Global and regional governance of One Health and implications for global health security

doi:10.1016/S0140-6736(22)01597-5

Review

. 2023 Feb 25;401(10377):688-704.

doi: 10.1016/S0140-6736(22)01597-5. Epub 2023 Jan 19.

Global and regional governance of One Health and implications for global health security

Azza Elnaiem¹, Olaa Mohamed-Ahmed², Alimuddin Zumla³, Jeffrey Mecaskey⁴, Nora Charron⁴, Mahamat Fayiz Abakar⁵, Tajudeen Raji⁶, Ammad Bahalim⁷, Logan Manikam⁸, Omar Risk⁹, Ebere Okereke¹⁰, Neil Squires¹¹, John Nkengasong⁶, Simon R Rüegg¹², Muzamil M Abdel Hamid¹³, Abdinasir Y Osman¹⁴, Nathan Kapata¹⁵, Robyn Alders¹⁶, David L Heymann¹⁷, Richard Kock¹⁴, Osman Dar¹⁸

Affiliations

¹ Royal Free London NHS Foundation Trust, London, UK.
² UK Health Security Agency, London, UK; Nuffield Department of Population Health, University of Oxford, Oxford, UK. Electronic address: olaa.mohamed-ahmed@ukhsa.gov.uk.
³ Department of Infection, Division of Infection and Immunity, University College London, London, UK; National Institute for Health and Care Research Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK.
⁴ DAI Global Health, London, UK.
⁵ Institut de Recherche en Elevage pour le Développement, N'Djaména, Chad.
⁶ Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia.
⁷ Harvard T H Chan School of Public Health, Boston, MA, USA.
⁸ Global Health Programme, Royal Institute of International Affairs, London, UK.
⁹ Department of Population, Policy and Practice, University College London Great Ormond Street Institute of Child Health, London, UK.
¹⁰ Tony Blair Institute for Global Change, London, UK.
¹¹ UK Health Security Agency, London, UK.
¹² Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
¹³ Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan.
¹⁴ Royal Veterinary College, University of London, London, UK.
¹⁵ Zambia National Public Health Institute, Ministry of Health, Lusaka, Zambia.
¹⁶ Global Health Programme, Royal Institute of International Affairs, London, UK; Development Policy Centre, Australian National University, Canberra, ACT, Australia.
¹⁷ Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
¹⁸ Global Operations, London, UK; Global Health Programme, Royal Institute of International Affairs, London, UK.

PMID: 36682375
DOI: 10.1016/S0140-6736(22)01597-5

Review

Global and regional governance of One Health and implications for global health security

Azza Elnaiem et al. Lancet. 2023.

. 2023 Feb 25;401(10377):688-704.

doi: 10.1016/S0140-6736(22)01597-5. Epub 2023 Jan 19.

Authors

Affiliations

¹ Royal Free London NHS Foundation Trust, London, UK.
² UK Health Security Agency, London, UK; Nuffield Department of Population Health, University of Oxford, Oxford, UK. Electronic address: olaa.mohamed-ahmed@ukhsa.gov.uk.
³ Department of Infection, Division of Infection and Immunity, University College London, London, UK; National Institute for Health and Care Research Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK.
⁴ DAI Global Health, London, UK.
⁵ Institut de Recherche en Elevage pour le Développement, N'Djaména, Chad.
⁶ Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia.
⁷ Harvard T H Chan School of Public Health, Boston, MA, USA.
⁸ Global Health Programme, Royal Institute of International Affairs, London, UK.
⁹ Department of Population, Policy and Practice, University College London Great Ormond Street Institute of Child Health, London, UK.
¹⁰ Tony Blair Institute for Global Change, London, UK.
¹¹ UK Health Security Agency, London, UK.
¹² Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
¹³ Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan.
¹⁴ Royal Veterinary College, University of London, London, UK.
¹⁵ Zambia National Public Health Institute, Ministry of Health, Lusaka, Zambia.
¹⁶ Global Health Programme, Royal Institute of International Affairs, London, UK; Development Policy Centre, Australian National University, Canberra, ACT, Australia.
¹⁷ Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
¹⁸ Global Operations, London, UK; Global Health Programme, Royal Institute of International Affairs, London, UK.

PMID: 36682375
DOI: 10.1016/S0140-6736(22)01597-5

Abstract

The apparent failure of global health security to prevent or prepare for the COVID-19 pandemic has highlighted the need for closer cooperation between human, animal (domestic and wildlife), and environmental health sectors. However, the many institutions, processes, regulatory frameworks, and legal instruments with direct and indirect roles in the global governance of One Health have led to a fragmented, global, multilateral health security architecture. We explore four challenges: first, the sectoral, professional, and institutional silos and tensions existing between human, animal, and environmental health; second, the challenge that the international legal system, state sovereignty, and existing legal instruments pose for the governance of One Health; third, the power dynamics and asymmetry in power between countries represented in multilateral institutions and their impact on priority setting; and finally, the current financing mechanisms that predominantly focus on response to crises, and the chronic underinvestment for epidemic and emergency prevention, mitigation, and preparedness activities. We illustrate the global and regional dimensions to these four challenges and how they relate to national needs and priorities through three case studies on compulsory licensing, the governance of water resources in the Lake Chad Basin, and the desert locust infestation in east Africa. Finally, we propose 12 recommendations for the global community to address these challenges. Despite its broad and holistic agenda, One Health continues to be dominated by human and domestic animal health experts. Substantial efforts should be made to address the social-ecological drivers of health emergencies including outbreaks of emerging, re-emerging, and endemic infectious diseases. These drivers include climate change, biodiversity loss, and land-use change, and therefore require effective and enforceable legislation, investment, capacity building, and integration of other sectors and professionals beyond health.

PubMed Disclaimer

Conflict of interest statement

Declaration of Interests We declare no competing interests. The views and opinions expressed in this paper are those of the authors and not of their institutions.

Comment in

One Health action for health security and equity.
One Health High-Level Expert Panel. One Health High-Level Expert Panel. Lancet. 2023 Feb 18;401(10376):530-533. doi: 10.1016/S0140-6736(23)00086-7. Epub 2023 Jan 19. Lancet. 2023. PMID: 36682373 Free PMC article. No abstract available.

Cited by

Linkages between Soil Security and One Health: implications for the 2030 Sustainable Development Goals.
Swan T, McBratney A, Field D. Swan T, et al. Front Public Health. 2024 Sep 18;12:1447663. doi: 10.3389/fpubh.2024.1447663. eCollection 2024. Front Public Health. 2024. PMID: 39360248 Free PMC article. Review.
A bibliometric analysis of One Health approach in research on antimicrobial resistance.
Fang Z, Tu S, Huang J. Fang Z, et al. Sci One Health. 2024 Sep 3;3:100077. doi: 10.1016/j.soh.2024.100077. eCollection 2024. Sci One Health. 2024. PMID: 39350920 Free PMC article.
Navigating the Nexus of Bioethics and Geopolitics: Implications for Global Health Security and Scientific Collaboration.
Klimovich-Mickael A, Sacharczuk M, Mickael ME. Klimovich-Mickael A, et al. J Bioeth Inq. 2024 Aug 20. doi: 10.1007/s11673-024-10379-3. Online ahead of print. J Bioeth Inq. 2024. PMID: 39164608
IHR-PVS National Bridging Workshop for Somalia: An interactive and participatory approach for operationalizing the One Health roadmap.
Osman AY, Saidouni A, Wambua LW, Mahrous H, Malik SMMR, Lubogo M, Van de Weerdt R, Adam AH, Mohamed HH, Al Makhzoumi K, Ali GA, Nur MO, Fevre S, Mucheru G, Njue S, Mosindo AO, Sandhaus K, Wigand RC, Standley C, Sorrell E, Kock R, Guitian J, Zumla A, Dar O, Mor SM. Osman AY, et al. One Health. 2024 Jul 14;19:100858. doi: 10.1016/j.onehlt.2024.100858. eCollection 2024 Dec. One Health. 2024. PMID: 39157652 Free PMC article.
Global One Health index for zoonoses: A performance assessment in 160 countries and territories.
Sun ZS, Wan EY, Agbana YL, Zhao HQ, Yin JX, Jiang TG, Li Q, Fei SW, Wu LB, Li XC, Zhang QY, Liu JS, Gu SY, Guo ZY, Xue JB, Han LF, Zhang XX, Xia S, Welburn SC, Okpeku M, Guo XK, Wang ZJ, Chen JH, Zhang Y, Zhou XN, Kassegne K. Sun ZS, et al. iScience. 2024 Mar 11;27(4):109297. doi: 10.1016/j.isci.2024.109297. eCollection 2024 Apr 19. iScience. 2024. PMID: 38715943 Free PMC article.

See all "Cited by" articles

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions

LinkOut - more resources

Full Text Sources
- ClinicalKey
- Elsevier Science
Medical
- MedlinePlus Health Information

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Global and regional governance of One Health and implications for global health security

Affiliations

Global and regional governance of One Health and implications for global health security

Authors

Affiliations

Abstract

Conflict of interest statement

Comment in

Similar articles

Cited by

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical