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A time to deliver: Towards One Health

High-level event ‘Developing strategies for combating COVID-19 around the world’

At the World Health Summit 2020, BMZ firmly commits to a One Health approach 

At a WHS high-level event hosted by the Federal Ministry for Economic Cooperation and Development (BMZ) and Charité, Dr Maria Flachsbarth, Parliamentary State Secretary, made it clear: ‘To gird ourselves against future pandemics, we must recognise that humans, animals and environment are connected, and act accordingly.’ Prominent scientists and representatives of leading international agencies voiced their support for a multisectoral One Health agenda.

In recent months, BMZ has taken important strides in advancing the One Health agenda. The Ministry now has a One Health Directorate, guided by a scientific advisory board, to steer its One Health contributions at both the multilateral and bilateral level. In the first part of the high-level event ‘Developing strategies for combating COVID-19 around the world,’ which BMZ, together with Charité, hosted at this year’s World Health Summit (WHS), Dr Maria Flachsbarth, Parliamentary State Secretary, described how her ministry had started to mainstream a One Health approach across the interventions it supports. These range from improving surveillance, detection and research at the human-animal-ecosystem interface to robust investments in food and nutrition safety and measures to halt climate change, protect wildlife and maintain biodiversity.

What is One Health?
One Health stands for a holistic, interdisciplinary approach in the field of health that recognises the interconnectedness and interdependence of humans, animals and the environment. It focuses on preventive measures in all three areas with the aim to maintain health and reduce health risks. According to the Lancet One Health Commission, ‘One Health highlights the synergistic benefit of closer cooperation between the human, animal, and environmental health sciences, as well as the importance of dismantling disciplinary and professional silos’ (Lancet, 2020).

One Health requires working beyond silos

WHO Director General, Dr Tedros Adhanom Ghebreyesus, expressed his wholehearted support for BMZ’s One Health endeavour via video message. Reminding the audience that the COVID-19 virus is a prime example of the pandemic potential of animal-human transmission, he called for concerted action between experts and professionals working in the fields of human and of animal health: ‘We must accelerate efforts to break down silos and start working in solidarity.’ Doing so is critical for strengthening pandemic preparedness: ‘With a multi-sectoral One Health approach, we will maximise the impact we have in detecting, preventing and managing potential future threats.’

Viruses use livestock as bridge between wildlife and humans

In his presentation, Prof Dr Christian Drosten, the director of the Institute of Virology at Charité University Medicine in Berlin, provided scientific insight into the emergence of such threats and their origins at the interface between animals and humans. In China, certain bat species carry SARS-related coronaviruses and people living in the same areas have been shown to have antibodies against them. But how exactly are people exposed? In the case of the SARS-2 coronavirus, racoon dogs – wild animals which fur merchants keep and slaughter in large numbers to feed a growing global fur market – may have served as the ‘bridge reservoir’ between bats and humans. 

According to Prof Drosten ‘wildlife can be a source of viruses of pandemic potential. But the best handle that we have is on their intermediary hosts, the livestock.’ He ended his presentation with the recommendation that livestock be prioritised as an additional tier in countries’ disease surveillance systems.

For diseases, there is no barrier between humans and animals 

Facts and figures presented by Prof Dr Thomas Mettenleiter, President of the Friedrich Loeffler Institute, Germany’s Federal Institute for Animal Health, further substantiated the urgent need for a One Health approach. Viral infections do not differentiate between humans and animals, he said, and 60% of all known viral infections, including the common cold, stem from animals. Every year, an average of five new viral diseases are discovered and three of them are zoonoses, which means that animals transmit them to humans. While the current pandemic has put the spotlight on zoonoses, Prof Mettenleiter urged the audience to keep in mind that pandemics can also be caused by bacteria. A One Health approach is therefore critical for combatting antimicrobial resistance (AMR). According to the latest estimates, between 4 and 5 million people will die due to AMR in both African and Asia by 2050, and AMR-related fatalities in the Americas and in Europe are also expected to range in the hundreds of thousands. 

For healthy people, we need a healthy planet

‘Why do we humans destroy the Earth, our only home?’ asked Dr Eckart von Hirschhausen, author, comedian and BMZ Ambassador for Sustainable Development Goal 3, which is health-related. He pointed out that humans have already eradicated 83% of all mammals in the wild and about half of the earth’s plants in order to generate space for increasing numbers of livestock. ‘We’re stealing the space that wild animals need to survive,’ and at the same time contributing to climate change – a global threat whose impact is likely to dwarf the effects of the COVID-19 pandemic. It is high time, he noted, for humans to recognise that the environment is not something ‘around’ us (as the German term ‘Um-welt’ suggests): ‘In reality, humans are part of creation’.

Dr Hirschhausen showed two graphics to illustrate the relationship between humans and Earth

One Health requires a concept, consensus and robust action

Asked to outline her organisation’s position on One Health, Dr Zsuzsanna Jakab, Deputy Director General, WHO, pointed out that WHO has been a firm supporter of a One Health approach since 2008, when, together with FAO, OIE and other UN organisations, it developed a first strategic framework for reducing the risk of infectious diseases at the animal-human-ecosystem interface. At the ‘Stone Mountain Meeting’ in 2010, they jointly defined steps to move the concept of One Health forward.

Dr Jakab thanked Germany, as the country holding the EU presidency, for putting the One Health approach high on the political agenda. According to her, the COVID-19 pandemic, the steady increase in AMR and the global need for food security underscores its relevance and shows that it requires the full collaboration of all sectors: ‘We need to develop a concept for One Health, we must build consensus around it and then use it for the implementation of coordinated and robust global health action.’ 

One Health depends on investments in partner country capacities

Dr Monique Eloit, Director General of OIE, agreed. She noted, however, that globally agreed concepts and plans can only be realised where partner countries are on board and have the required infrastructure, skills and resources. She therefore called for comprehensive investments in partner countries’ veterinary infrastructure and capabilities to allow them to implement a One Health approach, including the new tier of livestock surveillance that Prof Drosten had proposed. 

A model for the kind of investments now needed is BMZ’s support for the new One Health Centre in Africa (OHRECA) in Nairobi. OHRECA will develop capacity and support One Health network initiatives across Africa and develop pathways from research evidence to government policies to practices on the ground. 

Guided by science, BMZ is determined to lead and to deliver

Thanking all panelists for their contributions, Dr Birgit Pickel, Head of BMZ’s new Directorate Global Health, Pandemic Preparedness and One Health, and moderator of the event, asked Dr Flachsbarth how the different inputs heard in the session would inform future BMZ policy. Dr Flachsbarth responded that the presentations encouraged her that the BMZ should continue to play a leadership role in the area of One Health. The panelists’ perspectives also reinforced BMZ’s decision to ground policy in science by setting up a scientific advisory board. Last, but not least, Dr Flachsbarth welcomed the view that the time has come to move from concepts to action, recognising that human health ultimately depends on ecosystem integrity and on a healthy planet.

Anna von Roenne, October 2020

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