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推进人类-动物-环境健康以保障全球健康安全:有何证据?

Advancing One human-animal-environment Health for global health security: what does the evidence say?

机构信息

Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland.

Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland; Institute of Social Anthropology, University of Basel, Basel, Switzerland.

出版信息

Lancet. 2023 Feb 18;401(10376):591-604. doi: 10.1016/S0140-6736(22)01595-1. Epub 2023 Jan 19.

Abstract

In this Series paper, we review the contributions of One Health approaches (ie, at the human-animal-environment interface) to improve global health security across a range of health hazards and we summarise contemporary evidence of incremental benefits of a One Health approach. We assessed how One Health approaches were reported to the Food and Agricultural Organization of the UN, the World Organisation for Animal Health (WOAH, formerly OIE), and WHO, within the monitoring and assessment frameworks, including WHO International Health Regulations (2005) and WOAH Performance of Veterinary Services. We reviewed One Health theoretical foundations, methods, and case studies. Examples from joint health services and infrastructure, surveillance-response systems, surveillance of antimicrobial resistance, food safety and security, environmental hazards, water and sanitation, and zoonoses control clearly show incremental benefits of One Health approaches. One Health approaches appear to be most effective and sustainable in the prevention, preparedness, and early detection and investigation of evolving risks and hazards; the evidence base for their application is strongest in the control of endemic and neglected tropical diseases. For benefits to be maximised and extended, improved One Health operationalisation is needed by strengthening multisectoral coordination mechanisms at national, regional, and global levels.

摘要

在本系列论文中,我们回顾了“同一健康”方法(即在人类-动物-环境界面上)在改善全球卫生安全方面的贡献,总结了“同一健康”方法带来的增量效益的最新证据。我们评估了“同一健康”方法是如何在监测和评估框架内向联合国粮食及农业组织(粮农组织)、世界动物卫生组织(OIE,前称世界动物卫生组织)和世卫组织报告的,包括世卫组织《国际卫生条例(2005)》和 OIE 兽医服务绩效。我们审查了“同一健康”的理论基础、方法和案例研究。来自联合卫生服务和基础设施、监测-应对系统、抗菌素耐药性监测、食品安全和保障、环境危害、水和环境卫生以及动物传染病控制等方面的例子清楚地表明了“同一健康”方法的增量效益。“同一健康”方法在预防、备灾以及对不断演变的风险和危害的早期发现和调查方面似乎最为有效和可持续;其应用的证据基础在控制地方病和被忽视的热带病方面最为有力。为了最大限度地扩大和扩展效益,需要在国家、区域和全球各级加强多部门协调机制,以实现“同一健康”的更好运作。

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