One Health in the Lab: Healthy Planet, Healthy People

Changes to the Earth’s climate and environment are vast and widespread, affecting everything from the planet’s surface temperatures to the pH of the ocean’s waters. But what does that have to do with the clinical lab? As weather patterns shift, animal health and habitats change, environmental pollution increases, and pathogens evolve, humans around the world are encountering new threats to their health. Warmer temperatures and habitat shifts are bringing zoonotic pathogens to new regions; meanwhile, pollution and poor antibiotic stewardship are exacerbating the critical global problem of antimicrobial resistance. Coupled with contaminated food and water sources, diseases affecting livestock and working animals, and the loss of biodiversity that may harbor new materials for use in disease diagnosis and treatment, it’s clear that our health and the health of the planet are inextricably linked.

This “One Health” concept is driving cross-disciplinary efforts to address health challenges in humans, animals, plants, and ecosystems as a whole. To learn more about the lab’s part in this work, we spoke to Oladele Ogunseitan, presidential chair and distinguished professor of Population Health and Disease Prevention at the University of California, Irvine’s Joe C. Wen School of Population and Public Health.

What is One Health—and how do clinical laboratory professionals play a role?

The One Health High-Level Expert Panel established by four United Nations agencies (the World Health Organization, the Food and Agriculture Organization, the UN Environment Programme, and the World Organisation for Animal Health) defines One Health as “an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems.” The concept recognizes that the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) is closely linked and interdependent.

The One Health framework mobilizes multiple sectors, disciplines, and communities at varying levels of society to work together to foster well-being and tackle threats to health and ecosystems. At the same time, these collaborators work to address the collective need for clean water, energy, and air; safe and nutritious food; action on climate change; and sustainable development. Integrative and collaborative field epidemiology, laboratory diagnosis, vaccine development, and patient care have been the hallmarks of the One Health approach—and these priorities need intensive capacity development in clinical practices and infrastructure to ensure that there are no weak links in our global early warning systems for pandemic prevention and response.

What areas of One Health are currently attracting attention?

One of the most urgent areas of work in One Health is the development of a robust response to antimicrobial resistance. We have come to rely on antibiotics to curb infectious diseases in humans and in animals, but a lot of our waste contaminates environments with antibiotic residues and provokes the development of resistance among bacterial populations. This problem demands a quintessential One Health approach.

At the same time that we are dealing with the silent scourge of antibiotic resistance, we must also be prepared for the “next” pandemic. Bird flu cases in humans are rising—and that is a major threat to global health that requires a One Health approach and major investments in clinical laboratory infrastructure across all countries.

How can labs contribute to pandemic preparedness efforts?

The COVID-19 pandemic made the general public keenly aware of the importance of clinical laboratory diagnostic tests for both prevention and treatment purposes. Many people now know the difference between antibody tests and genetic material tests. I think it is important to build on that salience and continue to educate the public about the timeliness of getting tested and other preventive approaches for pandemic prevention and preparedness.

Climate change is shifting the nature of health and disease around the world. What are some emerging concerns?

A One Health approach is crucial for dealing with climate change and health. COP-28 marked the first time health was at the center of the climate agenda; however, we must not forget that there are still existing and emerging threats to global health. Importantly, the mental health issues that accompany pandemics and climate change are a major development. I do not think that clinical laboratories have done enough to protect the general population in terms of preventive diagnosis and patient care. I think the general public’s awareness of psychological therapy as a response to mental health conditions is greater than their awareness that biochemical and physiological parameters underlie many neurological conditions—or that these conditions can benefit from strong clinical diagnostics and interventions.

What have been some of the most positive recent developments regarding global health?

Increasing acceptance of vaccination and “home-based diagnostic” tests for screening have been spectacularly successful—yet there are still challenges in terms of vaccine hesitancy and the public’s uncertainty regarding the timing of screening and testing. Public health education needs to catch up with progress in clinical diagnosis, screening, and monitoring.

If you could fund or pursue one global health initiative that isn’t currently underway, what would you choose?

Integrative surveillance across animal, human, and environmental sectors with a shared platform. During COVID-19, we established that it is possible to monitor viruses in waste water, in animals, and in clinics for humans. This is the best early warning system for cities and communities. We need to advance this to the form of routine clinical practices across all domains of One Health.