This document discusses the economic benefits of a One Health approach to managing infectious diseases. It argues that a One Health approach can add value in three key areas: where resources are scarce; where resources are underutilized; and by taking a holistic view of food systems. A One Health approach that considers the entire food system context could improve understanding of health problems and allow for more proportional and timely responses. However, the benefits of One Health may not always outweigh the costs of institutional changes needed. Understanding the full impacts of issues like environmental effects, animal diseases, foodborne illness and nutrition within food systems could provide the tipping point for more widespread adoption of One Health.

1. Economic Benefits of a One Health
Approach
Jonathan Rushton
jrushton@rvc.ac.uk
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2. Acknowledgements
• Liz Redmond, Barbara Häsler & Ruth Rushton – UK
• Katharina Stärk, Dirk Pfeiffer, Javier Guitian – RVC, UK
• Nicoline de Haan – FAO, Rome
• Wantanee Kalpravidh, David Castellan – FAO, Bangkok
• Mark Rweyemamu and the SACIDS team
• Jeff Waage and colleagues at the Leverhulme Centre for
Integrative Research on Agriculture and Health, UK
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3. Overview
• Economic logic of health interventions
• Three areas where One Health can add value in
infectious disease management
• Is this added value sufficient for a One Health business
case?
• Being more ambitious in order to improve resource
allocation and improve economic and social returns
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4. Economic logic for investment in One Health
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5. Impact of a health problem
Without the
health
problem Losses due
Output to the health
($,€, ¥, £, problem
DALYs) With
control
Losses with
control
With the health
problem
Time
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6. Necessary versus sufficient information
• The losses due to a health problem are necessary
• However, they are not sufficient to make a judgment on
whether to intervene
• Going a step further it does not tell us either how, when
or where to intervene
Prevention is better than cure?
Stop or control at the source?
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7. Economic logic for investment
• Economic logic:
Where Avoidable Losses
are greater than
Costs of a Change in Disease Status
the investment is worthwhile
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8. Where would this economic logic translate into success
for One Health?
• Specific diseases
• Where resources are scarce
• Where resources are underutilised
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9. Specific diseases
Strong argument for specific, specialised approaches
Animal Zoonotic & Food- Human
Diseases Borne Diseases Diseases
Arguments for systems approaches
and more generalisation
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10. Where resources are scarce
• Many people live in geographical isolation
• A large proportion of these people are reliant on livestock
• Making resources available for either human or animal
health is difficult due to the limited availability of trained
resources and/or the lack of demand for such services
• One Health approaches would make sense in terms of
matching overall demand for animal and human health
services and the potential to supply adequate services
• Strong arguments for generalised services
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11. Where resources are underutilised
• Many facilities are built that have low throughput
• Human resources are trained in data collection, storage
and analysis but:
• in too fewer numbers and/or
• with a low demand for skills in their specific health
field
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12. Where resources are underutilised
• Low throughput and low demand often leads to poor
calibration of standards and variable output of results
• Small numbers of trained people limit interchange and
advancement in knowledge
• There are strong arguments that certain aspects of
human and veterinary diagnostics, data collection and
analysis need to be combined to create synergies which
will improve resource use
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13. Are the costs of the One Health interventions greater
than the benefits (avoidable losses)?
• The One Health concept is not new, but only recently
has this approach begun to gain momentum
• Yet it is not accepted by all parts of the health
professions, it is not mainstream
• It may be that the benefits from One Health infectious
disease management are too small to justify the costs of
large scale changes in resource allocation and
accompanying institutional change
• What could be the tipping point?
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14. Habitat Wildlife
Destruction Disease
Human Human Healthcare
Deaths Disease Costs
Environmental
impacts
Infectious disease
through food-borne
transmission
Food
Systems Malnutrition through
poor distribution and
availability of macro
and micro nutrients
Infectious disease Undernourished Over nourished
in animals
Production Animal Human Human Healthcare
Losses Healthcare Costs Deaths Disease Costs

15. Environmental
impacts
Food
Livestock
Disease
System Nutritional
Impacts
Problems
Food
Borne
Disease

16. One Health and Food Systems
• Food systems are central to food security, GDP and
employment
• They are also central to
• food safety
• food quality – in all dimensions
• environmental sustainability
• Understanding the food system (the milieu or context),
its positive and negative impacts, would allow resource
allocation proportionate to the scale of the problems
generated
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17. One Health and Food Systems
• Given the centrality of food systems to so many positive
and negative aspects of human welfare, one would
expect a combined public and private institutional
response
• Yet few countries have food ministries, and no
countries are in a position to estimate the relative
impacts on their economies of: environmental effects;
animal disease; food borne disease; and nutritional
problems created by food systems
• We are NOT yet in a position to be proportionate in our
responses to food system problems or even know what
these problems are
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18. Adding value through One Health
• A One Health approach that is interdisciplinary and food
system (milieu or context) focussed will be able to:
• Improve understanding of infectious and nutritional
health problem emergence and re-emergence that
allow proportionate and timely responses
• Identify where we need generalised systems of
health delivery
• Create synergies through combined use of
infrastructure and skillsets
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19. Think Systemically
Research Thoroughly
Act Personally
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20. One Health oriented Food Systems
Helping PEOPLE, Protecting PEOPLE
Working with PEOPLE