University of Basel, Basel, Switzerland
One Health as an Interdisciplinary Multispecies Health Approach
Two distinct ways of using One Health
The term ‘One Health’ is used in two distinct ways. First, it has been used as denominating a specific approach with origins in the 19th century combining veterinary and human medicine (Lerner, 2013). Through time this approach has widened substantially (Bresalier et al., Chapter 1, this volume). In a second way, the term is nowadays used as an umbrella for many approaches with a strong multispecies and multi- or interdisciplinary scope such as One Health, ecohealth (Rapport et al., 1999), health in social-ecological systems (Zinsstag et al., 2011), planetary health (Whitmee et al., 2015) and others. In order to avoid confusion and the risk of losing particular features of the specific One Health approach, one needs to separate between these two usages. One simple solution is to strictly use ‘One Health approaches’ when referring to the second sense and ‘One Health’ or ‘the One Health approach’ when referring to the first sense.
This chapter will focus on the One Health approach, its definition as well as implications of the definition. In order to aim for a ‘healthy’ concept one always needs to analyse how the concept is defined and where the boundaries to other concepts are. In everyday work, many crucial concepts such as health are not explicitly defined, rather one uses an implicit working definition. However, in dilemmas when one needs to think whether a certain state belongs to health or not, one needs to start thinking of the explicit definition of the concept of health. Here, our concept analysis will focus on different definitions of the One Health approach, what ‘One’ implies in terms of trans- and interdisciplinarity, and how to define ‘Health’ within the One Health approach.
Definitions of the One Health approach
There are several ways to define the One Health approach. The choice of definition influences where the boundaries for the approach are. One could distinguish a narrow and a wide approach of One Health (Lerner and Berg, 2017). In the narrow approach, One Health research is mainly constituted by collaborations between veterinary medicine and human medicine. In the wide approach, biological sciences, health economy and social sciences are also contributing to the research. Nowadays, the narrow approach is more or less abandoned in favour of the wide approach.
There are several wide definitions of One Health. In this book, Zinsstag et al. (Chapter 2, this volume) propose the following definition:
One Health [can thus be defined] as any added value in terms of health of humans and animals, financial savings, social resilience or environmental sustainability achievable by the cooperation of human and veterinary medicine and other disciplines when compared to the two medicines and other disciplines working separately.
(Zinsstag et al., Chapter 2, this volume, p. 16)
This approach is narrow in the emphasis on human and veterinary medicine. However, it is also wide in considering economical and biological sciences. Crucial for this definition is that there needs to be inter- or transdisciplinarity in order to achieve a One Health approach, because one cannot talk about One Health if there is no added value from transdisciplinarity.
Let us now compare this definition with some other definitions of the One Health approach. Gibbs (2014, 2018) has earlier gathered and compared different descriptions of One Health, but these three discussed below are present at the moment on their organizations’ homepages.
The One Health Initiative defines One Health as:
Recognizing that human health (including mental health via the human-animal bond phenomenon), animal health, and ecosystem health are inextricably linked, One Health seeks to promote, improve, and defend the health and well-being of all species by enhancing cooperation and collaboration between physicians, veterinarians, other scientific health and environmental professionals and by promoting strengths in leadership and management to achieve these goals.
(One Health Initiative, 2008)
The One Health Initiative definition focuses on interdisciplinarity. This is similar in one aspect to the definition used in this book, but the added value by transdisciplinarity is not recognized. The One Health Initiative definition is wide in recognizing all aspects of health care for humans, animals and the environment.
The World Health Organization (WHO) defines One Health as: ‘an approach to designing and implementing programmes, policies, legislation and research in which multiple sectors communicate and work together to achieve better public health outcomes’ (WHO, 2017). This definition focuses on the collaborative multidisciplinarity. Here, a more narrow view on health occurs due to focusing on better public health outcomes.
The One Health Commission defines One Health as: ‘a collaborative, multisectoral, and transdisciplinary approach – working at local, regional, national, and global levels – to achieve optimal health and well-being outcomes recognizing the interconnections between people, animals, plants and their shared environment’ (One Health Commission, 2009). The One Health Commission definition focuses, as does the definition in this book, on transdisciplinarity. There is an emphasis on health that is a connection between human, animal and plants in their environment.
To summarize, when one looks at collaboration, the definition in this book and that of the One Health Commission demand a transdisciplinary approach giving added value to, for example, research. The other two definitions are focused on multi- or interdisciplinary work. If one instead looks at which organisms are covered, the definition in this book is narrower than the One Health Commission (which explicitly also includes plant health) and the One Health Initiative (which includes ecosystem health) definitions. However, it is wider than the definition elaborated on the WHO homepage (referring to public health).
The Demarcation of ‘One’ in One Health
‘One’ in One Health refers to several sciences working together towards the same goal. To work together could imply different things, and the One Health approach in this book is not aiming for multidisciplinary science, which is when several disciplines work in parallel with each other while studying a subject. Rather it aims for trans- and interdisciplinarity (Berger-González et al., Chapter 6, this volume). To be able to call something a One Health research study, there needs to be trans- and interdisciplinarity involved, otherwise the research is public health, human medicine, veterinary medicine, health economics or social science. Also, a transdisciplinary approach aims for including more than science, thus, collaboration between researchers,
