One Health Approach Embraced as Challenges Emerge: Public Health Watch

Those who require a reminder of the importance of the One Health approach need look no further than the ongoing 2019 novel coronavirus outbreak (2019 n-CoV).

One Health, which is designed to foster and streamline communication between infectious disease professionals engaged in human as well as veterinary health, is essentially where the rubber meets road when an outbreak occurs. Although we still have a lot to learn about the origins of 2019 n-CoV, it’s safe to assume that One Health protocols and principles have played, and will likely continue to play, a key role in getting the ongoing crisis under control.

“One of the real take-home messages of 9/11 was that there was a lot of intelligence stove piped between various agencies and not a lot of cross-talk going on,” Greg Glass, PhD, a professor in the Emerging Pathogens Institute at the University of Florida who has written about One Health, told Contagion®. “Since then, at least in the public health area, we’ve found that we do a whole lot better when we share information.”

Historically, there has been some reticence among veterinary medicine specialists to have animals effectively serve as “sentinels” for humans in the face of disease outbreaks, Glass noted. However, this has changed in recent years, he and other experts said, because there has been an acknowledgement that both animals and humans are up against many of the same diseases, and the challenges they present.

Hence, if an “emerging” infectious disease is identified in animals—before it can be transmitted to humans—that should be considered a win-win, because humans can—hopefully—develop vaccines and drug therapies to control the disease in both populations. To use the example of 2019 n-CoV, coronaviruses as a family have, in many cases, been linked with bats.

And, investigators in China suggest the ongoing outbreak may be traced to a market in Wuhan, the city where the first human case was reported. The market sold fish and other animals, many of them still living or freshly killed, for human consumption.

“Animals are often the likely source of bacteria and fungi,” Glass said. “The goal is to catch these diseases before they become full-fledged pandemic. Not that we’re never going to miss anything or always catch diseases early. But people have gotten better at communicating and sharing information a whole lot faster” under One Health.

Indeed, the US Centers for Disease Control and Prevention (CDC) defines One Health as “a collaborative, multisectoral, and transdisciplinary approach—working at the local, regional, national, and global levels—with the goal of achieving optimal health outcomes recognizing the interconnection between people, animals, plants, and their shared environment.” The agency began implementing the approach in 2009, under the leadership of then-director of the National Center for Zoonotic, Vectorborne, and Enteric Diseases Lonnie King, DVM.

King, by the way, was recognized with the World Small Animal Veterinary Association’s Global One Health Award in 2013. In receiving that award, he said in a statement: “We are in an era of unprecedented change. Population growth, food safety and security, human and animal health concerns, and a host of other global forces are changing the needs of society with respect to veterinary medicine.”

We only mention that quote because it leads so well into the work being done under the rubric of One Health nearly 7 years later, including the battle against antibiotic-resistant pathogens. In another example, since 2016, the CDC, the Defense Threat Reduction Agency (DTRA), and the Food and Agriculture Organization of the United Nations have been engaged in a partnership with the government of Uzbekistan focused on the prevention of zoonotic diseases through “new approaches in tracking diseases, improved medical tests, and the standardization of clinical guidelines.”

Uzbekistan is currently facing challenges in controlling and preventing zoonotic diseases, including brucellosis, which occurs in people and livestock, given inadequate health and veterinary systems, and limited laboratory and surveillance system capacities.

“A lot of the agencies are taking communication and cross-talk a lot more seriously and that’s good to see,” Glass said. “We’re still not sure what’s going to happen with coronavirus, but I feel a lot more comfortable that the systems we have in place are working the way they we might hope they would work.”