Chagas disease in Florida: An emerging one health challenge in the United States.

The pandemic legacy of antimicrobial resistance in the USA

Integrating One Health governance in China: Assessing structural implementation and operational entry points

IntroductionThe wildlife trade is an important arena for intervention in the prevention of emerging zoonoses, and leading organisations have advocated for more collaborative, multi-sectoral approaches to governance in this area. The aim of this study is to characterise the structure and function of the network of transnational organisations that interact around the governance of wildlife trade for the prevention of emerging zoonoses, and to assess these network characteristics in terms of how they might support or undermine progress on these issues.MethodsThis study used a mixed methods social network analysis of transnational organisations. Data were collected between May 2021 and September 2022. Participants were representatives of transnational organisations involved in the governance of wildlife trade and the prevention of emerging zoonoses. An initial seed sample of participants was purposively recruited through professional networks, and snowball sampling was used to identify additional participants. Quantitative data were collected through an online network survey. Measures of centrality (degree, closeness, and betweenness) were calculated and the network’s largest clique was identified and characterised. To understand the extent to which organisations were connected across sectors, homophily by sector was assessed using exponential random graph modelling. Qualitative data were collected through semi-structured interviews. The findings from the quantitative analysis informed the focus of the qualitative analysis. Qualitative data were explored using thematic analysis.ResultsThirty-seven participants completed the network survey and 17 key informants participated in semi-structured interviews. A total of 69 organisations were identified as belonging to this network. Organisations spanned the animal, human, and environmental health sectors, among others including trade, food and agriculture, and crime. Organisation types included inter-governmental organisations, non-governmental organisations, treaty secretariats, research institutions, and network organisations. Participants emphasised the highly inter-sectoral nature of this topic and the importance of inter-sectoral work, and connections were present across existing sectors. However, there were many barriers to effective interaction, particularly conflicting goals and agendas. Power dynamics also shaped relationships between actors, with the human health sector seen as better resourced and more influential, despite having historically lower engagement than the environmental and animal health sectors around the wildlife trade and its role in emerging zoonoses.ConclusionThe network of transnational organisations focused on the governance of wildlife trade and the prevention of emerging zoonoses is highly multi-sectoral, but despite progress catalysed by the COVID-19 pandemic, barriers still exist for inter-sectoral interaction and coordination. A One Health approach to governance at this level, which has gained traction throughout the COVID-19 pandemic, was shared as a promising mechanism to support a balancing of roles and agendas in this space. However, this must involve agreement around equity, priorities, and clear goal setting to support effective action.

Introduction The Field Epidemiology Training Program (FETP) in the ECOWAS region focuses on enhancing early detection and rapid response to disease outbreaks. Introducing the One Health curriculum in FETP is critical in addressing public health challenges by integrating human, animal, and environmental health sectors. The One Health Frontline Field Epidemiology Training Program (FETP) curriculum is designed to equip public health professionals with a multidisciplinary approach to address health challenges at the human-animal-environment interface. This regional approach strengthens multisectoral collaboration and ensures a transdisciplinary network of field epidemiologists who can coordinate and share data effectively across sectors. Methods A Joint CDC-WAHO training of trainers workshop on One Health FETP Frontline Curriculum was held from July 22 to 26, 2024, in Saly, Senegal. A teach-back method was employed, with participants presenting curriculum topics in PowerPoint, group discussions, and case studies. Mentors from 15 ECOWAS countries were trained to implement the curriculum. They engaged in exercises, multisectoral discussions, and field activity preparations. Feedback on the curriculum was collected daily to improve content and training delivery. Results The curriculum integrates epidemiology, veterinary medicine, and environmental health to foster a holistic understanding of disease prevention, detection, and response. A new field activity is the intersectoral site visits so that participants can see how other sectors conduct similar surveillance activities and multi-sectoral outbreak investigations. Sixty participants, including 36 mentors, from 15 ECOWAS countries attended the workshop. Participants represented human, animal, and environmental health sectors, with additional support from development partners like CDC, FAO, WHO, and USAID. The workshop successfully familiarized participants with One Health principles and how to apply them to surveillance, outbreak investigations, and data management. Feedback collected during the workshop highlighted the need for further adjustments in curriculum content and mentor training strategies to accommodate diverse regional needs. Conclusion The introduction of the One Health curriculum to the FETP Frontline training in the ECOWAS region successfully built One Health multisectoral collaboration and enhanced public health surveillance capacity. The workshop’s outcomes show a promising start toward improved detection, response, and management of zoonotic diseases. Future steps include cascading training at national levels, continued evaluation, and curriculum adaptation to local contexts.

Background and Aim: Human antibiotic formulations in animal feed for therapeutic and non-therapeutic purposes have contributed to antimicrobial resistance worldwide; however, little evidence is available in low- and middle-income countries. We aimed to generate evidence of antibiotic use across the human and animal health sectors by investigating the overlap in antibiotic use in community settings in rural blocks of Pune District, India, following the World Health Organization’s (WHO) Access, Watch, Reserve (AWaRe) classification. Materials and Methods: An exploratory pilot study using a cross-sectional design in two randomly selected rural blocks of the Pune district included 138 interviews with general physicians (GPs, n = 62), pharmacists (n = 60), and veterinary practitioners (n = 16) using semi-structured interview schedules and the WHO AWaRe classification. IBM-Statistical Package for the Social Sciences, Version 21.0 software was used for descriptive statistics and to calculate the proportions of the different antibiotic groups. The WHO AWaRe classification was used to describe antibiotic use by the study participants and to assess the overlap in antibiotic use. Results: Our study provides evidence of an overlap in human and animal antibiotic use in rural community settings across the human and animal health sectors. Amoxicillin (access group), penicillin (access group), and ofloxacin (watch group) were used in both human and animal health. Amoxicillin and penicillin were used to treat common bacterial infections, ofloxacin was used to treat skin infections in humans and animals, and ofloxacin was used to treat pneumonia in animals and urinary bladder infections in humans. In contrast, azithromycin (watch group), cefixime (watch group), and amoxicillin (Access Group), with or without other antibiotics, were the most commonly used antibiotics by GPs in humans. Conclusion: We confirmed the overlap in antibiotic use across the human and animal health sectors in rural community settings, suggesting the need for interventions following the One Health approach. Further, research is required to assess the patterns of this overlap, as well as behavior, knowledge, and potential solutions to help avoid this overlap and prevent the rampant use of antibiotics in the animal and human health sectors in rural community settings. Keywords: antimicrobial resistance, antibiotics use, overlap, rural India, WHO AWaRe.

Risk assessment of emerging infectious diseases in China under the One Health framework.

Background Antimicrobial resistance (AMR) is a pressing global public health challenge that requires coordinated multisectoral responses. In line with the Global Action Plan (GAP) on AMR, Jordan developed its first National Action Plan (NAP) for 2018–2022 to guide multisectoral efforts. This study aimed to evaluate the implementation of Jordan's AMR NAP, identify progress and challenges across its five strategic objectives, and suggest actionable recommendations for strengthening future AMR responses. Methods The Jordan Center for Disease Control (Jordan CDC) conducted a comprehensive 'end-term evaluation' for the NAP 2018–2022. Data were collected from approximately seventy national stakeholders through a national workshop and follow-up electronic communications. The evaluation tool included sector-specific and multisectoral indicators aligned with the NAP's five objectives. Descriptive statistical analysis was performed using SPSS to determine implementation rates across human, animal, and environmental health sectors, applying the One Health approach. Results The evaluation revealed uneven implementation across NAP objectives, with notable achievements in the rational use of antimicrobials (69%) completion, mainly in the human health sector. Infection prevention and control (IPC) efforts reached (63%), while surveillance-related activities achieved (56%). Awareness-related activities reported limited progress (47%), and no activities were implemented under the research and innovation objective. Multisectoral collaboration was limited, particularly in the animal and environmental sectors. Significant barriers included the absence of a unified communication strategy, lack of dedicated funding, insufficient investment in human resources and laboratories, and disruptions caused by the Coronavirus Disease 2019 (COVID-19) pandemic. Conclusions Despite progress in different areas, the overall implementation revealed significant challenges, particularly in research, multisectoral collaboration, and One Health integration. Future action should prioritize a unified national AMR policy framework for strategic planning, emphasizing resource distribution, active participation of all relevant sectors, and systematic monitoring and evaluation to inform policymaking. Strengthening coordination between human, animal, and environmental sectors is essential to achieving a robust, One Health-aligned AMR response in Jordan.

Introduction: Antimicrobial resistance (AMR) remains a critical global health issue contributing to increased morbidity and mortality. Antimicrobial stewardship (AMS), surveillance, and infection prevention and control (IPC) programs have been established and implemented to mitigate this crisis. Alongside this, advancements in nanotechnology and artificial intelligence (AI) or machine learning have enhanced academic tone and readability in combating AMR. This study employed a comprehensive narrative review approach to provide detailed evidence of AMS programs initiated to address AMR across One-Health sectors (human, animal, plant, and environmental health). Methods: A comprehensive narrative review was conducted to assess the global implementation of AMS, surveillance, and IPC programs, nanotechnology, and AI aimed at curtailing the rising prevalence of AMR. We also focused on the impacts of these AMS programs across diverse populations and settings. Relevant literature published between January 1995 and June 2025 was extracted from PubMed, Google Scholar, and Scopus databases. Results: The findings of this review demonstrate that AMS, surveillance, and IPC programs have been successfully established and implemented in some hospitals, community pharmacies, academic institutions, communities, and animal health. These programs have significantly promoted the rational use of antimicrobials in the One Health sector, prevented infections, reduced the emergence of antibiotic-resistant bacteria, improved adherence to treatment guidelines, awareness and knowledge of AMR, and patient outcomes. Advancements in technology, including nanotechnology and AI/machine learning, have shown promise in enhancing AMS and surveillance programs aimed at combating AMR. However, there is a dearth of empirical data on AMS activities within the environmental and animal health sectors, pointing out a critical gap in the One Health approach to AMR mitigation. Conclusions: This review underscores the importance of developing and implementing AMS, surveillance, and IPC programs as effective strategies to combat AMR using a One Health approach. Consequently, the study found very little information regarding AMS activities in the animal and environmental health sectors despite global problems as climate change. Notably, this study emphasizes the importance of embracing nanotechnology and AI within the healthcare system as innovative tools to combat AMR. It further highlights the need to promote integrated AMS, IPC, and surveillance programs across the One Health continuum, leveraging all available strategies to effectively combat AMR.

One Health is a collaborative approach that requires synergies between human, animal and environmental health sectors, other key sectors, and partners supporting these capacity-building efforts. Multiple One Health capacity-building tools are available that can be used independently or together. Two tools that have been used in sequence to inform each other include the US Centers for Disease Control and Prevention's One Health Zoonotic Disease Prioritization (OHZDP) Process and University of Minnesota/US Department of Agriculture's One Health Systems Mapping and Analysis Resource Toolkit™ (OH-SMART). In August 2017, a workshop was held in Islamabad, Pakistan, that integrated these two tools for the first time. In this integrated workshop, we used the OHZDP to develop a list of priority zoonotic diseases for Pakistan and OH-SMART™ to conduct a partner assessment and disease-specific gap analysis. Both tools were used to identify areas for One Health collaboration for the priority zoonotic diseases. Additionally, we trained 11 in-country facilitators representing the human and animal health sectors on both tools. This manuscript describes the integration of these two tools-using the Pakistan workshop as a process case study-to inform future efforts to implement One Health tools synergistically. Implementation of the technical and logistical aspects of the integrated workshop was detailed: (1) workshop preparation, (2) facilitator training, (3) workshop implementation and (4) workshop outcomes. Sixteen months after the workshop, we conducted an in-country facilitator survey to follow-up on the utility of both tools and the training for facilitators. We evaluated facilitator survey results using a qualitative analysis software Atlas.ti. Using the OHZDP Process and OH-SMART™ together achieved continuity between the two processes and provided a professional development opportunity for in-country facilitators. Based on the success of this integrated workshop, partners developing and implementing One Health tools should recognize the importance of collaboration to maximize outcomes.

Surveillance and response strategies for zoonotic diseases: a comprehensive review

Most infectious diseases that recently emerged in humans originated in animals. Besides close contact between animals and humans, other factors probably contribute to the cross-species transmission of infectious diseases. It is critical to establish effective mechanisms for coordination and collaboration between the animal, human, and environmental health sectors before new threats emerge by bringing the different sectors together to tackle endemic zoonotic diseases of greatest concern. Such multisectoral partnerships should begin by identifying priority zoonotic diseases for national engagement with equal input from the different sectors. Improvements in surveillance and data sharing for prioritized zoonotic diseases and enhancements of laboratory testing and joint outbreak response capacities in the human and animal health sectors will create and strengthen the mechanisms necessary to effectively detect and respond to emerging health threats, and thereby enhance global health security.

BACKGROUNDOne Health (OH) is a multisectoral approach that aims to optimise health of people, animals and the environment, recognising their interconnection. Despite gaining political support in recent years, examples of successful OH implementation among governmental institutions across the European Union/European Economic Area (EU/EEA) remain limited.AIMTo identify key enablers and barriers to collaboration across human, animal and environmental health sectors, and provide a framework to support national OH operationalisation in the EU/EEA.METHODSSemi-structured interviews were conducted with 26 experts from national public health institutes in 15 EU/EEA countries, recruited through European Centre for Disease Prevention and Control networks. Transcripts were analysed through qualitative content analysis.RESULTSCollaborations between human and animal health sectors were reported, but greater integration of the environmental sector is needed to strengthen OH partnerships. Analysis of opportunities and challenges highlighted key interlinked elements that can facilitate sustainable OH implementation. Strong political leadership emerged as pivotal to drive policy coherence in nexus areas, embed collaborative activities within core funding, and facilitate cross-sectoral partnerships at the technical level.CONCLUSIONThis qualitative study provides an overview of enablers and barriers to OH collaboration at the national level. The findings constitute the basis for an empirically derived framework emphasising the cyclical relationship between political leadership and cross-sectoral technical collaboration. Incremental steps, starting with strengthening existing cross-sectoral relationships, have the potential to generate self-reinforcing progress and enhance emergency preparedness. These empirical insights provide a foundation for developing and evaluating OH policies in EU/EEA countries, complementing existing international guidelines.

BackgroundThe One Health concept promotes the enhancement of human, animal and ecosystem health through multi-sectorial governance support and policies to combat health security threats. In Vietnam, antimicrobial resistance (AMR) in animal and human health settings poses a significant threat, but one that could be minimised by adopting a One Health approach to AMR surveillance. To advance understanding of the willingness and abilities of the human and animal health sectors to undertake investigations of AMR with a One Health approach, we explored the perceptions and experiences of those tasked with investigating AMR in Vietnam, and the benefits a multi-sectorial approach offers.MethodsThis study used qualitative methodology to provide key informants’ perspectives from the animal and human health sectors. Two scenarios of food-borne AMR bacteria found within the pork value chain were used as case studies to investigate challenges and opportunities for improving collaboration across different stakeholders and to understand benefits offered by a One Health approach surveillance system. Fifteen semi-structured interviews with 11 participants from the animal and six from the human health sectors at the central level in Hanoi and the provincial level in Thai Nguyen were conducted.ResultsEight themes emerged from the transcripts of the interviews. From the participants perspectives on the benefits of a One Health approach: (1) Communication and multi-sectorial collaboration; (2) Building comprehensive knowledge; (3) Improving likelihood of success. Five themes emerged from participants views of the challenges to investigate AMR: (4) Diagnostic capacity; (5) Availability and access to antibiotics (6) Tracing ability within the Vietnamese food chain; (7) Personal benefits and (8) Managing the system.ConclusionThe findings of this study suggest that there is potential to strengthen multi-sectorial collaboration between the animal and human health sectors by building upon existing informal networks. Based on these results, we recommend an inclusive approach to multi-sectorial communication supported by government network activities to facilitate partnerships and create cross-disciplinary awareness and participation. The themes relating to diagnostic capacity show that both sectors are facing challenges to undertake investigations in AMR. Our results indicate that the need to strengthen the animal health sector is more pronounced.

IntroductionElectronic information systems (EIS) that implement a ‘One Health’ approach by integrating antimicrobial resistance (AMR) data across the human, animal and environmental health sectors, have been identified as a global...

Antimicrobial resistance (AMR) in bovine mastitis has become an increasing concern for public and veterinary health, compromising the effectiveness of conventional treatments and raising management costs. Mastitis is primarily caused by Staphylococcus aureus and Escherichia coli, pathogens that have shown increasing resistance to common antibiotics such as penicillin and tetracycline. The One Health approach, integrating human, animal, and environmental health sectors, emerges as an effective strategy to combat resistance and improve treatment efficacy. This study systematically reviewed articles published between 2020 and 2025, utilizing PubMed, BIREME and SciELO databases, aiming to assess how the One Health approach impacts AMR in mastitis and explore sustainable therapeutic alternatives. A total of 19 articles meeting the inclusion criteria were selected, addressing the prevalence of AMR in mastitis pathogens as well as the application of vaccines and phytotherapies as alternatives to antibiotic use. Results showed that resistance primarily increased due to excessive antibiotic use, while the One Health approach was found promising in controlling resistance by integrating veterinary, public health, and environmental practices. Additionally, sustainable alternatives such as vaccines and phytotherapies proved effective in reducing resistance without introducing new resistance issues. This study concludes that the implementation of the One Health approach, combined with sustainable alternatives, offers an effective model for controlling antimicrobial resistance in bovine mastitis. However, it is important to highlight the scarcity of in-depth studies on the long-term efficacy and viability of sustainable therapeutic alternatives. The lack of robust data limits the application of these solutions in the field and emphasizes the urgent need for new studies to confirm their effectiveness on a large scale. The implementation of public policies encouraging collaboration among human, animal, and environmental health sectors is also essential to optimize outcomes in managing antimicrobial resistance.