Advancing One Human-Environmental-Animal Health for Global Health Security: What does the evidence say?

The ongoing COVID-19 pandemic vividly illustrates that the emergence of a new lethal pathogen of probable animal origin in one part of the world affects public health everywhere. In this article, we review the contributions of human-animal-environmental (ONE-HEALTH [OH]) approaches to improving global health security (GHS) across a range of health hazards and summarise contemporary evidence of incremental benefits of an OH approach and impact on reporting to FAO, OIE and WHO. Using IHR (2005) Monitoring and Evaluation Framework and OIE Performance of Veterinary Services Pathway (PVS) reports, case studies and a narrative literature review, we assess progress of inter-sectoral OH approaches to build human capacity, bridges between stakeholders and institutional adaptation at national and international levels to contribute to global health security (GHS) across a range of health hazards. Examples from joint health services and infrastructure, surveillance-response, antimicrobial resistance (AMR) surveillance, food safety and food security, environmental hazards, water and sanitation, and zoonoses control clearly show incremental benefits of OH approaches. OH approaches appear to be most effective and sustainable in the prevention, preparedness and early detection of evolving risks/hazards and the evidence base for their application is strongest in the control of endemic and neglected tropical diseases. Significant gaps remain at the OH interface to rapidly detect and reduce the risk of widespread community transmission of new and re-emerging infections. For benefits to be maximised and extended, improved One Health Operationalisation (OHO) is needed with strengthening of multisectoral coordination mechanisms, for example by fostering a closer interaction between the IHR (2005) and OIE PVS Pathways. Case studies show evidence for OHO at the institutional and community level. The FAO, OIE and WHO currently play pivotal roles in stimulating OHO at the national and regional levels but will need increased support and allies to both strengthen current activities as well as address a wider set of health hazards across the Socio Ecological System. Progress in sustained OHO should be urgently prioritised at global, regional and national levels by building on, and inclusively broadening existing institutional collaborations at the wildlife-domestic animal-environmental-human interface to better reflect evolving risks and hazards across the Socio-Ecological System