Public Health

The Abyss Stares Back: Silos in One Health and the Emergent Need to Breach them

Reflections on recent publications criticising the One Health approach for not having enough cross-sectorality.

The One Health approach, widely adopted and acknowledged as the way forward in dealing with issues which cut across sectoral compartments, has sometimes being criticized for inadvertently promoting the very approach of silo-ism in the name of specialization, that it was developed to breach. In a not-so-recent bibliometric analysis of published One Health literature, this very claim is put to test, using social network analysis to measure interdisciplinarity in One Health studies constructing dynamic pathogen transmission models.

The study finds that the dynamic disease modelling community not only grew in size but also in diversity, in keeping with the growing range of calls for One Health proposals. A walk trap algorithm was used to identify the communities within a large number of peer-reviewed publications (n=2258); three separate communities were identified. Two of them corresponded to very clear cut disciplinary silos: ecology and veterinary sciences – the disciplines which have contributed maximally to the development and understanding of the One Health approach. The third was a more heterogeneous group, which defied a clearer disciplinary epithet. Efforts to identify sub-communities in this group identified two clear sub-communities: epidemiology and mathematical biology. This third group, perhaps, comes closest to the definition of One Health research as we in public health have been using.

Venn diagrams of cross-community authorship through time. Each year’s Venn diagram is scaled to reflect the number of authors with two or more papers in our paper bank over the preceding 5 y. Number of authors with two papers in the same journal community are represented by disjointed regions of the circles, and number of authors with papers in two different communities are represented by the area of the intersections. Each circle is scaled to reflect the total number of authors with papers in that community during the 5 y prior to the label year. Areas are on a log-scale, and total number of authors with multiple papers each year is reported below each Venn diagram.

This paper, which was published in PLOS Biology, is heavy on the mathematics, but yet, is not completely unintelligible. Leaving aside the social network analysis bit – which is a topic I am not very conversant in – the rest of the results are quite plausible and intuitive. In fact, they reinforce some of the assertions and criticisms levelled against the One Health approach in a recent commentary published in the BMJ Global Health.

Some of the trends were positive, encouraging, and in line with the perceived growth of One Health as a recognized research appraoch. Also encouraging was the fact that more and more authors were contributing to journals in two or more communities (as identified above). This indicates not only an expanding One Health researcher base but also, the fact that they are doing more interdisciplinary work over time.

However, the authors identify limited evidence of information movement between the three research groups – the very problem which spawned the discipline of One Health. As I have long-suspected, the authors identify that there is limited engagement from the medical research community, creating hurdles in strengthened interactions across the human medicine interface of human-animal-environment interface issues.

The study further reinforces the assertion that we had placed in one of our earlier publications on the need to restructure One Health/EcoHealth education, perhaps by disrupting the medical curricula a little bit to introduce students to the concept earlier in their medical careers. In addition, moves to create platforms for allowing better interaction between scientists and clinicians from various interfacing disciplines is an aspect which has remained poorly acknowledged. There is very limited funding for this type of work, especially in a world where research funding is ever contracting. In addition, the trend of siloed existence of ecology and veterinary researchers within the One Health community does little to address the lack of involvement of the human health partners. It thus becomes a matter of vital importance to enable cross-disciplinary efforts, and although there is germinating traces of a “One Health” group, without continued funding support, and dedicated resources allocated to capacity building, it is likely to meet with limited success and stunted growth. However, one hs to guard against the temptation to be overly critical, for, it would be perhaps the most foolhardy to throw the baby out with the bathwater.

Skeptic Oslerphile. PhD Student in the Department of International Health at the Johns Hopkins Bloomberg School of Public Health. Past: 1) Public Health Scientist and Program Manager, Translational Global Health Policy Research Cell, Department of Health Research, Ministry of Health and Family Welfare, Government of India. 2) Scientist, Indian Council of Medical Research, National Institute of Cholera and Enteric Diseases; 3) Senior Research Associate, Public Health Foundation of India. Interests include: Emerging Infections, Public Health, Antimicrobial Resistance, One Health and Zoonoses, Diarrheal Diseases, Medical Education, Medical History, Open Access, Healthcare Social Media and Health2.0. Opinions are my own!

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