The genesis for this book has been my involvement with an interdisciplinary team working with hard-to-reach rural communities in South-East Asia and the Pacific, and the challenges we faced in explaining our One Health approach to funding bodies. Government organisations and peer reviewers, unfamiliar with One Health methods, asked what did agriculture have to do with human health? While interdisciplinary research is now actively encouraged in some universities, research institutes, and policy and funding bodies are yet to fully understand how One Health methods, while complex in nature, offer an alternative way to solve intractable problems that have thus far eluded solutions.

This book is a window into the interconnectedness of the sentient beings on the planet and the world they inhabit. It will provide readers and researchers with the fundamentals underpinning One Health. Governments concerned for the livelihoods of hard-to-reach rural communities in all countries know these communities suffer despite efforts to improve their situations. Millions of dollars of aid money directed to improving livelihoods in low-resource countries have yet to make a significant difference. Lack of will is not the problem. The human development report: human development for everyone (United Nations Development Programme 2017) reported uneven human development, with millions struggling with hunger, poverty, illiteracy, and malnutrition: one in three people is malnourished, more than one in ten lives in extreme poverty, and the same number cannot read or write. The 2017 Save the Children Report, Short changed: the human and economic cost of child undernutrition in Papua New Guinea, argues that reducing poverty and improving livelihoods of people, particularly emphasising the nutrition crisis, is a priority. These grave findings should not be surprising: the speed of population growth, reduced areas for food production, water scarcity, emerging infections, and other anthropogenic changes are making the planet unstable, with increasingly unequal access to safe environments and food security for many inhabitants in the poorest countries.

A 2016 study of Australian funding outcomes published in Nature showed that research involving multiple disciplines is less likely to be funded when compared to projects with a narrow, more specialised focus (Bromham, Dinnage and Hua 2016). Governments, statutory funding bodies and universities are structured according to specific disciplines – public health experts or agriculturalists or vets – and are less familiar (or comfortable) with a holistic approach. Peer review of interdisciplinary research requires a more expansive view, one that accepts and anticipates that the usual metrics may not always be appropriate or helpful. Academic track records across a range of disciplines will not fit one model, nor will the research methods be familiar to all. One Health projects also take more time and usually cost more than research funded under the Australian Competitive Grants Category 1 schemes such as the Australian Research Council and the National Health and Medical Research Council or Public-Sector Research Income grants under Category 2. The two- to three-year time frames typical of these research grants are too short for projects aiming to improve human–animal–environmental health.

Over the last decade, we have come to better understand unintended consequences of progress: climate change, habitat destruction, food insecurity, wealth inequality, species extinction, and zoonosis. Addressing these consequences and facing new challenges demand we respond but not by doing the same thing over and over. Yet there is evidence that we continue to repeat errors from the past. When the railroad network in India was built under British rule in the 19th century it paved the way for trade and mass travel, symbolising the ingenuity of the British in the post-industrial world. But railways also paved the way for infectious diseases, shocking labour conditions, and changed landscapes – unintended side effects that remain today. Raw sewage dropped from trains enabled the spread of disease by organisms (vectors) that transmit disease between humans or from animals (birds, insects, rodents) to humans; sewage also penetrated the underground water table. Trains also harbinger epidemic diseases such as cholera and influenza. The unintended consequences of human actions are found everywhere, not just in India and not just in the last century. Plastic bags in the Pacific Ocean, constituting around 80 per cent of marine debris, are being consumed by marine life as they fragment into smaller and smaller pieces, causing environmental devastation. The Green Revolution of the mid-20th century achieved spectacular success bringing agricultural technologies to poor countries where famine and starvation were frequent occurrences. However, the success in providing adequate carbohydrate nutrition was followed by a complacency regarding agricultural sustainability and food quality, resulting in environmental degradation and the double burden of malnutrition now afflicting all countries.

Tackling problems from just the perspective of a human, or of an animal, or of the land are unintended consequences of the 20th-century obsession with specialisation. This approach fails to recognise the interconnectedness of humans, animals, ecosystems and climate. Planetary Health, EcoHealth, and One Health are terms in this book that describe methods for solving these universal problems. The different terms express similar themes: multidisciplinary, transdisciplinary, interdisciplinary collaborations, a system approach, close engagement with communities, knowledge transfer, gender equity, and sustainability.

The Global Research Council meeting in New Delhi in 2016 identified interdisciplinarity as a key feature in future research and advocated increased support from governments and funding bodies, noting that their role in shaping interdisciplinary research is paramount (Lyall et al. 2013). Universities emphasise multidisciplinary research, but in reality One Health projects still occur opportunistically through networking rather than from an organised structured framework. Designing a One Health intervention involves more actors than traditional siloed research – the communities of interest must be engaged from the beginning – including identifying the problem they want to solve. This adds to the complexity and cost.

This book is for governments, health, agricultural and environmental administrators, bureaucrats, philanthropic organisations, and funding bodies as well as the general reading public, particularly in low- and middle-income countries. Written for non-specialist readers, it explains what One Health is and how it works. Its practical approach shows the benefits when people with different skills and knowledge work with communities to resolve problems.

To date, One Health funded initiatives have emphasised the human–animal interface, prompted by the urgency of containing the spread of disease from animals to humans (zoonosis). This book is not just about zoonoses because much has already been written about emerging and re-emerging infections; there is general acceptance that most emerging infections are caused by anthropogenic influences on the ecology (Lindahl and Grace 2015). How to contain the spread of infections remains a vexed issue. The 2018 Bangkok Statement acknowledged that despite advances in knowledge and practice, epidemics and pandemics remain a threat (Prince Mahidol Award Conference 2018). Attendees at that conference also called for the removal of ‘the professional, bureaucratic and cultural barriers, as well as the obstacles inherent within social, economic and political processes, that silo human health, animal health and the environmental sectors from effective multi-sectoral partnership and actions’.

This book describes different pathways to a sustainable planet. Attention to natural systems and understanding how the parts of different systems interrelate is a core understanding for One Health research and a theme in all chapters. To understand one component of the system it is also necessary to understand how the other parts relate and interact. This interdependence is what specialisation neglects.

​Why the urgency

In mid-2017 scientists from around the globe signed for the second time a ‘Warning to humanity’. The first notice signed in 1992 by 1,500 scientists included most of the living Nobel laureates in the sciences. Back then they drew attention to the destruction caused by ozone depletion, human population growth, climate change, biodiversity destruction, forest loss, and ocean dead zones, concluding that ‘humans were on a collision course with the natural world’ (Ripple et al. 2017). In 2017, the stratospheric ozone layer had stabilised but stalled progress prompted the second notice. This call for action sets out the steps to the sustainability of humanity, other species, and environs.

Readers will appreciate that One Health is not new, first appearing in the 19th century when industrialisation and overcrowded cities were hosts to cholera epidemics. The origins of that disease were uncovered by environmental and health workers who discovered that water, sewage and drainage all played a role in spreading the disease. Since these public health advances, the 20th and 21st centuries have seen the development of specialisation and a move away from the polymaths. Specialisation happens in many domains including biology but in humans it refers to the process of accumulating expert knowledge or skill in a particular area. There have been unquestionable benefits from specialising (antimicrobial medicines, vaccines, surgical advances, technology) but there have also been unintended consequences. Becoming an expert in an area has often been at the cost of working with multiple disciplines – work that necessarily understands the relevance of context and the interrelatedness of different components in any system. While the authors in this book are specialists in their domains of study and work in different professions, countries and environments, they share a common humanity in their wish to improve the health of the planet and the health of humans, animals and the environment.

Acknowledgements

I thank the authors of the chapters for their enthusiasm for One Health and for coming together in such a collaborative way to share their experience knowledge and vision for the health of the planet and its inhabitants. Professor Tania Sorrell, the Director of the Marie Bashir Institute for Infectious Diseases and Biosecurity, was supportive of this project from the beginning. I thank her for that support and showing leadership in multidisciplinary research. Sydney University Press, in particular Agata Mrva-Montoya, is thanked for their patience and confidence that the book would eventuate.

Finally, I especially thank Robert Pullan (Australia) and Chas Alexander (United Kingdom), two professional writers who knew little about One Health; they provided editorial assistance particularly in relation to the use of clear English.

​Works cited