One Health: A Unified Global Response to Address Emerging Zoonoses

Two tenets at the core of the One Health concept are the belief that human and animal health are irrevocably entwined and that the improvement of both requires close collaboration between the medical and veterinary professions with support from allied disciplines.

The One Health Concept as we see it today, has gone through a process of evolution, since the 1960’s. Keeping pace with different zoonotic infections and outbreaks, it responded by developing its own charter and mission statements, to which countries aligned themselves with. The paras below outline this systematic and eventful journey.

The One Health approach evolved from a Classical construct and is today, endorsed by countries around the world. In the 1960’s Calvin Shwabe coined the expression ‘One Medicine’ with the intention of developing a unified approach that could be followed by both human and veterinarians, against zoonoses.

In September, 2004  the Wildlife Conservation Society in New York developed the ‘One World, One Health’ credo along with the 12 “Manhattan Principles” ( and in December, 2007, a more concrete road map was developed at a historic meeting in New Delhi where representatives from 111 countries and 29 international and regional organisations participated in dialogue with European Union (EU), United States, United Nations Senior Influenza Coordination (UNSIC) and the Government of India.

A broad and ambitious vision was mapped, taking forward the concept of ‘One World, One Health’ in terms of pandemic preparedness and human security. Certain key decisions were taken at this forum:

- Each government would encourage functional links between human and animal health systems, while investing in sustainable capacity for preventing and controlling high risk infectious diseases in animals, within country and in conjunction with neighbouring nations through cross border cooperation

- Standard guidelines of international organisations would be used to help governments and other stakeholders to move more rapidly towards the One World One Heart (OWOH) vision

Next, the Interagency Strategic Framework was outlined  in October, 2008, contributing to OWOH. This strategic framework was geared to reduce risks at the animal-human-ecosystems interface. Backing this goal were UNSIC, Food and Agriculture Organization (FAO), World Health Organization (WHO), United Nations Children’s Fund (UNICEF), Office International des épizooties (OIE, also known as the World Organisation for Animal Health) and World Bank (WB). These deliberations helped outline a new vision in 2008. More than 120 countries and 26 international and regional organisations focused on paving the way for having an enhanced worldwide effort that could reduce risks associated with emerging diseases of animal origin. It also aimed to finalise an interagency strategic framework.

European Commission's endorsement of One Health

A European Commission statement on One Health was made in Sharm-El-Sheikh in 2008 where the evolution of the AI response towards a concept of a  more integrated and global approach to health was welcomed and encouraged.

Intersections  between human health, animal health and ecosystems are multiple: ecology of diseases, relations between health and availability of RNR, sanitary aspects of environment, food safety, food security, animal-human interactions.”

Emerging and re-emerging diseases including those at the interface of human/animal/ecosystems are a threat, together with climate change, natural disasters, deforestation and armed conflict. Therefore they should be part of the EU policies for crisis prevention.”

“One Health must be linked to livelihood and equity; no resignation vis-à-vis existence of different health standards across nations; diseases affecting animal production or labour force having negative economic and social impact; gender aspects”

The One Health approach fitted in with EU objectives of promoting global security, social justice, international cooperation, multilateralism and fighting poverty.

PACE was the first programme to systematically include a wildlife facet of veterinary activities and System of Health Surveillance (SVS) projects since the early 1990’s. Recent initiatives include the new EU animal health strategy that focused on all issues linked to animal health, including public health, research and sustainable development, importance of preventative measures like vaccination, disease surveillance and emergency preparedness, reliance on cross-sector support and cooperation and research in joint infectious diseases programmes, key areas for cooperation, vector-borne diseases, novel integrated surveillance methods, vaccine development and neglected zoonoses; regional programme Asia.

In March 2009, a meeting was held in Winnipeg hosted by the Public Health Agency of Canada (Centre for food borne, Environmental and Zoonotic Infectious Diseases) following a proposal made in SES. Experts from 23 countries participated and working sessions on best practices were held on developing integrated international, national and regional capacity in surveillance; ensuring adequate international national and regional capacity in addressing public and animal health including communication; ensuring functioning of national emergency response capacity; promoting inter-agency and cross sectoral collaboration and partnership; controlling the Highly Pathogenic Avian Influenza (HPAI) and other existing and potentially re-emerging infectious diseases and conducting strategic research. Optional sessions on wildlife, biosecurity and next steps.

Hanoi Declaration

The path breaking Hanoi Declaration which was adopted unanimously was held in IMCAPI, Hanoi 2010. Attended by 71 countries and regional bodies, it focused on cross sectorality while respecting autonomy of the various disciplines that contributed to OH. The  meeting  outlined a clear agenda . Major documents were presented.

The Declaration was a new key milestone that was adopted after the Beijing Declaration of January, 2006 that specified forward looking and opening avenues for further partnerships and involvement of countries, regions in the concept of ‘One Health’. It attempted to strengthen jointly animal and human health systems on a long term basis. It acknowledged that the majority of high impact infectious diseases had recently affecting humans had arisen at the animal-human-environment interface.

It clearly outlined the way forward:

  • Address continuation of responses to HPAI, H5NI and other zoonotic diseases but, more importantly ensure permanent readiness for all potential pandemics and all high impact health threats
  • It aimed to reduce risks, known or unknown, that exist at the interface between animals, humans and the environment calling for innovative approaches and thinking
  • An increased and improved collaboration between sectors and disciplines was found to be essential in full respect of autonomy and management of all of them. Recent outbreaks of H5N1 and A/H1N1 had emphasised the need to revisit communication strategies and tools.

It was clearly felt that the time had come to relook the scenario and accept that at the end of the 21st century mankind was likely to experience dramatic changes of environment and increased movements in all dimensions. Leaders and populations had to learn to live again with uncertainty and to prepare and respond to risks and incidents of an unpredictable nature. A ‘One health’ cross sectoral approach is needed.

One Health in the present context

By this time, the need for a sustained cross sectoral policy which could coordinate and deal with serious threats that arose at the animal-human-environment interface, had been more than felt.

One Health was a first step towards improving health outcomes incorporating human and animal health policies in all relevant sectors. Several declarations have called for understanding cross cultural nature of any threat, with particular focus on the capacity of health systems, for rapid interdisciplinary action; for development of national strategies, plans and interventions to stimulate whole-of-society, multi-sector, multi disciplinary and community-based actions when addressing disease threats that arise at animal-human-environment interface.

UNSCI and World Bank came up with the Animal and Pandemic Influenza: A framework for Sustaining Momentum. And in 2011-13, another Declaration placed the One Health approach truly into practice.

A recent meeting on “Operationalising One Health: A Policy Perspective – Taking Stock and Shaping an Implementation Roadmap” held at Stone Mountain in Atlanta, Georgia, USA (4-6 May, 2010) brought together a select group of leaders, including representatives from the policy and economic sectors, to structure and outline tangible actions and policies that would be critical to the success of "One Health" at the national and global levels.

Convened by the World Organisation for Animal Health (OIE), the Food and Agriculture Organisation (FAO) of the United Nations, the World Health Organisation (WHO), and the United States Centers for Disease Control and Prevention (CDC), the meeting builtupon the recommendations and conclusions drawn from the One World One Health:  from ideas to action expert consultation that was that was held in Winnipeg, Manitoba, March 2009 (

Also read

Confronting zoonoses through closer collaboration between medicine and veterinary medicine (as ‘one  medicine’)
One Health Initiative will unite human and veterinary medicine
One World - One Health