Justice (retd) KS Radhakrishnan & Varda Mehrotra
The World Health Organisation (WHO) in 2018 came out with a hand book “Managing Epidemics”, precisely a year before the outbreak of the pandemic COVID-19, where it mentioned: “Given the effects of globalisation the intense mobility of human populations and the relentless urbanisation, it is likely that the next emerging virus will spread fast and far. It is impossible to predict the nature of this virus or the source, or where it will start spreading.”
Soon after, as forecasted, the world saw the emergence of COVID-19 in December 2019 and its origin was traced to “Huanan Seafood Wholesale Market”, a wet market in Wuhan, China. The European Food Safety Authority (EFSA) has stated that 75% of infectious diseases in humans originate from animals while US Centers for Disease Control (CDC) stated 75% of emerging diseases in people are zoonotic.
Keeping in view these statistics, it has become a necessity to adopt a coordinated, collaborative, multidisciplinary, and cross-sectoral approach to address the risks that originate in the animal- human ecosystems. This interdependency has led to the notion of “One Health” which has found favour with world organisations.
"One Health" is a collaborative effort where multiple stakeholders work in tandem to attain optimal health for people, animals, and the environment. More and more people are coming to realise that human health is closely interconnected with animal health and the environment. In fact, Food and Agricultural Organization (FAO) also advocated for adopting a comprehensive approach such as "One Health" to manage the intricacies of changing the disease landscape.
It is interesting to note the Supreme Court of India’s judgment in Animal Welfare Board of India vs. A Nagaraja case laid down the principle of eco-centrism, a nature centric approach. The Court, in its judgment, reminded the community that humans are only one part of the earth. In India, at present solution-based approaches and level-based collaborations are being deliberated upon; however, the need is to create a sustainable level-based collaboration where third-parties can be integrated into the larger system of One Health to achieve scalability, sustainability, and cost effectiveness.
India must develop a standalone One Health policy. This collaboration should not be restricted within the borders. To develop a feasible and comprehensive policy, it must be ensured that both government and private agencies play their roles effectively. India can reach out to global institutions and gain access to world class scientific communities to translate its uncoordinated efforts into streamlined, productive, and result yielding endeavours. The current pandemic COVID-19 further reiterates the need for collaboration at the global level to make One Health Approach a successful reality.
Currently, India has both human disease (IDSP) and animal disease (NADRS) surveillances. But these two systems need a strategic approach where they can be integrated to prepare a roadmap for creating a unified One Health surveillance system in the country. To enhance multi-sectoral coordination, a veterinarian was recruited in the IDSP for managing the One Health aspect. It is an appreciative move but more such initiatives are required to solidify the One Health approach.
Awareness campaigns are essential to reach grassroots in India; education can go a long way in creating the right buzz for the cause. Professional bodies like the Indian Medical Association and the Indian Veterinary Association can come together to develop the study material for inclusion in the curriculum. Additionally, taking a cue from the US, India can set up One Health Clinics. The country with its burgeoning population can benefit immensely with such clinics where primary care can be provided through health & wellness centers. These centers in the future can act as preventive clinics to address the issues related to One Health.
For any collaboration and coordination, national and global ramifications of One Health must be understood. The governments at the highest levels need to integrate their efforts with various ministries and organizations working in this domain to achieve the desired results. Even qualified individuals such as doctors, clinicians, trainers, and researchers need to become a part of this endeavour to make the Indian health system resilient. Hence, it is essential to understand the diverse stakeholders in the health system and revisit the fundamentals of the healthcare system to develop an effective strategy for One Health.
(Justice K.S. Radhakrishnan is former Supreme Court Justice, India and is on the Advisory Board of Federation of Indian Animal Protection Organisations & Varda Mehrotra is the Executive Director of FIAPO. Views expressed are personal.)