One Health: are we doing it wrong?

one health

‘Conferences reflect and construct the field’

Gonzales-Santos and Dimond, 2015:239

Melbourne convention centre
Melbourne Convention and Exhibition Centre, location for One Health Ecohealth 2016 Image: Violet Barasa

International scientific meetings are great for many reasons. But I also found myself profoundly frustrated and disappointed when I attended the 4th International One Health Congress, One Health EcoHealth 2016, in Melbourne recently.

More and more congresses gather researchers and others interested in tackling One Health – a concept based on the recognition that human, animal and environmental health are inter-related and so a collaborative, multidisciplinary and integrated approach to zoonoses research, policy and management is needed. The approach presents an unprecedented complex global challenge for collaboration among a wide range of stakeholders, for which knowledge and experience are still very limited.

Disease surveillance: Richard Nyberg, USAID via Flickr
Disease surveillance. Image: Richard Nyberg, USAID via Flickr

One Health Ecohealth 2016, as well as its precursor held in the Netherlands in 2015, reflected, in concentrated form, the main problems the field of One Health is facing. This discourse has been largely driven by the security motives of wealthy countries and framed as having solutions in natural science research.

The domination of One Health by such a perspective is dangerous for it may prevent alternative framings of One Health and One Health solutions from developing. Below are three directions I support for a better One Health.

Inclusion, ethics and diversity

Although inclusion was spoken about sincerely at these One Health congresses, it was not very evident in practice. Of the 36 confirmed speakers and chairs at the 2015 congress, 75% were white Caucasian men from developed countries, 8% were women and I estimated that over 90% were more than 40 years old. I could not recognise myself in this demographic and wondered how a young woman from Africa, Asia or Latin America could do so?

One of the stated goals of the 2016 congress was ‘enabling inclusive participation of delegates from diverse backgrounds’. Yet, only 36% of invited speakers were women and only 11% of attendees were from developing countries.

In both congresses, the relationship between wealth and One Health practices was often presented in negative and patronising ways. A concluding statement such as, ‘Resource-poor households were more likely to adopt poor practices,’ for example, really is using the word ‘poor’ to mean ‘non-Western’.

Numerous projects funded and led by wealthy organisations in low- and middle-income regions were advertised. However, the risk of seeing the benefits achieved collapsing when foreign funding runs out remained unaddressed.

Furthermore, One Health proponents have not yet moved beyond the so-often futile approach of ‘convincing’ local communities to an approach of listening to their needs and beliefs and collaborating with them on disease control solutions that respect these.

If One Health is to have a positive impact, differences in wealth, culture and belief among programme participants must be understood, respected and taken into account in an ethical and inclusive manner.

Beyond ‘success stories’

Promoting the abstract notion of One Health appeared to be the main goal of these two congresses. As engaging donors with One Health is so crucial to those who initiated the movement, criticisms or comments that question the applicability or definition of One Health are often perceived as threats to the success of such events.

At these congresses, discussions and debates about improving the application of the One Health concept to practices on the ground were not welcome. Instead, there was a long parade of presentations of programmes labelled as One Health success stories, most of which lacked rigorous evaluation or evidence to back up the claim of success.

This all seemed like preaching to the converted rather than challenging them to openly and constructively reflect on potential issues. Only after we critically explore One Health as an idea capable of guiding people’s behaviour within complex environments that are subject to various on-the-ground constraints will One Health start making sense. Although some speakers and attendees did offer thoughtful criticism and examples of failures, these attracted little attention and thought-provoking questions remained un-answered.

Embed social sciences

At these congresses, scientific consideration of social dynamics were notably absent. When mentioned at all, they took the form of anecdotal experiences or ‘gut feelings’ related by researchers in the natural sciences who were unfamiliar with the methods and standards of evidence in the social sciences.

In the dominant One Health discourse set by the natural sciences, topics and concepts such as nutrition, policy, conflict settings, gender, corruption, education, governance, climate change, sustainability, and water are often raised, but without any accompanying application of rigorous social science research to give them place and meaning.

Yet, social scientists in many prestigious universities and research institutes, including my own department, carry out sound research on multi-sectoral collaboration, global governance, sustainability, public health systems and so on, all relevant to better understanding what One Health could be and how to apply it. The One Health concept may achieve little of value unless the social sciences are harnessed to its service.

To sum, my experience of One Health events is that they too often illustrate the pitfalls of narrow perspectives which impede the exploration of a diversity of pathways and futures leading to a holistic approach to health.

However, they also illustrate a great opportunity. Researchers with the ability to bridge established disciplines and mind-sets will be key to significant progress in holistic fields like One Health.


Sophie Valeix is based at IDS where she is working on her PhD, ‘Socio-Anthropological Dimensions of Zoonotic Diseases in Africa’. She is a member of the STEP Centre.

4 comments:

  1. Love this! Thank you Sophie.This describes my reality – I work in the developing world (Caribbean)using One Health/Ecoealth to work on complex issues facing the my country and region.

  2. One Health Approach depends on the Health policy taken by a Country with motivated political will.Other wise it will be limited theoretically within four walls of seminar halls…

  3. Great piece and very interesting observations about the enormous limitations that stem from not challenging the silo-ed approaches which still prevail: interestingly it was the AHRC who funded the innovative cross disciplinary project Chickens and People project reported on at http://scicultchickens.org/

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