Rai Bir Doj, Tessema Gizachew A, Fritschi Lin, Pereira Gavin
Curtin School of Population Health, Curtin University, 400 Kent St, Bentley, Perth, Western Australia 6102, Australia.
enAble Institute, Curtin University, 400 Kent St, Bentley, Perth, Western Australia 6102, Australia.
One Health. 2024 Feb 15;18:100695. doi: 10.1016/j.onehlt.2024.100695. eCollection 2024 Jun.
The international authorities, such as the Food and Agriculture Organization of the United Nations, World Health Organization, World Organization for Animal Health, United Nations Environment Programme, and World Bank, have endorsed the One Health concept as an effective approach to optimize the health of people, animals, and the environment. The One Health concept is considered as an integrated and unifying approach with the objective of sustainably balancing and optimizing the health of people, animals, and ecosystems. Despite variations in its definitions, the underlying principle remains consistent - recognizing the interconnected and interdependent health of humans, animals, and the environment, necessitating interdisciplinary collaboration to optimize health outcomes. The One Health approach has been applied in numerous countries for detecting, managing, and controlling diseases. Moreover, the concept has found application in various areas, including antimicrobial resistance, food safety, and ecotoxicology, with a growing demand. There is a growing consensus that the One Health concept and the United Nations Sustainable Development Goals mutually reinforce each other. The World Bank has recommended five domains as foundational building blocks for operationalising the One Health approach, which includes: i) One Health stakeholders, roles, and responsibilities; ii) financial and personal resources; iii) communication and information; iv) technical infrastructure; and v) governance. The domains provide a generalised overview of the One Health concept and guide to its application. We conducted a scoping review following the five-staged Arksey and O'Malley's framework. The objective of the review was to map and synthesise available evidence of application of the One Health approach to five major zoonotic diseases using the World Bank domains. Publications from the year 2004, marking the inception of the term 'One Health,' to 2022 were included. Information was charted and categorised against the World Bank domains identified as . We included 1132 records obtained from three databases: Embase, Medline, and Global Health; as well as other sources. After excluding duplicates, screening for titles and abstracts, and full text screening, 20 articles that contained descriptions of 29 studies that implemented the One Health approach were selected for the review. We found that included studies varied in the extent to which the five domains were utilised. Less than half the total studies (45%) used all the five domains and none of the studies used all the sub-domains. The environmental sector showed an underrepresentation in the application of the One Health approach to zoonotic diseases as 14 (48%) studies in 10 articles did not mention it as a stakeholder. Sixty two percent of the studies mentioned receiving support from international partners in implementing the One Health approach and 76% of the studies were supported by international donors to conduct the studies. The review identified disparate funding mechanisms employed in the implementation of the One Health approach. However, there were limited discussions on plans for continuity and viability of these funding mechanisms in the future.
联合国粮食及农业组织、世界卫生组织、世界动物卫生组织、联合国环境规划署和世界银行等国际权威机构已认可“同一健康”概念,认为这是一种优化人类、动物和环境健康的有效方法。“同一健康”概念被视为一种综合统一的方法,目标是可持续地平衡和优化人类、动物和生态系统的健康。尽管其定义存在差异,但其基本原则保持一致——认识到人类、动物和环境的健康相互关联且相互依存,需要跨学科合作以优化健康成果。“同一健康”方法已在许多国家用于疾病的检测、管理和控制。此外,该概念已在包括抗菌药物耐药性、食品安全和生态毒理学等各个领域得到应用,且需求不断增加。越来越多的人达成共识,即“同一健康”概念与联合国可持续发展目标相互促进。世界银行推荐了五个领域作为实施“同一健康”方法的基础构建模块,其中包括:i)“同一健康”利益相关者、角色和责任;ii)财务和个人资源;iii)沟通与信息;iv)技术基础设施;v)治理。这些领域提供了“同一健康”概念的总体概述及其应用指南。我们按照阿克斯和奥马利的五阶段框架进行了一项范围审查。审查的目的是利用世界银行的领域,梳理并综合“同一健康”方法应用于五种主要人畜共患疾病的现有证据。纳入了从2004年(“同一健康”一词首次出现之年)至2022年的出版物。针对确定的世界银行领域对信息进行了制表和分类。我们纳入了从三个数据库(Embase、Medline和全球卫生)以及其他来源获取的1132条记录。在排除重复项、筛选标题和摘要以及全文筛选后,选择了20篇包含对29项实施“同一健康”方法研究描述的文章进行审查。我们发现,纳入的研究在利用这五个领域的程度上各不相同。不到一半的研究(45%)使用了所有五个领域,没有一项研究使用了所有子领域。在将“同一健康”方法应用于人畜共患疾病方面,环境部门的代表性不足,因为10篇文章中的14项研究(48%)未将其作为利益相关者提及。62%的研究提到在实施“同一健康”方法时得到了国际伙伴的支持,76%的研究得到了国际捐助者的支持以开展这些研究。审查确定了实施“同一健康”方法所采用的不同资金机制。然而,关于这些资金机制未来的连续性和可行性计划的讨论有限。