impact on preventing disease.

There is no doubt that the next outbreak is coming. However, if we invest in One Health today, our combined expertise can potentially change the outcome for humans and animals.