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Our planet is facing significant challenges. Urbanisation and deforestation, war and political collapse, together with the rise of “anti-science”, represent particular challenges to global human health.
The sheer magnitude of these challenges can sometimes leave us, as individuals, as professional communities or even as sectors, feeling overwhelmed and unable to respond. It might be helpful to take inspiration from the fact that 50 years ago this year, we overcame an astronomical challenge – the earth’s gravitational pull – and put a man on the moon!
This was achieved by over 400,000 researchers and engineers from more than 20,000 universities and private companies, working together to overcome a single challenge in a world without Google Docs, Drop Boxes or Skype calls… Opportunities like this meeting, which brings together over 1000 researchers and over 100 NGOs from different regions and sectors, can help us overcome the challenges we face (and hopefully achieve stellar outcomes!).
One Health – the theme of our discussions this year – is an excellent example of how the Society is uniquely placed to facilitate the convening of technical expertise and perspectives, and provide the space for genuine discussion, challenges and solutions.
Although the concept of One Health has been around for over 200 years, we still have some way to go to define how the alignment of veterinary and human public health and environmental services can improve health outcomes.
This concept is often applied to zoonotic diseases, and rightly so:
But a One Health approach has the potential to respond to a much broader and more complex set of issues, appreciating how the interactions with our environment, and the species with which we share that environment, contribute to health.
Take for example the issue of respiratory disease in women in rural India – this may initially be seen as a problem requiring the input of only the health profession; a closer examination of the immediate environment, however, will show that the fuel being used in the household stove is cow dung, and the dung is produced by cows that have been fed on pesticide-contaminated rice straw. When the dung is burned in the small, unventilated kitchen, it emits a hazardous gas that causes significant respiratory damage. To identify the cause of the condition, and to generate appropriate solutions, this problem must be viewed through human, animal and environmental lenses.
One definition that appeals to me is to think about One Health as a joint risk assessment, bringing different sectors together to identify all risk factors relating to public health events from the human, animal and environmental perspectives. Such partnerships allow joint planning of interventions that not only mitigate the risk from the point of view of each sector, but also ensure there are no unintended consequences of these interventions, alongside ongoing surveillance.
This year’s discussions provide encouraging examples of the successful application of One Health approaches, such as using trusted veterinary services to reach pastoralist and itinerant communities. As we know, accessing hard-to-reach communities will become increasingly important as we aim to leave no one behind – and in some settings, long standing livestock programmes are able to facilitate access to some of the most marginalised populations.
Despite the strong rationale and some examples of success, there are challenges to delivery at the necessary scale and with the available resources.
These challenges are often structural and predictable – multisectoral collaboration is always difficult, and this is compounded by the absence in many settings of a clear authority to lead and implement One Health approaches at the local, national and international level.
But they are also political and cultural: political in the sense that a One Health approach requires shifting away from sectoral or disease-specific agendas; and cultural in that One Health requires an openness for experts and professionals in human, environmental and veterinary health to work in an interdisciplinary (and perhaps more humble) way.
The Royal Society is very well placed to respond to these challenges by bringing together the collective knowledge, experience and networks of members to affect change: through identifying research gaps, calling for increased funding, and driving policy change, utilising the society’s significant role as a trusted and impartial source of information for the public and policy makers.
We are also continuing to ensure that urgent priorities and neglected areas are communicated in a non-political way, amplifying messages and mobilising resources for the longer term – a particular challenge at a time when so much of the public debate is focused on short-term and domestic agendas, to the detriment of global issues that ultimately impact on national health and prosperity.
I propose three key examples of how the RSTMH can overcome One Health challenges:
I am confident that this meeting will significantly contribute to developing a One Health agenda for the Society and the wider community, which will demonstrate the true value of intersectoral working and the value that the Society can provide.