Global environmental changes are being caused by increasing population pressures and urbanization, changes in social structure and governance, and the economic activities needed to support a rapidly increasing global population. The result has been environmental degradation, ecosystem disturbances, and geophysical changes that threaten the gains made in population health. These interact with poverty, income inequalities, and other factors to increase the burden of a wide range of adverse health outcomes.
Plato: Allegory of the cavesTheory of ideas
One Health: learning from the past, defining the present, envisioning the future
One Health: learning from the past, defining the present envisioning the future• On whose shoulders do we stand?• Why are we here?
The past: linking health and development (1)• 1978 Primary health care (Alma Ata) – Mandate: Health Ministers met… – Paradigm: Health for all, bottom-up, participatory, holistic health care embedded in community development
Linking health to sustainable development: economic, social, environmental• 1992 Rio Conference on Sustainable Development Environment Principle 1: "Human beings are at the centre of concerns for sustainable development. They are entitled to HUMAN a healthy and productive life DEVELOPMENT in harmony with nature."Social -healthEconomi -educationc -gender
Linking health to sustainable development: economic, social, environmental• 1992 UN Framework Convention on Climate Change• 1993 World Development Report “Investing in Health”• 2000 Millenium Development Declaration• 2000 Poverty reduction strategies
Health is at the center of the world’s development agenda• MDG 1 Reduce poverty and hunger by 1/2• MDG 2 Achieve universal primary education• MDG 3 Promote gender equity• MDG 4 Reduce child mortality by 2/3• MDG 5 Reduce maternal mortality by 3/4• MDG 6 Reverse trend of HIV, malaria, tuberculosis• MDG 7 Improve ecological sustainability• MDG 8 Build global partnership Missing? Global environmental change/ climate change? Non-communicable diseases?
Development and MDGs Environment 7 HUMAN DEVELOPMENT Social -education 2Economi 8 -gender 3c 1 -health 4-6
Linking health to sustainable development: economic, social, environmental• 2001 Commission Macroeconomics and Health• 2001 Global Fund for AIDS, malaria, tuberculosis• 2001 Intergovernmental Panel Climate Change• 2005 Millenium Ecosystem Assessment• 2006 EcoHealth founded (IAEH)• 2003 Concept of “Global Health” (World Health Report)
Global health: problems and solutions are universal • Public health problems have similar causes and effects worldwide • Policy solutions have similar scientific principles, but are highly context-specific • Research methods to study problems and to evaluate solutions are universal9
Global Health a multisectoral and transdisciplinary concept• Global Health applies ‘where the determinants of health or health outcomes circumvent, undermine or are oblivious to the territorial boundaries of states…. ….. and this beyond the capacity of individual countries alone to address through domestic institutions.’ Lee K, Collin J eds. (2005) Global Change and Health• Global Health Diplomacy• Global Health Security• Global Health Policy• Global Health vs International health vs Public Health
Pathways from Global Change to Human Health Global change Demographic change Aging Environmental Economicfamily structures degradation, activities urbanization ecosystem Trade disturbances, wealth creation Social change geophysical and distribution Institutions changes governance Human health
Questions we might ask• Why did it start? • In the case of ONE HEALTH – External shock – Pandemics, EID, food security – Failure to address problems – Siloed institutions, EcoHealth?• Who was at the base? • I am not sure• What was missing? • Communication between “silos”• Which goal? • Self• Mandate? • No(t yet)• Institution, convention, • Concept + network concept or network• Problem-driven? • Yes – -> transdisciplinary? – -> transsectoral?• Sustainability? • Too early to tell
Peace Nobel prize winners 2008 Case study: IPCC Largest coordinated world-wide scientific review objective: informing governments 80 lead editors 800 lead authors 5000 reviewers (plus web review) 100 review editors
Human health impacts of climatechange are a major topic for the 5th IPCC report Data are scarce, hence the assessments have been vague until now
IPCC case study- any lessons?• Part of the UNFCCC, and • Lean bureaucracy, mainly inter-governmental driven by 1000s of scientists convention, signed by • Trans-disciplinary heads of state • Trans-sectoral• Follow-up by annual COPs • Evidence-based• Mandated network of • Policy oriented (mandate) scientists of all disciplines and sectors • Innovative process• Host institutions, only • Sustainable lean secretariat and 4 technical support unit
Future challenges• Political economy: poverty + inequity, capitalism loses support, financial crises, democratization – formal and informal (WWW, grassroots organizations), crisis of global governance• Global environmental threats: climate, soils, water, biodiversity loss• Urbanization and migration• Food safety and security• Pandemics, emerging infectious diseases, resistance• Ageing population in low-middle income countries (LMICs)• Non-communicable diseases in LMICs• Universal access to prevention and care
One Health: learning from the past, defining the present envisioning the future• On whose shoulders do we stand?• Why are we here?• What are: our mission, concept, members, stakeholders?• What “radically new” communication and work processes to achieve trans-dis and trans-sec can we develop?• What, if any, institutional framework do we need?
Leaving on a positive note…OK, That’s All, thank you