Healthy humans, animals, ecosystems - One Health in Eastern and Southern Africa

In a recent visit to South Sudan, we met with livestock herders as they were tending to their livestock in a cattle camp outside of Juba. One of the most memorable conversations was with a woman who reported how most of her cattle were sick, and how her family members had also gotten sick. How so? She shared harrowing insights on how transmissible diseases took the lives of their livestock, facing the community with the unwanted decision to take the animal carcasses as food, as they had no other source of nutrition, and then how they suffered diseases themselves as a result.

To them, the interconnection between these events is only natural, as they have a keen and entrenched understanding that the community’s health is tightly bound to that of their livestock. Animal diseases, they see, will inevitably affect their health, as animals are an integral part of households not only through food, but through workforce and livelihood . In this tight proximity, spillovers are only natural. Healthy animals thus lead to sound, prosperous communities.

To us, this conversation provided a deep testament of the importance of One Health, the concept that the health of humans is interconnected with that of animals, and the ecosystems that hosts us all. As conflict, migration, and climate change put pressure on our food systems, these dynamics change, increasing the frequency and severity of infectious disease events.

Fostering resilience through health hinges on our success in bridging across sectors to deploy multidisciplinary, integrative operations that address health issues that lie at the human-animal-environment interface. This can be done via tighter communication, shared knowledge, and all-encompassing monitoring and surveillance towards effective early warning systems, among other interventions.

This is particularly warranted in Africa, as the continent faces most drivers of emerging infectious diseases, such as conflict, migration, human encroachment into wildlife habitats, and poorly planned urban dwellings. The continent is a hotspot for zoonotic diseases and has experienced the impact of successive epidemics that are projected to have caused a loss of over 227 million years of healthy life and an annual productivity loss of over $800 billion in the past two decades.

A recent analytical piece in Botswana and Namibia conducted a deep-dive into human, animal, and environmental health systems in both countries. The analysis presents a promising cast of institutional actors which are likely to be effective agents of One Health in areas like epidemiology, pandemic prevention, and natural resources management. The two adjacent countries have much in common in terms of climate, topography, and economy; and the transboundary nature of infectious diseases means that effective risk management stands to win from joint approaches.

Diseases do not recognize borders, and in the still-wider context of globalization, the significance of this clearly transcends regions as well as individual countries. The possibility of a programmatic, bi-national approach to One Health therefore suggests itself as one with considerable practical merit.

In a time of post-pandemic recovery, compounded by a severe food security crisis, One Health becomes an imperative. Eastern and Southern Africa is seeing a renewed motivation to adopt a One Health approach, and is at a fairly nascent stage of adopting it into health systems.

Our World Bank team is excited to have received donor contributions to launch an Eastern and Southern Africa One Health Regional Initiative . This initiative will allow us to engage concerned countries in an advanced One Health Dialogue, and it will draw from the recommendations of the analysis in Botswana and Namibia to support zoonotic disease prevention and preparedness at the human-animal-environment interface.

An initial stakeholder and resource mapping will inform a phased approach that will start by establishing a One Health platform for cooperation and knowledge sharing, then build a cadre of professionals readily available to respond to health threats across participating countries. Throughout, the initiative will support the strengthening of cross-sectoral and institutional response capacity.

The time of fragmented operations in which animals and humans are siloed, and environment is a bystander, are over.