Rear Adm. William S. Stokes is an assistant surgeon general in the U.S. Public Health Service who applies his expertise in laboratory animal medicine and toxicology in his work at the National Institute of Environmental Health Sciences of the National Institutes of Health. A veterinarian, he currently directs the Interagency Center for the Evaluation of Alternative Toxicological Methods within the National Toxicology Program, which has headquarters at NIEHS. He was a member of the AVMA One Health Initiative Task Force, which recently recommended increasing professional collaboration in the interconnecting fields of animal, human, and environmental health. Dr. Stokes spoke to JAVMA News about his career in public health, the ideas of the task force, and the roles of environmental health and comparative medicine in the one-health concept.
What are some examples of how your career in public health has involved collaboration between veterinarians, physicians, and other scientists?
In the Army Veterinary Corps, my first assignment was at the Army Medical Research Institute of Infectious Diseases. I worked with veterinarians, physicians, and scientists who specialized in not only laboratory animal and comparative medicine but also pathology, virology, bacteriology, entomology, and other areas. We were part of a team using animal models to develop vaccines and other ways to prevent infectious diseases.
I then went to work at Tripler Army Medical Center as chief of veterinary services for the Department of Clinical Investigation. There I was part of a research team to investigate clinical problems, using animal models to find improved surgical procedures and treatments for human medical practice. I was the only veterinarian, and I really enjoyed being able to apply my veterinary expertise to cutting-edge clinical research.
After I transferred to the U.S. Public Health Service, my first assignment was at the National Institutes of Health in Bethesda, Md. I helped develop an accredited institutional animal care and use program and facilities for the intramural research program at NIH. This was another great experience, working with outstanding researchers who welcomed veterinarians as part of the research team.
What were some of the key ideas of the One Health Initiative Task Force?
The task force found examples of where applying the one-health concept had been very productive, and we felt that the benefits could be expanded by further collaborations among all health professionals working together to promote and advance the health of animals, people, and our environment.
One of the things we focused on was how do we make this a household term that's understood by all people? There's a lot of excitement in trying to broaden this concept beyond public health and biomedical research—and helping practitioners understand that they serve an important role in connecting with their clients in ways that can benefit not only the health of the pets but also the health of their clients.
For example, the information that practitioners provide to clients about pet health can also benefit the client—because pets and people share so many diseases and conditions, such as diabetes and obesity. So practitioners can really help increase the health literacy of the American public. People are very interested in the welfare of their pets, so they'll pay attention.
How do environmental health and comparative medicine fit into the one-health concept?
The environment can affect our health and animal health because we're constantly in contact with our environment—the air we breathe, the water we drink, the food we eat—and we can be exposed to a lot of things that may cause adverse health effects. Almost every disease has an environmental component. It's either caused by an agent in the environment, or environmental agents contribute to that disease in some way.
As we look back over history, we can find many examples of how animals in our environment have served as early-warning sentinels of infectious and toxic agents that can affect human health. Clearly there's a benefit in more closely monitoring the health of wildlife populations as well as individual animals—pets, livestock, zoo animals—so we can detect these agents as early as possible and intervene to minimize or avoid adverse impact on humans or broader animal populations.
As for comparative medicine, it's again a team approach with health professionals—veterinarians, physicians, and scientists—using animal models to translate research advances from the bench to the bedside and public health practice. Finding ways to prevent or cure diseases in people also benefits animals because better interventions, pharmaceuticals, and treatments can often be applied to veterinary medicine.