Erkyihun and Alemayehu.

Zoonoses (2022) 2:37

DOI 10.15212/ZOONOSES-2022-0037

REVIEW ARTICLE

One Health Approach for the Control

of Zoonotic Diseases
Gashaw Adane Erkyihun1,* and Meseret Bekele Alemayehu1

Edited by:
Abstract Kun Yin, Shanghai Jiao Tong University
School of Medicine, China
Zoonoses are infectious diseases that can be transmitted from animals
to humans and/or from humans to animals. Approximately 75% of new Reviewed by:
emerging and re-emerging disease pathogens are zoonotic: 60% spread from Reviewer 1, Xun Li, University of
Maryland Baltimore, USA
domestic and wild animals, and 80% are of concern regarding bioterrorism. The other reviewer chose to be
For the past 20 years, the world has faced several zoonotic disease outbreaks. anonymous.
Some zoonoses can cause recurring outbreaks, such as Ebola virus disease,
*Corresponding author:
salmonellosis, Marburg disease, rabies and anthrax. Still others, such as the E-mail: [email protected] (GAE)
novel coronavirus causing COVID-19, have the potential to cause worldwide
1Veterinary Public Health Directorate,
pandemics. The high risk of emerging and reemerging disease spillover and
Ministry of Agriculture, Addis Ababa,
burden has been increased by extensive interactions among animals, humans Ethiopia
and ecosystems. Hence, this complex health threat strongly requires a multi-
sectoral collaboration known as the One Health approach. This article discusses Received: September 13 2022
Revised: October 23 2022
recent scientific policies, initiatives, best practices, systems and challenges Accepted: November 15 2022
in One Health. The critical rapid review method was used, with a particular Published Online: November 30 2022
emphasis on available and recent global information. Literature found in
Google Scholar and PubMed, and data publicly available on the websites of
major global, regional and national organizations were included. The aim of
this article is to provide compiled information and increase awareness.
Key words: awareness, collaboration, emerging and reemerging, infectious
diseases, multi-sectoral, one health approaches, zoonotic diseases

INTRODUCTION global multi-sectoral economies [6]. In

the past decade, zoonotic diseases have
Zoonoses are infectious diseases that
cost more than 20 billion US dollars in
can be transmitted from animals to
humans and/or from humans to ani- direct costs and 200 billion US dollars in
mals [1,2]. More than 75% of emerging indirect costs [7]. Worldwide, more than
disease pathogens are zoonotic: 60% of 25% of the original forest cover has been
them spread from domestic or wild ani- lost due to frequent encounters of humans
mals to humans, and 80% are of con- and domestic animals with wildlife.
cern regarding bioterrorism. Worldwide, Human activities have severely destroyed
these emerging zoonoses account for 2.5 or altered more than 75% of terrestrial
billion cases and 2.7 billion death each environments and 66% of marine envi-
year [3,4,5]. These zoonotic diseases are ronments. Consequently, infectious dis-
becoming growing health threats world- ease transmission has been exacerbated,
wide and, in the past 20 years, have been thus causing as much as 20% global ani-
reported to cause billions of US dollars mal production loss and severely affecting
of economic damage in many local and food security [3].

© 2022 The Authors. Creative Commons Attribution 4.0 International License

2 Erkyihun and Alemayehu

For the past 20 years, the world has faced several This complex and interconnected health threat based
zoonotic disease outbreaks, such as the viral diseases of on animal–human–environment interactions strongly
Ebola virus disease, hantavirus disease, the highly path- requires inter-sectoral integration and/or collaboration
ogenic avian inf luenza, West Nile disease, Rift Valley not only to decrease the burden, but also to enable future
fever, severe acute respiratory syndrome, Marburg disease, effective prevention and control of all zoonotic diseases
rabies, Middle East respiratory syndrome, monkeypox dis- [3,15]. This goal can be achieved through the One Health
ease, and the COVID-19 pandemic, as well as the bacterial approach and its coordination mechanisms. The One
diseases of anthrax, brucellosis, tuberculosis, salmonello- Health approach is an effective platform organizing all
sis, and Escherichia coli (O157:H7) and Yersinia pestis relevant stakeholders (in animal, human, environmental
infections. Some zoonoses can cause recurring outbreaks, and other relevant sectors), which also can provide sub-
whereas others may cause potential worldwide pandem- stantial benefits for health sectors and their development
ics and have been declared public health emergencies of goals through convening relevant governmental agencies
international concern by the World Health Organization [16,17]. However, the implementation mechanisms of the
(WHO) [3,8,9] One Health approach to decrease and prevent zoonotic
Because of the world’s interconnectedness, the threat diseases remain poorly understood and have received little
of a given disease somewhere is a threat everywhere. The attention worldwide, particularly in low income coun-
high risk of emerging and reemerging disease spillover and tries. Moreover, the dynamics, and the economic and epi-
burden has been increased by the extensive interactions demiological mechanisms of preventing and controlling
among animals, humans and ecosystems, as a result of the persistence and emergence of zoonoses are unclear [8].
exponential growth of livestock and human populations; To obtain compiled information for better understand-
rapidly increasing urbanization and changing farming sys- ing effective systems for controlling zoonotic diseases,
tems; close interactions between wildlife and domestic reviewing and framing the One Health approaches, poli-
animals (followed by forest encroachment, habitat destruc- cies and available global best practices is critical. Therefore,
tion and ecosystem changes); globalization in the trade of this article discusses recent scientific policies, initiatives,
animal and animal products; antimicrobial resistance; and best practices, systems and challenges. The critical rapid
climate change [4,10]. Land use changes due to improper review system was applied to major studies gathered by
use and overuse of natural resources, together with the searching peer-review databases for One Health related
effects of climate change (such as f loods, drought, forest terms, and the findings are discussed with particular
fires and the heat island effect) have led to severe degrada- emphasis on all available and recent global information.
tion and/or destruction of entire ecosystems, thus result- Studies found in Google Scholar and PubMed, and data
ing in a loss of natural protection against disease emer- publicly available on the websites of major international,
gence. In contrast, wildlife habitat fragmentation because global, regional and national organizations were included.
of infrastructure development, urbanization and unregu- This review differs from previous reviews in its attempt
lated exploitation (through extensive hunting, trade and to include major and recent scientific policies, initiatives,
consumption) has contributed to decreasing biodiversity; best practices, systems and challenges and solutions of the
increasing disease vector and host interaction; and exac- One Health approach. The aim of this article is to increase
erbating disease spillover across wild animals, domestic community awareness of One Health.
animals and humans [11]. Antimicrobial resistance due to
the misuse of antibiotics and other medicines, particularly ONE HEALTH: DEFINITION, HISTORICAL
in animal rearing, hinder the treatment of diseases and ADVANCEMENT AND IMPORTANCE
resistant microorganisms. Environmental pollution has
also facilitated the spread of disease via water, air and soil Definition
[12]. In addition, foodborne pathogens such as bacteria, One Health an interdisciplinary, multi-sectoral and col-
viruses and parasites have increased the worldwide bur- laborative approach that can function at global, regional,
den of diseases. Currently, food safety is affected by sev- national and local levels, with the objective of ensuring
eral challenges (such as population growth and migration, optimal health through the recognition of connections
changes in food production and distribution systems, glo- among environment, humans, animals and plants [18].
balization of the food trade, growth in meat consumption This integrated and unifying approach can mitigate and
and frequent consumption of meat by humans), which can prevent health threats at the interface of the environment,
result in continual contamination and the occurrence of humans, animals and plants, with the objective of achiev-
food-borne disease [13]. Consumption of contaminated ing and sustainably balancing or optimizing public and
food causes foodborne illness and death of 600 million animal health, food and nutritional security, sustainable
and 400,000 people, respectively, each year. The sources ecosystems and fair trade [19]. The One Health approach
of these foodborne illnesses are products of animal ori- mobilizes several disciplines and sectors as well as com-
gin, fruits, vegetables and contaminated water. Therefore, munities at different levels in working together to com-
food safety should be assured through an integrated mul- bat health and ecosystem threats. It is aimed at addressing
ti-disciplinary approach [8,3,14]. the collective need for clean water, energy and air, safe
One Health Approach for the Control of Zoonotic Diseases 3

and nutritious food, taking action on climate change and between veterinary and human medical schools [23,24].
contributing to sustainable development. One Health is The Global Conference on One Health, held in May 2015
a global paradigm for challenge driven teamwork that by the World Veterinary Association (WVA) and World
forges co-equal and all-inclusive collaboration across Medical Association (WMA), was also one of the most
human, animal, plant and environmental health areas important actions that expanded the One Health platform
[20]. In terms of legislation and policy, the One Health by recommending an increase in interdisciplinary collab-
approach can be enforced to implement programs, policies oration between veterinary and medical professionals to
and legislation through communication across several sec- improve animal and human health. Since then, the One
tors working together to achieve better health [21]. Health concept has become more accepted, and its initia-
tives have rapidly been gaining a wider platform [25].
Historical advancement of the One Health
approach The scope of One Health
The One Health approach concept was launched in 19th The following areas requiring the One Health approach
century by Rudolf Virchow (1821–1902) after he incorpo- at all levels of academia, government, industry, policy and
rated veterinary medicine into human health and asserted research, because of the interconnectedness of human, ani-
the absence of a dividing line between them. Subsequently, mal, environmental, plant and whole planet health: agricul-
the One Health concept grew worldwide, and at the start tural production and land use; animals (as sentinels for envi-
of the first of 21st century showed a paradigm shift; since ronmental agent and contamination detection and response);
then, interdisciplinary collaboration has expanded [22]. antimicrobial resistance mitigation; biodiversity (conserva-
The Wildlife Conservation Society formulated the One tion medicine); climate change and its effects on humans,
World-One Health concept, in 2004, by establishing animals and ecosystems; clinical medicine; sector of infor-
a cross-sectional approach to prevent epizootic or epi- mation communication and outreach; comparative medi-
demic diseases and maintain ecosystem integrity. The cine; disaster preparedness and response; disease surveillance
United Nations Food and Agriculture Organization and prevention of both infectious (zoonoses) and chronic
(FAO), World Organization of Animal Health (OIE), diseases; economics; environmental health; food safety and
United Nations Children’s Fund, World Bank and United security; global trade; the human-livestock bond; natural
Nations System Inf luenza Coordinator documented a resource conservation; occupational health risks; plant and
strategic framework for decreasing risks of infectious soil health; professional education and training; public pol-
diseases at the human–animal–environment interface, icy and regulation; research; water safety; and the welfare/
entitled “Contributing to One World, One Health,” in well-being of animals, humans, ecosystems and the planet
2008. In the same year, this strategic framework was sup- [5,26,27]. A One Health Umbrella formulated by One
ported by World Medical Association (WMA) through Health Initiative and One Health Sweden to demonstrate
a resolution on the collaboration between human and the scope of the One Health approach (Fig 1) is the best
veterinary medicine, including joint educational efforts example of collaboration among One Health stakeholders.

FIGURE 1 | The ‘One Health Umbrella’ developed by the networks ‘One Health Sweden’ and ‘One Health Initiative’ to illustrate the scope of
the ‘One Health concept’. Available on www.onehealthinitiative.com and previously published in Ref. [28].
4 Erkyihun and Alemayehu

Why the One Health approach? The Importance of the One Health approach
Animals and humans are infected by many of the same The One Health approach is used to conduct joint disease
microorganisms because they live in a shared ecosys- surveillance; control and prevent zoonotic diseases out-
tem. For example, most zoonotic diseases, such as rabies, breaks; improve food safety and security; and decrease anti-
anthrax and brucellosis, can be effectively prevented in microbial resistant infections to improve human and animal
humans by controlling an animal source of the causative health. By promoting strong collaboration among relevant
agents. Drug resistant microorganisms can be transmitted sectors, the One Health approach strengthens the disease
between humans and animals through contaminated food surveillance system, the data sharing mechanism with all
and direct contact. Environmental pollution, ecosystem stakeholders, diagnostic laboratory systems, and the network
destruction, antimicrobial resistance (due to misuse of for early response and detection of zoonoses. This approach
antibiotics) and consumption of contaminated food (caus- clearly enhances the zoonotic disease prevention and con-
ing foodborne illness due to consumption of products of trol workforce and ensures effective and coordinated pub-
animal origin, fruits, vegetables and contaminated water) lic health emergency preparedness, in which all strategies
are also among the relevant problems in which they cannot contribute to the effective reduction of zoonotic diseases.
controlled and eliminated by one sector alone. Therefore, Generally, the One Health approach strongly supports inter-
to effectively address these issues, a well-coordinated national health security through its effective multi-sectoral
One Health approach in the human–animal–environ- collaboration, coordination and information communica-
ment sectors is required [10,17,29]. Moreover, advancing tion at the interface between relevant sectors by address-
the Sustainable Development Goals (SDGs), particularly ing common health threats, such as zoonoses, antimicrobial
SDG-3 (“Ensure healthy lives and promote well-being for resistance, food safety and security issues [18,32,33].
all at all stages”) and SDG-15 (“Protect, restore and pro-
mote sustainable use of terrestrial ecosystems, sustainably How can work contribute to One Health?
manage forests, combat desertification, halt and reverse The One Health approach promotes collaboration, coor-
land degradation and halt biodiversity loss”), provides a dination and communication across all sectors (Fig 2)
unique opportunity for relevant sectors to work in a col- among animal, human, environmental and other relevant
laborate manner [30,31]. disciplines. Consequently, anyone can contribute to the

FIGURE 2 | The collaboration, coordination and communicating system of One Health across all sectors [34].
One Health Approach for the Control of Zoonotic Diseases 5

actual implementation of One Health strategies through The conference discussed the importance of working
participating in human, animal/wildlife and environmen- together to promote a One Health approach; awareness
tal health. Professionals (human and veterinary medicine of the interdependence of animal, human and environ-
and environmental health cares) can greatly contribute by mental health; and the necessity of involving other disci-
applying this approach to regular practice [18,34]. plines, such as economics, social behavior, food security
and safety [38].
Initiatives driving the One Health approach
Several global One Health initiatives have been used and The world medical and veterinary association one
developed to assist countries by facilitating and increasing health collaboration
the capacity of the One Health approach, together with In 2012, these two organizations signed a memoran-
designing strategies, implementation programs, policies, dum of understanding to integrate a unified approach for
legislation and studies to improve global health security, addressing common health threats and working effectively
achieve SDGs, comply with the international health regu- to improve global health. Their agreement focuses on
lations and handle common health threats [35,36]. zoonoses such as rabies control, antimicrobial resistance
and education [39].
International ministerial conference on avian and
pandemic influenza The one health global conference
Representatives from 29 international organizations and The World Medical and Veterinary Associations held a
111 countries, in December 2007, convened in New conference in May 2015 (Spain) and strongly agreed on
Delhi, India, and promoted the idea of One Health by the need for increasing multidisciplinary collaboration
creating linkages between and animal and human health among human and veterinary professionals to improve
systems for pandemic preparedness. At the time, the meet- common wellbeing [40].
ing representatives clearly recommended the One Health
approach for effective preparedness [18]. Operational framework of One Health for
strengthening animal, human and environmental
The world medical association resolution health systems
In 2008, the World Medical Association made a resolu- The World Bank was developed this framework in order
tion for real collaboration among veterinary and human to provide One Health orientation and support one health
medicine. The Association recommends collaboration, sectors in terms of implementing and understanding the
and strongly supports joint education between human and approach. The framework provides important initiatives and
veterinary schools [37]. tools for supporting One Health by strengthen in the ani-
mal, human and environment sectors. Generally, the frame-
A collaboration of FAO, WOAH, WHO, United work was established to provide a generalized overview of
Nations International Children Emergency Fund the concept of One Health and application guidance [6].
(UNICEF) World Bank and UNESCO
In 2007, these major international organizations meet in Quadripartite memorandum of understanding
India and developed a joint strategic framework to respond for the One Health collaboration
to emerging and reemerging infectious diseases, particu- On March 17, 2022, the FAO, WOAH and WHO
larly avian inf luenza. This Joint Strategic Framework was updated their former tripartite agreement to a new quad-
entitled “Contributing to One World, One Health” and ripartite agreement by incorporating the United Nations
built on the lessons of the One Health concept [18]. Environmental Programme as an equal partner work-
ing on One Health in collaboration. Accordingly, the
Tripartite agreement among three international Directors General of the four organizations signed a mem-
organizations orandum of understanding agreeing to increase collabo-
The World Organization for Animal Health (WOAH), ration to maximize and optimize the health of animals,
FAO of The United Nations and WHO have agreed to a humans, the environment and plants. The agreement not
tripartite agreement in April 2010 for working together on only provides a legal framework for those organizations to
antimicrobial resistance, tuberculosis, rabies, and Middle combat challenges at the ecosystem–animal–human inter-
East respiratory syndrome-coronavirus. This agreement face, but also enhances the reinforcement of international,
proposes and advances a long term strategic direction regional, national and local health services [41].
for international collaboration, with the aim of sharing
responsibilities and coordinating global health activities at One Health approach actions for the control
the interface of humans, animals and ecosystems [16]. of zoonotic diseases
Globally, neglected tropical diseases have greatly affected
The first one health congress more than 1 billion people in disadvantaged and margin-
In 2011, an international One Health Congress was held in alized communities. Acting quickly to efficiently control
Melbourne, Australia, by representatives from 60 nations. the burden of zoonoses through One Health is critical
6 Erkyihun and Alemayehu

[42]. Currently, several global One Health initiatives have priority intensifies cross-cutting approaches through
been used and developed to assist countries by facilitat- coordination and integration actions in key sectors, and
ing and increasing the capacity of One Health approach, is implemented by targeted actions such as enhancing
together with designing strategies, implementation pro- common delivery working platforms on animals and
gram, policies, legislation and studies to improve global humans; prioritizing neglected tropical diseases within
health security, attain SDGs, comply with International human–animal–­environmental health systems; and coor-
Health Regulations and handle common health threats. dinating with other sectors in neglected tropical disease
For example, the WHO, FAO, WOAH and United interventions, such as strengthening cross-sectoral coor-
Nations Environmental Programme have collaborated on dination mechanisms. The other pillar is changing cul-
using the One Health approach to predict, detect, respond ture and operating models to facilitate country mandate
to and prevent global health threats, as well as to promote by n­ urturing and sustaining a country-led One Health
sustainable development, [43]. action. This pillar is achieved through targeted action,
The WHO has launched a historical One Health such as creating ownership at national and sub-national
approach action companion document to combat levels (through responding to specific needs of the popu-
neglected tropical diseases through a 2021–2030 roadmap, lation and global health security agenda), defining stake-
with the aim of supporting countries, international holder roles (by managing priorities across nations and
organizations stakeholders and non-state actors in achiev- sectors), and aligning organizational setup, operating
ing the goals through a trans-disciplinary, cross-cutting models and philosophy [42].
approach. The document intended three main priorities
or roadmap pillars to be achieved by each group. The One Health systems: best examples and practices
first pillar is accelerating programmatic action by inte- Tripartite Zoonotic Guide (TZG)
grating the One Health system for neglected tropical This system-based One Health approach (Fig 3) and/or
diseases and achieving targeted actions, such as technical multi-sectoral coordination mechanism was prepared by
progress (through guidance and evidence based inter- the FAO, WOAH and WHO to address zoonotic dis-
vention), service and strategy delivery (surveillance and eases in various nations. This systematic guide provides
joint risk assessment), and integrating funding, advo- a Generalized One Health Framework (Fig 4), achieved
cacy collaboration and multi-sectoral action. The second through five steps that describes a clear structure for the

FIGURE 3 | System based program of One Health: zoonotic disease specific program compared with other areas [44].
One Health Approach for the Control of Zoonotic Diseases 7

FIGURE 4 | Generalized One Health Framework achieved through five steps [44].

One Health approach in the prevention of zoonotic dis- of wildlife crimes and human-wildlife conf lict. This
eases [44]. project was mandated by the government of Malawi to
secure and rehabilitate wildlife and injured animals, and
Clinical Project in One Health work with communities to promote peaceful co-existence
This One Health approach implementation clinical pro- with wildlife, capacity building among wildlife profes-
ject (Fig 5) in Malawi offers a crucial lifeline to victims sionals and research to inform the country’s conservation

FIGURE 5 | The One Health Clinical Project in Malawi and the coordination of Lilongwe Wildlife Trust, Available on https://www.lilongwewil-
dlife.org/clinical-project-one-health and previously published in Ref. [15].
8 Erkyihun and Alemayehu

management plan [45]. Some of the disciplines that are Joint disease surveillance
showed in Fig 5 are illustrated as follows. For early detection of zoonotic diseases, joint and/or
coordinated surveillance systems should be considered by
all relevant sectors. The main objective of joint surveil-
Veterinary medicine
lance for zoonotic diseases is to identify the disease events
Human health can clearly be safeguarded by effectively
and support the application of coordinated response, pre-
promoting animal and environmental health, which is
vention and mitigation measures. In addition to support-
the responsibility of the veterinary profession, whose
ing research areas, the understanding of disease burden,
central mission is maintaining animal health and wel-
monitoring and intervention is facilitated [49].
fare and public health. Veterinary medicine is the main
Joint surveillance of zoonotic diseases involves engage-
department in the One Health approach involved in
ment of relevant sectors, and common data including
securing food safety and wildlife care, disease surveil-
identification numbers, time series data, sites of common
lance and zoonosis prevention for farm and/or domestic
exposure and/or geospatial data sources. These efforts
animals [46].
require case definitions for surveillance, case detection
methods and procedures for case confirmation, includ-
Comparative medicine
ing laboratory results. The joint surveillance system also
This field examines similarities and differences between
require the development of a specific technical group that
veterinary and human medicine, with an emphasis on the
can be involved at all One Health institutions as well as a
animal origin of human diseases together with the roles
strategic plan to prevent the disease [50,51].
and responsibilities of veterinarians and animal resource
centers. It plays a role in reduction, replacement and
Increase the capacity of laboratories
refinement of animal models in research and facilitates
Laboratory capacity, and sector specific and multi-­sectorial
translation of knowledge, surveillance, data sharing, cross
integration are highly important for the success of zoono-
collaboration across multi-sectors [47].
sis prevention. In addition, conducting joint training and
laboratory protocol sharing for One Health responsible
Human medicine
sector laboratories is important to detect the same path-
In the One Health approach, human medicine plays a
ogens. Each laboratory should serve as a reference labora-
role in human health through the prevention and control
tory and create linked database networks over the relevant
of zoonotic diseases, disease surveillance, research, and
sectors to improve reporting, data sharing and early detec-
data sharing among human health providers and related
tion of zoonotic disease outbreaks [52,53].
sectors [48].
Emergency preparedness and response
Agriculture and ecology
Relevant sectors must be trained and coordinated to
An integrated comprehensive approach to health involves
respond together to a given zoonotic disease outbreak
both living and nonliving components on the land, and
through resource sharing and efficient cost associated
links between ecological changes and human activity. It is
with the outbreak control. Relevant sectors must prepare
concerned with land use changes due to improper use and
a sector specific emergency preparedness platform for
overuse of natural resources; climate change, which leads
their prioritized diseases and should support a participa-
to degradation of entire ecosystems; mining of domestic
tory approach including preparedness and response activi-
animals and wildlife habitat destruction; and disease spill-
ties, which might include joint risk assessment, simulation
over at the wild animal–domestic animal–human inter-
exercise and preparedness and contingency planning [16].
face. Generally, it addresses the effects of antimicrobial
resistance, environmental contamination, climate change,
Developing workforce
biodiversity, habitat loss and human encroachment into
Establishing a competent global, regional and national
wildlife areas [48].
One Health workforce of public health, domestic ani-
mal, wildlife and environmental professionals is critical
Effective One Health approaches to reduce to respond to, prevent and control disease outbreaks.
zoonotic diseases Countries should be prepared to detect, respond to, con-
According to the Africa Center of Disease Communication, trol and prevent any zoonoses by using a diverse workforce
FAO, WOAH, and United States Centre of Disease including experts such as physicians, veterinarians, labo-
Control and Prevention, the most effective One Health ratory technicians and epidemiologists. The workforce
approaches that are commonly used to combat zoonotic should be supported by education and legislation [36].
diseases include joint surveillance, increased laboratory
capacity, emergency preparedness and response systems, Risk communication
workforce and technical working group establishment, Each One Health approach should incorporate com-
prioritization of major zoonotic diseases, and effective munication strategies including all stakeholders by con-
communication and information sharing. sidering how they can engage, communicate and share
One Health Approach for the Control of Zoonotic Diseases 9

information. The communication strategy includes for- the main challenges of One Health include diverse emerg-
mal channels of communication, programs and messag- ing and reemerging zoonotic diseases; increased human–
ing, thus enabling sharing of resources and maximizing animal–ecosystem interaction because of the exponen-
public support [16]. tial growth of livestock and human populations; rapidly
increasing urbanization and changing farming systems;
Effective communication and information sharing very close interactions between wildlife and domestic ani-
On the basis of the information collected from all sources, mals that can result in forest encroachment (followed by
data sharing for stakeholders aids in understanding of the habitat distraction and ecosystem change); globalization of
existing disease burden. The systems can create data shar- trade in animal and animal products; antimicrobial resist-
ing platforms across relevant organizations and enable ance; and climate change [26].
their timely integration [16].
Solutions
One Health coordination mechanisms to combat Integrated activities are needed at multiple levels, includ-
zoonoses ing the grassroots national level, and regional and global
The most effective One Health coordination mechanisms levels. One Health must effectively operationalize, and the
to effectively combat zoonotic diseases are formulating described lines of work require implementation through
operational frameworks with specific roles and respon- cooperation and intersectional dialogue. Research insti-
sibilities of stakeholders; establishing formal commu- tutions must extensively cooperate in One Health issues
nication and collaboration systems that can be applied through effective studies on emerging pathogens and
across all relevant sectors; capacity building, strength- mechanisms of disease spillover, and monitoring of risks
ening and institutionalization of the approach; address- of prevention and control strategies of zoonotic and/or
ing priorities, such as zoonoses, food safety and security, infectious diseases [11]. Strong intersectional collabora-
antimicrobial resistance and climate change); and devel- tion across the human and veterinary health, wildlife and
oping local, national, regional and international strate- environment sectors can enhance regular joint surveil-
gies with inclusive goals, objectives and activities for rel- lance capacity, understanding of the dynamics of zoonotic
evant sectors, which describe how collaboration will be disease emergencies and provision of an actual frame-
accomplished [16]. work for effective implementation of health measures
[56]. Every national public health institution and other
CHALLENGES OF THE ONE HEALTH relevant institution must be committed to ensuring the
APPROACH AND POSSIBLE SOLUTIONS institutionalization of One Health in their regular plans
and/or activities [54]. Countries worldwide must encour-
Challenges age higher education institutions to integrate One Health
Although considerable activities, effort and progress have principles and philosophies into academic curricula and
strengthened the One Health approach in the past dec- research areas. Moreover, diagnostic laboratory capacity
ades, its institutionalization and sustainable and/or reg- must be increased, and government leadership must be
ular operationalization within government institutions advised or made aware of their commitment to the One
remain challenging, owing to various constraints that Health approach [15]. To develop legal solutions for the
might contribute to weaknesses in effective coordination, implementation of One Health approach, identifying legal
such as differences in resource allocation among human, principles and institutional dynamics of relevant sectors
animal and environmental health programs, and dispar- beyond their sector specific legislation is important [21].
ities in education and training in various disciplines and
fields. Owing to the lack of appropriate budgeting and
CONCLUSION AND RECOMMENDATION
coordination, occasional attempts to control and prevent
zoonoses through One Health approach are not well inte- Re-emerging and emerging zoonoses are an increasing
grated [28,54]. In most nations, poor coordination and international threat. In the past 20 years, they have caused
integration across the human–animal–environmental very high economic and public health damage in many
health sectors persists in terms of information sharing; a local and global multi-sectoral economies. Over the past
lack of commitment of government officials in supporting 20 years, several deadly zoonotic disease outbreaks have
One Health with financing and leadership (particularly been reported worldwide. Because of global intercon-
in developing countries); competing priorities among nectedness at the human–animal–environment interface,
zoonotic diseases prevention and control measures; lim- the threat of a given disease somewhere is a threat every-
ited diagnostic laboratory capacity to detect causative where. Thus, zoonotic diseases may become the main
agents; and weak or absent legislation implementing the public health and economic challenge globally in the
One Health approach, particularly through public private coming decades. Hence, a strong multi-sectoral collabo-
partnerships. Universities in most parts of the world can- rative and institutional system (the One Health approach)
not include One Health course curricula in human, vet- is required to effectively reduce the burden of, prevent
erinary medicine and other disciplines [21,55]. Moreover, and control those zoonoses. Reviewing and compiling
10 Erkyihun and Alemayehu

available One Health approach mechanisms, policies and review. Trans R Soc Trop Med Hyg [Internet]. 2021 Jan 28 [cited
2022 Jul 30];115(2):147-168. Available from: https://academic.
strategies is critical. In this review article, major globally
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and mapped out, together with challenges and solutions practices on the different fields of One Health in China. Vol. 4.
Biosafety and Health. Elsevier B.V.; 2022. 23-29.
to improve understanding. On this basis, we recommend
14. WHO. Online course on Global Health at the Human-Animal-
that all One Health stakeholders worldwide aggressively Ecosystem Interface [Internet]. 2022 [cited 2022 Jul 30].
work toward the promotion, implementation and institu- Available from: https://www.who.int/news/item/24-05-
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15. Erkyihun GA, Gari FR, Edao BM, Kassa GM. A review
ACKNOWLEDGEMENTS
on One Health approach in Ethiopia. One Heal Outlook.
We express our gratitude to the staff members of Ministry of 2022;4(1):8.
Agriculture (with special emphasis Veterinary Public Health 16. WHO/OIE/FAO. Taking a Multisectoral One Health Approach:
Directorate) for their unreserved follow-up and support. A Tripartite Guide to Addressing Zoonotic Diseases in
Countries [Internet]. 2019. Available from: http://www.fao.org/
documents/card/en/c/CA2942EN/.
CONFLICTS OF INTEREST
17. WHO. One Health is critical to addressing zoonotic public health
We confirm and declare that the manuscript was prepared without threats and environmental issues [Internet]. 2022 [cited 2022
any conflicts of interest and financial relationships. Jul 23]. Available from: https://www.who.int/news/item/21-
03-2022-one-health-is-critical-to-addressing-zoonotic-public-
health-threats-and-environmental-issues.
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Gashaw Adane Erkyihun (BVSc, MVSc in VPH) is a professional and

researcher in the field of zoonotic infectious diseases at the Ministry of
Agriculture and Addis Ababa University, Ethiopia with full-time professional
expertise at Veterinary Public Health Directorate for the past 4 years. He has
also more than 20 years of experience in animal health and/or livestock man-
agement. With a background in veterinary science (as a profession), he has
acquired extensive multidisciplinary knowledge in areas of animal health care,
microbiology and epidemiology of zoonotic infectious diseases particularly in
brucellosis in humans and livestock. He has been collaborating with national
and international organizations on zoonotic diseases. He has published more
than three scientific publications in peer-reviewed journals. He is a secretary
of National Brucellosis Prevention and Control Technical Working Group at
National One Health Steering Committee. His research interests include
zoonotic diseases (brucellosis, rabies, anthrax), One Health approach, emerg-
ing infectious diseases and control of zoonotic diseases based on the One
Health concept.