Zinsstag Jakob, Schelling Esther, Bonfoh Bassirou, Fooks Anthony R, Kasymbekov Joldoshbek, Waltner-Toews David, Tanner Marcel
Swiss Tropical Institute, PO Box, CH-4002 Basle, Switzerland.
Vet Ital. 2009 Jan-Mar;45(1):121-33.
The 'One Medicine' concept by Calvin Schwabe has seen an unprecedented revival in the last decade and has evolved towards 'One Health' conceptual thinking, emphasising epidemiology and public health. Pathologists rightly recall the contribution of their discipline by close genomic relationship of animals and humans e.g. in cancer genetics. We need to change our 'us versus them' perspective towards a perspective of 'shared risk' between humans and animals. Professional organisations have declared their adhesion, governments have created joint public and animal health working groups and numerous research and surveillance programmes have been incepted as demonstrated on the 'One Health Initiative' website. Above all these beneficial developments, we should not forget however, that there remains a huge divide between human and veterinary medicine borne from unprecedented (over) specialisation of disciplines and increasingly reductionist approaches to scientific inquiry. What is required now is a radical paradigm shift in our approach to global public health with practical approaches and 'hands-on' examples to facilitate its application and accelerating necessary leverage of 'One Health'. We propose elements of an open 'tool box' translating the 'One Health' concept into practical methods in the fields of integrated disease surveillance, joint animal-human epidemiological studies and health services development, which we hope might serve as a discussion basis for mutually agreed practical cooperation between human and animal health with special emphasis on developing countries.
卡尔文·施瓦贝提出的“同一医学”概念在过去十年中经历了前所未有的复兴,并已朝着“同一健康”的概念性思维发展,强调流行病学和公共卫生。病理学家通过动物和人类在基因组上的密切关系,如在癌症遗传学方面,正确地回顾了他们学科的贡献。我们需要将“我们与他们”的视角转变为人类与动物之间“共同风险”的视角。专业组织已宣布支持,各国政府已成立公共卫生与动物卫生联合工作组,并且如“同一健康倡议”网站所示,已启动了许多研究和监测计划。然而,在所有这些有益的发展之上,我们不应忘记,由于学科前所未有的(过度)专业化以及科学探究中日益简化的方法,人类医学和兽医学之间仍然存在巨大差距。现在需要的是在我们应对全球公共卫生的方法上进行根本性的范式转变,要有实际的方法和“实际操作”的例子来促进其应用并加速“同一健康”的必要影响力。我们提出一个开放的“工具箱”的要素,将“同一健康”概念转化为综合疾病监测、人畜联合流行病学研究和卫生服务发展领域的实际方法,我们希望这可以作为人类卫生与动物卫生之间达成相互认可的实际合作的讨论基础,特别强调发展中国家。