Lysaght Tamra, Capps Benjamin, Bailey Michele, Bickford David, Coker Richard, Lederman Zohar, Watson Sangeetha, Tambyah Paul Anantharajah
Centre for Biomedical Ethics, National University of Singapore, Singapore, Singapore.
Department of Bioethics, Dalhousie University, Halifax, Canada.
PLoS One. 2017 Jan 27;12(1):e0170967. doi: 10.1371/journal.pone.0170967. eCollection 2017.
One Health (OH) is an interdisciplinary collaborative approach to human and animal health that aims to break down conventional research and policy 'silos'. OH has been used to develop strategies for zoonotic Emerging Infectious Diseases (EID). However, the ethical case for OH as an alternative to more traditional public health approaches is largely absent from the discourse. To study the ethics of OH, we examined perceptions of the human health and ecological priorities for the management of zoonotic EID in the Southeast Asia country of Singapore.
We conducted a mixed methods study using a modified Delphi technique with a panel of 32 opinion leaders and 11 semi-structured interviews with a sub-set of those experts in Singapore. Panellists rated concepts of OH and priorities for zoonotic EID preparedness planning using a series of scenarios developed through the study. Interview data were examined qualitatively using thematic analysis.
We found that panellists agreed that OH is a cross-disciplinary collaboration among the veterinary, medical, and ecological sciences, as well as relevant government agencies encompassing animal, human, and environmental health. Although human health was often framed as the most important priority in zoonotic EID planning, our qualitative analysis suggested that consideration of non-human animal health and welfare was also important for an effective and ethical response. The panellists also suggested that effective pandemic planning demands regional leadership and investment from wealthier countries to better enable international cooperation.
We argue that EID planning under an OH approach would benefit greatly from an ethical ecological framework that accounts for justice in human, animal, and environmental health.
“同一健康”（OH）是一种针对人类和动物健康的跨学科协作方法，旨在打破传统研究和政策的“壁垒”。“同一健康”已被用于制定人畜共患新兴传染病（EID）的应对策略。然而，在相关论述中，很大程度上缺乏将“同一健康”作为更传统公共卫生方法的替代方案的伦理依据。为了研究“同一健康”的伦理问题，我们调查了新加坡这个东南亚国家在管理人畜共患新兴传染病方面对人类健康和生态优先事项的看法。
我们采用了一种混合方法研究，对32位意见领袖组成的小组使用了改进的德尔菲技术，并对新加坡的部分专家进行了11次半结构化访谈。小组成员根据通过该研究制定的一系列情景，对“同一健康”的概念以及人畜共患新兴传染病防范规划的优先事项进行评分。访谈数据采用主题分析进行定性研究。
我们发现，小组成员一致认为“同一健康”是兽医、医学和生态科学以及涵盖动物、人类和环境卫生的相关政府机构之间的跨学科合作。虽然在人畜共患新兴传染病规划中，人类健康通常被视为最重要的优先事项，但我们的定性分析表明，考虑非人类动物的健康和福利对于有效和符合伦理的应对也很重要。小组成员还建议，有效的大流行规划需要区域领导以及富裕国家的投资，以更好地促进国际合作。
我们认为，在“同一健康”方法下的新兴传染病规划将极大地受益于一个伦理生态框架，该框架兼顾人类、动物和环境卫生方面的公平正义。
