Though many countries around the world have acknowledged its importance and are going towards a One Health approach, moving from theory to practice is a different kettle of fish. The obstacles are many, from financial to logistical ones, the involvement of stakeholders struggles to fall into place.

What are the main challenges the One Health approach faces nowadays, and which obstacles would such policies encounter in the near future?

In the previous episode of the series, we discussed how the costs involved were the first (and obvious) obstacle to the implementation of One Health policies. Besides them, One Health, as a holistic approach, is problematic due to its inner self: it calls for integrated response, which means getting stakeholders of different fields, and from all over the world, to sit at the same table, or at least, to find a way that encourages common brainstorm on ambitious projects. 

So, how do we do that?

A Worldwide Decision-Making Process Seeking Governance

A natural instinct would be to look in the direction of governments worldwide, and see what steps can be made, regarding international cooperation.

But to get there, One Health policies first require for a consensus to be reached, within each of these governments.

Especially the way of action of the One Health policies remains an unanswered question – should those policies be implemented on a disease-focused or a system-based basis?

Every One Health policy will have a political impact at both national and international level, especially while COVID-19 remains under the spotlights. Therefore, consistency is a must.

Some countries have already made the jump and succeed in driving One Health policies in an efficient manner. For example, Senegal and Mali have already been working together for more than a decade to monitor and prevent zoonotic outbreaks. Also, in Liberia, the One Health coordination platform has effectively reduced the risk of new emerging pandemics.

But still, while cooperation with neighbors’ countries might seem like a first step, it is still not enough to reach global solutions.

This raises the question of the necessity of a global leadership.  Should a country or an existing organization be mandated to centralize global efforts?

Alternatively, should a new organization be constituted to this end?

On that matter, the existing One Health Commission is mainly focused on “connect, create, educate” and this thorough work does not leave a lot of space for coordination. On the other hand, organizations like OIE, FAO and WHO have already collaborated on the matter, and even agreed to extend their agreement.

While the idea of One Health isn’t new, and carries over a lot of knowledge and ideas – improved governance is key to strengthening One Health capacity.

Communication between Industries

One of the reasons that improved governance is so challenging is that the One Health approach requires to unravel each and every industry’s way of functioning, to build new automatisms in an already well-anchored ecosystem.

For example, veterinarian sources, the human health sector, and environmental data are currently very well segregated and drawing an integrative model is a challenge to do from scratch.

This limitation certainly prevents a full understanding between all parties that have no pre-existing integrative global analysis to base their decisions on. A very good example for it is the attempt of implementation of One Health policies made  in Canada in 2002. The disengagement of the various governmental departments decreased the effectiveness and speed of the response.

In addition, communication finds itself even more challenged as both the public and the private sectors are involved. Indeed, several decisions-making involve both sectors that must find a satisfying balance, while defending interests that are, by definition, different.

The Limits of Homogenization

One Health policies, in their nature, include all sectors and try to treat them all with the same level of importance. Having said that, homogenization encounters its natural limits: global problems are unequal.

The issues that a country has to face answer their own rules, and prioritization will vary accordingly. Issues won’t be approached in the same manner, either at a macro level – as being socio-economic or educational issues for instance – but also at a micro level – as there may be some discrepancies between gender for instance. COVID-19, for example, has been affecting genders differently, with more cases among men and possible death rates of up to 20% more than women. The real challenge is determining policies at the global level that can later on be applicable locally, with regards to the national differences – and ensuring that the international collaboration would be able to replicate the implementation at any location.

Add that to the fact that different countries have different regulations, priorities and timetables, so policies which will be set internationally may not be suitable for implementation everywhere, and certainly not at the same time. For example, when it comes to environmental measures, in the U.S., only several states banned the use of plastic bags altogether, while in Europe, all single-use plastic products will be completely forbidden as of July 2021.

The Impact of Stakeholders’ Current Involvement

The One Health Commission and organizations like PREDICT have been connecting stakeholders and harnessing their support. The collaborations include wildlife farms, hospitals, hunters, rural communities, development boards and more.

Local enterprises who have adopted the One Health approach have already shown high returns on investments – in Kenya, for instance, the CDC and the local government have been working tirelessly together to implement One Health policies since 2004. First, by launching a Field Epidemiology and Laboratory Training Program (resulting in MSc), offered to scientists, medical doctors, as well as veterinarians working within government ministries. Then, establishing an effective governmental cross-sectoral coordination unit, which among other successes, has improved outbreak investigations. All of these achievements advocate for implementing such policies in other countries in order to control, prevent zoonotic pathogens and improve diagnosis.

Investing in One Health initiatives means investing in the long run, and might not suit everyone. The implementation of the One Health policies will take time, and constitutes a “learn by doing” process. Keeping in mind the clear vision of the societal impacts of those policies is going to be a must to achieve this ambitious goal.

In summary: a lot of questions still remain unanswered when it comes to implementing One Health policies, but the positive expected outcomes are no longer considered “nice to have” but are really a must for our societies that are starting to think long-term.

Looking forward, the One Health approach, despite the hurdles, would possibly be adopted gradually in many countries around the world. In the next episode, we will discuss and examine what the future holds for the initiative.