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    From “one medicine” to “one health” and systemic approaches to health and well-being

    Being confronted with multiplex patterns of global shift, the intricate interconnection of humans, pet animals, livestock and wildlife and their social and ecological environment is distinct and needs integrated approaches to human and animal health and their relevant social and environmental contexts. The history of centralized thinking of human and animal health is briefly analysed from early historical period, to the basis of universities in Europe, up to the inauguration of comparative medicine at the end of the 19th century. In the 20th century, Calvin Schwabe forged the notion of “one medicine”. It acknowledges that there is no difference from paradigm between human and veterinary medicine and both disciplines can help in the development of each other.

    Taking into account a wider approach to health and well-being of societies, the initial idea of “one medicine” was extended to “one health” through constructive applications and thorough verifications in various contexts. Given the global health thinking in recent decades, ecosystem approaches to health have been realised. In reference to manifold ecological thinking that goes beyond humans and animals, these approaches examine perplex connections between ecosystems and health, termed as “ecosystem health”. Despite these interdependent conceptual and methodological developments, most of human and animal health thinking and actions remain independent disciplinary silos. Proof for added value of a logical utilization of “one health” compared to individual sectorial thinking, is however, now increasing.

    Integrative thinking is increasingly being intended in academic curricula, clinical practice, ministries of health and livestock/agriculture and international organisations. Challenges are still present, targeted on fundamental questions such as how does “one health” evolve and what are the elements of a modern theory of health? The close association of humans and animals in their social and ecological context relates to the idea of “human-environmental systems”, also known as “social-ecological systems”. The theory and practice of understanding and managing human activities in the comprehension and management of human activities has been established by members of The Resilience Alliance and was leveraged largely in the Millennium Ecosystem Assessment, including its work on human well-being results. This in turn includes systems theory applied to human and animal health.

    Examples of positive system approaches to public health demonstrates unexpected outcomes. Analogous to “systems biology” which targets mainly on the interplay of proteins and molecules at a sub-cellular level, a systemic approach to health in social-ecological systems (HSES) is an inter- and trans- disciplinary study of complicated synergies in all health-related fields. HSES moves beyond “one health” and “eco-health”, aimed at determining emerging properties and determinants of health that may derive from a systemic view varying from molecules to the ecological and socio-cultural context, as well from the analogy with several disease endemicities and health systems frameworks.

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    Join us in the upcoming QS WorldClass 2019 under the theme of “One Health: University-Industry Collaboration in Medical Technology and Beyond” from 12-14 June 2019 in Hong Kong.

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