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:
Reviewer 1, Xun Li, University of
emerging and re-emerging disease pathogens are zoonotic: 60% spread from domestic Maryland Baltimore, USA
and wild animals, and 80% are of concern regarding bioterrorism. For the past 20 The other reviewer chose to be
years, the world has faced several zoonotic disease outbreaks. Some zoonoses can anonymous.
cause recurring outbreaks, such as Ebola virus disease, salmonellosis, Marburg disease, *Corresponding author:
rabies and anthrax. Still others, such as the novel coronavirus causing COVID-19, E-mail: [email protected] (GAE)
have the potential to cause worldwide pandemics. The high risk of emerging and 1
Veterinary Public Health Directorate,
reemerging disease spillover and burden has been increased by extensive interactions Ministry of Agriculture, Addis Ababa,
among animals, humans and ecosystems. Hence, this complex health threat strongly Ethiopia
requires a multi- sectoral collaboration known as the One Health approach. This article
Received: September 13 2022
discusses recent scientific policies, initiatives, best practices, systems and challenges Revised: October 23 2022
in One Health. The critical rapid review method was used, with a particular Accepted: November 15 2022
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

Zoonoses are infectious diseases that the past decade, zoonotic diseases have
can be transmitted from animals to cost more than 20 billion US dollars in
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
of economic damage in many local and affecting 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 effective prevention and control of all zoonotic diseases
disease, rabies, Middle East respiratory syndrome, [3,15]. This goal can be achieved through the One Health
monkeypox dis- ease, and the COVID-19 pandemic, as approach and its coordination mechanisms. The One
well as the bacterial diseases of anthrax, brucellosis, Health approach is an effective platform organizing all
tuberculosis, salmonello- sis, and Escherichia coli relevant stakeholders (in animal, human, environmental
(O157:H7) and Yersinia pestis infections. Some zoonoses and other relevant sectors), which also can provide sub-
can cause recurring outbreaks, whereas others may cause stantial benefits for health sectors and their development
potential worldwide pandem- ics and have been declared goals through convening relevant governmental agencies
public health emergencies of international concern by the [16,17]. However, the implementation mechanisms of the
World Health Organization (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
of a given disease somewhere is a threat everywhere. The little attention worldwide, particularly in low income
high risk of emerging and reemerging disease spillover coun- tries. Moreover, the dynamics, and the economic
and burden has been increased by the extensive and epi- demiological mechanisms of preventing and
interactions among animals, humans and ecosystems, as a controlling the persistence and emergence of zoonoses are
result of exponential growth of livestock and human unclear [8]. To obtain compiled information for better
populations; rapidly increasing urbanization and changing understand- ing effective systems for controlling
farming sys- tems; close interactions between wildlife and zoonotic diseases, reviewing and framing the One Health
domestic animals (followed by forest encroachment, approaches, poli- cies and available global best practices is
habitat destruc- tion and ecosystem changes); critical. Therefore, this article discusses recent scientific
globalization in the trade of animal and animal products; policies, initiatives, best practices, systems and
antimicrobial resistance; and climate change [4,10]. Land challenges. The critical rapid review system was applied
use changes due to improper use and overuse of natural to major studies gathered by searching peer-review
resources, together with the effects of climate change databases for One Health related terms, and the
(such as f loods, drought, forest fires and the heat island findings are discussed with particular emphasis on all
effect) have led to severe degrada- tion and/or destruction available and recent global information. Studies found in
of entire ecosystems, thus result- ing in a loss of natural Google Scholar and PubMed, and data publicly available
protection against disease emer- gence. In contrast, on the websites of major international, global, regional
wildlife habitat fragmentation because of infrastructure and national organizations were included. This review
development, urbanization and unregu- lated exploitation differs from previous reviews in its attempt to include
(through extensive hunting, trade and consumption) has major and recent scientific policies, initiatives, best
contributed to decreasing biodiversity; increasing disease practices, systems and challenges and solutions of the One
vector and host interaction; and exac- erbating disease Health approach. The aim of this article is to increase
spillover across wild animals, domestic animals and
community awareness of One Health.
humans [11]. Antimicrobial resistance due to the misuse
of antibiotics and other medicines, particularly in animal
ONE HEALTH: DEFINITION, HISTORICAL
rearing, hinder the treatment of diseases and resistant
microorganisms. Environmental pollution has also ADVANCEMENT AND IMPORTANCE
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, oration between veterinary and medical professionals to
policies and legislation through communication across improve animal and human health. Since then, the One
several sec- tors working together to achieve better health Health concept has become more accepted, and its initia-
[21]. tives have rapidly been gaining a wider platform [25].
Historical advancement of the One Health The scope of One Health
approach The following areas requiring the One Health approach
The One Health approach concept was launched in 19 th at all levels of academia, government, industry, policy and
century by Rudolf Virchow (1821–1902) after he incorpo- research, because of the interconnectedness of human, ani-
rated veterinary medicine into human health and asserted mal, environmental, plant and whole planet health:
the absence of a dividing line between them. agricul- tural production and land use; animals (as sentinels
Subsequently, the One Health concept grew worldwide, for envi- ronmental agent and contamination detection and
and at the start of the first of 21 st century showed a response); antimicrobial resistance mitigation; biodiversity
paradigm shift; since then, interdisciplinary collaboration (conserva- tion medicine); climate change and its effects
has expanded [22]. The Wildlife Conservation Society on humans, animals and ecosystems; clinical medicine;
formulated the One World-One Health concept, in sector of infor- mation communication and outreach;
2004, by establishing a cross-sectional approach to comparative medi- cine; disaster preparedness and
prevent epizootic or epi- demic diseases and maintain response; disease surveillance and prevention of both
ecosystem integrity. The United Nations Food and infectious (zoonoses) and chronic diseases; economics;
Agriculture Organization (FAO), World Organization of environmental health; food safety and security; global
Animal Health (OIE), United Nations Children’s Fund, trade; the human-livestock bond; natural resource
World Bank and United Nations System Inf luenza conservation; occupational health risks; plant and soil
Coordinator documented a strategic framework for health; professional education and training; public pol- icy
decreasing risks of infectious diseases at the human– and regulation; research; water safety; and the welfare/
animal–environment interface, entitled “Contributing to well-being of animals, humans, ecosystems and the planet
One World, One Health,” in 2008. In the same year, this [5,26,27]. A One Health Umbrella formulated by One
strategic framework was sup- ported by World Medical Health Initiative and One Health Sweden to demonstrate
Association (WMA) through a resolution on the the scope of the One Health approach (Fig 1) is the best
collaboration between human and veterinary medicine, example of collaboration among One Health stakeholders.
including joint educational efforts

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
anthrax and brucellosis, can be effectively prevented in anti- microbial resistant infections to improve human and
humans by controlling an animal source of the causative animal health. By promoting strong collaboration among
agents. Drug resistant microorganisms can be transmitted relevant sectors, the One Health approach strengthens the
between humans and animals through contaminated food disease surveillance system, the data sharing mechanism
and direct contact. Environmental pollution, ecosystem with all stakeholders, diagnostic laboratory systems, and
destruction, antimicrobial resistance (due to misuse of the network for early response and detection of
antibiotics) and consumption of contaminated food (caus- zoonoses.This approach clearly enhances the zoonotic
ing foodborne illness due to consumption of products of disease prevention and con- trol workforce and ensures
animal origin, fruits, vegetables and contaminated water) effective and coordinated pub- lic health emergency
are also among the relevant problems in which they preparedness, in which all strategies contribute to the
cannot controlled and eliminated by one sector alone. effective reduction of zoonotic diseases. Generally, the
Therefore, to effectively address these issues, a well- One Health approach strongly supports inter- national
coordinated One Health approach in the human–animal– health security through its effective multi-sectoral
environ- ment sectors is required [10,17,29]. Moreover, collaboration, coordination and information communica-
advancing the Sustainable Development Goals (SDGs), tion at the interface between relevant sectors by address-
particularly SDG-3 (“Ensure healthy lives and promote ing common health threats, such as zoonoses,
well-being for all at all stages”) and SDG-15 (“Protect, antimicrobial resistance, food safety and security issues
restore and pro- mote sustainable use of terrestrial [18,32,33].
ecosystems, sustainably manage forests, combat
desertification, halt and reverse land degradation and halt
How can work contribute to One Health?
biodiversity loss”), provides a unique opportunity for
The One Health approach promotes collaboration, coor-
relevant sectors to work in a col- laborate manner [30,31].
dination and communication across all sectors (Fig 2)
among animal, human, environmental and other relevant
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
achieve SDGs, comply with the international health regu- effectively to improve global health. Their agreement
lations and handle common health threats [35,36]. focuses on 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 common wellbeing [40].
meet- 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
veterinary schools [37]. and tools for supporting One Health by strengthen in the
ani- mal, human and environment sectors. Generally, the
A collaboration of FAO, WOAH, WHO, United frame- work was established to provide a generalized
Nations International Children Emergency Fund overview of the concept of One Health and application
(UNICEF) World Bank and UNESCO guidance [6].
In 2007, these major international organizations meet in
India and developed a joint strategic framework to Quadripartite memorandum of understanding
respond to emerging and reemerging infectious diseases, for the One Health collaboration
particu- larly avian inf luenza. This Joint Strategic On March 17, 2022, the FAO, WOAH and WHO
Framework was entitled “Contributing to One World, One updated their former tripartite agreement to a new quad-
Health” and built on the lessons of the One Health ripartite agreement by incorporating the United Nations
concept [18]. Environmental Programme as an equal partner work-
ing on One Health in collaboration. Accordingly, the
Tripartite agreement among three Directors General of the four organizations signed a mem-
international 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
antimicrobial resistance, tuberculosis, rabies, and Middle to combat challenges at the ecosystem–animal–human
East respiratory syndrome-coronavirus. This agreement inter- face, but also enhances the reinforcement of
proposes and advances a long term strategic direction international, regional, national and local health services
for international collaboration, with the aim of sharing [41].
responsibilities and coordinating global health activities at
the interface of humans, animals and ecosystems [16]. One Health approach actions for the control
of zoonotic diseases
The first one health congress Globally, neglected tropical diseases have greatly affected
In 2011, an international One Health Congress was held more than 1 billion people in disadvantaged and margin-
in Melbourne, Australia, by representatives from 60 alized communities. Acting quickly to efficiently control
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 nurturing 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 lation and global health security agenda), defining stake-
roadmap, with the aim of supporting countries, holder roles (by managing priorities across nations and
international organizations stakeholders and non-state sectors), and aligning organizational setup, operating
actors in achiev- ing the goals through a trans- models and philosophy [42].
disciplinary, cross-cutting approach. The document
intended three main priorities or roadmap pillars to be
One Health systems: best examples and practices
achieved by each group. The first pillar is accelerating
Tripartite Zoonotic Guide (TZG)
programmatic action by inte- grating the One Health
This system-based One Health approach (Fig 3) and/or
system for neglected tropical diseases and achieving
multi-sectoral coordination mechanism was prepared by
targeted actions, such as technical progress (through
the FAO, WOAH and WHO to address zoonotic dis-
guidance and evidence based inter- vention), service and
eases in various nations. This systematic guide provides
strategy delivery (surveillance and joint risk assessment),
a Generalized One Health Framework (Fig 4), achieved
and integrating funding, advo- cacy collaboration and
through five steps that describes a clear structure for the
multi-sectoral action. The second

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

sidering how they can engage, communicate and

share
10 Erkyihun and Alemayehu

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

available One Health approach mechanisms, policies and review. Trans R Soc Trop Med Hyg [Internet]. 2021 Jan 28 [cited
strategies is critical. In this review article, major globally 2022 Jul 30];115(2):147-168. Available from: https://academic.
available One Health policies, strategies, systems, coor- oup.com/trstmh/article/115/2/147/6121885.
dination mechanisms, initiatives and best practices for 12. Multi-partner. Biodiversity for Health and Pandemic Prevention. 2021
(November):1-70.
developed and developing countries have been introduced
13. Li Q, Guo C, Hu H, Lu J. Towards One Health: reflections and
and mapped out, together with challenges and solutions practices on the different fields of One Health in China. Vol. 4.
to improve understanding. On this basis, we recommend Biosafety and Health. Elsevier B.V.; 2022. 23-29.
that all One Health stakeholders worldwide aggressively 14. WHO. Online course on Global Health at the Human-Animal-
work toward the promotion, implementation and institu- Ecosystem Interface [Internet]. 2022 [cited 2022 Jul 30].
Available from: https://www.who.int/news/item/24-05-
tionalization of the One Health approach.
2018-online-course-on-global-health-at-the-human-animal-
ecosystem-interface.
ACKNOWLEDGEMENTS 15. Erkyihun GA, Gari FR, Edao BM, Kassa GM. A review 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: A
Directorate) for their unreserved follow-up and support.
Tripartite Guide to Addressing Zoonotic Diseases in
Countries [Internet]. 2019. Available from: http://www.fao.org/
CONFLICTS OF INTEREST documents/card/en/c/CA2942EN/.
17. WHO. One Health is critical to addressing zoonotic public health
We confirm and declare that the manuscript was prepared without any
threats and environmental issues [Internet]. 2022 [cited 2022 Jul
conflicts of interest and financial relationships.
23]. Available from: https://www.who.int/news/item/21-
03-2022-one-health-is-critical-to-addressing-zoonotic-public-
REFERENCES health-threats-and-environmental-issues.
18. US CDC. One Health Basics [Internet]. 2022 [cited 2022 Jul 30].
1. World Health Organization. Zoonoses. 2022 [cited 2022 Jul 21].
Available from: https://www.cdc.gov/onehealth/basics/index.html.
Available from: https://www.who.int/news-room/fact-sheets/
19. FAO. One Health [Internet]. 2022 [cited 2022 Jul 30]. Available
detail/zoonoses.
from: https://www.fao.org/one-health/en.
2. CDC. Zoonotic Diseases. 2021 [cited 2022 Jul 21]. Available
20. WHO. One Health High-Level Expert Panel (OHHLEP) [Internet].
from: https://www.cdc.gov/onehealth/basics/zoonotic-diseases. html.
2020 [cited 2022 Jul 30]. Available from: https://www.who.int/
3. WOAH. One Health [Internet]. 2022 [cited 2022 Jul 23].
groups/one-health-high-level-expert-panel/members.
Available from: https://www.woah.org/en/what-we-do/
21. UN FAO. One Health legislation. FAO; 2020.
global-initiatives/one-health/. 22. Monath TP, Kahn LH, Kaplan B. Introduction: One Health
4. World Economic Forum. What are zoonotic diseases - and how perspective. ILAR J. 2010;51(3):193-198.
dangerous are they? [Internet]. 2022 [cited 2022 Jul 21]. Available 23. Coleman W. Contributing to One World, One Health. Med Hist
from: https://www.weforum.org/agenda/2022/07/ zoonotic- [Internet]. 2008;31(1):111-113. Available from: ftp://ftp.fao.org/
disease-virus-covid/. docrep/fao/011/aj137e/aj137e00.pdf
5. One Health Commission. Why One Health? [Internet]. 24. Buttigieg M. A review of the One Health concept: increasing
2022 [cited 2022 Jul 30]. Available from: https://www. awareness and collaboration between the Maltese medical and
onehealthcommission.org/en/why_one_health/. veterinary professionals. Malta Med J [Internet]. 2015;27(5):34-
6. Berthe FCJ, Bouley T, Karesh WB. Le Gall FG, Machalaba CC, 37. Available from: http://www.um.edu.mt/umms/mmj/
Plante CA, et al. 2018. B. Operational framework for PDF/MMJ_53.pdf%0Ahttps://www.cabdirect.org/cabdirect/
strengthening human, animal and environmental public health abstract/20163020524.
systems at their interface. Washington, D.C.: World Bank Group. 25. Jones KE, Patel NG, Levy MA, Storeygard A, Balk D, Gittleman JL,
[Internet]. 2018. Available from: https:// et al. Global trends in emerging infectious diseases. Nature.
documents.worldbank.org/en/publication/documents-reports/ 2008;451(7181):990-993.
documentdetail/703711517234402168/operational-framework- for- 26. Tessema TB, Gizachew A. One Health Program: Its Future
strengthening-human-animal-and-environmental-public- health- Implications, Challenges and Opportunities: Review. 2015
systems-at-their-interface. (August).
7. World Bank. PEOPLE, PATHOGENS AND OUR PLANET 27. One Health Outlook. One Health Aims and Scope [Internet].
Volume 2 - The Economics of One Health. World Bank. 2022 [cited 2022 Aug 7]. Available from: https://
2012;2(69145):1-65. onehealthoutlook.biomedcentral.com/submission-guidelines/ aims-
8. Gebreyes WA, Dupouy-camet J, Newport MJ, Oliveira CJB, and-scope.
Schlesinger LS, Saif YM, et al. The global one health paradigm: 28. Gibbs EPJ. The evolution of One Health: a decade of
challenges and opportunities for tackling infectious diseases at the progress and challenges for the future. Vet Rec. 2014 Jan
human, animal, and environment interface in low-resource settings. 25;174(4):85-91.
PLoS Negl Trop Dis. 2014;8(11):e3257. 29. Mackenzie JS, Jeggo M. The One Health approach-why is it so
9. WHO. Disease Outbreak News [Internet]. 2022 [cited 2022 Jul important? Vol. 4. Tropical Medicine and Infectious Disease.
23]. Available from: https://www.who.int/emergencies/ disease- MDPI AG; 2019.
outbreak-news. 30. United Nations D of E and SA. THE 17 Sustainable Development
10. Jones BA, Grace D, Kock R, Alonso S, Rushton J, Said MY,
Goals [Internet]. 2015 [cited 2022 Aug 7]. Available from:
et al. Zoonosis emergence linked to agricultural intensification and https://sdgs.un.org/goals.
environmental change. Proc Natl Acad Sci U S A. 2013 31. Food and Agriculture Organization of the United Nations. A
May;110(21):8399-8404. future scope for One Health regulation, The Development Law
11. Tidman R, Abela-Ridder B, de Castañeda RR. The impact of Service [Internet]. 2022 [cited 2022 Aug 7]. Available from:
climate change on neglected tropical diseases: a systematic https://www.fao.org/legal-services/resources/detail/
en/c/1477431/.
12 Erkyihun and Alemayehu

32. Sinclair JR. Importance of a One Health approach in advancing global

44. Ghai RR, Wallace RM, Kile JC, Shoemaker TR, Vieira AR, Negron
health security and the Sustainable Development Goals. Rev Sci Tech
ME, et al. A generalizable one health framework for the control of
(International Office of Epizootics). 2019;38:145-154.
zoonotic diseases. Sci Rep. 2022 May 21;12(1):1-11.
33. Africa CDC. One Health Program [Internet]. 2021 [cited 2022 Jul
45. LWT. Clinical Projects in One Health, Malawi [Internet].
30]. Available from: https://africacdc.org/programme/
2019 [cited 2021 Nov 26]. Available from: https://www.
surveillance-disease-intelligence/one-health/.
lilongwewildlife.org/clinical-project-one-health/.
34. WHO. Tripartite and UNEP support OHHLEP’s definition of “One
46. van Herten J, Meijboom FLB. Veterinary responsibilities
Health” [Internet]. 2021 [cited 2022 Dec 8]. Available from:
within the One Health framework. Food Ethics. 2019 Aug
https://www.who.int/news/item/01-12-2021-tripartite-and- unep-
1;3(1-2):109-123.
support-ohhlep-s-definition-of-one-health.
47. Macy J, Horvath TL. Comparative medicine: an inclusive crossover
35. Gostin LO, Friedman EA. The sustainable development goals: One-
discipline. Yale J Biol Med. 2017 Sep 1;90(3):493-498.
Health in the world’s development agenda. JAMA.
48. Lerner H, Berg C. The concept of health in One Health and some
2015;314:2621-2622.
practical implications for research and education: what is One
36. De La Rocque S, Caya F, El Idrissi AH, Mumford L, Belot G,
Health? Infect Ecol Epidemiol. 2015;5:25300.
Carron M, et al. One Health operations: a critical component in the
49. Hattendorf J, Bardosh KL, Zinsstag J. One Health and its
International Health Regulations Monitoring and Evaluation
practical implications for surveillance of endemic zoonotic
Framework. Rev Sci Tech (International Office of Epizootics).
diseases in resource limited settings. Acta Trop. 2017 Jan
2019;38:303-314.
1;165:268-273.
37. World Medical Association. Declaration of Helsinki [Internet].
50. Stop N, Partners TB. Joint external evaluation by international health
2008 [cited 2022 Aug 9]. Available from: https://www.
regulations. 2011;1-26.
wma.net/what-we-do/medical-ethics/declaration-of-helsinki/ doh-
51. Falzon LC, Alumasa L, Amanya F, Kang’ethe E, Kariuki S,
oct2008/.
Momanyi K, et al. One Health in action: operational aspects of
38. MacKenzie JS, Jeggo MH. The first international one health
an integrated surveillance system for Zoonoses in Western Kenya.
congress. EcoHealth. 2011;7:1-2.
Front Vet Sci [Internet]. 2019 Jul 31 [cited 2022
39. JVMA. Promotion of “One Health” [Internet]. 2020 [cited 2022
Aug 9];6:252. Available from: https://www.frontiersin.org/
Aug 9]. Available from: http://nichiju.lin.gr.jp/en/activity/
article/10.3389/fvets.2019.00252/full.
onehealth.html.
52. Taboy CH, Chapman W, Albetkova A, Kennedy S, Rayfield MA.
40. WVA/WMA. One Health Global Network [Internet].
Integrated disease investigations and surveillance planning: a
2015 [cited 2022 Aug 9]. Available from: http://
systems approach to strengthening national surveillance and
www.onehealthglobal.net/meetings/meetings-2015/
detection of events of public health importance in support
wvawma-global-conference-on-one-health/.
of the International Health Regulations. BMC Public Health.
41. World Health Organization. Quadripartite Memorandum of
2010;10(Suppl 1):1-6.
Understanding (MoU) signed for a new era of One Health
53. Belay ED, Kile JC, Hall AJ, Barton-Behravesh C, Parsons MB,
collaboration [Internet]. 2022 [cited 2022 Aug 7].
Salyer S, et al. Zoonotic disease programs for enhancing
Available from: https://www.who.int/news/item/29-04-2022-
global health security. Emerg Infect Dis. 2017 Dec
quadripartite-memorandum-of-understanding-(mou)-signed- for-
1;23(13):S65-S70.
a-new-era-of-one-health-collaboration.
54. Lee K, Brumme ZL. Operationalizing the One Health approach: the
42. WHO. Ending the neglect to attain the sustainable development
global governance challenges. Health Policy Plan. 2013;28:778-
goals: a road map for neglected tropical diseases 2021–2030
785.
[Internet]. 2022 [cited 2022 Oct 22]. Available from: https://
55. Fasina FO, Fasanmi OG. The One Health landscape in Sub-
www.who.int/publications/i/item/9789240010352.
Saharan African countries consumer perception of milk safety in
43. One Health Initiative. World Health Organization One Health:
Kenya The One Health landscape in Sub-Saharan African
approach for action against neglected tropical diseases 2021- 2030
countries. 2020;87. Available from: https://www.cgiar.org/
[Internet]. 2022 [cited 2022 Oct 22]. Available from:
funders/.
https://onehealthinitiative.com/world-health-organization- one-
56. Batsukh Z, Tsolmon B, Otgonbaatar D, Undraa B, Dolgorkhand A,
health-approach-for-action-against-neglected-tropical- diseases-
Ariuntuya O. One Health in Mongolia. Curr Top Microbiol
2021-2030/.
Immunol. 2013;366:123-137.

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.