The "One Health" concept, which emerged at the beginning of the 21st century, is a transdisciplinary framework that considers health issues at the intersection of the human world, the animal world and ecosystems. The interconnections between living things need to be considered to combat the risk of pandemics and, more generally, to take care of the planet and all its inhabitants. The University of Liège, under the impetus of Vice-Rector for Research Michel Moutschen, wants to formalise this approach through a 'One Health House'.
he 'One Health' concept emerged in the 2000s. However, it was not until the Covid-19 crisis that the term began to gain ground among the uninitiated. A rather too perfect illustration of the interdependence between animal health, human health and environmental health, the pandemic acted as a spectacular wake-up call: humans do not live in a setting - nature - with secondary characters, animals, plants or micro-organisms. On the contrary, we live in an interconnected world that brings together all living beings. And like most infectious diseases - 58% of the 1,400 pathogens that can infect humans are of animal origin - Covid is a zoonosis, a disease transmitted from animals to humans.
Simon Lhoest, a lecturer and researcher in forest resource management at Gembloux agro-Bio Tech, observes that "there is a much greater risk of zoonoses today than in the past, particularly because of the growing influence of human activities on natural ecosystems, deforestation in particular, but also our increased presence in these ecosystems. In addition, the demographic explosion is creating areas with a very high risk of new emerging diseases in certain regions of the world". Population movements, international trade and travel are all responsible for circulating viruses on a global scale.
In this sense, the increased risk of a pandemic, like the loss of biodiversity, can be seen as an effect of the functional alteration of the living network. "At the heart of 'One Health' is the notion of the network. There is a real science of networks," explains Michel Moutschen, Vice-Rector for Research at ULiège. Theorists such as Albert-László Barabási have worked on both electrical networks and the networks of the human body. And they found similarities: for a network to be functional, its nodes have to be connected in a certain way, and if these nodes are attacked, the network collapses". For the Vice-Rector, who is also a doctor specialising in immunodeficiency, the concept of "One Health" echoes the theory of hygiene, which postulates that reducing our contact with micro-organisms - fewer vaginal deliveries, disinfected environments, etc. - leads to a malfunctioning of the immune system. - This is an example that shows that the immune system is not functioning properly, which is one of the main reasons for the upsurge in allergies in modern society. "This is an example that shows that when the network of connections is impoverished, there is an alteration in health that is subsequently translated into disease", he comments.
Like the risk of a viral pandemic, antibiotic resistance is a good illustration of the power of these interconnections and their disruption. Directly caused by our over-consumption or misuse of antibiotics, antibiotic resistance could, according to the World Health Organisation (WHO), become the leading cause of human death worldwide by 2050, well ahead of cancer. Antibiotic resistance is a problem linked to the way we treat ourselves and the way we feed ourselves. It also affects our industry and our ability to innovate in the face of bacteria that are quick to adapt.
A SALUTOGENIC APPROACH
Faced with the threat of pandemics and antibiotic resistance, the "One Health" approach calls for preventive action. Prevent by seeking new balances, by understanding, repairing and caring for the living network. In addition to the collaborative management of identified risks, the "One Health" concept speaks of "health production", an approach known as "salutogenic" in the words of the American sociologist Aaron Antonovsky. It's about working on the determinants of health, but also on the determinants of determinants, ever further upstream," explains Nicolas Antoine-Moussiaux, coordinator of the master's specialisation in integrated health risk management at ULiège. This approach calls for more and more diverse collaborations and for learning together". Nicolas Antoine-Moussiaux welcomes a wide range of people to this constantly evolving master's programme: doctors, veterinary surgeons, pharmacists, agronomists, nurse epidemiologists, anthropologists and environmentalists. The idea," he explains, "is for all these people to be able to combine their experience and use it in a new way to collaborate with others who conceptualise things differently, who don't have the same priorities and sometimes don't have the same values.
For his part, Simon Lhoest points out that "for a long time, working in our own disciplinary bubble was the dominant practice. More recently, however, researchers have taken an interest in interdisciplinarity. The downside is the risk of bringing together people with such different profiles that they end up having little in common. The 'One Health' concept can only work if researchers understand each other". However, this approach is now essential, given the complexity of the problems we face and the way in which they are interwoven. Systems thinking is important," continues Nicolas Antoine-Moussiaux, "because it requires us to see the world as a set of interconnected systems and sub-systems. Faced with converging crises, we need to bring together our analyses and our solutions. The interconnection of problems must be matched by the interconnection of disciplines, points of view and ways of knowing.
One Health" is also part of a major conceptual evolution, which has gradually abandoned the idea of nature governed solely by its own laws, in favour of the notion of the living. "This invites us to take seriously the strong interdependencies between humans and non-humans. Their co-evolution, within a multitude of collectives, is no longer seen as a disturbance, but as the norm", explains Dorothée Denayer, biologist and socio-anthropologist, co-director of SeeD (socio-ecology, investigation and deliberation) within the Faculty of Science at Uliège. Biodiversity is declining, while certain species are proliferating. Yet in the paradigm of an ideal and predictable nature, these two phenomena are considered to be 'to be eradicated', without our being able to understand the human-living relationships in these phenomena. So the question is no longer simply: what practices should be used to eradicate this exotic animal or that virus? More fundamentally, we need to ask ourselves how we can establish more sustainable relationships with non-human beings. And it's a huge task, given how inhospitable our societies are to them, and how much they have neglected these issues of living together...
of living together...".
Dorothée Denayer's interest in 'One Health' stems from her fieldwork with wildlife managers - marine turtles in Congo-Brazzaville and brown bears in the Pyrenees. "I've been very interested in 'care', which comes from the medical sciences, nursing and feminist movements, and which is now being used in environmental 'care' to analyse a range of approaches aimed at preserving, repairing and ensuring the survival of species or natural environments. These approaches, too often regarded as purely technical, raise several ethical dilemmas. What are the relationships between the players involved in these activities aimed at their protégés? To what extent are the wild animals we take care of still wild? Sometimes, for them, caring for nature means destroying problematic animals, and passion often mingles with suffering. But in these care practices, the welfare of humans and the welfare of animals are intimately linked".
Simon Lhoest, who is coordinating the launch of a research project on the prevention of zoonoses on the outskirts of Lubumbashi in the Democratic Republic of Congo, also stresses the importance of scientists not practising "parachuted science", but taking the time to immerse themselves in the local context and to take account of the expertise of the various players on the ground. This transdisciplinary approach is encouraged by the 'One Health' approach, which advocates inclusiveness and collaboration at all levels. We will monitor wildlife populations to characterise them and find out about their distribution," explains the researcher. Secondly, we will study local habits in terms of the use of bushmeat, from hunting in the forest to consumption and sale on the markets. We will also consider the gender dimension within the sector: who handles the meat? At what stage? And what is the risk of disease transmission at each stage for each audience? We know that it is mainly handling that increases the risk of transmission (and not consumption as such), particularly during butchering, which women generally carry out. At the same time, we are going to monitor the potential pathogens carried by rodents and primates", intending to identify guidelines for risk prevention.
DIVERSITY OF POSSIBILITIES
Today, the 'One Health' approach is attracting growing interest from the scientific world and major international organisations such as the World Health Organisation (WHO), the Food and Agriculture Organisation (FAO), the World Organisation for Animal Health (OIE) and the United Nations Environment Programme (UNEP). In Belgium, this approach is embodied by the public institution Sciensano, resulting from a merger between the former Veterinary and agrochemical study and research centre and the former Scientific Institute of Public Health, which carries out joint public and animal health missions. Having a national scientific research agency with this focus is almost unique in the world," says Nicolas Antoine-Moussiaux. This is also the case for our Federal Public Service for Public Health, Food Chain Safety and the Environment, which promotes this One Health approach. In this favourable Belgian context, ULiège is now affirming its desire to promote and formalise this approach, in particular through a "One Health House", a collaborative space modelled on the KUl's "Health House". ULiège is committed to this approach," emphasises Michel Moutschen. It is the only university in the Wallonia-Brussels Federation to train veterinarians, doctors and agronomists all at the same time. This is a considerable advantage. What's more, the concept involves notions of environmental health. We are a post-industrial city that is particularly concerned by these issues.
All disciplines and faculties are concerned by this new framework. For Guénaël Devillet, Director of the Fundamental and Applied Economic Geography Department (Segefa), it is relevant to many issues relating to geography and territories. "I do a lot of work with students on the food transition. The 'One Health' approach enables us to measure how the transition in the world of agriculture can directly influence human health, for example. And to assess how we can maintain our food resilience, which goes hand in hand with invalidating certain intensive farming techniques that annihilate biodiversity, which sometimes come from faraway lands with less stringent standards and controls. These standardised products, which are less rich in nutrients and even packed with additives for preservation, in turn, encourage pathologies such as certain cancers." The same goes for land-use planning: halting suburbanisation would both reduce the risks for residents (floods and mudslides in some cases) and generate benefits for the ecosystemic health of flora and fauna.
"The 'One Health' approach invites us to explore the diversity of possible trajectories with the stakeholders concerned, rather than imposing expertise in the form of a single solution that is good everywhere, all the time," Dorothée Denayer sums up. This mobilises our creativity, our ability to think ahead and, above all, to deliberate". It's a stance that not only raises new research questions but also provides new, multiple and evolving answers, far removed from simplism, dogmatism and 'it's only a matter of time'. "Today, in Wallonia, the trapping of wild animals is being redeveloped. It was used to eradicate wild boar as part of the fight against swine fever. Its effectiveness is now encouraging it to combat exotic species such as raccoons," explains the researcher. Our research should encourage and support a much-needed social debate on the role of trapping and, more broadly, on the processes used to eradicate living creatures. Raccoons are so prolific that many local residents are now concerned. Other citizens protect, feed or shelter these animals, at the risk of being considered bad citizens. I believe that these attachments should be taken seriously because they have something to tell us about inter-species conviviality and possible ways of repairing our world".
Because it advocates inclusiveness and negotiation with all stakeholders, the 'One Health' approach calls for a new dialogue and a new relationship with living things. The premise is almost philosophical," adds Professor Michel Moutschen. It's the idea that it's impossible for humans to be happy and healthy if this is at the expense of the happiness and well-being of other living beings, animals and plants.
A healthy human being in a healthy world: that is the ambition of this approach, where everything fits together.