Author : Vikrom Mathur

Expert Speak Health Express
Published on Apr 05, 2024

Constitutional provisions for the right to health cannot be realised without integrating frameworks for the health of people and the planet.

Adopting the One Health approach

This essay is part of the series titled: World Health Day 2024: My Health, My Right


The Indian Constitution does not formally recognise the right to health as a fundamental right. However, the Directive Principles of State Policy outline the State’s duties, along with local bodies like panchayats and municipalities, to ensure that citizens have access to quality healthcare. In the absence of any explicit constitutional mandate on the right to health, the Supreme Court of India has interpreted the right to life, as stated in Article 21 of the Constitution, to include the right to health, aiming to uphold human dignity. Most recently, the National Health Policy of 2017 emphasises the State’s commitment to providing accessible, affordable, and equitable healthcare services to all citizens.

It is becoming increasingly evident that human health and planetary health are deeply interlinked, and India must integrate them while guaranteeing the right to health for all its citizens.

Debates around the right to health have become prominent after the devastating global impact of the COVID-19 pandemic along with new and emerging health threats induced by climate change. Experts have predicted that climate change, along with changes in land use, will make it more likely for infectious viruses to pass from wild animals to humans. Over 70 percent of infectious disease outbreaks in the future are predicted to be caused by zoonotic spillover. Therefore, it is becoming increasingly evident that human health and planetary health are deeply interlinked, and India must integrate them while guaranteeing the right to health for all its citizens.

This year’s World Health Day theme, ‘My Health, My Right,’ presents a timely opportunity to spark these conversations connected to the right to health, while reiterating the link between the health of humans, animals and natural ecosystems. This commentary reviews the ‘One Health’ approach, which provides a strong framework for integrating human health and planetary health. 

Human health and planetary health interlinked

Climate change has proven to be a serious threat to human health. Changes in weather patterns coupled with unmitigated infrastructure development are degrading natural ecosystems by polluting air and water and reducing access to nutritious food and shelter—all of which impact human health. While we reimagine India’s healthcare systems to improve human health, it is perhaps the right moment to argue that human health and planetary health are strongly interconnected.

Prioritising public health in adaptation policies and supporting them through necessary investments is a potential way forward in dealing with this polycrisis.

The well-being of our planet directly impacts the well-being of its inhabitants, including humans. By preserving and restoring ecosystems, reducing pollution and promoting sustainable practices, we not only protect the environment but also enhance the overall health and quality of life for present and future generations. In this regard, it is important to reframe climate change as a public health issue and build the necessary systems to address this complex challenge. Prioritising public health in adaptation policies and supporting them through necessary investments is a potential way forward in dealing with this polycrisis.

One Health approach 

Some frameworks already exist that can integrate human health and planetary health. “One Health is one such interdisciplinary approach that recognises the interconnection between the health of humans, animals, and the environment. It emphasises collaboration among various fields such as medicine, veterinary medicine, ecology and public health to address shared health issues. By working together, these disciplines can develop comprehensive strategies to tackle global challenges like infectious diseases, emerging zoonoses that have epidemic or pandemic potential, environmental challenges, and ultimately promoting overall well-being.

In India, efforts under the National “One Health” Mission are also underway. While the focus of the mission extends beyond addressing diseases from a human health point of view and includes animal health, it falls short of addressing ecosystem health. The emphasis has been strongly on preventing future epidemics and pandemics, but this has to move beyond and include wider aspects of planetary health. The “One Health” mission can be extended to national policies addressing public health to address the challenge holistically.

While the focus of the mission extends beyond addressing diseases from a human health point of view and includes animal health, it falls short of addressing ecosystem health.

One Health approach can be streamlined into the Indian healthcare system through several key strategies at various levels. A few of these strategies are discussed below:

Policy integration and legislation: India’s approach towards emerging infectious diseases has been reactive at best, with strong mechanisms designed for disaster response. Previously, during H5N1 influenza, India had briefly adopted the One Health approach and institutionalised collaborative frameworks as a response to arrest the public health crisis. Unfortunately, this did not lead to a long-term policy framework. There is a need for the National Health Policy to adopt an interdisciplinary approach and integrate policies that recognise the interconnectedness of human, animal and environmental health. This involves revising existing public health legislation to incorporate One Health principles and ensuring that new health policies consider impacts across these domains.

Institutional collaboration: One Health approach calls for a unified strategy with various government departments and agencies coming together for a collective and proactive response. This involves strong multi-sectoral linkages with national, state and local-level agencies responsible for human health, animal welfare, wildlife protection and environmental conservation. This collaboration must be institutionalised through the establishment of an Inter-Ministerial Task Force and a Joint Monitoring Group at the national level. Similar coordinating bodies can be constituted down to the local level.

International cooperation: One Health approach can emerge as a strong tool for international cooperation in the coming decades, as countries across the world are working towards its implementation in their respective national policies. It can provide a strong framework to address cross-boundary health threats and share best practices. Here, India can play a leading role in the regional One Health initiatives. However, these efforts must be supported by creating funding mechanisms both within the country and at a global scale. Relocating existing resources and seeking new funding sources, including tapping into development cooperation funds may be essential here.

One Health approach can emerge as a strong tool for international cooperation in the coming decades, as countries across the world are working towards its implementation in their respective national policies.

Research and training: Efforts towards the adoption of One Health must also include interdisciplinary research that addresses health issues at the human-animal-environment interface. This can be achieved by introducing these concepts in the curricula of medical, veterinary, and environmental science education and creating a strong talent pool of professionals across these fields. Efforts must also include supporting studies on zoonotic diseases, antimicrobial resistance, food safety, and environmental health risks, as well as the development of innovative solutions to these challenges.

Conclusion

To address the complex public health challenge in the country, it is perhaps time to strengthen the right to health for all citizens. While doing so, there is a need to reimagine the public health systems that adopt the One Health framework. This reimagination requires efforts from multiple sectors which may be challenging at times. Implementing these strategies requires strong leadership, mutual trust, and cooperation between various stakeholders.


Vikrom Mathur is Senior Fellow at the Observer Research Foundation

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