The increased mobility of people, domestic animals, and insect vectors, together with major strains on ecosystems around the world, has encouraged the World Economic Forum to rank the spread of infectious diseases second only to water crises as a serious global threat.1 Current global health frameworks are poorly equipped to deal with the threat of emerging infectious diseases because narrowly focused vertical programmes do not address the overlap between human and animal health, nor incorporate the necessary social, economic, and ecosystem expertise. The adoption of more integrated approaches to human health is central in planetary health,2 and underlies the UN's Sustainable Development Goals. However, achieving policy implementation at the country level remains difficult, and as a result, implementation is scarce.
The 2014 Ebola virus outbreak in west Africa revived the Global Health Security agenda. It also emphasised the need to better understand the mechanisms and circumstances that lead to the spread of pathogens between animals and human beings. Two major reports3,4 of the outbreak commented on the low public health capacity, poor linkage between human and animal health surveillance systems, and dismal implementation of the International Health Regulations (IHRs) approved by the World Health Assembly in 2005, particularly in countries in which the risk of disease emergence is greatest. In response, the USA committed US$1 billion towards core capacity building in at least 30 developing countries, and the UK created a £1 billion fund in partnership with the Bill & Melinda Gates Foundation to tackle infectious diseases. Australia did not make any financial commitments in response, but has a unique opportunity to display leadership in the Asia-Pacific region, which contains multiple areas that have not met core IHR capacity requirements and are potential hotspots for disease emergence.
The Marie Bashir Institute for Infectious Diseases and Biosecurity at the University of Sydney organised a meeting to examine how inclusive One Health, EcoHealth, and Planetary Health approaches to emerging infections could be promoted in Australia. Key barriers and proposed solutions were identified at the meeting by experts from a wide range of disciplines (appendix). The difficulty of framing a simple value argument was perceived as a major barrier. Outbreaks and epidemics, or even the perceived threat of epidemics, lead to a flurry of activity, but lessons learned and interim policies developed during these crises are rarely consolidated during interepidemic periods. Australia has no formal framework within academic or government institutions to facilitate and support the cross-disciplinary collaboration required for optimal surveillance and response planning. The Australian National Antimicrobial Resistance Strategy 2015–19,5 jointly developed by the Department of Health, and the Department of Agriculture and Water Resources of the Australian Government, represents a more integrated approach, but it has not been extended to other emerging infections. Finding sustainable solutions to the health challenges posed by the 21st century will require more fluid academic and government structures to enhance collaboration across traditional boundaries, as well as strong unity of purpose between the One Health, EcoHealth, and Planetary Health communities.
Moon, S, Sridhar, D, Pate, MA et al. Will Ebola change the game? Ten essential reforms before the next pandemic. The report of the Harvard-LSHTM Independent Panel on the Global Response to Ebola. Lancet. 2015; 386: 2204–2221