"We're At War"
This post has been on the tip of my tongue since our first lecture in the Foundations of One Health module over two weeks ago. As promised, I want to move away from recounting the mundane tales of my life and use this as a forum to share some of the cool things I am learning and the thoughts they provoke. (But also you can check out my next post in a week to read about my highs and lows of London in the past six weeks).
The realms of health and medicine as a science tend to be very human centric. Even the way we define a zoonotic disease (a disease from animals) is a very human focused definition--the disease is not of concern to us unless it is transmitted to AND causes illness in people. What's interesting about One Health is that its eventual purpose is to challenge this human egoism by moving the spotlight to animals, the environment, and what humans are doing to these things.
Such a post-humanism approach, as my course director described it, seems necessary when we are talking about the "big picture" of the state of the world. Today, we throw around buzz words like "conservation" and "sustainability," but our practices, our strides towards these ideals, are meaningless when we continue to put humans on a pedestal of preference and superiority.
I had never heard such a pessimistic view of sustainability before, but I think my course director had a serious point here. Our efforts for "sustainability" are mostly counterproductive and motivated by selfishness. Our goals for sustainability tend to stem from the argument that we should preserve our planets and resources to ensure our own future survival--to propagate the human race.
We tend to ignore the impacts such actions--whether those are actions promoting sustainability or conservation or those harming them--have on the many other organisms cohabitating with us on this planet. And what impact they have on us. This is where One Health comes into play. When we respond to infectious disease issues that arise, medical faculties often don't see that they may be part of the problem. Without understanding the other half of the equation--the animal hosts, vectors, and pathogens themselves where these infectious diseases actually come from--and by investing on treatment, rather than prevention, we make things more difficult in the long run.
Unfortunately, One Health and similar movements are largely led by the veterinary community. Human health professionals (and the rest of society) tend to ignore what the veterinary community already understands about our interconnectedness with animal (and plant) life. The closest we have come to acknowledging "the other half of the equation" has been a rather negative approach. Over our existence as a species, we have painted nature as this dark force to be overcome. Natural disasters devastate societies, animals (and bugs!) can make us sick, the battles go on and on. It's unpredictable. It's scary. It's evil. It's us versus them.
These attitudes towards dirt and the "wild" make it difficult to find long-lasting solutions. Instead, we slap shoddy bandaids over the problems. Case and point: antibiotics. Our abuse, misuse, overuse of antibiotics in ourselves, animals, and plants is coming back to bite us in the rise of antimicrobial resistant (AMR) strains of pathogens we've assumed as practically harmless. What does this mean? (It's amazing that antibiotics have only been in our history for the past 100 years or so. And in case you were wondering, AMR is going to be one of the biggest challenges we face over the course of this next century).
The policy realm has had a heavy hand in this framing problem. The apocalyptic discourse, the panic, the drama is what finally influences policy changes. Our paranoia and our need to control everything is probably what drives us to fight this war against diseases that we think can be defeated. The problem is that diseases don't disappear. And the fact that we do not understand the multitude of reservoir hosts these inimical pathogens find refuge in and the mechanisms by which they function prove that this war cannot be won through the silos in which we tend to work.
One Health is a response to crisis. But to be the most effective, we need to undergo this paradigm shift and see One Health solutions as a revolution in social, economic, and health systems. This will require acknowledging that human health is not just about the health of humans--our health is indefinitely intertwined with the health of our environment and animals--and not one of these is more or less important than the others. With such multi-species entanglements, it shouldn't be a question of nature versus culture. We live and die together. All of these systems must work together, like the harmonious medley of strawberries, Nutella, and waffle pictured below, to truly protect our world's health.