One Health Scorecard

Community of Practice

The One Health Scorecard was developed in a collaborative effort of WHO TDR, four African research groups and Global Health Group International with the aim to improve local health by a guided operationalization of transdisciplinary and adaptive management in the context of socio-ecological systems. It built on a TDR-IDRC Research Initiative on VBDs and Climate Change (2012-2017) with a milestone meeting held in Brazzaville in 2019. WHO TDR website

The purpose of this community of practice is to provide an interactive means of planning, learning, improving, networking, communication, information exchange, collaboration, and an objective evaluation of program maturity for anyone attempting to apply and implement One Health as described below.

Background

Although the concept of One Health was first articulated two decades ago, its operationalization has been challenging. Only recently has to been possible to begin translating its basic tenets as first proposed by the originators of One Health into an evidence-based research and methodological framework.

It should be noted that the group that first proposed One Health were focused on the growing problem, of emerging and resurging zoonotic diseases. Others now define One Health more broadly, however, the tenets and relevant theory, principles and concepts are still applicable. Especially broadly applicable, and critical to carrying out successful interventions, whether to mitigate the risk of disease emergence or any health challenges, is the area of methodological research today referred to as implementation, research or science. This has developed only relatively recently.

The same can be said for addressing the major tenants first proposed: application of transdisciplinary, ecosystem-based approach, focused on the human animal-environment-interface. While the latter is most clearly relevant in the context of zoonotic disease emergence, this “interface” insinuates ecology, the study of the interaction among and between species, particularly from a system perspective. Therefore, this perspective, and in fact what is broadly called the ecosystem approach, ecosystem management, and sometimes ecosystem-based management, is existential to understanding and implementing efforts that ensure the maintenance, and even restoration, of human environments – or more precisely healthy human-natural systems.

To be sustainable, such systems must not only be sustainable, but simultaneously support the health of humans, domesticated animal and crop species and varieties, along with natural communities your plants, animals, and microbes. Thus another critically important development in the past two decades has been the maturation of the field of research and intervention associated with the social-ecological systems framework. This framework embodies a set of theories, principles, concepts, and procedures combined (and actually overlap) those of implementation research. As with ecosystem management, from which the social-ecological systems framework primarily evolved, implementation research addresses real-life problems; i.e., challenges that exist outside the clinic or laboratory, in local communities, districts, and even healthcare institutions. Clinical, laboratory and even epidemiological research design is largely centered on controlling variables in order to isolate and potentially identify causal relationships and understand the underlying mechanisms involved.

In real life situations, sometimes also called in the “real world” very little is controllable. In fact, in the system being studied and/or subject to an intervention variables are not controllable.  Attempts to do so can even result in negative outcomes. Acknowledging this distinction between systems that are controllable and the systems we operate in real life, technically referred to as “complex adaptive systems“ is essential in understanding and designing one health problems and interventions. Well, it is not necessary for One Health researchers and professionals to understand CAS in detail, which is largely the domain of the theoretical physicist and theoretical systems ecologist, it is essential to understand that there is a fundamental distinction between the normal systems we are accustomed to doing our research in and on, and real-life systems. The social-ecological system framework is currently the most widely accepted body of theory, concepts, principles and practices discovered, and designed to assess and conduct interventions applying complex adaptive systems science.