What’s all the fuss about One Health?

It won’t necessarily come naturally to think that a quantum chemist writes a piece on comparative medicine for BVA, yet here we are. When I was invited to write this blog by BVA President Justine Shotton, following the Royal Society of Medicine’s (RSM) One Health: The Missing Link conference, it became clear the trans- and inter-disciplinary nature of my own work could serve as an appropriate introduction to a piece on One Health.

The One Health Commission defines the term as a “collaborative multisectoral, and trans-disciplinary approach - working at local, national, and global levels – to achieve optimal health and well-being outcomes recognizing the interconnections between people, animals, plants, and their shared environment.” However, what does this actually mean in practice for day-to-day activities and especially for clinicians?

My introduction to One Health

I was introduced to the concept of One Health four years ago, when building up my own research group in Leicester. Originally from a farming background, I kept Hebridean and Soay sheep, Dexter cattle and many native breeds of poultry as a youngster, experience which fuelled my interest in animal sciences, medicine and genetics. However, it appeared I had a predisposition for the physical sciences and I went on to do an undergraduate Masters in Chemistry and PhD in Computational Biochemistry at the University of Bath.

It was my PhD work which first made me consider trans-disciplinary approaches to problem-solving; many months were spent converting code from ancient programming language FORTRAN to less ancient FORTRAN in order to think about how many electrons were in an enzyme, and what they did therein. When I moved to an academic position in Leicester, I realised some of the basic code and algorithms I had worked on in Bath could be adapted to help analyse metabolic health data. I was reminded of a story from a close collaborator on portability of problem-solving: he had designed an algorithm to control the valves of industrial engines and had miraculously realised that in fact a small tweak converted this into a classification module for oncology patients, which has been widely used for decades.

All these factors made me think: surely there are ways to take our understanding of the engineering of individual classes of life forms to support our work across species and general boundaries? So, I began working on cross-species metabolic disease, getting my first large research grant from Cancer Research UK (CRUK) and two of the UK Research Councils. The project involved a totally multidisciplinary team of around 30 people, brought together through a CRUK sandpit event, split into teams to quickly create viable projects to address early detection of cancer through liquid biopsies. Our team consisted of an electrical engineer, a consultant oncologist, cancer biologist, geneticist and quantum chemist. Not necessarily the group one would form to find early signs of breast cancer from readily accessible biofluids, yet there we were.

A need for less linear approaches to medicine

You might wonder why I’m reciting this narrative in a BVA Blog on One Health. Good question. Each of these points relating to multi-, trans- and inter-disciplinarity embody the very nature of One Health. Every day, we are learning more about the inner workings of living things across humans, animals and plants, and there are hugely important links that we can make between each of these. Indeed, Queenan et al. argue we are still entrenched in very linear approaches to medicine: human, animal and environmental, with the concept of environmental medicine still a slight question mark. Who are the “environmental clinicians” of the world who can link with human and animal medics?

But whether purposefully or inadvertently, some great strides are being made in comparative and cross-species medicine. Particularly following the pandemic, as a society we are so much more appreciative of the close link between animal and human disease. Almost three quarters of emerging human infectious diseases in the last 30 years have originated in animals - all the more reason to explore these links. There are also links for non-communicable diseases: a personal interest of mine being renal diseases where we use felines as models for humans.

But how do we do this? The RSM’s One Health: The Missing Link conference in late 2021 regrouped some key players in the area, including BVA’s President, members of the UK One Health Coordination Group, and the RSM’s own Comparative Medicine Council. The event highlighted the need for policy direction at the highest level to promote activity in the One Health space. This has already begun to some extent within UK funding bodies, with initiatives such as the Zoonoses and Emerging Livestock Systems – Associated Studentships (ZELS-AS) training programme and wider funding such as Global Challenges Research Fund (GCRF) projects to address health disparities across LMICs. However, defined objectives and initiatives to target key problems in the One Health space remain conspicuously absent.

What next?

We are at a key turning point in the One Health space. Public appreciation of comparative medicine is at a high following the events of the pandemic, and under the auspices of international initiatives such as the United Nations sustainable development goals, we have an opportunity to design new and emerging ways to tackle health challenges through comparative and translational approaches. Let’s make it work.

About the author: Professor Philippe Wilson covers roles across the One Health space: he holds the Chair in One Health at Nottingham Trent University’s School of Animal, Rural and Environmental Sciences and Medical Technologies Innovation Facility, is Chief Scientific Officer for one of the largest Primary Care Networks in the NHS and serves on the Department for Food, Environment and Rural Affairs’ Farm Animal Genetics Committee. He is Co-Director of the NTU-NHS Doctoral Training Academy in Healthcare and Clinical Practice, and a member of the Food Standards Agency and Public Health England Committee on the Toxicity of Chemicals in Food, Consumer Products, and the Environment. He was named by Forbes Magazine in 2017 as one of their 30 under 30 in Science and Healthcare, awarded the Joseph Black Medal by the Royal Society of Chemistry in 2019 and named as one of the top 100 analytical scientist in the world by The Analytical Scientist Magazine in their 2021 “Power List”.