Ridde Valéry, Guillard Étienne, Faye Adama
Université Paris Cité, IRD, INSERM, CEPED, Paris, France.
ISED, Institut de santé et développement, Université Cheikh Anta Diop, Dakar, Sénégal.
Med Trop Sante Int. 2022 Jul 18;2(3). doi: 10.48327/mtsi.v2i3.2022.255. eCollection 2022 Sep 30.
The COVID-19 pandemic has led to a rediscovery of the concept of "One Health" and the idea that animals, humans and the environment are intimately linked. This is not a new concept, but it is still labile, contributing to inevitable confusion. There is still a lack of action on the ground, and "One Health" fails to integrate all three dimensions. This editorial aims to share six challenges for implementing the "One Health" approach in order to avoid the pitfalls of other global health initiatives. One Health programmes cannot be relevant and sustainable without the active involvement of communities. This deployment implies the necessary decolonisation of health, i.e. a rethinking of how programmes are governed, financed, formulated, implemented and evaluated, with and for the citizens and countries concerned. It cannot be done without addressing social inequalities in health and power issues. This approach leads to questioning the exploitation models of both agricultural and natural resources. Thinking about "One Health" implies thinking about issues and interventions from an intersectoral, inclusive and participatory perspective, from an interdisciplinary, if not transdisciplinary perspective, and understanding the resulting complexity. Finally, research findings should be taken into account to build public actions. Considering these different challenges and adopting a systemic and interdisciplinary perspective anchored in local contexts according to a participatory and inclusive approach thus seems essential to us to respond in an appropriate, relevant and sustainable manner to the issues associated with "One Health".
新冠疫情促使人们重新发现了“同一个健康”的概念以及动物、人类和环境紧密相连的观点。这并非新概念，但仍不稳定，导致了不可避免的混乱。实际行动仍有所欠缺，“同一个健康”未能整合所有三个维度。本社论旨在分享实施“同一个健康”方法面临的六大挑战，以避免其他全球卫生倡议所存在的缺陷。没有社区的积极参与，“同一个健康”项目就无法做到切实可行和可持续。这种部署意味着卫生领域必要的去殖民化，即重新思考项目如何由相关公民和国家进行治理、筹资、制定、实施和评估。如果不解决卫生领域的社会不平等和权力问题，就无法实现这一点。这种方法促使人们质疑农业和自然资源的开发模式。思考“同一个健康”意味着从跨部门、包容和参与的角度，从跨学科（甚至是超学科）的角度思考问题和干预措施，并理解由此产生的复杂性。最后，应考虑研究结果以构建公共行动。对我们来说，考虑这些不同挑战并根据参与性和包容性方法，在地方背景下采用系统和跨学科的视角，对于以适当、切实可行和可持续的方式应对与“同一个健康”相关的问题似乎至关重要。
