Operationalizing the One Health approach: the global governance challenges

TLDR

The One Health approach, which seeks integrated collaboration across human, animal, and environmental health sectors, has faced operational challenges despite broad commitment. The paper aims to demonstrate that One Health is impeded by dysfunctions in global health governance and proposes institutional reforms, case studies, and global support to overcome these barriers. The authors analyze global health governance dysfunctions—such as institutional proliferation, fragmentation, resource competition, absence of overarching authority, and donor-driven vertical programmes—and suggest institutional reforms, case studies, and global support to address them. These governance dysfunctions have partly caused shortcomings in how One Health has been articulated to date.

Abstract

While there has been wide-ranging commitment to the One Health approach, its operationalisation has so far proven challenging. One Health calls upon the human, animal and environmental health sectors to cross professional, disciplinary and institutional boundaries, and to work in a more integrated fashion. At the global level, this paper argues that this vision is hindered by dysfunctions characterising current forms of global health governance (GHG), namely institutional proliferation, fragmentation, competition for scarce resources, lack of an overarching authority, and donor-driven vertical programmes. This has contributed, in part, to shortcomings in how One Health has been articulated to date. An agreed operational definition of One Health among key global institutions, efforts to build One Health institutions from the ground up, comparative case studies of what works or does not work institutionally, and high-level global support for research, training and career opportunities would all help to enable One Health to help remedy, and not be subsumed by, existing dysfunctions in GHG.