Industrialisation, urbanisation, and globalisation have substantially improved human life expectancy over the past century. In tandem, an expanding array of interlinked threats to humans, other animals, plants, and a myriad of other biotic and abiotic elements in our shared ecosystems has been generated. These threats include emerging and re-emerging infectious diseases, antimicrobial resistance (AMR), non-communicable diseases (NCDs), jeopardised food safety and security, freshwater scarcity, climate change, pollution, and biodiversity loss. These pressing health and sustainability challenges exceed the scope of any single discipline, government ministry, or societal sector, underscoring the need for interdisciplinary, transdisciplinary, and multisectoral collaboration, as well as for a socioecologically oriented systems perspective that appreciates the fundamental interconnections between humans, other animals, and the wider ecosystem.
When this Commission first convened in 2019, One Health was a highly visible, but also greatly evolving, concept and approach. Predominantly driven by the veterinary sector, the primary focus of One Health in early years had been on zoonotic diseases, but more recent years have seen an increasingly interdisciplinary and transdisciplinary expansion and diversification of the concept, a proliferation of initiatives, and growing concerns about fragmentation and insufficient conceptual clarity. There was a need to advance not only conceptual expansion, but also consensus, as well as aligned, interdisciplinary, transdisciplinary, and multisectoral efforts towards One Health operationalisation, implementation, and institutionalisation. We set out to address these needs and leverage One Health as a crucial and viable approach to achieving equitable, sustainable, and healthy socioecological systems—the vision of the Lancet One Health Commission. The zoonotic underpinnings of the COVID-19 pandemic and its wide-ranging effects across sectors necessitated a radical rethink of the role of One Health in pursuing sustainable development and substantially shaped the importance and trajectories of the Commission's work.
The Commission's methodology entailed convening a diverse, transnational, and interdisciplinary group of experts, who conducted an informed synthesis and appraisal of the current state of knowledge and evidence regarding the need for and value of One Health, which resulted in the proposal of key avenues for One Health operationalisation, implementation, and institutionalisation. We build on new and evolving One Health advances, including the One Health Joint Plan of Action, launched by the One Health Quadripartite, and the definition of One Health, One Health principles, and theory of change put forth by the One Health High-Level Expert Panel (OHHLEP).
This Commission is guided by a One Health ethos comprising principles of holism and systems thinking, epistemological pluralism, equity and egalitarianism, and stewardship and sustainability. The Commission also engages a socioecological systems perspective that sheds light on the crucial importance of the environment, including plants, soil, water, air, wildlife, biodiversity, and climate. In our approach, we have deliberately avoided boundaries between humans, other animals, and the environment. As reflected in the key messages, the evidence synthesis and appraisal was structured via sections dedicated to surveillance, infectious diseases, AMR, NCDs, health systems, and food systems.
The Lancet One Health Commission provides a cutting-edge appraisal of where One Health has come from, where it is now, and what a viable future should be. One Health was not mentioned in the 2030 Sustainable Development Agenda; however, the impact of the COVID-19 pandemic brought into acute focus the fundamental interconnections between humans, other animals, plants, and a myriad of other biotic and abiotic elements in the ecosystem, and, consequently, how healthy sustainable socioecological systems could be achieved via a One Health approach. The consensus around One Health that has been built by the One Health Quadripartite and OHHLEP, which has been reinforced by this Commission, is essential for addressing the threats to health posed by infectious diseases, AMR, NCDs, and planetary crises; harnessing data and artificial intelligence for disease surveillance and health-care delivery; forging equitable partnerships and inclusive collaborations; and generating necessary insight into socioecological interconnection. As such, One Health is a crucial catalyst in the pursuit of an equitable, sustainable, and healthy future, and must be central to the post-2030 global health and sustainability agenda.
}, year = {2025}, journal = {The Lancet}, publisher = {Elsevier BV}, issn = {0140-6736}, url = {https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)00627-0/fulltext?dgcid=raven_jbs_aip_email}, doi = {10.1016/s0140-6736(25)00627-0}, language = {eng}, }