Science

One Health: From Scientific Concept to Political Reality

One Health: Prior to the Covid-19 crisis, no one in the public space had heard of this concept. However, the idea of ​​”one world/one health – one planet/one health” appeared in the early 2000s with the support of the World Organization for Animal Health (OMSA), the World Health Organization (WHO) and the Food and Agriculture Organization of the United Nations (FAO) was before that, the prerogative of a handful of specialists – infectious disease specialists, climatologists, anthropologists, ecologists, veterinarians …

Its goal is simple: to strengthen the links between human health, animal health and the prevention of environmental risks, to reduce vector-borne diseases, in particular those transmitted from animals to humans (zoonoses). Successive successions of unforeseen or unpredictable health crises such as mad cow disease, H5N1, Ebola and now Covid-19 and monkeypox have shed light on this concept. In fact, they are all related to outbreaks of animal diseases and environmental changes. From a scientific point of view, this priority is undeniable: 60% of human infectious diseases are of animal origin, 40% of crop losses are caused by infectious diseases, and 20% of global livestock losses are pathogens, according to INRAE, the national research institute for agriculture, food and the environment. environment.

In fact, more and more politicians are dealing with this issue. The government’s roadmap for addressing the challenges our country must face in health and prevention seems to support three priorities. First, of course, the need to “search for meaning for caregivers as the health crisis comes as a head-on shock to the hospital and its partners.” Then improving “our preparation and our response to health risks in the logic of global health.” And, finally, the endless struggle with territorial inequality in health and medical merit. An agreed triptych that is now yet to be brought to life: saving a public hospital, promoting One Health, and fighting social and medical inequalities.

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New board dedicated to general health

At the same time, following the self-dissolution of the Scientific Council and the Vaccine Strategy Steering Committee (Cosv), the executive branch created a new committee more broadly focused on emerging risks and not just infections. So the immunologist Bridget Authran was appointed head of the “committee to monitor and predict health risks.” The creation of this organization is a radical change in culture and is good news in itself. Especially since research is following the same trend with the expansion of the National Agency for AIDS Research (ANRS) mission to emerging diseases with a budget to match.

The field of activity of this new council, which should determine public policy, will be mainly devoted to global health. His job will no doubt be easy on a scientific level, as his constitution will be able to play the card of interdisciplinarity and divide the disciplines, unlike a Covid-19 scientific council. In fact, we remember how few veterinary and environmental experts have been involved in managing the coronavirus crisis. On the other hand, his political inclination will be more complex, as the theme of “One Health” significantly affects the interdepartmental, even international.

Practical application requires full coordination between the Ministries of Health, Ecological Transition, Economy, Agriculture, and even Defense, if we refer, for example, to the “secret of defense” that surrounds stockpiles of doses of smallpox vaccine and Tecovirimat. the only drug currently available for monkeypox. It will also be necessary to mobilize all sectoral government policies, from national to territorial. But the Covid experience has shown us that what is demonstrated scientifically is not necessarily politically understandable.

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Gilles Pialo is the head of the infectious disease department at the Tenon Hospital in Paris.

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