Within One Health, the environment has for too long taken a back seat to animal and human health concerns, undermining the ability to achieve integrated approaches to health programming. But that misplaced emphasis is changing. This was one conclusion we took away from the recent 8th World One Health Congress (WOHC2024) in Cape Town, South Africa.
The environmental health sector is recognized as essential for achieving both human and animal health but financial investment and organizational commitment are unclear, undermining the role balanced ecosystems play in overall health outcomes. Collaboration must be enhanced across the three sectors to build trust among representatives from environmental health that their priorities are valued and aligned with the other sectors to contribute to a One Health approach.
One way of doing this is to afford environmental specialists leadership roles in One Health initiatives. DAI’s Integrated Natural Resource Management (INRM) Activity is putting that idea into practice with One Health approaches led by the environment sector. The INRM Health Threat Extension Pilot, for example, uses climate data to guide early warning systems for health threats related to the increasing prevalence of malaria in rice-growing areas of Mozambique and to predict measles outbreaks in Somalia based on vaccination campaigns and climate and weather data.
The fight against anti-microbial resistance (AMR) similarly illustrates the importance of taking an environmentally informed approach to health. This year’s 79th United Nations General Assembly, featuring the second High Level Meeting on AMR, echoed the WOHC2024 in stressing the need to tackle AMR in the environment. AMR can proliferate in the environment—such as in the soil, water, or plants—and without intervention, can expose animals, agriculture, food systems, and humans to resistant bacteria. DAI’s Fleming Fund portfolio addresses AMR in the environment in Bangladesh, Indonesia, and Pakistan by improving surveillance systems and strengthen laboratory capacity across One Health sectors. Without sustained environmental sector support, efforts like Fleming Fund are at risk of being undermined.
Measuring One Health to Improve Operations
Another takeaway from the Cape Town event is that for One Health programs to truly be intersectoral, they need to work toward integrated goals. One way to advance that objective is to employ robust monitoring systems and real-time data linked to shared indicators. WOHC2024 showed that these systems are urgently needed to operationalize One Health initiatives faster, but how do we design targets that fit different sector goals? Developing One Health indicators and utilizing indicators that already exist between sectors, for example, such as a program that improves health systems and builds climate resilience,, could boost collaboration. In Bangladesh, the U.S. Agency for International Development (USAID)’s System Strengthening for One Health Activity utilizes this integrated approach to program monitoring for uniting the animal, human, and environmental sectors and aligning goals by ensuring system strengthening targets are measured across sectors.
Regionalized Approaches Can Provide Frameworks for Success
Like all development programs, One Health initiatives must be tailored to the communities they serve, but within the One Health framework this process can be particularly challenging because the priority given to each sector—human, animal, or environment—can vary across different contexts. Balancing these priorities requires a nuanced approach, particularly when it comes to resource allocation. Successful One Health initiatives depend on fostering understanding and alignment among sectors to ensure that all perspectives are considered, valued, and integrated into cohesive strategies. Perhaps even more than other programming, One Health approaches cannot simply be copied from one context and pasted into another, but need to be closely guided by regional, country, and local needs.
That said, global frameworks such as the One Health High-Level Expert Panel’s Theory of Change can provide the structure and support needed to inform and apply a One Health approach locally. Establishing regional bodies to provide a framework of One Health for practitioners at lower levels can help. Under the USAID ASEAN PROSPECT and follow-on Partnership Program activities, for example, DAI is helping to establish the Association of Southeast Asian Nations (ASEAN) One Health Network, which has brought together member states to collaborate on One Health issues—leading to improved coordination, capacity, and technical knowledge sharing. Similar approaches could support other regions.
Building on Progress
One Health has made remarkable strides. But to maintain this momentum, we must continue to address the gaps that remain. By building trust, fostering leadership, and ensuring that all sectors—including the environment—are fully engaged, we can ensure that a One Health approach continues to meet the complex health challenges of our time.
