Publications One Health as a pillar for a transformative pandemic treaty

EXECUTIVE SUMMARY

Shortcomings in local, national, and global governance are recognized as key drivers of the emergence and re-emergence of diseases of animal origin, the devastating impacts of which have been highlighted by the COVID-19 pandemic. In this policy brief, we explain the pivotal role that an equity-oriented One Health (OH) approach can play in pandemic prevention and preparedness. We recommend that the OH approach be integrated into the prospective pandemic treaty, and we articulate how, by harnessing multisectoral coordination mechanisms (MCMs), a OH-informed pandemic treaty can complement and enhance connectivity among existing international agreements; advance pandemic prevention and preparedness, as well as human, animal, and environmental health more broadly; and generate significant cost-savings. The recently initiated collaboration for OH between the OIE-FAO-WHO tripartite and the UNEP is among several high-level endeavours with the potential to cement the OH approach within global health, sustainability agendas and policies. However, OH undertakings to date have, although widely endorsed, resulted in predominantly ‘soft’ forms of global health governance, such as the Manhattan and Berlin Principles, as well as, more recently, several G20 declarations. Although principles, declarations, and voluntary guidelines can contribute significantly to OH institutionalization and implementation, the COVID-19 pandemic and a multitude of interlinked global health and sustainability challenges, including not only the risk of emerging and re-emerging infectious diseases, but also climate change, antimicrobial resistance (AMR), and food insecurity, underscore the urgent need for proactive OH approaches to pandemic prevention and preparedness. These proactive OH approaches must address: 1) the inherent limitations of the International Health Regulations (IHR) and existing treaties of relevance for human, animal, and environmental health, 2) challenges associated with the regulation of animal health, including with respect to wildlife trafficking and live animal markets and 3) barriers to effective legislation regarding AMR, food safety,land use, and biodiversity loss and other policy issues that impinge on pandemic prevention andpreparedness.The prospective pandemic treaty is a powerful opportunity to 1) incentivize the establishment of OH infrastructure, including integrated OH surveillance systems that, in partnership with international organisations and countries, connect and share data on infectious pathogens in wildlife, companion animals, livestock, humans, and the environment (i.e. soil and water), as well as on risk factors for disease emergence; 2) build OH capacity and pandemic preparedness monitoring and assessment into the global governance architecture, which will depend on the adoption of an inter-/ transdisciplinary OH evaluation framework and methodology, including metrics for measuring OH success; and 3) help establish a permanent global One Health structure that, among other tasks, could oversee and provide technical and scientific support during treaty implementation, review and resolve evolving policy issues, and contribute to current and forthcoming pandemic protocol and guideline negotiations. In carrying out these activities, the structure would work in close collaboration with relevant initiatives such as the One Health High-Level Expert Panel (OHHLEP) and other relevant global entities. Clear financial and technical support mechanisms are necessary to ensure global solidarity and equitable allocation of resources. In this regard, we also call for OH to be fully embedded in the funding architecture for pandemic prevention, preparedness, and response.