History and
Mission of the
One Health
Initiative
Evolution
Application
Benefits
Not a new
concept….however….
A New Professional
Imperative!!
1986

20 mo. old male, severe,
chronic, watery diarrhea –

Lasted over 6 weeks

Contagious: Mom got it,
Dad got it, quite debilitating

Pediatrician unable to identify cause, treated
symptomatically

Baby: dehydrated, losing weight

Both parents were DVMs…. Took soiled diaper to
Vet School parasitologist
-
Protozoans: genus Cryptosporidium.
This hopefully would be quickly
identified today by pediatricians??

Can be deadly in AIDS patients

Major outbreaks often result from waterborne
transmission

Oocysts highly infectious and resistant to harsh
conditions / cleaners (chlorine)
Human-human, animal-human, fecal-oral, and
waterborne transmission
Cyclical life cycle!!!!!


Ecuador's Tungurahua volcano
Photograph by Guillermo Granja, Reuters
Amazon River



Traveled to Ecuador on assignment: Boated the
Amazon, climbed a volcano- Came home with many
Insect Bites
Two weeks later: swollen painful joints, fever, skin
lesions, discolored fingernails, shortness of breath
Radiographs = lung lesions, >10 CT scans =
granulamatous visceral lesions
Veterinary Medicine, Mind over Miller, July 2011
Two years and 76 specialists later:
tentative diagnoses of Hodgkin’s
Lymphoma, Non-Hodgkin’s
Lymphoma, scabies,
scleroderma,
gastrointestinal
Anonymous Image
stromal tumors (GIST)
 Scheduled for exploratory surgery for GIST, thought
most likely to be sarcoma
 Blood sample to
Dr. Ed Breitschwerdt
at the NCSU
Vet School…….found
Two years and 76 specialists later:
tentative diagnoses of Hodgkin’s
Lymphoma, Non-Hodgkin’s
Lymphoma, scabies,
scleroderma,
gastrointestinal
Anonymous Image
stromal tumors (GIST)
 Scheduled for exploratory surgery for GIST, thought
most likely to be sarcoma
 Blood sample to
Dr. Ed Breitschwerdt
at the NCSU
Vet School…….found
Bartonella vinsonii
 After surgery - the surgeon
reported to father - found no
evidence of malignancy.
 Father answered, “I never thought
she had a malignancy…(I believe)
she has Bartonellosis’.
Surgeon replied:
“I’m a surgeon…I don’t know
what bartonellosis is.”
This is why we need to include One Health Education in
Graduate Medical Education for all specialties.
Veterinary Medicine, Mind over Miller, July 2011
“The danger that the decline
of bees and other pollinators
represents to the world’s food
supply was highlighted …..
when the European
Commission decided to ban
a class of pesticides
suspected of playing a role in
so-called “colony collapse
disorder.”
http://www.telegraph.co.uk
Photo: PA , March 29, 2014
Monarch Migration
Plunges to Lowest
Level in Decades
The number of monarch butterflies that completed an
annual migration to their winter home in a Mexican forest
sank this year to its lowest level in at least two decades,
due mostly to extreme weather and changed farming
practices in North America, the Mexican government and a
conservation alliance reported on Wednesday.
By MICHAEL WINES NY Times: March 13, 2013
Human –
Animal
Interactions:
Not always
our smartest
behaviors!!!
http://nationallinkcoalition.org/
Puccini Foundation
A vaccine developed in dogs is helping
dogs with malignant melanoma and the
findings have been applied to
create a similar vaccine for humans!
glioblastoma multiforme, GMB
~ in humans and dogs
“Between animal and human medicine there
are no dividing lines –Nor should there be.”
Rudolf Virchow, MD, 1821-1902
(Father of Cellular Pathology)

1821-1902
Rudolf Virchow “Between animal and human
medicine there is no dividing line…..nor should
there be”; coined term ‘zoonosis’.

1848-1932
Bernard Bang, Dutch MD / DVM, isolated
Brucella abortus from cows, natural reservoirs,
Bang’s Dis. Is zoonotic.

1849-1919

may have
1850-1914
Sir William Osler, MD: Father of modern
medicine: studied under Rudolf Virchow:
1st coined term ‘One Medicine’?
Daniel Salmon, DVM, early USDA APHIS; hired
human physicians to work across disciplines

1854-1934
and
Thiebold Smith, MD in Bureau of Animal Industry
found that heat killed pathogens could
immunize…led to vaccines against typhus
to Jonas Salk producing the polio vaccine




1854-1941 John McFadyean, DVM, MD, challenged Robert
Koch assertion that bovine TB was of no concern to
humans
1884-1974 Karl Meyer, DVM, MD, UC Berkley, integrated fields
of veterinary and human medicine (typhoid,
malaria,
influenza, brucellosis, anthrax,
plague……etc)
1947
The Veterinary Public Health Division is established
at CDC led by James Steel
1984
2002

2004
Calvin Schwabe uses the term
"One Medicine" in his 1984 text
‘Veterinary Medicine and Human Health’
First annual One Medicine Symposium
is held in North Carolina (continues today)
Sept: The Wildlife Conservation Society
(WCS) publishes the 12 Manhattan Principles for
establishing a holistic approach to preventing
epidemic/epizootic disease and for maintaining
ecosystem integrity
2003 International Union for Conservation
Of Nature (IUCM). Launched the
AHEAD Forum
(Animal Health for
the Environment And
Development)
Osofsky, S.A., Cleaveland, S.,
Karesh, W.B., Kock, M.D., Nyhus, P.J.,
Starr, L., and A. Yang, (eds.). 2005.

2004 (Nov), 2005, 2007, 2009 Wildlife Conservation Society holds One
Health Symposia in Bangkok, China, Brazil and Brazil respectively

2007: The AMA and AVMA partner in a One Health Initiative Task Force
between human and veterinary medicine

2007 One Health Initiative website team (Kaplan, Kahn, Monath,
Woodall) began grassroots web communications platform

2008
JAVMA, Vol 233, No. 2, July 15, 2008

2008: FAO, OIE, WHO, UNICEF, UNSIC, World Bank develop joint
pandemic flu response plan
We need a way to
communicate / learn
ACROSS disciplines
2009
•
The One Health Office is established at CDC
•
USAID establishes the Emerging Pandemic Threats program
•
One World, One Health Expert Consultation in Winnipeg,
Manitoba
•
U.S. One Health Commission is chartered as a 501c3 non-profit
•
Ron Davis, MD and AMA One Health Champion, dies of pancreatic
cancer
•
IOM sponsors One Health Summit in Washington, D.C.
Why the environment and environmental change matter to One
Health, Meredith A. Barrett , Aaron H. Stoertz, Timothy A.
Bouley, One Health Initiative Website NEWS, September 23, 2010
2010
•
The Hanoi Declaration
•
The Tripartite Concept Note is published
•
FAO, WHO, OIE hosts “Stone Mountain Meeting,"
defines specific actions to move the concept of One
Health forward
•
The United Nations and the World Bank recommend
adoption of One Health approaches
•
The European Union reaffirms its commitment to
operate under a One Health umbrella
2011
•
The 1st International One Health Congress is held in
Melbourne, Australia
•
The 1st One Health Conference in
Africa is sponsored by OCHEA
Tripartite organized a High
Level Technical Meeting
in Mexico City
•
2012
• The Global Risk Forum sponsors the first One Health
Summit in Davos, Switzerland (also 2013, 2014)
• USDA One Health Office is established
2013 The 2nd International One Health Congress is held in
conjunction with the Prince Mahidol Award Conference,
Bangkok, Thailand
We came from
‘generalists healers’ >>
to be very specialized
with amazing
capabilities ………..
and in the process………
‘lost’ our ability to
see and function
in the bigger
picture.
News Bulletin:
It’s up to ‘us’ to create a true
paradigm shift.
There are ‘many’ clusters or ‘bubbles’ of One
Health activity around the U.S. and world trying
to do that.
NC State University – College of Veterinary Medicine
Heal the Past……
Live the Present….
Obesity: a
major
cause of
death
today
Hyperthyroid cats
Contribution to Childhood obesity? – postulated
Environ Health Perspect. 2012; 120(7):1049-54.
Obesity: a
major cause
of death today
Could there
be links in
our
environment
??????
www.thescientist.com
Bacillus thuringiensis
(or Bt) is a Grampositive, soil-dwelling,
bacterium commonly
used as a biological
pesticide
Developed from a naturally
occurring bacteria,
Streptomyces griseoviridis,
Mycostop Biological
Fungicide thrives in the
root zone of plants.
Prince Mahidol Award
Conference - Jan, 2013
Bangkok, Thailand
All health professionals
•
•
•
•
•
DVMs, MDs, Environmental Health workers
Food Producers/Retailers, Lab Animal
professionals
Agricultural Researchers, Wildlife Managers
Architects, City planners and Lawmakers
The Lay Public, housewives, husbands
We are All in This
Together----- making
One Health very much
a ‘Team’ sport.
Is up to us –
the One Health
Stakeholders……
Even when the
Odds are against
Us and the Path is
Steep
Is up to us –
the One Health Stakeholders
The Charter of the One Health
Commission is
- to ‘Educate’ and ‘Create’
networks to improve health
outcomes and well-being of
humans, animals and plants and
to promote environmental
resilience through a
collaborative, global One Health
approach.
- https://www.onehealthcommission.org/
Heal the Past……
Live the Present….
Barrett et al. , Front Ecol Environ 2010; doi:10.1890/090159
Be Prepared!!!
Be a First Line of Defense.
Know what emerging diseases might look like
in Your arena.
Seek collaborations with colleagues in other
disciplines=> Make them aware of
One Health

Increased Interdisciplinary Programs/Teams

Increased Information Sharing / Networking

Improved Disease Prevention/Interventions

Improved Approaches to Therapy

Improved Public Health

Improved Environmental and Plant Health

More focused research on One Health issues
How can we implement
The One Health Dream / Movement / Concept?

One Health Educational Programs that prepare
experts on issues that fall at the interface of our
health disciplines

Include more education on ‘One Health’ issues and on
the environmental impacts on animal and human health


Provide mechanisms for human, animal, plant, environmental
health disciplines to interact more directly

Go to / present at each other’s professional meetings

Create interdisciplinary (One Health) CE requirements

Publish in each other’s journals
Establish Health Care Teams - Ex: Orthopedist?
Arthritis? Test for Lyme, Brucella? Vector-Borne Dis
Bridge the Silos!
One Health thinking will lead us to the kinds of vision
and interactions the early One Health players had, with
the added benefits of all we have learned and are
learning
within our specialties,
The Charter of the One Health
Commission is
- to ‘Educate’ and ‘Create’
networks to improve health
outcomes and well-being of
humans, animals and plants and
to promote environmental
resilience through a
collaborative, global One Health
approach.
- https://www.onehealthcommission.org/