One Health, One World: Can One Health Mitigate Effects of the Next infectious disease Threat?
Lyn Gilbert1
1 University of Sydney; Sydney Infectious Diseases Institute
‘One Health’ (OH) acknowledges the interdependence of human, animal, plant, and environmental health. Most emerging/re-emerging infectious diseases (EIDs) are endemic in animals, in developing countries, and occasionally cause localised human disease outbreaks, before spreading into new human populations in new locations. EIDs have been triggered by, for example: altered land use (Ebola); intensive animal husbandry (highly pathogenic avian influenza [HPAI]); exploitation of wild animals for trade and/or consumption (SARS). Antimicrobial resistance (AMR) of human pathogens is mainly due to human use, with varying contributions from veterinary medicine, agriculture, aquaculture and/or environmental contamination. Understanding these associations has not, yet, led to significant, if any, reduction in either the risk of another EID emergency or AMR.
Addressing EID and AMR risks, using OH approaches. will require ambitious global, national and local strategies. As one small step towards this daunting challenge, my colleagues and I investigated stakeholder and public attitudes to OH, by conducting: (i) Delphi surveys of 52 Australian human and animal health practitioners and policymakers, to explore the potential for cross-sectoral collaboration; (ii) community juries, in a suburban and a rural community, to assess public attitudes to antibiotic resistance, prescribing, and potential remedies; (iii) a survey of ~2000 representative Australians to determine their preferences, between 18 pairs of OH strategies or outcomes, based on hypothetical scenarios; (iv) a survey of >1200 medical, dental and veterinary practitioners’ knowledge and attitudes to antibiotic resistance, its causes, and ways to improve prescribing. The results provided insight into values that could promote OH approaches.