[LUM#15] One Health

[LUM Magazine] - Published on February 8, 2022 in Science-Society

For the past fifteen years, the One Health approach has been developing in research projects involving both the Global South and the Global North to combat emerging risks, including zoonoses. Aurélie Binot, anthropologist and agronomist at the Astre* laboratory, explains.

To begin with, could you define the OneHealth approach for us?
One Health is a holistic approach to health that integrates human, animal, and plant health (see CIRAD PowerPoint presentation ). It emerged in the early 2000s and was officially launched by the United Nations in 2008 with the aim of tackling zoonoses, which account for 75% of human infectious diseases. It is based on the idea of intersectorality, linking health with other development sectors such as agriculture, the environment, rural development, land use planning, etc.

Is this the first time that health has been considered in an integrated way?
No, it was discussed as early as 1987 in the Brundtland Report and atthe Earth Summit in Rioin 1992. Alongside the One Health movement, there have also been schools of thought such as Ecohealth, One Medicine, Global Health and, more recently, Planetary Health, all of which focus on the relationships between human and animal health and the state of ecosystems (see: From One Health to Ecohealth, mapping the unfinished work of integrating human, animal and environmental health, Serge Morand (CNRS-Cirad), Jean-François Guégan (INRAE-IRD), Yann Laurans (Iddri), Décryptage, May 2020). This proliferation of schools reflects the creativity we need today to design and implement actions to manage health risks.

Is this a preventive approach?
The goal is to shift from a pathogenic paradigm to a salutogenic paradigm. How can we ensure that we remain healthy in a healthy environment? I am not just talking about the biological health of humans, animals, and plants. We can also look at social justice and the fight against poverty, as long as local stakeholders believe that this really contributes to the health of their region.

You mention the United Nations. Is the institutional dimension important?
Yes, the success of One Health depends on this strong international governance, which gives it its legitimacy. In 2008, the One Health framework brought together the World Health Organization (WHO), the World Organization for Animal Health (OIE), and the Food and Agriculture Organization of the United Nations (FAO) in a tripartite agreement. They were later joined by the United Nations Environment Programme (UNEP). This has enabled progress to be made in terms of public policy and local action.

Do these programs concern the South as much as the North?
The first programs, particularly those under the Ecohealth framework, were aimed more at developing countries, very rural areas where the state is unable to provide healthcare systems. Thirty years later, agricultural intensification, biodiversity loss, globalization, and other factors have led to dramatic health problems, and countries in the North have not been spared. Ultimately, we are all learning from each other. This is very fruitful in terms of cross-pollination.

In fact, since July 20, you have been participating in a new One Health program in the South.
This is the"health-territories" program, led by CIRAD, which brings together, for a period of five years, a whole cluster of projects focusing on the link between agroecological transition and global health in Southeast Asia and West Africa. We want to see how changing agricultural practices (in terms of production systems, supply chains, and resource management methods) can impact the health of the territory.

Can you give us an example?
In Benin, we are working with the National Institute for Agricultural Research (INAB) on the sustainability of cotton production practices, and in Senegal with the Higher Institute for Training and Applied Research (ISFRA). There, the focus is more on issues related to land tension in a context where farmers, herders, and agri-food companies find it difficult to engage in dialogue. We want to co-construct frameworks for consultation between these different actors in the agro-ecological transition to support them in activities that will improve the overall health of their territory.

You are both an agronomist and an anthropologist. How does this dual role benefit you?
My background as an agronomist allows me to understand what is involved in agricultural production systems, but my work today is primarily anthropological. I analyze local representations and work with local stakeholders to define what they consider to be their health, with the aim of translating this into changes in practices, particularly agricultural practices.

Is there also a supportive approach to your work?
Yes, and that is the second focus of anthropological work. The emergence of these new approaches was very quickly accompanied by the idea that local populations needed to be involved. This cannot be done in a top-down manner; we need to mobilize herders, village chiefs, and farmers, and work together to develop a conceptual framework for the health of the territory by identifying the attributes of this health and transforming them into indicators for measuring change.

In practical terms, how do you work with local stakeholders?
We work within the framework of collaborative workshops to support the implementation of "living labs " with participatory maps, serious games, and forum theater. Our methodology combines modeling, theory of change, and foresight. We provide support for dialogue and co-learning dynamics... It's not about getting everyone to agree or smoothing over social reality, but about understanding health as a common good.

Keywords: LUM#15, LUM Magazine, Research, Health