VN November 2021

Vetnuus | November 2021 10 Article One Health has evolved from a concept to an operational framework to address major societal issues. The idea that there is a link between human health and the environment and animal health is not new. It can be traced as far back as to the Greek physician Hippocrates (c. 460 BCE – c. 370 BCE) in his text “On Airs, Waters, and Place” where he promoted the concept that public health depended on a clean environment. Lucius Junis Moderatus Columella wrote a work, “ Segregation and Quarantine” , an early text on agriculture and led to a basic form of One Health. It advised people and animals to be kept separate on farms. The World Bank highlighted One Health in 2010 with People, Pathogens and Our Planet Volume 1: Towards a One Health Approach for Controlling Zoonotic Diseases. This work also provided an early graphic depiction of One Health (fig 1.) In this graphic, One Health is indicated as the very narrow intersection of the three interconnected circles of Humans, Wildlife and Domestic Animals. The One Health framework has often been represented by three intersecting circles the representing human health, animal health, and environmental health reflecting the One Health Commission definition: One Health is a collaborative, multisectoral, and transdisciplinary approach-working at the local, regional, national, and global levels- to achieve optimal health and well-being outcomes recognizing the interconnections between people, animals, plants and their shared environment. (fig. 2) This definition broadened the scope of One Health beyond zoonotic disease. It began to include other functional domains such as the human-animal bond, food safety and security, translational and comparative medicine, antimicrobial resistance, climate change adaptation, and other focus areas. The three aspects of One Health, human health, animal health and environmental health, have mainly been adopted and integrated into national and international frameworks as seen in the Global Health Security Agenda, an international program to address critical emerging biothreats that incorporates One Health. 3 This three circle graphic, while helpful to envision groups working together collaboratively, oversimplifies the One Health construct and does not address broad scope of One Health issues and the barriers to effective and efficient One Health action. Barriers to One Health in practice have been previously identified, including: • Legal Authorities • Funding • Institutional Culture • Processes • Terminology • Facilities • Infrastructure • Information Technology However, even including human health, animal health and environmental health does not provide enough of the spectrum Beyond Three Circles: A Broader View of One Health Gary A Vroegindewey, DVM, MSS, DACVPM Professor Director, One Health Program LincolnMemorial University-College of VeterinaryMedicine Figure 1. The One Health focus on zoonotic disease continued with the World Health Organization, World Animal Health Organization (OIE), and United Nations Food and Agriculture Organization publishing “Taking a Multisectoral One Health Approach : A Tripartite Guide to Addressing Zoonotic Diseases in Countries”. Figure 2.