IN my previous article, I provided an overview of the one health approach to zoonotic outbreaks and its significance. Today, I want to focus on the human health perspective within this framework. We’ll begin by exploring the concept of public health and its unique aspects. Then, we’ll examine the various phases of an outbreak—preparedness, alert, response and recovery—and how the One Health approach can be applied throughout these stages. How does the public health system shape these phases? We’ll also address some challenges, emphasizing that One Health is fundamentally a mindset.
What is public health? When people hear this term, they often think of doctors, nurses, medicines, treatments, hospitals and patients. However, that’s only one aspect—healthcare, which focuses on treating individual patients. The World Health Organization (WHO) defines public health as “the art and science of preventing disease, prolonging life and promoting health through society’s organized efforts.” Public health aims to keep people healthy and improve well-being by focusing on entire populations, recognizing that disease risks can arise anywhere. Certain groups may be at higher risk of infectious diseases due to biological factors like age, behavioral factors like occupation and environmental factors like living conditions.
Implementing prevention and outbreak control measures can be challenging due to various human factors. Conflicting priorities, lack of awareness, misinformation, and conspiracy theories can hinder the effectiveness of public health initiatives. Additionally, public health messages may not reach all groups. Engaging communities in designing prevention campaigns can enhance their impact. While public health operates at a population level, decisions on disease control are always shaped by morals, medical ethics, and individual values, which can differ significantly from the perspectives of the animal health sector and may lead to conflicting priorities.
For public health to be effective, collaboration among all stakeholders is essential. A Ministry of Health or public health agency typically manages and directs these stakeholder actions. Stakeholders include national health institutes, policymakers, epidemiologists, laboratory scientists, local health departments, clinicians, community leaders, religious groups, health workers, traditional healers, business leaders, educators, journalists, social media influencers, and the public. Each stakeholder can impact others’ health, making their collaboration crucial during a health crisis.
In the case of zoonotic diseases, this group expands to include the Ministry of Agriculture and Livestock, the Ministry of Environment, veterinarians, farmers, abattoirs, veterinary laboratories, meteorologists, entomologists, and more. Building relationships and establishing the right contacts take time, which is challenging during a crisis. Therefore, investing in these relationships during the preparedness phase is crucial. Speaking of preparedness, it is the first of four phases in the One Health framework for managing zoonotic outbreaks: Preparedness, Alert, Response, and Recovery. These phases align with the public health emergency response approach in human health. Let’s delve into each of these phases.
Preparedness is the most critical phase in responding to any outbreak. The groundwork for an effective response is laid before a crisis occurs. A significant aspect of preparedness is relationship-building. People collaborate best when they’ve previously met, understand each other’s roles, and trust one another. This trust is fostered through regular meetings, discussions about potential zoonoses, joint training events, surveillance efforts, and simulation exercises. While it may seem time-consuming, these activities are vital for effective outbreak response. The close relationship between public health and healthcare is also crucial during a crisis. Ensuring healthcare continuity and developing contingency plans for essential public health operations is vital.
—The writer is Associate Professor (Health Economics), Health Service Academy (Degree Awarding Institute), Chak Shahzad, Islamabad.
