In a globalised world, the health threats to animals, people, plants and the environment are increasingly driven by interconnected crises such as infectious diseases, antimicrobial resistance, climate change and ecological degradation. The COVID-19 pandemic in particular highlighted the urgent need for more globally integrated and cross-sector collaboration and One Health strategies to protect our people, animals, plants and environment.
The Lancet One Health Commission was convened in 2019 and comprises more than 40 global leaders from academia, science, public health and policy, as well as funders and international organisations. Supported by renowned universities and research institutes, the group has launched this report to inform the future of One Health and help shape health governance, sustainability planning and policy development.
The RVC’s expertise made important contributions to the report, including systems thinking, application of One Health to food systems and One Health economics. This ensured considerations of funding and financing, and the One Health value proposition.
Creating the report, the Commission conducted extensive literature reviews, cross-sector stakeholder engagement, analysis of existing frameworks, knowledge sharing and expert dialogue. It builds on the work of organisations, such as the Quadripartite for One Health and the Intergovernmental Panel on Climate Change, but advances a holistic and systems-level thinking of health in socio-ecological systems, building on One Health principles and governance.
The report found that there are currently siloed sector responses and existing health systems neglecting environmental and socioecological determinants of disease, limiting the effectiveness of interventions. Surveillance systems across humans, animals and ecosystems are also disconnected, and there is a lack of shared indicators, frameworks and dedicated financing for One Health initiatives.
Furthermore, low- and middle-income countries are disproportionately affected but underrepresented in funding and decision-making. Education systems and public awareness are unprepared to support the shift toward One Health thinking, and the private sector is under-engaged and at times misaligned with One Health values. Compounding this, it was found that food systems, a major driver of environmental and health pressures, are not adequately addressed in health planning, and ultimately, a growth-at-all-costs economic mindset is undermining the development of a sustainable future.
The report, therefore, outlines a set of key recommendations to improve the implementation of One Health approaches. These are:
- Institutionalise One Health and associated governance structures at global, national and local levels
- Operationalise One Health through policies that embrace systems thinking and incorporate the interdependencies between people, animals and environments
- Build integrated and shared health surveillance systems across people, animals and environments
- Shift economic paradigms towards equity, sustainability and health for all
- Ensure equitable, innovative, effective and sustainable One Health financing
- Institutionalise One Health in private sector governance and operations
- Institutionalise One Health in higher education
- Promote transdisciplinary One Health research and knowledge production
- Foster One Health literacy across society through formal and informal education
- Transform food systems through a One Health lens
The Commission is now calling for individual, community, organisational, national, regional and international action to advance equitable, sustainable and healthy socioecological systems.
Professor Barbara Häsler, Professor in agri-health at the RVC and co-author of the report, said: ”After years in the making, we are very proud to see the Lancet One Health Commission report published. It provides deep and nuanced insights into the interconnectedness of the many health challenges the world is facing, and sheds light on topics neglected to date in One Health.
“The report highlights the need for multi-sectoral, multi-stakeholder and systemic solutions where everyone has a role to play. With its recommendations and avenues for the future of One Health, it is an excellent resource for sparking dialogue on how we can tackle collectively and collaboratively pressing health challenges like the triple planetary crises (climate change, biodiversity loss, and pollution), infectious diseases, food system risks, and antimicrobial resistance.”
