Practical Operationalization_One Health_WVA_2017

PRACTICAL OPERATIONALIZATION
OF THE ONE HEALTH APPROACH
UNITIVE MODEL FOR ATTAINING OPTIMAL HEALTH
2nd Global Conference on One Health
From One Health Concept to One Health Approach
10-11 November 2016 | Japan

Basic One Health ProblemAnalysis
FOCAL
PROBLEM
EFFECTS
CAUSES
Zoonoses Px & Cx divided among disciplines/systems
(Health, Agriculture, Environment….)
Silos of disciplinary & system domains for managing
cross-cutting (wicked) problems
Poor response to emerging pandemic threats
Slow response to
EID outbreaks
Overlaps in
program activities
Unpreparedness for
emergence of
zoonoses
Discipline/System-specific
approaches (issue-specific)
Separate Agencies & Heads
Different interests/priorities- conflicting
Competition in sourcing for funds and engaging donors

One Health Approach Constraints: viewpoint
• Sectoral and disciplinary boundaries continue to
exist
• Cross-sectoral/disciplinary collaborations remain largely ad hoc,
short-lived and sometimes arbitrary, triggered only during disease
outbreaks.
• Silo-mentality and disciplinary marginalization prevail
• Our aim is to institutionalise and sustain
integrative cross-sectoral and transdisciplinary
collaborations (field/community-based)
• To enable continuing EID program formulation and implementation

One Health Plus | One Health and Resilience
• While the main thrusts of One Health may appear as
primarily health sector concerns, lessons learned argue for
the organization of more holistic ‘Beyond Health’
approaches to infectious disease prevention and control, and
impact mitigation.
• Practical operationalization of One Health means there
should exist Interconnected All-Level Transdisciplinary
Interventions directed at empirical and theoretical
infectious disease outbreak problems.
Resilience- The capacity of systems to overcome threats
e.g. Through safe farming, food and clean water sources

One Health Definition Re-examined
• Collaborative effort of multiple disciplines to
attain optimal health for people, animals, and our
environment (The American Veterinary Medical Association)
“Addressing health risks at the human-animal-ecosystem interface
requires strong partnerships among all stakeholders.”
- WHO, FAO, OIE

One Health within Transdisciplinarity
• Transdisciplinarity or transdisciplinary
collaborations enable effective solutions to
“wicked problems”- wicked problems require
creative solutions that move beyond discipline-
specific approaches to address a common
problem. Disease outbreaks and emerging
pandemic threats and impacts are among wicked
problems.
EPTs and impacts as wicked problems

IOM Global Forum on Innovations in Health
Professional Education Definitions (2013)
• Unidisciplinary = those from a single discipline work together to
address a common problem
• Multidisciplinary = those from different disciplines work
independently, each from a discipline-specific perspective, with a goal
of eventually combining efforts to address a common problem
• Interdisciplinary = an interactive process; work jointly, each from a
discipline-specific perspective, to address a common problem
• Transdisciplinary = an integrative process; synthesizes and extends
discipline-specific theories/concepts/methods to create new
models/language to address a common problem
• Adapted from Rosenfield, 1992

Education is Key:
Towards Transdisciplinary Collaborations
http://www.greenwichschools.org/page.cfm?p=6697

“Transdisciplinarity”
"Being a transdisciplinarian is like being an
essential ingredient in a gourmet dish- where
each ingredient focuses on the making of the
gourmet dish, and not just on being the most
essential ingredient-- to attain this state
requires a gourmet chef who understands well
his ingredients and sees the value in All."

Innovative OHR Higher Education Paradigm
Transdisciplinary/Trans-systems
Solutions to Wicked Problems
For Example
The University of the Philippines System is innovating
on curricula and teaching and learning methods- i.e.
field, community and response-based learning making
use of FGDs and TTXs

Pillars of a Transdisciplinary One Health
and Resilience Education
Emerging
Disease
Epidemiology
Management and
Policy
Disaster
Response &
Preparedness

One Health & Resilience Education Program
• Enable focused field-based collaborations among
multiple disciplines and systems
• To attain optimal health for people, animals, and our environment
• Impart transdisciplinary knowledge necessary for
managing wicked problems and complex systems
• Strategically change mindset of leaders, civil servants and all actors
(generation of Transdisciplinarians)
• Support leadership development
• Competencies in One Health and Resilience systems development,
implementation and management.
“Unitive Education”– Expertise that can unite efforts

How to get there (Optimal Health)?- Key Steps
• Substantiate disciplinary interconnectedness through
thorough documentation of the perspectives and actual
experiences of concerned disciplines in dealing with
disease causalities and cascading impacts, and the
drivers of risks and vulnerabilities
• Map multi-faceted and multi-disciplinary insights on the
identified problems
• Assign corresponding transdisciplinary collaborative
solutions or interventions
• Evidence gained will allow for clear identification of
disciplinary roles, and where and how these roles
intersect in effecting collaborative and interdependent
interventions

Transdisciplinary and Trans-systems Interdependencies:
Understanding how disciplinary domains or security
systems are able to support each other (Synergy Metrix)
• Each system and disciplinary domain maps out its key essential functions or roles, and the
enabling functions or elements- e.g. for biosecurity to effectively prevent infectious
disease emergence and outbreaks, this must be enabled by numerous elements including
providing families with means to acquire food and earn livelihood
Identify Transdisciplinary
Collaborative Solutions
vis. the problem domains
- For instance- How food
security-resilience relates
to biosecurity? How does
one impact on the other?
Step 3
Identify Disciplinary
Solutions vis. the
problem domains
Step 2
Identify the Problems
(Disease/disaster causes
and impacts/ risks and
vulnerabilities)
Step 1 • Actualize actions through
policies and institutional
changes, and strategic plans.
• Instill in everyone the ‘Crisis
Mentality’- people naturally
unite when faced with life and
death situations- the
continuing state of poverty is
a persisting and pestering
crisis.
System Drivers and Enablers:
• Integrative Management and Communication Platforms
• Integrative Education and R & D Platforms
*Formulate a Field Guide on Fostering Transdisciplinary Collaborations at Grassroots- e.g. with rabies and
Reston Ebola virus as focal diseases

Functional systems that have not been effectively
synergized, or have traditionally operated in silos:
• Biosecurity (including One Health)
• Health security (Referring to primary health care and
universal health coverage)
• Food security
• Energy security
• Environmental security (including conservation)
• Social security (all aspects of poverty reduction,
education, social services)
• Protection security (referring to peace and order)
• Disaster security

Transdisciplinary Interventions:
Problem Domains
• Health-Medical | Ecological-Industrial |
Socio-Cultural | Governance
• Within these domains are the fine elements of the
Art and Science of One Health:
• Integrative governance and management platforms
• Mindset-change education and training
• Discipline-specific technical competencies
• Integrative research and development

All-level Interconnected Disaster Interventions
Governance
Policies-Regulations
Multi-sector Management Platforms
Leadership & Response Teams
Technical Education/Training
Communication
Resources-Tools-Logistics
Preparedness
ImpactsCauses
Ecological-Industrial
Environmental Protection
Pollution Control
Agro-Industrial Practices Change
Climate Change Adaptation
Urban Planning
Land and Extraction Control
Socio-cultural
Behavior Change
Education
Livelihood
Food Source
Power Source
Protection from harm
Population Management
Poverty Alleviation
Health-Wellbeing
Early Detection-Surveillance
Biosecurity-Infection Control
Quarantine-Containment
Health Products
Vaccination-Treatment
Nutrition-Water
Emergency Management
HAZARDS
RISKS/
VULNERABILITIES
All Level = National - Subnational - Local/Community All-Hazards Approach

Transdisciplinary Disease Outbreak Interventions
Governance
Communication
Preparedness
ImpactsCauses
Pollution Control
Urban Planning
Socio-cultural
Behavior Change
Education
Livelihood
Food Source
Power Source
Poverty Alleviation
Health-Wellbeing
Health Products
Nutrition-Water
RISKS/
VULNERABILITIES
DISEASE
OUTBREAKS

Basic One Health Disciplinarity
1. Health and Biomedical Sciences (human and animal
health)
2. One Health Management-Governance
3. Risk Assessment-Communication-Management and
Research
4. Communication, Information and Logistics Systems
5. Multi-sectoral/ transdisciplinary Approaches
6. One Health Education and R&D
7. Field Social Sciences- e.g. economics, medical
anthropology, sociology
8. Environmental-Ecological, Agricultural, Industrial and
Engineering Sciences

ImpactsCauses
RISKS/
VULNERABILITIES
DISEASE
OUTBREAK
Recognizing the Wicked Problems

• Disasters
• Climate change
• Land use change
• Hunting
• Markets/trade
• Food and water insecurity
• Extraction
• Pollution
• Global travel
• Over population
• Population displacement
• Conflict (war)
• POVERTY
Disease risks lurk in our ecosystem

ImpactsCauses
Health-Wellbeing
Health Products
Nutrition-Water
RISKS/
VULNERABILITIES
Health Sector- All-level Interventions
Non-medical contributors
• Local leaders
• Police
• Food and water
suppliers
• Health product technologists
• Social scientists
• Community workers
• Educators
• Engineers
• Military
• Environmentalists
Scientific Expertise
• Physicians
• Veterinarians
• Nurses
• Medical Technologists
• Biotechnologists
• Pharmacists
• Public Health Workers
• Epidemiologists
• Biosecurity Experts
• Nutritionists
• Vaccinologists
• Sanitation
• Biologists
• Chemists
DISEASE
OUTBREAKS

ImpactsCauses
RISKS/
VULNERABILITIES
Environmental Sector- All-level Interventions
Contributors
• Medical
• Local leaders
• Police
• Educators
• Communication
• Industrialists
• Engineers
• Geologists
Pollution Control
Urban Planning
DISEASE
OUTBREAKS
• Climatologists
• Agriculturists
• Urban Planners
• Toxicologists
• Foresters

ImpactsCauses
RISKS/
VULNERABILITIES
Governance- All-level Interventions
Contributors
• Medical
• Social workers
• Engineers
• Industrialists
Expertise
• National-Local leaders
• Legislators
• Educators
• Communication
• Logisticians
• Strategic planners
• Various technical experts
• Military
• Police
• Community organizers
DISEASE
OUTBREAKS
Governance
Multi-sector Management
Platforms
Communication
Preparedness

ImpactsCauses
RISKS/
VULNERABILITIES
Socio-Cultural Sector- All-level Interventions
Contributors
• Medical
• Local leaders
• Police
• Private groups
• Agriculturists
• Religious groups
• Social/community workers
• Anthropologists
• Human ecologists
• Economists
• Educators
DISEASE
OUTBREAKS
• Communication
• Urban Planners
• Business managers
• Housing experts
• Gender experts
Socio-cultural
Behavior Change
Education
Livelihood
Food Source
Power Source
Poverty Alleviation

Key Concepts – Fostering and Managing Focused
Transdisciplinary Collaborations
One Health and Resilience System Management
• Good OHR Governance Structures and Platforms
• Good OHR Leaders
• Good OHR Field Workforce
• Good Understanding of Principles and Practices for
Effective Execution of Collaborative OHR Field and
Community-based Actions/Responses

All sectors
across
security systems
need to
collaborate
Integration of Whole-of-Society Approaches
Multi-sectors to Multi-systems

One Health-Resilience Transdisciplinarity
Governance
Communication
Preparedness
ImpactsCauses
Pollution Control
Urban Planning
Socio-cultural
Behavior Change
Education
Livelihood
Food Source
Power Source
Poverty Alleviation
Health-Wellbeing
Health Products
Nutrition-Water
HAZARDS
RISKS/
VULNERABILITIES

One Health and Resilience
• One Health must be operationalized within the
broader One Resilience Approach, where the
ultimate goal is the ‘unity of humanity in mind and
action’– Comprehensive Security
• Stakeholders should be able to naturally
overcome traditional barriers impeding valuable
transdisciplinary collaborations toward wicked
problems-- hazards, disasters and social
disruptions

Framework for Integrated Security Systems
The integration of all disciplinary domains and security
systems capacities along areas of sectoral
interdependencies and synergies for the unitive attainment of
health, food/water, energy, social, environmental and disaster
resilience.
• By this approach, multi-systems and stakeholders impacted
by a human health problem (e.g. Ebola virus infection
outbreaks) are expected to work better together to address
the common "wicked" problem.
• Under this unitive model for attaining optimal health for
humanity and the ecosystem, the word ONE must
operationally translate to true transdisciplinarity.

Our Calling as OHR Transdisciplinarians
“Let us encourage variable One Health
disciplinary centrality* in relation to
multifaceted “wicked problems”. Let us
encourage the transdisciplinary aspiration for
All to commonly understand, perceive,
appreciate and weigh problems, and provide
solutions to our common problems in a
unitive manner.”
• Inter-operability of Individuals, Agencies, Sectors
and Systems

An advocacy for us to
“Think and Work as ONE”
All should ask:
• What concern of mine is also your
concern?
• What concern of yours is also my
concern?
Disciplines and Sectors should
naturally support and depend on
each other
Unity of Humanity in Mind and Action
One Health and Resilience
http://www.rugbyabp.com
http://livingwatersphilippines.org

What compels us to think and work as One?
• Appreciate the failed state
• No First and No Last
• Change how we think and do
• Crisis mentality for humanity
• Interconnectedness and Interdependence
• Desire the Oneness

By Heart and Mind We Shall Rightly Live
Oh, is it not that our reflections should be pure and true?
And should not our good intentions be what we do?
That all our cares we can easily let go?
Is it not by Heart and Mind that we shall rightly live?
If so, let us then think with our heart and feel with our mind.
Oh, should we not always want to pour out all of our good selves?
Are we not to love others, friends or foes?
That true forgiveness we must possess?
We must then think with our heart and feel with our mind.
We must never think of ourselves.
But to think of others so that from our hearts streams will flow.
That to love others we may live ever rightly so.
Let us not compete or live with pride.
Let us just let out the sweetness from our Hearts and Minds.

“Think and Work as ONE”
For further discussion please contact the proponents:
Noel Miranda- nljmdc@gmail.com
Peter Cowen- peter_cowen@ncsu.edu

Practical Operationalization_One Health_WVA_2017

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