"One Health" - The potential of closer collaboration between human and animal health

The history of integrative thinking of human and animal health is rich and dates back hundreds of years (Schwabe, 1984), was an important component of the foundation of universities in Europe (Ruegg, 2004) as well as governed comparative medicine at the end of the 19(th) century (Saunders, 2000). In the 20(th) century, it was Calvin Schwabe's thorough rethinking of the concept of "one medicine" in 1976 that fully recognized the close systemic interaction of humans and animals for nutrition, livelihood and health (Schwabe, 1984). Today, the earliest forms of healing of humans and animals are still widely practiced in traditional pastoral societies. It is thus not surprising that the contemporary "one medicine" idea grew out of experiences in African communities. The concepts and studies presented in this paper are based on the validation of the concept of "one-medicine" in West-African pastoralist settings which led to an extension of the original concept to a broader approach to health and well-being resulting in the framework of "one health" that was further validated in a number of situations and settings in African and Asia (Roth et al., 2003; Schelling et al., 2007, Zinsstag et al., 2007). "One health" is clearly also an integral part of the ecosystem health approach promoted by Rapport et al. (1998). Zoonoses are certainly the most prominent examples of compulsory interactions between human and animal health. The interaction of humans and animals in Africa is inextricably linked and hence needs - besides the biomedical perspectives - a thorough rethinking of institutions, legislations, communication and funding of both sectors. There is still a large untapped potential of new institutional and operational models for providing health services jointly to remote populations which is particularly relevant with regard to resources constraints, ongoing health sector reforms and the human resource crisis (Schelling et al., 2005; Zinsstag et al., 2009a). Concretely, there is a great further potential for innovative, cost-effective approaches to zoonoses control as documented for brucellosis (Roth et al., 2003; Zinsstag et al., 2005) and rabies (Zinsstag et al., 2009b). Such examples - in addition to the ongoing research and global discussions surrounding bird and swine flu - justify and call for possibly setting up a global fund for zoonoses, similar to and/or linked to the Global Fund to fight HIV/AIDS, Tuberculosis and Malaria (Zinsstag and Tanner, 2008). The prospects and challenges of "one-health" focus around questions of an adequate theory of health and well-being and how the interdependence of humans and animals can be understood with given social-ecological systems leading to reconciling disease systems within a health and social system context. At the practical level, this boils down to questions on how disease surveillance systems, planning and priority setting as well as the implementation of interventions and their economic appraisal can be designed to capture the human and animal health issues guided by a comprehensive "one medicine" perspective as reflected in the "tool box" for successful one-health applications (Zinsstag et al., 2009a). Aiming at (i) generating effective, system-based public health responses to zoonoses, particularly also to the emerging, re-emerging and/or neglected diseases, as well as (ii) to well-being and (iii) to sustainable development of our societies, imply the rigorous and coherent translation of the "one-health" concepts into health policy and daily public health practices.