Human-animal-environmental health collaborations around the world

One Health is an integrative effort across disciplines that recognises that the health of people, animals and environment is interlinked.

In a blog shared with KTN, Mishal S. Khan (London School of Hygiene and Tropical Medicine, Chatham House), Julia Spencer (Chatham House) and Afifah Rahman-Shepherd (Chatham House) discuss human-animal-environmental health collaborations around the world: what are they focusing on, and what should they be focusing on?

One Health, EcoHealth, and, more recently, Planetary Health are all examples of approaches that are based on the notion that improvements in health may be achieved by fostering greater multi-disciplinary collaboration between the human health, animal health, and environmental sectors. This notion has received growing political and financial support over the past 15 years, driven in part by recent epidemics caused by emerging and re-emerging infectious diseases of animal origin, such as SARS and Ebola. It is therefore unsurprising that we have seen a rapid growth in initiatives that bring together stakeholders from these three sectors. What is intriguing, however, is that the strategies employed by these initiatives to achieve their aims —both individually and collectively—have not been objectively monitored or analysed. Without a database of existing One Health initiatives or even search terms to start from, our team set about systematically identifying One Health Networks (OHNs), which we defined as collaborations that include multiple organisations collectively working across at least two of the three sectors: human health, animal health, and the environment.  Our analysis, published last week in The Lancet Planetary Health, raises as many questions about the strategic direction of OHNs as answers.

For the first time, our study quantifies the growth of OHNs operating across the globe. Overall, we identified 116 unique OHNs and were able to find enough information in their publicly available materials to analyse 100 of these in detail. We found that the majority of networks were formed after 2005 (86%), and that the most rapid growth occurred between 2012 and 2014 (see Figure 1).

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However, this expansion has been uneven, and there has not been a large growth in the number of South-South collaborations, by which we mean networks formed between organisations headquartered within or across Asian or African low and middle-income countries without involving stakeholders headquartered in the Global North (e.g. in Europe, the United States, or Australia). In fact, there were only four OHNs that were run exclusively by organisations across Asia and Africa (Figure 2).

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Another clear finding was that the increase in new collaborations across the human, animal, and environmental health sectors has not been matched by the development and reporting of indicators to track progress. Only 15% of networks mentioned having a monitoring and evaluation strategy, and even fewer made these plans fully available online. Our study’s findings raise important questions that we were unable to answer, as they require wider discussion. Below we throw out some of these questions for debate.

• Do we need standardised indicators to monitor and evaluate OHNs and initiatives that support human-animal-environmental health sector collaboration more broadly? What would these indicators look like and how would we define success for multisectoral collaborations?
• Does the One Health community need to make a concerted effort to engage environmental health stakeholders in more human-animal health collaborations? We found that nearly one third of ONHs analysed did not engage the environmental sector, and Sabiha Y Essack‚Äôs commentary on our article highlights this finding.
• Should private, for-profit organisations be more widely engaged in One Health collaborations? Currently, OHNs are largely composed of government and academic bodies, whereas for-profit organisations are included in less than a quarter of the networks analysed. Is there a good reason for this? There are certainly concerns about the potential conflicts of interest that may arise when for-profit organisations are involved in health initiatives, particularly in priority setting and decision-making. However, some also argue that stronger public-private partnerships are essential to reaching many global health milestones, including those outlined in the Sustainable Development Goals. For example, Francesca Viliani, Head of Public Health Consulting Services and Community Health Programmes at International SOS, explains: ‚ÄúMany private operators active globally could contribute very sophisticated systems dealing with health and safety, as well as ecosystem services and biodiversity, making them a unique partner for One Health Networks. Reducing the risk of any outbreak is a public good and it would be more efficient and effective adopting a whole of society approach, which includes the private sector‚Äù.
• At present, the majority of OHNs appear to focus on communication and collaboration, data and information sharing, and capacity building. Are other critical activities, such as advocacy, policy development, and community engagement, being overlooked? Or is the main purpose of these networks to primarily facilitate better communication?

The first step towards answering these questions is to have a database of OHNs and a systematic method to compare them. We now have this. We invite colleagues to build upon our database—through further analyses, advocacy, or additional data collection—in order to optimise how substantial resources being channelled towards human-animal-environmental health collaborations are being used.

Dr Gabriela Juarez Martinez, Knowledge Transfer Manager (Pharma and Medtech) at the Knowledge Transfer Network (KTN) is one of the first to comment on the importance of further work in light of this new publication:

“One Health is an integrative effort across disciplines that recognises that the health of people, animals and environment is interlinked. Industry plays an important role in the translation of innovation. The UK’s Knowledge Transfer Network is uniquely placed to support and facilitate cross-sector collaborations and we are looking forward to working with the One Health team at Chatham House and other One Health actors to further support industry engagement and explore industry-led collaborations.”

You can read the full analysis, published last week in The Lancet Planetary Health, by clicking here.