conceptual grounding and operational outlook.
There are signs of convergence in various fields in systems biology, the social sciences and networks of ecological scholars such as the Resilience Alliance6 (Zinsstag et al., 2011). The interactions of humans, animals and the environment are not straightforward. They are part of human-environment systems or SES. SES are, in the words of economist Elinor Ostrom, complex, multivariable, non-linear, cross-scale and changing (Ostrom, 2007). Humans and animals are inextricably linked to ecological systems, both natural and manmade, called cultural and social systems. Biomedical health sciences need to interact with all scholarly pursuits related to social systems, like sociology, economy, political sciences, anthropology and religion. Similarly, they need to interact with ecology, geography and all environment-related sciences. All these processes span across scales, like from molecules to populations. Health can be considered as an outcome of SES and so we speak about health in social-ecological systems (HSES) (Fig. 2.3). HSES clearly transcends One Health conceptual thinking as defined above. Considering health as an outcome of SES relates to theory of complexity and systems theory (Bertalanffy, 1951). Attempts to understand health in complex systems can be regarded as processes generating unexpected and new phenomena (described by the term ‘emergence’).7 Currently, we are exposed to a number of unintended and poorly understood damages to natural resources and life support systems, like climate change or nuclear catastrophes, which cannot be tackled by normal reductionist scientific approaches. Normal expert knowledge is no longer sufficient in situations of high uncertainty as we have experienced in the recent past and well postulated in writing about ‘post-normal science’ (Bunch and Waltner-Toews, Chapter 4, this volume). Planetary health aspires to demonstrate linkages of global change and health (Horton et al., 2014; Pongsiri et al., 2019).
Fig. 2.3. Health in social-ecological systems (HSES).
One Health and transdisciplinarity
As developed in the previous section, One Health is a scientifically established and validated concept that also created a movement with its origins in management of disease threats to humans and animals (Zinsstag, 2012). During development of health services and zoonoses control in developing countries, scientists engaged with communities, authorities and other stakeholders (Danielsen and Schelling, Chapter 14, this volume; Léchenne et al., Chapter 19, this volume). Periodic communication of research findings by scientists to all stakeholders, such as local communities, peripheral health workers and public health and VPH practitioners, led to more integrated research processes, assuring validity, social relevance and translation for impact. As a consequence, mutual trust increased gradually. Progress in One Health research can clearly benefit from combining academic and non-academic knowledge in the search for improving health and access to health care for humans and animals in pastoralist communities (Schelling et al., 2007b). Engagement of science with non-academic stakeholders and knowledge is a form of ‘transdisciplinary’ research, as a further development of ‘interdisciplinary’ approaches, which usually combine different academic disciplines such as medicine and social science, but do not encompass non-academic stakeholders. Mittelstrass defines ‘transdisciplinarity’ as a form of research that transcends disciplinary boundaries to address and solve problems related to the life-world (Hirsch Hadorn et al., 2008). Transdisciplinarity clearly matches the concept of ‘post-normal’ science, as discussed above (Hirsch Hadorn et al., 2008; Bunch and Waltner-Toews, Chapter 4, this volume; Berger-González et al., Chapter 6, this volume).
In conclusion, One Health represents a harmonic development of traditional VPH within the context of transdisciplinarity and post-normal science, challenged by the situation of our planet that is threatened by the overwhelming demands of populations of people, companion animals, livestock and wildlife (Box 2.2). As such, it raises questions that encompass conventional understandings of comparative medicine but go far beyond this into the intense, unstable and complex interactions among culture, economic aspirations and ecological sustainability. The interactions over time from which health emerges are embedded in narratives that reflect the concerns of the scholars and political leaders who espouse them. These narratives clarify points of disagreement and conflict but also suggest possibilities, if not for resolution of conflicts, then at least as avenues for accommodating multiple perspectives (Waltner-Toews, 2017).
Box 2.2. Summary of theoretical issues of One Health.
One Health can be defined as any added value in terms of health of humans and animals, financial savings or environmental services achievable by the cooperation of human and veterinary medicine when compared with the concepts of approaches of the two medicines working separately.
• One Health inevitably sheds light on the human–animal relationship and bond. It should reflect on the normative aspects (values) of the human–animal relationship with emphasis on improving animal protection and welfare in an inter-cultural context.
• One Health engages with the public in a transdisciplinary way, considering all forms of academic and non-academic knowledge for practical problem solving at the animal–human interface. The strongest leverage of One Health is observed when it is applied to practical societal problem solving.
• One Health approaches are embedded into ‘ecohealth’ conceptual thinking, which are further expanded to ‘health in social-ecological systems’ (HSES) addressing complex issues of human-environment systems.
Notes
1 Original citation in German ‘Es gibt keine wissenschaftliche Barriere zwischen Veterinär- und Humanmedizin, noch sollte es eine geben; die Erfahrung der einen muss gebraucht werden für die Entwicklung der anderen’ (Saunders, 2000).
2 Protocol for handling animal welfare cases in cooperation with the Hindu community. Available at: http://archive.defra.gov.uk/foodfarm/farmanimal/welfare/documents/hindu-protocol-0812.pdf (accessed 27 March 2020).
3 Calvin Schwabe, Hoofprints of Cheiron, Book two, page 262 unpublished memoirs.
4 Calvin Schwabe, Hoofprints of Cheiron, Book two, page 223 unpublished memoirs.
