Emerging infectious disease outbreaks like Ebola, Zika or the new Coronavirus cast a glaring light on the dangers of ‘zoonoses’ – infectious diseases transmitted between animals and humans – one of the many symptoms of an ailing planet, alongside high population densities, increased global mobility, degraded ecosystems, climate change, social injustice and other issues. This is why BMZ now pursues the One Health approach, focusing on the interaction of people, animals and the environment.

A paradigm shift in BMZ’s approach to health

The COVID-19 pandemic has been stretching health systems to their limits, worsened social inequalities and plunged more and more people into poverty. But infectious diseases are just some of the multidimensional crises the world is facing at present and they call for a more unified approach. With its new One Health strategy, the German Federal Ministry for Economic Cooperation and Development (BMZ) takes the mutual dependencies and interactions between humans, animals and the environment into account.  

‘The COVID-19 pandemic can function as a window of opportunity for systematic change,’ says Dr Maria Flachsbarth, Parliamentary State Secretary, BMZ. ‘Even before the pandemic, our ministry has recognised the close link between animal, human and environmental health – one cannot be achieved without the other. That is why we have set up a new directorate for pandemic prevention, One Health, animal health and biodiversity’ she adds. 

Read the full interview with Dr Maria Flachsbarth on BMZ’s One Health approach.

What is One Health?

According to the World Health Organization (WHO), One Health is 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. COVID-19, for example, may be seen as a symptom of a multidimensional crisis stemming from a complex combination of degraded ecosystems, lost biodiversity, polluted air, water and soil, climate change and social injustice. The graphic shows how BMZ’s One Health approach takes this interplay into account and focuses on preventive measures in order to preserve health and reduce risks for humans, animals and the environment on which both of them depend.  

Anchoring a One Health approach in international cooperation

Following the avian influenza pandemic in mid-2000, the WHO, the Food and Agriculture Organization (FAO) and the World Organisation for Animal Health (OIE) decided to formalise and expand their collaboration on the One Health approach. This developed into a partnership between the WHO, the FAO and the OIE in 2018. ‘We cannot deal with human health, animal health, and ecosystem health in isolation – we have to look at them together, and address them together. This partnership pools the unique expertise of each organization and brings their combined weight to bear to do just that, via a ‘One Health’ approach,” said FAO Director-General, Jose Graziano da Silva. 

At the World Health Summit 2020, Dr Monique Eloit, Director General of World Organisation for Animal Health (OIE), noted that globally agreed concepts and plans can only be realised where partner countries are on board and have the required infrastructure, skills and resources. 

With a goal to reduce health risks, strengthen human and veterinary health systems and improve early warning systems to achieve better epidemic and pandemic prevention, starting from 2021, BMZ will allocate up to 150 million euros each year. BMZ has already increased its financial contributions to multilateral organisations and initiatives that support the One Health approach such as OIE and the International Livestock Research Institute (ILRI). After the United States, the United Kingdom and the European Union, Germany is the fourth biggest supporter of research in areas relevant to One Health.

World Health Organization Director General, Dr Tedros Adhanom Ghebreyesus, expressed his wholehearted support for BMZ’s One Health endeavour at the 2020 World Health Summit in October: ‘We must accelerate efforts to break down silos and start working in solidarity. With a multi-sectoral One Health approach, we will maximise the impact we have in detecting, preventing and managing potential future threats.’ 

KfW und GIZ support the implementation of the strategy

German development cooperation began to support more holistic programmes some time ago. ‘The Ebola pandemic in 2015 was one of the triggers for the more holistic programmes,’ explains Dr Renate Herrmann, Advisor Animal Health and One Health with Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ). ‘There were two big pandemic preparedness programmes which began in East and West African countries – and grew bigger and bigger as more NGOs joined, we built networks and tried to work with different organisations,’ she says, explaining that the programmes grew in scope with the understanding that pandemic preparedness needed to involve different multiple sectors.

Today, there are three new programmes at GIZ head office that support the implementation of the strategy. The first supports BMZ in international and policy questions – the Sector Initiative One Health. The second supports implementation at regional and partner country level – the global programme One Health. The third supports the International Alliance against Health Risks in Wildlife Trade. KfW, the German development bank, also pursues a One Health approach in many of its projects (see one example from Vietnam further below).

How do the German-supported regional and bilateral projects realise the One Health approach?

A One Health approach at regional level 

According to Damien Bishop, Head of Regional Programme Pandemic Preparedness in ECOWAS for GIZ, ’in our efforts to strengthen public health institutes in the ECOWAS region, we have been pursuing a One health approach. We did this, for example, by connecting animal, human and environmental health in the risk communications strategy that we developed with the West African Health Organization. As a part of this, we mapped out key One Health partners and the links between them,’ he explains. ‘We are also supporting the development of a One Health course tailored to the conditions in ECOWAS, which will help to build a One health network across the region,’ he adds. 

BMZ also supports pandemic preparedness with a One Health approach in East Africa: In June 2019, almost 300 participants took part in a Field Simulation Exercise on the Kenyan-Tanzanian border, convened by the East African Community (EAC) Secretariat on the potential outbreak of Rift Valley Fever (RVF) and supported by German Development Cooperation. RVF is a mosquito-borne disease that is endemic in the area during the rainy season and can have devastating effects on ruminants and also infect humans. The goal of the simulation was to test preparedness and responses not just for RVF, but for any outbreak of an infectious disease of public health concern. Just like the cattle which transmitted the disease, viruses don’t need visas to cross borders, so it is vital that countries in the East African Community region are alert and prepared and know how to respond to infectious disease emergencies. The exercise was very timely, as East Africa was and remains on high alert for Ebola, as well as other infectious diseases such as Yellow Fever, Marburg, Crimean Congo and Rift Valley Haemorrhagic Fevers.

Vietnam: Clamping down on zoonoses from the market to the rainforest

Vietnam is known as a zoonotic hotspot due to the widespread consumption of wild animal products, whether as food or as local medicines or talismans. As a result, the likelihood of illnesses jumping from wild animals to humans is high. On behalf of the German Federal Ministry for the Environment, Nature Conservation and Nuclear Safety (BMU), KfW Entwicklungsbank, in cooperation with WWF, is financing measures to prevent zoonoses. Market stalls, shops and restaurants which broke the law by selling banned wild animal products were identified and their details passed to the local authorities. Meanwhile, stricter checks have reduced violations by 70%. Rangers now patrol the conservation areas in search of wild animal traps. Such measures against poaching also reduce the risk of dangerous pathogens reaching illegal markets and spreading to humans. 

Lao PDR, Cambodia, Indonesia and the Philippines: Teaching One Health in schools

Based on the understanding that schools can help children to develop healthy habits that last a lifetime. German-supported programmes in Laos, Cambodia, Indonesia and the Philippines are teaching pupils about the importance of hand washing, clean water and help to de-worm children who are infected. Schools are also places where the three different domains of One Health – human health, environment and pathogens of animal origin – naturally intersect.

‘When you work on de-worming children, you can also raise their environmental awareness and their understanding of the links between human and animal health,’ says Dr Lea Knopf, Advisor Animal Health and One Health with GIZ. ‘Often the same parasites affect humans and animals, so why not also educate the children about this? There’s a recognition now that this is much more effective than just conducting a de-worming programme. One could involve medical staff, vets, environmentalists, community health workers, and so on.’

Towards One Health as shared compass for international cooperation. 

‘More One Health projects involving partner countries will be developed and implemented in the next three years’ says Dr Flachsbarth. ‘These projects will address the interfaces between human, animal and environmental health in food security, agricultural production and fisheries, water management, biodiversity or nature conservation. I would like to see the One Health approach firmly anchored across German development cooperation.’ 

Inna Lazareva, March 2021