One Health: Past Successes and Future Challenges in Three African Contexts
One Health: Past Successes and Future Challenges in Three African Contexts
复制标题
DOI：
10.1371/journal.pntd.0002884
复制
发表时间：
2014-05-01
影响因子：
3.8
通讯作者：
Welburn, Susan C.
中科院分区：
文献类型：
--
作者：
Okello, Anna L.;Bardosh, Kevin;Welburn, Susan C.
背景：最近出现的人畜共患疾病，如高致病性禽流感（HPAI）和严重急性呼吸系统综合症（SARS），促成了围绕卫生安全和大流行防范的全球卫生主导叙事，呼吁卫生、兽医和环境部门在不断发展的“同一个健康”运动中加强合作。十年后，“一个健康”的倡导者面临着越来越大的压力，要把这种方法从理论转化为行动。方法/主要调查结果：采用了定性案例研究方法来审查“一个健康”国际对话及其在非洲卫生政策范围内的实际执行之间正在出现的关系。与尼日利亚、坦桑尼亚和乌干达的政策制定者、政府官员和学者进行的一系列关键信息提供者访谈（n = 32）作为三个独立的案例研究提出。每个案例都考察了“同一个健康”运作的一个重要方面，围绕控制新出现的和被忽视的人畜共患疾病，包括高致病性禽流感、非洲人类锥虫病和狂犬病。这项研究发现，虽然人们普遍对在非洲采用“同一个健康”方法抱有热情，而且有强有力的肯定理由，但确定不局限于流行病的其他情况将有助于扩大其吸引力，特别是对于通常不在“全球”职责范围内处理的具有国家或区域意义的地方病和被忽视的疾病。结论/意义：没有“一刀切”的方法可以实现实现“同一个健康”方法所需的部门间协作、大量资源调动和政治合作。不能低估、忽视或以自上而下的方式规定个别国家的要求。这篇文章促成了越来越多的讨论，而不是关于是否应该实施“同一个健康”，而是如何实现这一目标。
Background: The recent emergence of zoonotic diseases such as Highly Pathogenic Avian Influenza (HPAI) and Severe Acute Respiratory Syndrome (SARS) have contributed to dominant Global Health narratives around health securitisation and pandemic preparedness, calling for greater co-operation between the health, veterinary and environmental sectors in the ever-evolving One Health movement. A decade later, One Health advocates face increasing pressure to translate the approach from theory into action.Methodology/Principal Findings: A qualitative case study methodology was used to examine the emerging relationships between international One Health dialogue and its practical implementation in the African health policy context. A series of Key Informant Interviews (n = 32) with policy makers, government officials and academics in Nigeria, Tanzania and Uganda are presented as three separate case studies. Each case examines a significant aspect of One Health operationalisation, framed around the control of both emerging and Neglected Zoonotic Diseases including HPAI, Human African Trypanosomiasis and rabies. The research found that while there is general enthusiasm and a strong affirmative argument for adoption of One Health approaches in Africa, identifying alternative contexts away from a narrow focus on pandemics will help broaden its appeal, particularly for national or regionally significant endemic and neglected diseases not usually addressed under a "global" remit.Conclusions/Significance: There is no 'one size fits all' approach to achieving the intersectoral collaboration, significant resource mobilisation and political co-operation required to realise a One Health approach. Individual country requirements cannot be underestimated, dismissed or prescribed in a top down manner. This article contributes to the growing discussion regarding not whether One Health should be operationalised, but how this may be achieved.