GRF One Health Summit 2012, Davos: Presentation by Prof. Rainer Sauerborn - Chair and Director - Institute of Public Health - Heidelberg University Medical School

1. One Health:
learning from the past,
defining the present
envisioning the future
• On whose shoulders do we stand?
• Why are we here?

2. 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

3. 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
-health
Economi
-education
c
-gender

4. 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

5. 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?

6. Development and MDGs
Environment 7
HUMAN
DEVELOPMENT
Social
-education 2
Economi
8 -gender 3
c 1 -health 4-6

7. 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)

8. Daszak, Science ,2000

9. 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 universal
9

10. 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

11. Pathways from Global Change
to Human Health
Global change
Demographic
change
Aging Environmental Economic
family structures degradation, activities
urbanization ecosystem Trade
disturbances, wealth creation
Social change geophysical and distribution
Institutions changes
governance
Human health

12. 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

13. 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

14. Human health impacts of climate
change are a major topic for the 5th
IPCC report
Data are scarce,
hence the assessments have been vague until
now

16. 12/2014
2010
Innovative
process 6/2014
2011

17. 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

18. 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

19. 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?

20. Leaving on a positive note…
OK, That’s All, thank you

21. BMJ 2003; 327: 1460-61
Control