The One Health approach for integrated eco-systemic health – Quotidiano Sanità

by Carla Collicelli

We now know a lot about the health risks associated with environmental degradation and global threats such as climate change and the loss of biodiversity, but the awareness of the benefits that environmental health brings to our psychophysical well-being and urgency is still very lacking. to activate forms of shared responsibility with respect to the new prevention paradigms inspired by the One Health vision, in the transition towards sustainability

19 OTT – The devastating impact of a viral epidemic in a developed country like ours has made the shortcomings of our welfare model immediately evident as never before, and has placed the whole world before the need to seriously consider the appeals. launched in the recent past with respect to universal health coverage, equity of access to health services, the relationship between human health and environmental and animal well-being and primary prevention.

This is what was declared, for example, in the context ofHigh-level Meeting on Universal Health Coverage (Universal Health Coverage, UHC in the English acronym) of September 2019, which underlined how the threats to the health of humanity are multiplying, and how old and new diseases are spreading, in the face of which it is necessary to rethink the approach to the theme of well-being and to study a real paradigm shift.

And this is what was reaffirmed in the UN 2030 Agenda through the 17 Sustainable Development Goals, in particular with regard to social and environmental objectives, from the defeat of poverty, to quality education, to gender equality, to decent work, the reduction of inequalities, the contrast of environmental and climatic deterioration, the international partnership.

Based on similar considerations, the Working Group of the Alliance for Sustainable Development (ASviS) which deals with Goal 3 (Health and well-being for all at all ages), has used the lockdown period to develop a new type of reflection. on the epidemiological challenges of the current period and the related consequences on the health and social organizational structures, focusing in particular on the theme of prevention, with a view to One Health, the eco-systemic approach that takes into account in an integrated way the risks connected to environmental and anthropogenic factors and the global risks of pandemics.

The definition One Healthcoined in 2004 in the conference called by Wild Conservation Society (Manhattan principles), has until now been mainly applied to animal health, food safety, zoonotic epidemics and antibiotic resistance. The approach must now be taken into more careful consideration as regards also the pollution of natural resources and the destruction of biodiversity, urban design and territorial, production and transport planning, and the exploitation of the technological and IT potential for safeguard the integrity of the planet.

It is from this context and its numerous articulations that today’s reality largely depends, characterized by the aggravation of an epidemiological situation previously characterized by a double load (double burden of desease) of acute (viral and bacterial) and chronic diseases (such as tumors, cardiovascular, respiratory, dysmetabolic and neurodegenerative diseases), and today further complicated by the resurgence of viral epidemics and the aggravation of the forms of fragility of subjects with multiple risk factors .

Hence the awareness of the fact that health understood in a global sense, both geographically and culturally and with respect to the different forms of life, must become a shared reference on a global level, thereby following the principles already enunciated in the Declaration of Alma Ata and how indicated by the Italian Network for the Teaching of Global Health, according to an approach that takes due account of the necessary interconnections, and also influences the structures of education and continuing training policies for the entire population.

Il Position Paper ASviS “Health and not just health, How to orient investments in health with a view to sustainable development “[1] , published at the beginning of October 2020 and which is the result of the reflections developed by the Goal 3 Working Group, examines the necessary strategic objectives to be exploited in the light of the current situation, together with some concrete proposals to be carried out for the revision of the model request and for an adequate and fruitful investment of the funds made available for the recovery. And it does so by indicating 4 intersectoral macro-areas of impact of the pandemic and 10 sectors of investment and reconstruction.

The 4 macro-areas of impact of the pandemic indicated by ASviS are: the socio-economic development model, to be refocused with respect to parameters of social and cultural enhancement, towards the construction of solid and sustainable supranational governance tools, and towards collaboration objectives , well-being and the fight against inequalities; the environmental issue, and in particular the connections between global environmental changes, including climatic changes typical of the Anthropocene era, and the fragility of vulnerable territories and urban areas with respect to human health and well-being; the area of ​​communication and information, with the risks that have emerged in terms of infodemic, disinformation and communication virality; and the area of ​​distributive justice and social equity, in particular as regards access to welfare and healthcare.

The 10 investment and reconstruction sectors, indicated by ASviS as priorities, are the following:
1. Residential and emergency health structures: technologies, devices, information technology and telematics;
2. Local health: intermediate structures between hospital and territory, technologies and instruments;
3. Biomedical and public health research;
4. Environment, climate, pollution and prevention;
5. Marginality: areas of socio-sanitary degradation, hospitalization facilities;
6. School and extra-school: school buildings, teaching tools and centers of school and para-school activity;
7. Work: safety of workers and plants;
8. City: green spaces, private mobility, public transport, public offices;
9. Extra-urban motor activity: mountain trails, open-air gyms, slow tourism;
10. Agriculture and territory: local agriculture, urban gardens, solidarity agriculture cooperatives.

The national event promoted by ASviS as part of the Sustainable Development Festival on 5 October last was also dedicated to these issues, entitled “Wellness ecosystem. One Health: towards a new interconnected vision of health[2] which has set itself the goal of disseminating the vision of One Health, reaffirming the unicum of environmental, animal and human health. Through a positive and dynamic narration, the interconnections between the psycho-physical well-being of man and the health of ecosystems were highlighted, as well as the link with the socio-economic themes of the 2030 Agenda, such as the intergenerational aspect, equity, cohesion social.

We now know a lot about the health risks associated with environmental degradation and global threats such as climate change and the loss of biodiversity, but the awareness of the benefits that environmental health brings to our psychophysical well-being and urgency is still very lacking. to activate forms of shared responsibility with respect to the new prevention paradigms inspired by the One Health vision, in the transition towards sustainability.

With the help of videos on the well-being of the planet and on the positive synergies between environment and well-being, such as in the case of “mountain therapy”, the event gave space and voice to the leading Italian experts on environmental issues and collective well-being .

Carla Collicelli

[1] https://asvis.it/public/asvis2/files/Approfondimenti/PositionPaperGdLGoal3.pdf

19 October 2020
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