Operationalising One Health: preparedness and response to zoonoses and emerging infectious diseases in Australia

The interconnectedness of human, animal and environmental health necessitates a One Health approach to ensure effective preparedness and response to EIDs and zoonoses. The overall aim of the research contained in this thesis is to identify pathways to operationalise One Health in Australia. The specific objectives were: i) Establish a vision for One Health in clinical practice; ii) Explore system level obstacles to disease investigation and management, particularly for EIDs and zoonoses; iii) Investigate operationalisation of One Health within Australian governance structures, health systems and clinical practice; and iv) Develop a strategy to facilitate operationalisation of One Health using a health system framework. A Delphi Survey using a panel of ‘One Health experts’ was used to establish research priorities and provide a vision of One Health in clinical practice. Parallel surveys of GPs and veterinarians explored practitioner experience with zoonoses, their level of concern, their confidence in diagnosis, management and treatment of zoonoses and willingness to engage in cross-professional practices. Analysis of qualitative data enabled identification of constraints faced by veterinarians in investigating atypical disease presentations which may be zoonotic. Key informant interviews enabled us to explore the contributions and experiences of individual veterinarians during COVID-19. Their insights provided evidence of the need for effective One Health systems to ensure Australia and the world can meet the continuing challenges of COVID-19 and future pandemics. This thesis provides an evidence base to address gaps and obstacles to operationalisation of One Health in Australia. Upskilling GPs and veterinarians through educational interventions will provide capacity and preparedness to clinical practitioners. Embedding One Health into existing health systems is necessary to optimise both national and global preparedness and response to EIDs and zoonoses