One Health contributions towards more effective and equitable approaches to health in low- and middle-income countries

Abstract

Emerging zoonoses with pandemic potential are a stated priority for the global health security agenda, but endemic zoonoses also have a major societal impact in low-resource settings. Although many endemic zoonoses can be treated, timely diagnosis and appropriate clinical management of human cases is often challenging. Preventive 'One Health' interventions, e.g. interventions in animal populations that generate human health benefits, may provide a useful approach to overcoming some of these challenges. Effective strategies, such as animal vaccination, already exist for the prevention, control and elimination of many endemic zoonoses, including rabies, and several livestock zoonoses (e.g. brucellosis, leptospirosis, Q fever) that are important causes of human febrile illness and livestock productivity losses in low- and middle-income countries. We make the case that, for these diseases, One Health interventions have the potential to be more effective and generate more equitable benefits for human health and livelihoods, particularly in rural areas, than approaches that rely exclusively on treatment of human cases. We hypothesize that applying One Health interventions to tackle these health challenges will help to build trust, community engagement and cross-sectoral collaboration, which will in turn strengthen the capacity of fragile health systems to respond to the threat of emerging zoonoses and other future health challenges. One Health interventions thus have the potential to align the ongoing needs of disadvantaged communities with the concerns of the broader global community, providing a pragmatic and equitable approach to meeting the global goals for sustainable development and supporting the global health security agenda.This article is part of the themed issue 'One Health for a changing world: zoonoses, ecosystems and human well-being'.

Keywords: One Health; global health; health equity; poverty; sustainable development; zoonoses.

Figure 1.

Maps showing African country-level data for: (a) percentage of population involved in agriculture—data from FAO [18]; (b) healthcare service provision shown by the number of people per physician—data from WHO [19]; (c) density of ruminant livestock (individuals km⁻²)—data from FAO [18]; (d) density of domestic dogs (dogs km⁻²)—data from Hampson et al. [2]. (Online version in colour.)

Figure 2.

Scheme illustrating the relative expenditure on human rabies PEP and mass vaccination of dogs in relation to dog vaccination coverage and the incidence of human rabies deaths in Africa, Asia and Latin America. Data from Hampson et al. [2].