Participants of the “Breaking Barriers” event in front of Schloss Friedrichsfelde Copyright: Frank Peters I Fotografie

‘I can see the barriers breaking already’, said Prof. Thomas Mettenleiter, founding co-chair of the One Health High-level Expert Panel (OHHLEP), as he welcomed 120 invited scientists, decision-makers and implementers to “Breaking barriers: Advancing the One Health agenda with a focus on the environment” on October 12-13 2023 in Schloss Friedrichsfelde, situated in the large and green Tierpark Berlin.

You’re already networking, not silo-ing, and that’s what we brought you here for.

Prof. Thomas Mettenleiter, OHHLEP

In her opening remarks, Dr Tania Vorwerk, Deputy Director-General, Federal Ministry for Economic Cooperation and Development (BMZ), emphasised that both her own and the Federal Ministry for the Environment, Nature Conservation, Nuclear Safety and Consumer Protection (BMUV) are committed to the One Health approach:

It is good that the One Health approach has become part of the Convention on Biological Diversity. And it is good, too, that it is mentioned at least 15 times in the draft of the pandemic treaty.

Dr Tania Vorwerk, BMZ

Dr Bettina Hoffmann, Parliamentary State Secretary, BMUV, confirmed this when she opened the events’ second day. She said that, for the environmental pillar of One Health, two important milestones had recently been reached: the creation of the Global Biodiversity Framework Fund and the adoption of the Global Framework on Chemicals.

Multiple co-hosts, one agenda

Four years after the ‘One Health, One Planet, One Future’ conference, at which the Berlin Principles were formulated, and one year after the launch of the Joint plan of Action of the Quadripartite, the “Breaking barriers” event was initiated and financed by BMZ and the Wildlife Conservation Society (WCS), with BMUV, the Quadripartite Collaboration on One Health (WHO, FAO, WOAH, UNEP), the Sector Initiative One Health and the International Alliance against Health Risks in Wildlife Trade as additional organisers and contributors. All co-hosts agreed that biodiversity conservation deserved a more prominent place on the global One Health agenda – and that “Breaking Barriers” should therefore put a strong focus on it.

Doreen Robinson, Head of Biodiversity, United Nations Environment Programme (UNEP), who welcomed participants in the name of the Quadripartite, admitted that the experience of co-organising the conference with five other parties had showed her once more that effective collaboration between many partners with different perspectives isn’t easy – yet that it is exactly what’s required for implementing the One Health approach:

I invite us to approach the next two days with deep humility, appreciating the great need for partnerships and different ways of thinking that will take us out of our comfort zones. To listen and to truly try to understand another perspective is hard! But the many co-hosting organisations at this event show that it can be done.

Doreen Robinson, UNEP

Poignant keynote presentations

In his introductory keynote, Thomas Mettenleiter explained how the concept of One Health evolved from recognising the intersections between human, animal and environmental health to the understanding that these three are fully interdependent aspects of one health and that effective interventions should therefore approach them as such, i.e. as One Health.

This means, for example, that prevention of zoonotic diseases should not just focus on inhibiting their transmission between humans, but rather on making sure that they are not transmitted from animals to humans in the first place (prevention at the source). The transmission from animals to humans, however, is often a consequence of humans occupying ever larger proportions of wild animals’ habitats, a trend that effective prevention at the source must reverse.  

In her keynote, Monica Medina, President and CEO of WCS, reflected further on these linkages and the important role that intact ecosystems play for human, animal and environmental health:

Science is clear on what is needed to combat the risk of pathogen spillovers while also mitigating the impacts of climate change, biodiversity loss, and the drivers of non-communicable diseases: We must protect the remaining ecologically intact areas.

Monica Medina, WCS

According to her, WCS was able to trace the spread of corona viruses in South-East Asia along the routes of the local wildlife trade. To prevent future pandemics, she said, interventions need to focus on prevention at source.  She invited everyone present to critically examine their own attitudes: ‘We need to change our fraught relationship with wildlife. The time for action is now.’

Dr Michael Nagel, Head of Programme “Support to the International Alliance against Health Risks in Wildlife Trade”, Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) showed how increased contact between humans and wild animals, with its inherent risk of pathogen spillover, is due both to changes in land use leading to habitat destruction and to the consumption and trade of wild animals and bushmeat. The Alliance aims to reduce this risk by ‘stepping up responses (including behavioural changes)’ to reduce contacts between humans and wildlife and its products, and by enhancing awareness and knowledge of these issues so as to ‘narrow the gap between science and implementation’.

Inspired panel discussions

Panel discussions addressed the policy-action nexus, integrated surveillance and the economics of One Health, highlighting the respective priorities of the participating panellists and building bridges between them. On the first panel, “Cross-Sectoral reflections and future Opportunities for One Health”, Doreen Robinson, UNEP, wondered whether the One Health field was still ‘too expert-driven and western science-based’. In response, Dr Mariam Wallet Mohamed Aboubakrine, Adjunct Professor, University of Ottawa & Co-Principal Investigator of the Arramat Project, advocated respecting and taking care and responsibility for Mother Earth. She presented the Arramat Project, which works ‘to strengthen Indigenous voices and capacities to document their knowledge about the importance of the whole environment (including biodiversity) to the health and well-being of their communities’.

Dr Keith Sumption, Food and Agriculture Organization of the United Nations (FAO) proposed that it was time to let go of professional titles that emphasise divides rather than commonalities: ‘Let us leave our current titles behind, we are all ‘health practitioners’’, he said. Dr Frauke Fischer, who teaches International Conservation at the University of Würzburg, pointed out that the dramatic loss of species plays much less of a role in the public consciousness than climate change, and that most of us still know far too little about ecosystem services, on which our lives, including our economies, depend:

60% of our GDP (Gross Domestic Product) depend on what I call “ecosystem services”. Yet we only invest 0.2% of our GDP in conserving it.

Dr Frauke Fischer, University of Würzburg

Looking to the future, Dr Kim Grützmacher, GIZ, recalled that it is vital for human survival to protect biodiversity and natural resources, to promote sustainable agriculture, to conserve and restore wetlands, and to think comprehensively and across sectors. It is precisely these systemic connections that the One Health approach establishes. She proposed that more cross-sectoral funding should be mobilised for interdisciplinary and intersectoral research on, and implementation of, the One Health approach.

Lively breakout sessions

All participants had opportunities to engage in lively discussions and learn from each other in eight breakout sessions with topics ranging from “One health in the age of mass information” and “Pollution and ecotoxicology” to “One Health Legal frameworks”. 

In the breakout session on soil health, Dr Bettina Hitzfeld, Head of Division of the Soil and Biotechnology Division at the Federal Office for the Environment, Switzerland, presented on the centrality of soil for the One Health approach – and on the need to make this more visible. Dr Marco Martuzzi, Director, Environment and Health Department, Italian National Institute of Health, agreed that the crucial health-soil interface deserved more attention, underlining, for example, the role of soil for food security, nutrition and access to a healthy environment. Participants agreed that, to change this, soil health should, for example, become a part of human health and animal health practitioners’ university curricula and existing tools to assess soil health and links with prevalent diseases should be shared more widely with One Health stakeholders.

In the breakout session “German flagship projects on Biodiversity/Health”, partners of these projects presented their work at the biodiversity-health nexus. In Zambia for example, the German-supported Nature for Health (N4H) initiative facilitated the development of a One Health Strategic Plan, signed and owned by three ministries responsible for human health, animal health and for the environment.

As partner of the German-supported International Alliance against Health Risks in Wildlife Trade, Dr. Christina Pettan-Brewer, Associate Professor, Director and Senior Veterinarian, One Health Brasil/Latin America (OHLAIC/CYTED) shared how she implements One Health training and research programmes with indigenous communities, for example in Brazil, where a boat visits indigenous communities along the Amazon to discuss One Health- and surveillance-related issues. She emphasised that the aim is to create opportunities for mutual learning between Global North and Global South.  

In the same vein, Joan Carling, Executive Director, Indigenous Peoples Rights International-IPRI, called for greater commitment to mutual learning and respect for indigenous knowledge. Indigenous communities depend on wildlife for their nutrition and their hunting practices, for example, are highly regulated to ensure sustainable food systems. She recommended to listen to the voices of indigenous leaders and indigenous women who, for family nutrition reasons, tend to know most about the human/animal/environment nexus. Participants exchanged on what they had learned about stakeholder engagement and productive co-creation processes and many connected on points of shared interests and possible future collaboration.

In the breakout session “One Health legal frameworks: Connecting the new WHO CA+ process to existing frameworks” it was agreed by all present that prevention at source must be prominent in the accord being negotiated under the auspices of the WHO, on pandemic prevention, preparedness, and response.

The cost efficiency of prevention

The closing plenary session of the event focused on the “Economics of Primary Prevention,” and was moderated by Dr Sue Lieberman, Vice President – International Policy at WCS. In his keynote speech on “ground rules for full cost-accounting”, Dr Erik Roos Lindgreen, Researcher circular economy and sustainability assessment, explained how product-oriented full costing underlines the significant cost-efficiency of prevention. Economic arguments can help experts make a case for the One Health approach because, as he put it, ‘the language of decision-makers is money’.

In the panel that followed – with Matthias Nachtnebel (German Development Bank KfW), Dr. Eveline DeCoster (Office of the Belgian Minister of Climate, Environment, Sustainable Development & Green Deal), Dr. Mariam Wallet Aboubakrine, Doreen Robinson and Jean Philippe Dop (WOAH) – important but complex questions were raised as in relation to (environmental) health as a global public good: How can we value nature for the services it provides? What is the role of markets? Where could the money come from, where does it need to go?

“Breaking barriers”: A kick-start for manifold intersectoral and interdisciplinary collaborations

Throughout the event, moderators kept reminding participants to use the event as opportunity for expanding their networks beyond familiar disciplines and institutions and for building bridges to other sectors and groups under the overarching One Health umbrella. And indeed: both the attractive surroundings and the way the event was organised resulted in participants doing just that. Not just email addresses and phone numbers were exchanged but also recommended readings and ideas for future joint projects or papers. Clearly, the event did not just break barriers but it kickstarted many valuable intersectoral and interdisciplinary linkages and new partnerships and collaborations. The Breaking Barriers event website – with a video, supporting materials and a key outcomes report – invites participants and the interested public to build on and further develop these results.

In her closing words, Molly Crystal, WCS, said: ‘We need to find ways to work with each other. This is not only a problem of needing more technical knowledge or information. At its heart, the challenge of a One Health approach is a challenge about people needing to break down silos, explore new perspectives, and collaborate across our various mandates to achieve a goal that is bigger than any one of us or our institutions or our sectors. This requires the humbling recognition that we cannot do it all alone by ourselves; we need each other, and we need to help each other.’

In just this collaborative spirit, the “Breaking Barriers” event ended with the launch of the Lancet / PPATS (Prevention of pandemics at the source) Commission on Prevention of Viral Spillover. As final speaker, Dr Wolfram Morgenroth-Klein, Head of Division Pandemic Prevention and One Health, BMZ, welcomed this new Lancet Commission as an effective way to bring together brilliant minds from different backgrounds and disciplines to jointly work on and close remaining knowledge gaps. ‘Prevention at the source is the first line of defence and the best way to prevent pandemics – and it needs more work and our attention.’

Anna von Roenne,
October 2023