One Health is defined as an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems.
The One Health approach brings together and draws on diverse expertise across public, veterinary and environmental health.
It is therefore a promising way to act at international, regional, national and local levels towards reducing future health risks and impacts for people, animals and ecosystems.
Lessons from recent disease outbreaks including COVID-19, Ebola and avian influenza have reinforced the importance of adopting the One Health approach.
One Health thinking is embedded in current efforts to reduce the spread of antimicrobial-resistant pathogens, ensure food safety, reduce water-borne contamination, and manage human and livestock interactions with wildlife.
It can also be seen in structural efforts to establish One Health collaborative, cross-departmental organizational structures.
To succeed, these efforts require a triple ‘inoculation’ of public, veterinary and environment health expertise together with an understanding of the wider systems involved.
While the overall approach has been around for some time, real implementation of One Health faces several challenges.
A key challenge stems from the many sectoral, domain, disciplinary, academic, organizational and investment silos that limit desired cross-communication and integration of effort and ultimately keep people, ideas and solutions apart.
Further, while each domain – medicine, public health, veterinary science or ecosystems health – has its own specific organizations and expertise, there are individual and institutional gaps in One Health capacities at the various inter-domain interfaces.
Gaps in One Health capacity also exist more globally around the thinking, planning, working, shared infrastructure, processes and learning that are necessary to deliver health through an integrated approach.
Capacitating the next generation
The Capacitating One Health in East and Southern Africa (COHESA) project is tackling some of these capacity gaps by enhancing the knowledge base for research and policy-making, strengthening national and subregional cross-sectoral collaboration, building academic capacities and One Health education, and growing the abilities of government and non-governmental actors to deliver One Health solutions.
The COHESA project is led by the International Livestock Research Institute (ILRI), the French Agricultural Research Centre for International Development (CIRAD) and the International Service for the Acquisition of Agri-biotech Applications (ISAAA) AfriCenter.
On 22–24 November 2022, ILRI and CIRAD convened a workshop hosted by the Botswana University of Agriculture and Natural Resources that brought together around 50 project partners from 10 countries to brainstorm and set priorities for the work package to equip higher education institutions to train the next generation in the One Health approach.
Specific activities under this work package include benchmarking of tertiary One Health training, co-developing short courses to fill priority gaps, developing the capacity of secondary and tertiary education institutes and research institutions to deliver One Health courses and content, and training the next generation of One Health researchers and trainers.
Lessons and insights
Opening presentations covered a One Health Regional Initiative for Eastern and Southern Africa funded by the World Bank, a curriculum development process led by the Southern African Regional Universities Association and a food safety curriculum benchmarking exercise led by the Inter-University Council of East Africa.
Following the presentations, a panel highlighted the importance of soft and technical skills to be able to work across One Health, systems thinking to see the whole picture and effect change in a complex interconnected world, being able to balance different problems and trade-offs, reaching beyond academia, promoting open curricula, and the need for skilled individuals and smart institutions to enable cross-sectoral and domain engagement.
Further inspiration for academic curriculum development was provided by the University of Gondar in Ethiopia, demonstrating how more integrated human and veterinary public health courses were developed alongside veterinary science course updates to meet the standards of the World Organisation for Animal Health, combined with summer courses, community outreach and skills upgrading for university staff.
As an example of how One Health messages might be communicated more widely, a case study from the United Kingdom’s Royal College of Veterinary Surgeons illustrated the development of an outreach scheme employing veterinary nurse ambassadors and other communication efforts to bring key messages to target groups in schools.
Visits to the Botswana University of Agriculture and Natural Resources and the University of Botswana exposed participants to real One Health problem scenarios, giving them a better appreciation of the types of capacities and competencies needed and implications for One Health curriculum development.
Curriculum development priorities
The workshop participants identified five priority groups for curriculum development and how to deliver the One Health interventions. These are
● school pupils;
● undergraduate students;
● graduate and postgraduate students;
● education trainees; and
● in-service and working professionals (veterinarians, doctors, environmental scientists, nurses, wildlife personnel, lecturers and teachers).
The notion of ‘One Health-ness’ developed by the Network for Evaluation of One Health was mentioned as a useful framework and set of questions that could be used to help determine the extent that a research or training intervention truly meets One Health outcomes or is just focused on a single domain issue.
Collaborative research opportunities
Drawing from the various discussions, participants suggested areas where regional research collaboration could contribute to the project. These included
● developing a One Health investment roadmap;
● exploring communities understanding and perceptions of One Health;
● taking stock of small mammal related zoonotic risks in diverse socio-ecosystems;
● studying the impact of physical barriers at the people–animal–environment interface;
● mitigating zoonotic diseases through water, sanitation and hygiene;
● understanding antimicrobial resistance in buffalo metabolomics;
● evaluating the impact of One Health interventions;
● facilitating One Health collaboration in crisis situations; and
● adapting to the threat of mycotoxins in the face of climate change.
Among the ideas and approaches for follow up are the One Health ambassadors, open and adaptable content and courses, an accessible resource platform, and a community of practice or learning network.
For more details, access the workshop report or contact Theo Knight-Jones (t.knight-jones[at]cgiar.org).
The COHESA project is funded by the European Commission Organisation of African, Caribbean and Pacific States Research and Innovation Programme.
Photo: Participant introductions (credit: ILRI).