One-health wonders

Co-manager of a global one-health Web site, Dr. Bruce Kaplan is an ardent advocate for the one-health movement in collaboration with his physician colleagues Laura H. Kahn, MD, MPH, MPP, and Thomas P. Monath, MD. His career has taken him from serving as an epidemic intelligence officer for the Centers for Disease Control and Prevention to public affairs specialist for the Department of Agriculture's Food Safety and Inspection Service. Dr. Kaplan has also practiced small animal medicine for more than 22 years and worked as an editor, columnist, and author or co-author of book chapters and numerous scientific articles. Now retired, he lives in Sarasota, Fla. Dr. Kaplan shared the powerful backstory behind his passion for one health.

From your vantage point, how far along is the one-health movement in forging closer collaborations?

I believe there is a long road ahead relative to full-fledged one-health implementation. While the one-health movement is advancing expeditiously on some fronts, it is lagging behind on others. There is positive, strong movement within the public health and academic communities worldwide from veterinarians, physicians, and allied health scientists. Evidence of closer collaborations of the past and present are definitely emerging, and this is very encouraging.

Progress does not appear to be the same among veterinarians and physicians in private practice. Having spent the major part of my career as a private practitioner, this deficit is especially disappointing.

Another critical issue that needs to be aggressively addressed is the public affairs or public relations aspect. In the past two years, the stakeholders in the scientific community have not effectively publicized one health to crucial target audiences such as international media, political leaders, and the general public, despite ample opportunities. To date, one health is a concept known within esoteric circles for the most part. It will not advance unless it is communicated widely. This means we need creative professional public affairs/communications activism as soon as possible.

Eventually, a good deal hinges on current activities that AVMA and others are involved in to form an efficacious national One Health Commission to help implement and institutionalize the concept in the U.S.

What led you to commit yourself to mobilizing the health professions through this initiative?

I have been in a unique position for the past three years and particularly the last two as a result of my one-health activities in close, co-equal association with two physician colleagues and friends, Laura Kahn and Tom Monath. In the true spirit of one health, our physician/veterinarian team has established a large international grassroots base of individual supporters and advocates. Every month, I've received about a thousand e-mails from several hundred individuals. As the primary contents manager of the Kahn-Kaplan-Monath One Health Initiative Web site, www.onehealthinitiative.com, I get people's comments, pro and con. These reflect their interests, hopes, and criticisms. My position has made me privy to nearly all major global organizational and individual developments.

What drew you to those conclusions?

I've been aware of the critical need for one health in public health and biomedical research since graduating from Auburn's School of Veterinary Medicine in 1963. My early CDC days as an epidemic intelligence service officer in New Jersey allowed me to meet and communicate with some of the public health "one health" veterinarian and physician giants of the 20th century. For instance, I became acquainted in 1964 with the veterinarian-parasitologist Dr. Calvin Schwabe, the great leader who coined the term "one medicine," now called one health. I met with physician Richard E. Shope one afternoon at his rabbit research facility in North Jersey. Dr. Shope was the famous American virologist who discovered the Shope papillomavirus, the first mammalian model of a cancer caused by a virus. He was also the first to isolate an influenza virus and the first to vaccinate animals against influenza.

I became friends early on with veterinarian Dr. James H. Steele, the founder of the veterinary division at the CDC. Jim and I have communicated frequently over the last 40 years. All helped influence my passion for the cause.

In 2005 I had a personal battle with high-risk hepatocellular carcinoma, which is in remission now. I'm convinced that had one health been implemented 50 years ago, many like me would not have suffered the same dire cancer prognosis.

In April 2006 I had an auspicious contact with Princeton physician Laura Kahn that resulted in us forming a one-health partnership going on three years now. When physician Tom Monath joined us two years ago, his genius and enthusiasm helped propel our "triumvirate" into many notable successes.

Our recently published monograph in Veterinaria Italiana, www.izs.it/vet_italiana/2009/45_1/45_1.htm, is the first of its kind. Fifty-three authors and co-authors from 12 countries wrote a variety of one-health scientific articles that make a powerful case for a needed paradigm shift.

Laura, Tom, and I were convinced that we should enthusiastically promote one health because of all its obvious ramifications for accelerating health and health care developments. These have afforded and will afford life-protecting/lifesaving measures for untold millions in our generation and those to come. It has been a full-time job for me and a gratifying labor of love.

How can rank-and-file veterinarians and physicians become engaged? What about students?

This is a tough challenge and an essential question. In my mind and many others', one health represents the best possible future for practicing veterinarians and physicians and their patients, but to date, this critical segment of our health care community is generally unaware. A comprehensive educational campaign must be instituted across the board with cogent arguments and examples of how they and their patients will benefit. The "what's in it for me?" needs to be made clear.

Students in colleges of medicine, veterinary medicine, and public health are no exception, but they need to take up the banner, big time. Their future is at stake. It is also incumbent on current professors at these academic institutions to understand and teach the one-health principles recognized and known by early historical figures such as the father of modern pathology, Rudolf Virchow, and the father of modern medicine, Sir William Osler. Like our practicing doctors, students need to learn about the extraordinary values of all-inclusive, interdisciplinary collaboration free from provincial turf agendas.

Is there an urgency to any one-health activities, and if so, are they on track?

If fast-forwarding the process of protecting and saving human and animal life on the planet is important, then yes, there is an urgency for all one-health activities to be accelerated. On track? The jury is still out on that one, but I am optimistic.

Visit JAVMA's original "one-health wonder," Dr. James H. Steele, during the AVMA Annual Convention in Seattle, where he will greet well-wishers in the AVMA Exhibit Hall and sign his forthcoming biography, "One Man, One Medicine, One Health—the James H. Steele Story" by Dr. Craig N. Carter. Dr. Steele will be on hand at the American College of Veterinary Preventive Medicine booth from 1 p.m. to 4 p.m. Saturday, July 11, to Monday, July 14.