VN November 2021

Vetnuus | November 2021 6 The international One Health Day (November 3) provides an occasion to reflect on how the One Health approach benefits veterinary practice and health outcomes. Encouragingly, the approach is already being applied by veterinarians in South Africa on several projects and topics. This is cause for celebration – though there is much more to be done. The term One Health was first used in 2003 by Dr William B. Karesh, a wildlife veterinarian and global health visionary. In an interview about declines in Great Ape populations linked to the Ebola virus, which also affected humans, he remarked, “Human or livestock or wildlife health can’t be discussed in isolation anymore. There is just one health. And the solutions require everyone working together on all the different levels.” One Health makes practical sense when considering the severe and complex challenges faced locally and globally. Examples include the COVID-19 pandemic (itself likely of zoonotic origin), climate change, invasive alien species, chemical and waste pollution, water scarcity, soil degradation, and antimicrobial resistance. At the same time, endemic diseases present a continued threat to people and other species. These issues all have implications for nutrition and food security, disease control, and of course, health and economy. These complex challenges require integrating information from multiple sectors to sufficiently understand risks and impacts to human-, animal-, and environmental health. Many readers will relate to the concept of “silos” 1 , like the vertical structures seen on grain farms. A silo is how we tend to work within our professional sector (Figure 1). There are, of course, needs and benefits of doing so, mainly to build robust and specialised expertise. However, without also having the systems in place to bring together knowledge and action across sectors , we can end up with a narrow view of the problems at hand and the potential solutions. There are several ways to overcome our siloed way of working. One is to ensure the value veterinarians add is clearly recognised and harnessed by public health and environmental counterparts. The other is to ensure the veterinary community can take stock of relevant information that can help to prevent, detect, and respond to disease threats. Immediate success will involve increased sharing of helpful information, earlier detection of threats or cases, and improved understanding and action to prevent, detect, and respond to disease risks. Ultimately, this will help lead to improved animal-, human- and environmental health. The World Bank released a One Health Operational Framework in 2018 that guides investing inOneHealth 2 . AGlobal Plan of Action for One Health is being developed to support collaboration between four inter-governmental agencies: the Food and Agriculture Organization of the United Nations (FAO), the United Nations Environment Programme (UNEP), the World Health Organization (WHO), and the World Organisation for Animal Health (OIE). A One- Health High-Level Expert Panel has recently been established to advise these organisations. South Africa is well represented with two members on this Panel. Nationally many countries have established national One Health coordination platforms to support information sharing, priority setting, and planning. In some cases, such a platform offers the first real chance for communication and collaboration between government officials! Once again, South Africa was ahead of the curve by establishing the National One Health Forum in 2014 with the three national government Departments responsible for human health, animal health and agriculture, and environmental health 3 . At the local level, including in clinics and farms, veterinarians often use One Health approaches in regular practice each day – certainly more than one probably realises. For example, one knows how vital vaccinating cats and dogs is to help prevent human and animal rabies cases. But when one sees something unusual in an animal patient, does it prompt thinkingaboutwhether colleagues inhuman medicine may benefit from an alert? Does disease detection in animals automatically lead to measures to protect workers on farms to prevent transmission to and from them? If one sees heavy rains, does it stimulate concern about an increased risk of some vector- borne diseases? When working with animals recently moved from other farms or provinces, does one think about the environmental conditions and disease exposures where they originated? The topic of antimicrobial resistancemakes evident why One Health is so important. The selection of antibiotics used in veterinary medicine, agriculture, and fisheries can consider the antibiotics that are important for human medicine. Doing so can help maintain treatment effectiveness in humans. Similarly, farm animal waste management can help avoid disseminating unmetabolised antimicrobial residues and resistant bacteria and genes. Additional to this are the benefits of protectingwater quality and not attracting pests. One Health: How Collaboration Can Expand the Positive Impact of theVeterinarian Leading Article Figure 1. Typical professional silos and the need for coordination across sectors.