One Health: Integrated health for humans, animals and the environment

The One Health approach describes the goal of improving global health, minimising health risks and taking a holistic approach to the interaction between human, animal and environmental health. Global health has become the focus of increased interest in recent years, particularly due to the occurrence of the COVID-19 pandemic. The SARS-CoV-2 virus, which is the cause of the COVID-19 infection, is a zoonosis, which has helped make the public more aware of the importance of a broader definition of health.

Zoonoses are diseases that can be transmitted directly or indirectly between animals and humans. This can sometimes also lead to further human-to-human transmission. Many infectious diseases such as Malaria or Ebola are zoonoses. Theirfrequency continues to increase. Already, 75 per cent of newly emerging infectious diseases can be traced back to origins in the animal kingdom. In addition, intensified livestock farming, and the use of antibiotics connected with it are increasing the risk of multi-resistant germs developing, which can also become a danger to humans.

To address this concern, Malteser International is committed to implementing One Health projects in particularly vulnerable areas such as the DR Congo. Within the framework of the One Health approach, we want to achieve an improvement in health care and epidemic prevention. To achieve this, we work closely with various sectors on the ground, such as health care, research, agriculture, veterinary medicine, and hygiene actors and create exchange platforms for representatives of these sectors.

What is the One Health approach?

The One Health approach is based on the understanding of human health, animal health and the environment as an interconnected system. Actors from human medicine, veterinary medicine and the environment work together across disciplines to improve global health and reduce the risk of zoonotic diseases with epidemic potential, neglected tropical diseases and antimicrobial resistance.

The focus is on the interdependencies and interactions of human, animal and environmental health, which makes topics such as climate protection, nature conservation and the improvement of agricultural and food systems important pillars of the One Health approach.

Interdisciplinary cooperation ensures a continuous exchange of knowledge between the actors, which also promotes the possibility of new approaches to action in development cooperation.

One Health for pandemic prevention and control

Examples such as the COVID-19 pandemic and the emergence of other zoonotic diseases with global consequences such as various types of influenza, HIV or even major epidemics of the past such as the plague show the necessity of the One Health approach. The primary goal is to systematically counteract the emergence of zoonotic diseases and thus the spread of epidemics. To achieve this, health must be viewed holistically, and all sub-areas must be included.

One Health circle: humans, animals and environment as an interconnected system.
Photo: Malteser International

Linkages between human and animal health

More than half of all infectious diseases in humans can be traced back to zoonotic pathogens. Not only viruses, but also bacteria, parasites, arthropods, worms and prions can be risk factors. Infection does not only occur through direct contact with infected animals. It can also take place through contaminated food or intermediate hosts (so-called “vectors”) such as mosquitoes or ticks. The destruction of wild animal habitats and the development of often pristine areas results in a blurring of habitats , leading humans to come into contact with the species-specific pathogens of other animals. It is estimated that wild animals carry 1.7 million unknown virus species, many of which could be transmitted to humans.

Contact with livestock kept in small spaces and often treated inflationarily with antibiotics, as is the case with industrial factory farming, also favours the spread and transmission of zoonotic infectious diseases. This was a significant contributing factor to the avian flu pandemic (2006) or the swine flu pandemic (2009/2010).

Detection of pathogens under a microscope — Improving diagnostic capacities in local health facilities is one of One Health's goals. Photo: Malteser International

These kind of practices also facilitate the emergence of antimicrobial resistance (AMR) – creating pathogens that no longer respond to antibiotics and therefore pose an increased risk to human health.

500,000 cases of resistant tuberculosis pathogens are already reported annually, complicating efforts to combat tuberculosis worldwide. In addition, resistant pathogens pose the risk that even harmless diseases might become a problem in the future, as they can no longer be treated by simple antibiotic therapies.

Biodiversity is also suffering as a result of environmental destruction for the purpose of settlement or economic use, as well as due to climate change. Natural biodiversity not only sustains ecosystems, but its loss also poses a threat to modern pharmaceuticals, the production of which is largely based on biological resources and raw materials.

Preventive measures in the framework of the One Health approach

Effective prevention and control of these health risks requires an interdisciplinary approach that holistically considers the interfaces between humans and infection vectors, ecosystems, food, drinking water and climate. Fields of action in the sense of the One Health approach include, for example, measures to preserve ecosystems such as forests or oceans by creating protected areas where animals and nature can exist without human interference. In order to increase food hygiene, rule-based trade with wild animals and their products is needed both in the countries of origin and in the countries of consumption. By establishing so-called surveillance systems, an interdisciplinary collection, analysis and feedback of antibiotic consumption data in both the animal and human sectors is possible. The evaluation of this data can reveal correlations from which, for example, measures for the appropriate regulation and reduction of antibiotic resistance can be derived.

Central goals of the One Health approach

Prevention of zoonotic diseases that pose an epidemic or pandemic risk
Reduction of antimicrobial resistance and maintenance of effective medicine supply
Improve human, animal and environmental health through a holistic exchange between human, veterinary and environmental actors.

One Health at Malteser International: our activities

Man in protective gear — Protective gear is important during a disease outbreak, as here in DR Congo. Photo: Malteser International

As a continuation or extension of pandemic and epidemic prevention, Malteser International specifically integrates One Health components into existing development cooperation projects. Countries in the global South are particularly affected by infectious diseases - including the DR Congo, which has a large number of zoonotic infectious and neglected tropical diseases.

Since 2016, we have been supporting the population and public institutions in the prevention and control of serious infectious diseases such as plague, Ebola, cholera, and rabies. Existing health measures such as improving water, sanitation, and hygiene (WASH), food security and emergency aid in acute crises are complemented by One Health components as part of a holistic and interdisciplinary approach.

Malteser International works closely with local health authorities and is committed to strengthening the health system, for example by providing further training for staff in health facilities. Raising awareness among the population is one of the most important pillars for the long-term health of the communities. In trainings, we create awareness of diseases caused by a lack of food hygiene, especially the handling of meat or risky human-animal interactions and develop solutions to help prevent them. In addition, we emphasise the importance of clean drinking water for increased hygiene awareness and help to improve the supply of clean water to allow for better hygiene.

Strengthening diagnostic capacities, cross-sectoral data exchange, and networking of authorities will improve disease alerts and the collection of epidemiological data from the human and veterinary health systems. Community-based surveillance systems play a crucial role in our work. By this we mean, among other things, the continuous observation of possible changes in the environment, animals, and people of a region that could indicate a disease outbreak. To do this, we work closely with the population, who are the quickest to notice changes and suspected cases and who can then report them.

In addition to the prevention of infectious diseases of zoonotic origin, the rapid and coordinated control in the case of an outbreak, as well as the long-term strengthening of local health systems, are central goals of our project. After two successful pilot projects in the DR Congo, further One Health projects are to follow in the future, for example in Kenya. In this way, we are helping to improve the global health of people, animals and the environment. Support our work in the area of One Health with your donation.

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More about One Health and our work for a life in health for all people:

Combating Zoonoses Using the Example of Rift Valley Fever

Studies show that it is more efficient to combat zoonotic diseases at the animal level before they spread to humans. In this context, consistent implementation of the One Health approach enables early detection and control of the disease as well as efficient use of resources, helping to develop effective solutions for epidemic control. We describe ways in which One Health approach can be used to control Rift Valley fever (RVF).
A guest post by Dr. Bernard Bett, Senior Scientist, Animal and Human Health, at the International Livestock Research Institute (ILRI, Kenya) and Team Leader of the One Health Research, Education and Outreach Centre in Africa (OHRECA).

Together against COVID-19

Malteser International, together with local partners, is responding to the COVID-19 pandemic across its projects worldwide. We are improving infection prevention and control measures to protect communities and health workers, and prevent further spread of the virus. Because vulnerable people are disproportionately affected in times of crisis, we are committed delivering the lifesaving aid people in need around the world rely on.

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One Health: Integrated health for humans, animals and the environment

What is the One Health approach?