One Health: A Holistic Approach to Systematically Reduce the Risk of Future Pandemics

By Judith Baeta

In the last few decades there has been a significant increase in the number of infectious diseases outbreaks originating from animals that have affected people across the world — ebola, the bird flu, and of course, most recently COVID-19. The process involving the transmission of an animal pathogen to a human body is called zoonosis. But are humans passive victims of zoonosis, or does the increase in the interaction of human activity and our environment play a role?

Indeed,  it is the human impact on the environment that drives diseases.

Traditionally, the development of human societies has relied on the use of natural resources and land, however, the use of land for human activity has accelerated in the last 100 years. The modern process of industrialization has put natural ecosystems at service of humans. Following this anthropocentric view, Earth’s resources became another form of capital available to be used — often abused— and replaced with other forms of capital. Our environmental, social and economic policies have brought people closer in contact with wildlife and, consequently, have increased our exposure to viruses.

Current production and consumption patterns are creating an increasingly complex disease landscape that has dramatically altered how diseases emerge and spread. Deforestation and modification of land for industrial agriculture are creating bridges for human and wildlife interaction and are changing biodiversity in critical ways. Population growth and the mass-consumption culture have led to the expansion of the agricultural sector while increased globalisation has given rise to a food supply chain that spans over long distances. Factory farms pose an immediate risk of pandemic due to the crowding of almost genetically identical animals (genes selection for specific traits in farmed animals is a common practice) as the lack of genetic variations helps pathogens travel more easily. Similarly, the overuse of antibiotics in animals, corps and humans has favoured mutations in bacteria that evolved to become more resistant to drugs. Recent examples are the H5N1 avian influenza virus (or bird flu) that originated in China in 1997 that later, in 2009, circulated in pig farms in North America (swine flu).

But it is not only the food industry contributing to the issue. In the fashion industry, the use of fur fabrics is connected to trade involving animals as well. During the COVID-19 pandemic, mink farms in several countries have reported cases of infected animals. The case of Denmark in November 2020 became highly controversial when the government decided to cull the entire country’s mink population after mutation of the virus could potentially hamper the effectiveness of recent vaccine developments. One might question the ethical considerations of such industries in the first place.

The expansion of urban settlements is driving pandemics too. Scientists have found the closest relative to the SARS-CoV-2 virus in bats in the rural province of Yunnan in southwest China, characterised by its biodiversity. While bats are not included in our food supply chain, the region has gone through incredible change in the last few decades with new infrastructure developments resulting in increased human intervention in the natural environment. In developing countries in particular, the growth of urban population mainly due to mass migrations from rural areas often caused by prolonged drought periods. Rapid and unplanned urbanization in “slums” has made the development of adequate water, sanitation and hygiene facilities a major challenge that significantly increases the exposure to microbe spillover.

Before it gets too overwhelming, let’s face it: the world is becoming increasingly complex and interconnected.

Raising awareness and concerns about the unsustainable pathways of economic development in the last century have led to an increasing number of scientists, researchers, policymakers, regulators and consumers to start reconsidering our relationship with nature and to advocate for a greater systemic change. To address the 21st century challenges we will need transformative collective actions.

One Health is the “approach to designing and implementing programmes, policies, legislation and research in which multiple sectors communicate and work together to achieve better public health outcomes” (WHO, 2017). The concept is another manifestation of the transition towards a new paradigm of sustainable development, based on a more multi-dimensional approach that places the economy as a function of society which in turn is a function of the environment. Without a healthy and balanced planet nor economic or societal sustainability can be achieved.

Taking this holistic perspective, COVID-19 has put in evidence that our global system is in urgent need for a health check. Besides the direct consequences on individuals’ health, the pandemic has put unprecedented stress on healthcare systems across the world (too often under-resourced) and has caused a major shock to the global economy.  It has exposed some underlying issues in society by disproportionately affecting those in more vulnerable circumstances. As an example of the complexity of today’s challenges and its implications; people in lower socioeconomic levels are more often employed in the service sector which has been more directly impacted by the lockdown measures as remote work arrangements are not always available. The unequal access to digital devices and capabilities has brought to light a profound digital divide that has created new barriers due to the transition towards an increasingly online and technology-dependent way-of-living that  affects teleworking, education and access to public services.

Thus, treating the symptoms separately will not be enough to ensure the well-being of future generations.

Now that we know the dangers of human encroaching wildlife for global public health, it would be tempting to conclude that active surveillance of those areas of interaction is the solution. However, like pandemics; climate change, biodiversity loss, and the depletion of fisheries are different symptoms of our unhealthy relationship with the planet. If we want to tackle the problem at its root we must go a step further and fundamentally rethink our relationship with nature. Only this way, we will have thriving ecosystems that enable thriving societies.

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