Justice Is the Missing Link in One Health: Results of a Mixed Methods Study in an Urban City State

PLoS One. 2017 Jan 27;12(1):e0170967. doi: 10.1371/journal.pone.0170967. eCollection 2017.

Abstract

Background: One Health (OH) is an interdisciplinary collaborative approach to human and animal health that aims to break down conventional research and policy 'silos'. OH has been used to develop strategies for zoonotic Emerging Infectious Diseases (EID). However, the ethical case for OH as an alternative to more traditional public health approaches is largely absent from the discourse. To study the ethics of OH, we examined perceptions of the human health and ecological priorities for the management of zoonotic EID in the Southeast Asia country of Singapore.

Methods: We conducted a mixed methods study using a modified Delphi technique with a panel of 32 opinion leaders and 11 semi-structured interviews with a sub-set of those experts in Singapore. Panellists rated concepts of OH and priorities for zoonotic EID preparedness planning using a series of scenarios developed through the study. Interview data were examined qualitatively using thematic analysis.

Findings: We found that panellists agreed that OH is a cross-disciplinary collaboration among the veterinary, medical, and ecological sciences, as well as relevant government agencies encompassing animal, human, and environmental health. Although human health was often framed as the most important priority in zoonotic EID planning, our qualitative analysis suggested that consideration of non-human animal health and welfare was also important for an effective and ethical response. The panellists also suggested that effective pandemic planning demands regional leadership and investment from wealthier countries to better enable international cooperation.

Conclusion: We argue that EID planning under an OH approach would benefit greatly from an ethical ecological framework that accounts for justice in human, animal, and environmental health.

MeSH terms

  • Animals
  • Communicable Diseases, Emerging / epidemiology*
  • Communicable Diseases, Emerging / psychology
  • Environmental Health / ethics
  • Global Health / ethics*
  • Humans
  • Pandemics
  • Public Health / ethics*
  • Singapore
  • Zoonoses / epidemiology*
  • Zoonoses / psychology

Grants and funding

This research was funded with a Communicable Diseases-Public Health Research Grant from the Ministry of Health, Singapore (MOH/CDPHRG/0011/2014) for the project: One Health, Zoonotic Diseases and Pandemic Planning: Creating a Bioethics Framework in Singapore, URL: https://www.moh.gov.sg/content/moh_web/home/Fundings_and_Medical_Research/communicable_diseasespublichealthresearchgrant.html. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.