The convergence of people, animals, and our environment has created a new dynamic in which the health of each group is inextricably interconnected. The challenges associated with this dynamic are demanding, profound, and unprecedented. While the demand for animal-based protein is expected to increase by 50% by 2020,2 animal populations are under heightened pressure to survive, and further loss of biodiversity is highly probable.
On top of that, of the 1,461 diseases now recognized in humans, approximately 60% are due to multi-host pathogens characterized by their movement across species lines.3 And, over the last three decades, approximately 75% of new emerging human infectious diseases have been zoonotic.4 Our increasing interdependence with animals and their products may well be the single most critical risk factor to our health and well-being with regard to infectious diseases.
There is a growing concern that the world's latest generation could be the first in history to experience a reduction in life expectancy and health in general. Yet, veterinary and human medicines are considered separate entities and the obvious links between them frequently ignored. According to the KPMG study, "The Current and Future Market for Veterinarians and Veterinary Medicine in the United States,"5 published in May of 1999, "our traditional approaches and past requisite skills and levels of knowledge may not be commensurate with the rapid changes and new demands of food-animal industries and the shifting requirements needed for the corporate and public opportunities in the future. These include public health, biomedical research, and the global food system."
The need for a holistic, collaborative approach
One strategy to better understand and address the contemporary health issues created by the convergence of human, animal, and environmental domains is the concept of One Health. Although the concept of One Health is not new—the theory was supported by William Osler and Rudolf Virchow, the Father of Comparative Pathology, and re-articulated in Calvin Schwabe's 'Veterinary Medicine and Human Health'6 in 1984—our increasing interdependence with animals and their products has spurred the medical and veterinarian professions to readdress such an approach. This approach would encourage the collaborative efforts of multiple disciplines working locally, nationally, and globally, to attain optimal health for people, animals, and our environment.
The benefits of One Health
The benefits of a One Health approach include:
Improving animal and human health globally through collaboration among all the health sciences, especially between the veterinary and human medical professions to address critical needs
Meeting new global challenges head-on through collaboration among multiple professions—veterinary medicine, human medicine, environmental, wildlife and public health
Developing centers of excellence for education and training in specific areas through enhanced collaboration among colleges and schools of veterinary medicine, human medicine, and public health
Increasing professional opportunities for veterinarians
- Adding to our scientific knowledge to create innovative programs to improve health
The One Health Initiative Task Force (OHITF)
On April 14, 2007, the AVMA Executive Board took official action to establish a One Health Initiative by approving a recommendation by then-president Dr. Roger K. Mahr to establish a One Health Initiative Task Force (OHITF). The purpose of the task force was to study the feasibility of a campaign to facilitate collaboration and cooperation among health science professions, academic institutions, governmental agencies, and industries to help with the assessment, treatment, and prevention of cross-species disease transmission and mutually prevalent, but non-transmitted, human and animal diseases, and medical conditions.
The OHITF, comprising thirteen visionary individuals and communicators (See Appendix A), was charged by the AVMA Executive Board with the task of defining 'One Health', and providing recommendations and strategic actions that would support and expand the concept across the health professions. Just two months later, the American Medical Association House of Delegates followed suit, with unanimous approval of a resolution in support of One Health.
Partnership is critical to success
The veterinary profession must implement solutions to the critical workforce challenges in collaboration with multiple professions, including public health, human medicine, bio-engineering, animal science, environmental science, and wildlife. By working together, more can be accomplished to improve health worldwide, and the veterinary medical profession has the responsibility to assume a major leadership role in that effort. One Health calls for the collaborative efforts of multiple disciplines working locally, nationally, and globally to attain optimal health for people, animals and our environment.
The following recommendations, which are not listed in order of priority, were based on the findings of the One Health Initiative Task Force (OHITF) both during their meetings, and in the follow-up sessions held by the working groups. While the AVMA and the AMA plan to take a leadership role in this effort, the success of these recommendations will depend heavily on the collaboration of various health science professions, academic institutions, governmental agencies, and private industries.
- Create and fund a One Health Joint Steering Committee to begin the execution of the other recommendations and associated actions.
- Complete a One Health Proposal for Donors as well as a Business Plan and continue the process of engaging potential donors and sponsors.
- Create and implement initial components of a One Health Communication Effort.
- Engage an all-inclusive communications firm to develop and implement a communications plan and coordinate on-going media relations, public relations, publicity, marketing and advertising.
- Plan a study on One Health to be conducted by the National Academy of Sciences and secure the necessary funding to underwrite this effort.
- Develop, charter and form a National One Health Commission (to replace the Steering Committee) and recruit full-time staff in key positions to support the goals and mission of the Commission and complete the recommendations within this report.
- Appoint a national/global One Health Advisory Team to help support the National One Health Commission, and give it direction, counsel, and wisdom.
- Plan and hold a One Health National Summit.
Convene several panels and a national meeting to establish a national research agenda for One Health.
- Work toward the inclusion of key One Health outcomes for listing in the strategies for Healthy People 2020 and Healthy Animals 2010.
- Inform, engage, and solicit the support of medical, veterinary medical, and public health students and their respective organizations.
- Create a guiding coalition of liaisons, champions, and key supporters to promote the One Health concept.
Call to action
We now stand at the precipice of health care transformation where disease prevention and health promotion in people, animals, and our environment have become a critical strategic need. The most pressing need for a transformation of this magnitude is almost always vision and leadership. The OHITF recommendations can serve as an action plan to guide individuals and professions during the process of change. But, while the AVMA and AMA are eager and willing to take the lead on this effort, we cannot succeed without the support of others.
Decisions made today impact events of tomorrow. We live in a world in which the difference between what can be imagined and what can be accomplished has never been smaller. Veterinary medicine is in a unique position. Veterinarians are well grounded in population health, comparative medicine, and preventive medicine. The profession has the potential to help lead the efforts of One Health. However, this is not a given, and a reluctance by our profession or by the other health sciences to take this step, will, without question, be a lost opportunity that will be picked up by other groups.
The responsibility sits clearly on our shoulders. The human medical profession is faced with the same dilemma—it also must decide on its future role in One Health. Every profession has its defining moments—special points in time when talented individuals work cooperatively to influence the course of events for generations to come. For veterinary medicine and the other health sciences, that time is now.
Our recommendations will only be fulfilled if action is taken, resources identified and committed, and leadership supported. We urge you to join us in supporting the One Health Initiative.